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12070060CITY OF CUPERTINO BUILDING PERMIT j BUILDING ADDRESS: 7535 WATERFORD DR I CONTRACTOR: JOHN & KATHI LUCAS I PERMIT NO: 12070060 f OWNER'S NAME: ROHN & KATHI LUCAS 17535 WATERFORD DR I DATE ISSUED: 10/04/2012 OWNER'S PHONE: 6507042116 1 CUPERTINO, CA 95014 1 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that l have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I ant exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the. structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1 have and will maintain aCertificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regul s per the Cupertino Municipal Code, Section 9.18. ) A BUILDING PERMIT INFO: BLDG r ELECT PLUMB r MECH r_ RESIDENTIAL COMMERCIAL r JOB DESCRIPTION: ADD 99 SQ FT TO SFDWL, 300 SQ FT TO DECK REMODEL FAMILY 596 SQ FT, KITCHEN 171 SQ FT RE -ROOF 4 SQUARES Sq. Ft Floor Area: j Valuation: $125000 APN Number: 36617023.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. A Issued by: �`�� ]�!i Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. agent: I�� rte_ Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of vwrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Ad ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Signature t � �'c�i Date ] I Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINCi (408) 777-3228 •FAX (408) 777-3333 • l��ufriArl 67ctA2eLino.q ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI lv� REVISION / DEFERRED ORIGINAL PERMIT tl PRO,ECTADDRESS 953s Wal VGrTQr� brl'vQ, APN0 31.6 - I OWNER NAME T 1_ n L u PHONE _ � - � � r_ -7 C! E M` IL COLL j 3 @ a40O• Co yn / STREET ADDRESS 'w,n r •YN l,irfard Drive CITY, STATE, ZIP Cu x501 FAX CONTACT NAME GUlrt Cl�r�j PHONE so- 3 - a 609 E- L r m , Cows STR ADDRESS r I AY IWNER CIT STATE, ZIP CA r?+O FAX 11O ElOWNER-BUILDER❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT 91' ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME Curt r I I l►1 1�j� LICENSE NUMBER BUS. LIC N COMPANY NAME Flo - rn Ious t (,�,t ii !'t rc��C�S E-MAILd• od4, r h Q "..t a vna.L . c, o 1" FAX STREET ADDRESS 19,Howard AvQN l� CITY, STAT ,ZIP 4 a) 4 PHONE5o ' - q kl oo 7 Y DESCRIPTION OF WORK PU m OCU LAAh iC VK� r t� S 1 O V I 1 EXISTING USE PROPOSER UqU S CONSTR. TYPE # STORIES S I n V S USE TYPE OCC. SQ.FT. VALUATION (S) Exl G /� NEV FLO�O DEMO AREA �11Yg�5 ARE) _ �yy�r� AREA TOTAL NETAREA j��{�) SF�� Q BATHROOM REMODEL AREA Q KITCHEN D L AREA OTHER REMODEL ARE/ % GG (ETTAC PORCH AREA DECK AREA TOTAL DECKfPORCH AREA GARAGE AREA: U ATTACH #DWELLING UNITS: IS A SECOND UNIT YES SECOND STOR ❑YES / BEING ADDED? ®'F10 ADDITION? '140 1 FRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF PLANNRYQAPPL# 'J]NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLERROME? �kN0 RECEIVEDBY; OTAL VALUATION: t 2$ 0&O.W � By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided . correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: Z SUPPLE AL INFORMATION REQUIRED PLAN CHECK TYPE RqUONG$,UP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVPit THS -Co R 01AIL LING. KAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. L`T LxaPttr s ❑ FLANNINC'.PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ©' STANDARD ❑ PVBLIC WOR" form if any Hazardous Materials are being used as part of this project. � ❑ LARGE ❑ PuE, DFR'f Copy of Planning Approval Letter or Meeting with Planning prior to ❑,, MAJOR ❑ SANITARY SEWVJK DWIrRICT submittal of Building Permit application. ❑ LItRatl�l�ITAL Arr�it B1dgApp 2011. doe revised 06121 /11 'N 1T% CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 7535 waterford dr. TYPE OF CONSTR. DATE: 07/09/2012 REVIEWED BY: APN: BP#: `VALUATION: 1$125,000 *PERMIT TYPE: Building Permit II-B,111-B,IV,V-B PLAN CHECK TYPE. Addition PRIMARY SFD or Duplex USE: $1,230.00 2nd Unit? Yes F' No OTC. 0 Yes O No PENTAMATION 'I R3SFDADD PERMIT TYPE: WORK add famil 99 s.f. add deck 300 s.f. remodel famil and kitchen 771 s.f. re -roof ara a 596 s.f. SCOPE [sf(d Remodel, Other IREMRESOTH OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE 1D R-3 (Custom) II-B,111-B,IV,V-B 399 $1,512.00 IADDPLCK $1,230.00 IADDINSP Oc" PME Plan Check: $0.00 1 596 1 s.f. $467.00 Remodel, Other IREMRESOTH Permit Fee: $1,230.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 F4473 I s.f. Re -roof $75.00 IREROOFRES PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 399 1 $1,512.00 (....� i M 'IOI7 n. .` 1 $1,230.00 MEICII, III CI�IJR Y Q Yes Isla P ;UMB; �IOCTRLY 0 Yes ' No, E+ L EC, H©VRZY O' Yes O Flo MISC ITEMS P/ , $1,512.00 =s.f. $600.00 4,ti F- bt^,.,� , }r bb irysn E3 ie inv" Ph(mb b)"o h"'' Oc" NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the prelimina information available and are onl an estimate. Contact the De t or addn'1 in o. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,512.00 =s.f. $600.00 Remodel, Kitchen (<=300 sf) 1REMRESKIT Suppl. PC Fee: (F) Reg. 0 OTO -0 hrs $0.00 PME Plan Check: $0.00 1 596 1 s.f. $467.00 Remodel, Other IREMRESOTH Permit Fee: $1,230.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 F4473 I s.f. Re -roof $75.00 IREROOFRES PME Unit Fee: $0.00 PME Permit Fee: $0.00 (....� i M 'IOI7 n. .` '; fr7G7Ii li i.il'a„' 1 C'f'- 0 E) Work Without Permit? Yes (F) No $0.00 Advanced Planning, Fee: IPLLONGR $51.87 Select a Non -Residential Building or Structure Stron Motion Fee: IBSEISMICR $12.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $5.00 UBTOTAL$; $2,811.371$1,142.001 TOTALFEE; $3,953.37 Revised: 0710112012 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7535 WATERFORD DR CONTRACTOR: JOHN & KATHI LUCAS PERMIT NO: 12070060 OWNER'S NAME: JOHN & KATHI LUCAS 7535 WATERFORD DR DATE ISSUED: 10/04/2012 OWNER'S PHONE- 6507042116 CU.PERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALS License Class Lic. # ADD 99 SQ FT TO SFD WL, 300 SQ FT TO DECK REMODEL FAMILY 596 SQ FT, KITCHEN 171 SQ FT RE -ROOF 4 Contractor Date hereby that I licensed the Chapter 9 SQUARES affirm am under provisions of Section 7000 Division 3 the Business & Professions "IT ( commencingwith of of Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $125000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36617023.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS 90YPERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FR LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply Iss Date: t with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, wiI I do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (See.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino M nicipal Code, Chapter 9.12 a d I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code,�Sect�i�o5, 255 3 and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen0_60/-) Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit, Additionally, the applicant understands and will comply with all non -point ounce regulati8ns per the Cupertino Municipal Code, Section Licensed Professional 9.18. l Signature Dat ,,3'9 0i CUPERTiINO 1 NF'W CC1N.'CTRI IC" CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDIVWS, ON#,...L, 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build�i-nnga-cupertino.org "10N 1111 ATADDITION r-1 AT.TF.RATI(lN/TT IXI RFVTSI()N/fIFFFRR1ryT� 1lRTC1NAT PFRMTTf! /l�G 7D�6v% t PROJECT ADDREss 7535 Waterford Dr 7 APN # 366-17-023 OWNERNAME John Lucas PHONE 415-596-7281 E,MAILmodernhouse@me.com STREET ADDRESS same CITY, STATE, ZIP Cupertino FAX CONTACT NAME Curt Cline PHONE same E-MAIL same STREET ADDRESS 1245 Howard Ave CITY, STATE, ZIP Burlingame Ca 94010 FAX ❑ OWNER ❑ OWNER -BU ELDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Craig Smol len LICENSE NUMBER 968840 U NSE BUS. LIC # Contractorsen COMPANY NAME:, Srnollen the Builder E-MAIL craigsmollen@me.com FAX STREET ADDRESS 204 Richardson Dr CITY, STATE, ZIP Mill Valley PHONE 415-271-0568 ARCHI'TEC'T/ENGINEERNAME Curt Cline LICENSE NUMBERC26383 BUS.LIC# -. COMPANY NAMEModern House E-MAIL modernhouse@me.com FAX STREET ADDRESS 1245 Howard Ave CITY, STATE, ZIP Burlingame Ca. 94010 PHONE 415-596-7281 DESCRIPTION OF WORK TO ADD A BOX BAY IN THE LOCATION OF A FORMER BAY WINDOW EXISTING USE PROPOSED USE CON"E k STORKS USE TYPE OCC. SQ FT. VALUATION ($) EXISTG AREA NEW FLOOR DEMO AREA12 AREA TOTAL NET AREA / / / //4v� t// BATHROOM H KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL .AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWEL16i,N UNriS: TTSAs�C6NDiumr YES SECONDS`P'ORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED g" TOTAL VALUATION: PLANNING APPL M ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO 6 , By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the "information i have provided is rrect. i have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin struction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. - Signature of Applicant/AgenC 7� Date: }� SUPPLEMENTAL INFORMATION REQUIRED PLAT«I Il V I TYPE ROUTING $LIIP New SFD or Multifamily dwellings: Apply for demolition permit for 0 OVERT E-COVN rR LAINGPLAN REVIEW i existing building(s). Demolition permit is required prior to issuance of building permit for new building. El EXPRms '' PLANNING, PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TANo'k to PIURLIC" WORT form if any Hazardous Materials are being used as part of this project. 7 ARG7 IRfiIEPi Copy of Planning Approval Letter or Meeting with Planning prior to © C# SANITARY SEWER DISTRICT~ submittal of Building Permit application. MAJOR � t?VVIRUIalIM1E1N'I"AL NEAL'TII Rl.daiArm ?n l l do , rovkP1i 001? 111 l rm--7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E(f 711/12) ADDRESS: 7535 Waterford Drive DATE: 02/05/2013 REVIEWED BY: Sean APN: BP#: 12070060 *VALUATION: 1$5,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex . ldL'1'fi. 1he.§7, 1 eo, PENTAMATION PERMIT TYPE: 1GENRE WORK Revision #1: Add 19 sq ft bay window to front of residence. SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E(f 711/12) FEE t /Ccb' 1 1eaPa ,x I(w ( '/w"'A ir-v.lr !"c'rFlrtl f'c'e.' Fk,h /"('rm'v —L— ET—L—(i/r,L ET--1— l' 1y1twb /)/',pllt6rf'A i;YC! , fV;CS1J. . ldL'1'fi. 1he.§7, 1 eo, 1' FoW), 1w,/). N l'c: I 1, 1Pt..1fx5')" f'cc'r7l I NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E(f 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? © Yes Q No $0.00 2 hours $266.00 Plan Check, Hourly 1sTPr,NCrc Suppl. PC Fee: E) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? Q Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. © OTT 0. 07 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ('<ra, !rrfc PiE a lir:: F—T- 1c�r,zirrra,'r.r�t�'4 dG .�: Work Without Permit? O Yes (j) No $0.00 Advanced Planning Fee: $0.00 3 hours $399.00 Inspections 1STINSP Inspection, Hourly 7a'm;tri 001 11ml, ctllcE'io11 /"V'S. Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds C,omrnission Fee: IBCBSC $1.00 $1.50 $665.00( 77 1 7", $666.50 Revised: 0110112013 WW0WW1-- CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: PERMIT # Q - Q0 OWNER'S NAME:,.K Rtj r LUC PHONE # -q,4(o-32Rk-) GENERAL CONTRACTOR:' BUSINESS LICENSE # ADDRESS: i CITY/ZIPCODE: , CA I I I *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature -1(-) Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Owner / Contractor Signature -1(-) Date JOB ADDRESS: rj PERMIT #,_- i�.( .-' --' OWNER'S NAME: PHONE .#.:` r ; GENERAL CONTRACTOR: ' BUSINESS LICENSE) # =- ADDRESS: CITY/ZIPCODE.. Cquki