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12110087CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19369 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110087 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 1711 DELL AVE DATE ISSUED: 07/21/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ d MAIN STREET- SHOP #3- CONSTRUCT OF A NEW ONE STORY RETAIL BUILDING License Class Lic. # SHELL Contractor` �1 Date REV # 1 - ADD ROOF WALK PADS TO PLANS (RFI 504) & ADD (N) DESIGNATED GAS LINE & ELECTRICAL STUB OUT FOR OUTSIDE FP - ISSUED 1011115 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. Sq. Ft Floor Area: Valuation: $1043902 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 APN Number: 31620109.19369 Occupancy Type: erformance 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 EXPIRES IF WORK IS NOT STARTED permit is issued. WITHIN 180 DAYS OF PERMIT ISSUANCE OR APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is 180 DAYS FROM LAST CALLED INSPECTION. 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 e bY Date: upon the above mentionedproperty for inspection purposes. (We) agree to save Y — 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 RE -ROOFS: all non-pouyt source regulations petr the C peirtino Municipal Code, Section 9.18. All roofs shall be inspected prior to any roofing material being installed. If a roof is a installed without first obtaining an inspection, I agree to remove all new materials for Signature Date inspection. Signature of Applicant: Date: ® OWNER -BUILDER DECLARATION ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE compensation, will do the work, and the structure is not intended or offered for I have read the hazardous materials requirements under Chapter 6.95 of the sale (Sec.7044, Business & Professions Code) California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain 2. 1, as owner of the property, am exclusively contracting with licensed contractors to compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & construct the project (Sec.7044, Business & Professions Code). Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air I hereby affirm under penalty of perjury one of the following three declarations: contaminants as defined by the Bay Area Air Quality Management District I will 1. I have and will maintain a Certificate of Consent to self -insure for Worker's maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Compensation, as provided for by Section 3700 of the Labor Code, for the Health & Safety Code, Sections 25505, 25533, and 25534. performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by ner or authorized went: Date: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3. 1 certify that in the performance of the work for which this permit is issued, I shall CONSTRUCTION LENDING AGENCY not employ any person in any manner so as to become subject to the Worker's I hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If, after making this certificate of exemption, I for which this permit is issued (Sec. 3097, Civ C.) become subject to the Worker's Compensation provisions of the Labor Code, I Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address ARCHITECT'S DECLARATION APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 CUPERTINO ❑ NEW CONSTRIICTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING DIVISI 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 buildincl a.cupertino,o[g M A nnrrrn.r n ry I _ u _7APN# .wviuivivrLnr LtClCCLr UKIUINALFEKNIIJ#'-`'1 uuOr a t.cJ PROJECTADDRESS Shops 3 19369 Stevens Creek Blvd OWNERNAME Main Street. Cupertino Aggregator LLC PHONE (650) 344-1500 E-MAIL STREETADDRESS 2882 Sand Hill Rd, Suite 241 CITY, STATE, ZIP Menlo Park, CA 94025 TFAX CONTACT NAME Paul Hansen PHONE (40812-2121 E-MAIL phariseri@ShiiIcl lC..COiTt STREETADDRESS2882 San Hill Rd, Suite 241 :CITY, STATE, zip Menlo Park, CA 94025 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Mark Avila LICENSE NUMBER B3 3 6 974 LICENSE TYPE BUS. LIC # 5655 COMPANY NAME South Bay Construction E-MAIL manila@sbci. Com FAX (408)379-3256 STREETADDRESS 1711 Dell Avenue CITY,STATE,ZIP Campbell, CA PHONE (408) 379-5500 ARCHITECT/ENGINEER NAME Keri ROCIrlglles LICENSE NUMBER C12, 818 BUS. LIC# COMPANY NAMEKenneth Rodrigues & Partners, INC E-MAILkenr@krparchitects.com FAX (650) 9$0-0707 STREETADDRESS 445 N Whisman Rd Suite 200 CITY,STATE,ZIP Mountain View, CA 94043 PHONE (650) 965-0700 DESCRIPTION OF WORK 1.) Add walking pads to roof -mounted equipment, Sheet A4.4 -- RFI #504. 2.) Add gas and electrical stub -outs for fireplace, Sheets E0.3.3, E2.4, P2.4. EXISTING USEPROPOSED USE - CONSTR. TYPE #STORIES USE I TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH ❑ ATTACH I #DWELLING UNITS: I5 ASECOND UNIT []YES SECONDSTORY []YES BEING ADDED? []NO ADDITION? ❑NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES TAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOMEv - By my signature below, I certify to each of the following: I am the property owner or aut a agent to act o rty o is behalf. I hav his application and the information I hav provided is c ect. I have read the Description of Work and v s agree to comply with all applicable oeai--� ordinances and state laws relating to wilding o s t n. I -authorize representatives of Cupertino to a abo above -1 ified property for inspection purposes. J At i Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLANCHECXTYPE j!!,O TINGSLIP . ❑ OVEIf TrIF�;COUNTER . ❑ BUILnuvGxLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building.l]' EkPREss ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANnJUT I :rusraevi WORK, form if any Hazardous Materials are being used as part of this project. "0 Li1RGE ❑ ME DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to0' IO Q .8ANfrARYSE�i'ERDIsTRICT submittal of Building Permit application. ❑ EN VMONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 19369 STEVENS CREEK BLVD DATE: 08/28/2015 REVIEWED BY: MELISSA APN: .31620109.19369 BP#: 12110087 VALUATION: $0 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY Commercial Building Civil/Religious activities PENTAMATION in BQ zone? Yes No PERMIT TYPE: 1GENCOM WORK I REV # 1 - ADD ROOF WALK PADS TO PLANS RFI 504 & ADD (N)DESIGNATED GAS LINE & , SCOPE I ELECTRICAL STUB OUT FOR OUTSIDE FP y� - ---- -- --�—r»......... �...,. ..„.........g, ......��.... v.•.u� c c, uuicasuiy uervcI "taarau, ua-osava Dictrirf O}C f- Thoco f- nrn A -d __ ♦A... .. „7...,............ _.,c ....__•_ __z_za_ - _ _ ____________ FEE ITEMS (Fee Resolution 11-053 fff. 7/1/13 ___ _. .._�.._,.._ .... FEE »....„...,,,. „,.,,„. „,. ,, QTY/FEE ,,.... ,,..., w..c.•.ucc.. vvccua.c crcc yc c v uuuro c ora MISC ITEMS v. Plan Check Fee: Hourly Only? 0 Yes (j) No $0.00 hours Plan Check, Hourly $429.00 ISTPLNCx Suppl. PC Fee: ( Reg. 0 OT Mhrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feel Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAW $0.00 ,4 111:linhI .IP'crfil"e Fee: Work Without Permit? 0 Yes Q) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure 1ravelDoc. latrrerrruiion. Fee.s: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SI7BTOTAL'' $0.00 777777, $429.00 TOTALEi $429.00 Revised: 07/02/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19369 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110087 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 07/21/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 ET -1— LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL F] MAIN STREET- SHOP #3- CONSTRUCT OF A NEW ONE License Class_ Lic. # STORY RETAIL BUILDING SHELL Contractor 5, Date 7_ DEFERRED #1 -TRASH ENCLOSURE ISSUED 7/21/15 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 Sq. Ft Floor Area: Valuation: $1043902 performance of the work for which this permit is issued. 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: 31620109.19369 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 EISSUANCE 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 �gERMIT 180 DAYS �L 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 Date: granting of this permit. Additionally, the applicant understands and will comply with all non-po' C urce regulations per the Cupertino Municipal Code, Section 9.18. � RE-ROOFS: Signature Date `J All roofs shallcted 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, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.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. I 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 Municipal Code, Chapter 9.12 and Health & Safety Code, Sec ' 5505, 25533, and 25534. 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 the ns / Owner or authorized agent: i 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 CONSTRUCTION LENDING AGENCY 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 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 source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CUPERTINO ❑ NEW CONSTRUCTION --7 CONSTRUCTION PERMIT APPLICATION �,�� COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 •buildin cu ertino.or ❑ ADDITION ❑ ALTERATION / TI ❑ REVISI N / DEFERRE ORIGINAL PERMIT # o APN # r E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX r CONTACT NAME p 'V PHO STREET ADDRESS CITY, STATE, ZIP FAX OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ 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 LICENSE NUMBER BUS. LIC # COMPANY NAME STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE ROPOSE USE E #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NE DEMO DEMO TOTAL AREA ..... AREA {2 ,S AREA .�� NET AREA �( y Y BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA 1 GARAGE AREA: []DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES '� RECBIVED i I PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERHONSE? ❑NO �.'+� xr EV�''�£. �s: �nUA Yti {.:� By my signature below, I certify to each of the following: I am the property owner or authorized agent to act property owner's behalf. I have red this application and the information I ha provided is corre have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati ' d c n c ' n. h z representatives of Cupertino to enter thea ove-identified pigA* for inspection purposes. Signature of Applicant/Agent: SUPPLEMENTAL INFORMATIO QUIRED New SFD or Multifamily dwellings: Apply for demolition permit for � �' � � OVER THE-COUnTER � r r BUILbING YL.4N REVSEW r � existing building(s). Demolition permit is required prior to issuance of buildin r <' permit for new building. EXPRESS x `< sI PLANK GPLANREVIEW t Bldgs: Provide a completed Hazardous Materials Disclosure sTDARn PI)BLxoRlcs s _Commercial form if any Hazardous Materials are being used as part of this project. �_*y _Copy of Planning Approval Letter or Meeting with Planning prior toIT- Y 1 �i 1 , ❑ sArlrrsEWEx> sTRICT submittal of Building Permit application. BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION •rrt .i✓ �k v� a ADDRESS: 19369 scb DATE: 01/29/2015 REVIEWED BY: Mendez T -11,f }i ch£:F:,7.'. APN: BP#: *VALUATION: $40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Commercial Building USE: g Civil / Religious activities in BQ zone? 0 Yes (j) No PENTAMATION 1 GENCOM� PERMIT TYPE: WORK DEFERRED #- TRASH ENCLOSURE SCOPE 0,0 •rrt .i✓ �k v� a FEE vx{L.'CYt. Y�<Li3t C'nL'Cii:. '�l, fti}t`7. 3l£ti1 {.' te't"{: T -11,f }i ch£:F:,7.'. -Vec i.Amw l Fee: t%fta,,, h, Pt-rrn11. Fee: *: other'h-,sP. L�:] Other Pfwnbp.0-.1 her E'lec. IrsT% AWxh, t}ty. Fee: ,�°iY<nh, IrS�. Fee Elle. Insli1. Fee: - NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l into. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Deferred Submittal $572.00 IDEFSUBM Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXC $0.00 4dminisirafii%C' P'e E': 0 Work Without Permit? O Yes (D No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 � TiYdl%C'l�)C3L'iZfid£:12Z1�i1£3it �`rC't's; Strong Motion Fee: 1BSEISMICO $11.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUT.BTO r,S $13.20 $572.00 s TQ AL FEE 5.20 Revised: 01/06/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19369 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110087 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 07/21/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 1 LICENSED CONTRACTOR'S DECLARAT ON JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic.# MAIN STREET- SHOP #3- CONSTRUCT OF A NEW ONE STORY . RETAIL BUILDING SHELL Contractorf)cl"_D ate 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 Sq. Ft Floor Area: Valuation: $1043902 erformance of the work for which this permit is issued. �Iffave 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: 31620109.19369 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 10 DAYS OF PERMIT 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 S1 180 DAY F,R ;1VI LAST CALLED INSPECTI N. 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 Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply d with all non -point source regulations per the Cu ertino Municipal Code, Section 9.18. t 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, 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 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. I 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 Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25 05, 2553 and.25 34. Section 3700 of the Labor Code, for the performance of the work for which this Nt Owner or authorized age 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, I 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 source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CON!STR -C- "-N PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ° BUILDING DIVISION 10300 TORRE AVENUE ° CUPERTINO, CA 95014-3255 (408) 777-3228 ° FAX (408) 777-3333 ° building(Dcuoertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION I TI ❑ REVISTON I DEFERRED ORMTNAT- PRRMTT PROJECT ADDRESS APN # ORTIERNAME 66 F�b- bcs1 l'1 PHOID5—b - 3qq • )S0� E-MAIL STREET ADDRESS CITY, ST( Z1� FAX 203 12.eciwva5J shores �� z c, cd VV60J C t CA �t`fQ05 •3q{ •Dom? CONTACT NAME PHONEL evl h 2c� r LI z ° �4✓lhei'S La50- �I(�S-O OU enr'OKr 0rCh14ec-4- .Cam STREET ADDRESS 14`15 N Vv hLs rl�Ln rz�i �S Ae ?WO CITY, STATE, ZIP o� n� �n Vle-N CA Cl HO�J FAX ILP50 - Cho - O4 -G -7 ❑ OWNER ❑ OWNER -BUILDER ❑ 01ANTR AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME V LICENSE NUMBER LICENSE TYPE BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME C LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREETADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE R STORIES- USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KrrCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH JDECKARIEA ATTACH DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? ❑NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HONE? ❑ NO-.7`"ro's'a^,,.k,Y'�.,, CEIVED BY s "I °f`.` a y`' s,� TOTAL VALUATION: 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 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 relati bNilding construction I authorize representatives of Cupertino to enter the above -i entified roperty for inspection purposes. SignatureofApplicanUAg� Date: 1 , , e SUPPLEMENTAL INFORIAIATION REQUIREDcP�ec�E _ New SFD or Multifamily dwellings: Apply for demolition permit for !`x-v'",y-jib, Y Y �Q� ❑ .�.tK�w Y S- ¢''Q. C. ❑ , existing building(s). Demolition permit is required prior to issuance of buildingz�� OVER THE COUnTER zs BUILDIhGP1A RE}'IE�V ern ? �`Y,r x rk rhe k ermit for new building. P a ' �x A❑ ExTRESSri f£ r -�R P�j4�M1�LA7��RE`'IE�V�s: � :i}? w+¢, 4B .Y' ; r 3 2;'hlCht"F•4`" ''l �f _.Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sT .A" Rn kr � Sh. v..�2 0 -UB LICOM ; : "r?" ', form if any Hazardous Materials are being used as part of this project. �x�fY r "mac y- 3 i y 4. 1 Olt _ CoPY of Planning Approval Letter or Meeting with Planning prior to Copy 'w�zAJGR =� �� ® 54M1ITARYE�i'ERT)ISTRICT submittal of Building Permit application. , ��.?�...n;s<�.�,.f,:6..n:zt'"p..,...s.�t--�>x x-,.�.. '❑ �I�',YZRO�TII�NTAliIiE:AT.TH .4.SS� k,: B1d&,4pp 2011.doc revised 06/_71/11 9� 0TY OF CU PIERTRNO BUM DRNG P ERMRT BUILDING ADDRESS: 19369 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110087 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 07/21/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 Lf LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL License Class Lic. # 33G 6 � � MAIN STREET- SHOP #3- CONSTRUCT OF A NEW ONE STORY RETAIL BUILDING SHELL Contractor 50 �3 -- Date Z �� DEFERRED D #I-'II'IERASIH ENCLOSURE RE ISSUEIID 7/21/15 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 Sq. Ft Floor Area: Valuation: $1043902 performance of the work for which this permit is issued. 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: 31620109.19369 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 STARTLED correct. i agree to comply with all city and county ordinances and state laws relating �� 180 �� ®� �� ISSUANCE ®� 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 5. ILALED I[NSP]ECTION. 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 Date: with all non-po t urce regulations per the Cupertino Municipal Code, Section 9.1& RE-ROOFS: Signature Date Z All roofs shall cted 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: D 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, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.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. I 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 upertino Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sect' ns 505, 25533, and 25534. 2l permit is issued. Owner or authorized agent: Datc:ZL5 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. [f, after making this certificate of exemption, 1 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 Lender's Address APPLICANT CERTIFICATION I certify that 1 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION u 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (/ (408) 777-3228 • FAX (408) 777-3333 ^ buildin cu ertino.or CUPERTINO 66 F1 -IMW rnNSTRt 1cTrnN n AnnmoN n ALTERATION / Ti � REVISI N / DEFERRE ORIGINAL PERMIT # B1dgApp_2011.doc re»ised 06/21/11 l//1� r IVB APN # r E-MAIL STREET ADDRESS CITY, STATE, ZIP r CONTACT NAME ` 1� PHO � / W STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGrNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME � e STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTINGUSEROPOS USE E #STORIES o USE TYPE OCC. SQ.FT. VALUATION (S) EXISTGNEW y� DEMO TOTAL AREA =ARA ,orf ) I AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: 1S A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? [J -NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED$ UA 1 PLANNING APPL # [:]NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act brftheproperty owner's behalf. I have r d this application and the information I I provided is corre have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati ' d c n �UWz7epresentatives of Cupertino to enter thea ove-identifed p� for inspection purposes. Signature of Applicant/Agent: I Date: SUPPLEMENTAL FORMATIO QUIRED $ # PLAN CHECK,TYPE ,k k, . , . ROUTIhG'SL'IP ¢, New SFD or Multifamily dwellings: Apply for demolition permit fory�"#'t ❑COVER THE COUNTER 4 BUILDING P) AN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building, ❑ -t;,+ ' PLANn GPLAN REVIEW ;`"h' rtrtt& 3:f ti" f f*4Y1 ua xs Y Bldgs: Provide a completed Hazardous Materials Disclosure v sTpnDARD 1 y 3 PUBI I woltics _Commercial form if any Hazardous Materials are being used as part of this project xa * sa r " #"" �: ❑I, LARGE,„ i ti� " ' r `� � "�` Ay � � s' FIRE DEPT'tt �.� aye :� ' z �, s Copy of Planning Approval Letter or Meeting With Planning prior to submittal of Building Permit application. ❑ pIAJOR s ❑ SAISITARY SE�yERDISTRICT ,.+.�Lw»,. s :`�,.�F? �`,��,.� r� �" ,❑=EH�IItONMENTALL�HE9LTH,;�szt., B1dgApp_2011.doc re»ised 06/21/11 (r"Tf'F'\V (nW (rTTTTD17TD PTrT\\jn l u Ali 11 11 1L.V R' _�. W 11 LJ 11U 11 ALL V Y_x FEE IESUMAII OR - BUI[ILI<DRNG IIDI[VI EON (QTY/FEE ADDRESS: 99369 scb DATE: 01/29/2015 REVIEWEDBY: Mendez = # Deferred Submittal $572.00 IDEFSUBM APN: BP#: *VA]L>LTATION: 1$40,000 sPERh'[i IT TYKE: Building Permit PLAN CHECK TYPE: New Construction PREM ARY USE: Commercial Building Civil/ Religious activities in BQ zone? 0 Yes 0 No PENTAM[ATION PERMIT TYPE: I GENCOM WORK DEFERRED #- TRASH ENCLOSURE SCOPE 7.1 isrso. i en_: ................ 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 prelin:inarp information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE (QTY/FEE I MISC ITEMS ;LtCCJ', M in CiwP I'IrtPtb. I'Iaii = # Deferred Submittal $572.00 IDEFSUBM :99c'cla. Permit tire: PIc6,i"h" perrm"I 1`ee: FEI!er, Pc! -mit Fee $0.00 PME Plan Check: $0.00 0111' 1 1 o '!. In, p, EJ Other 11"emb Insh, Otho Elec. In; p. . Alech. lw;p. Fee: 1' wnb, lnsp. Fee: 7.1 isrso. i en_: 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 prelin:inarp information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE (QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 = # Deferred Submittal $572.00 IDEFSUBM Suppl. PC Fee: E) Reg. C) OT 0.0 lirs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. () OT 50::0d hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 Atfininistrwive Fee, -Q Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure 0 7 �- �iYdl'el1)O(.;E711F:Ydi'f1i1(Nt 1`E'E'4•; Strom Motion Fee: IBSEISMICO $11.20 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 'SUBTOTALS; $13.20 $572.00 ` TOTAL' Ft E: $585.20 Revised: 01/06/2015 CITY OF CU P]ERTINO BUILDING PERMIT BUILDING ADDRESS: 19369 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110087 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 07/21/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION. RESIDENTIAL [] COMMERCIAL MAIN STREET- SHOP 0- CONSTRUCT OF A NEW ONE License Class__ Lic. ti�(�� STORY Contractor Date BETA]()(. BUILDING SHELL I hereby affirm that I am licensed m�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: 1 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: $1043902 erformance of the work for which this permit is issued. ave 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: 31620109.19369 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 ��Pj1AYS®��1(SS>U�NCIE ®� to building construction, and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We) agree to save 180 DAYLAST CALLED INSIP]E T1C N. 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 Issued by: k Date: with all non -point source regulations per the Cu ertino Municipal Code, Section 9.18. t RE -ROOFS: Signature – Date 7771— 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 1, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.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. I 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 Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25 05, 2553a.n ,25 34. Section 3700 of the Labor Code, for the performance of the work for which this L permit is issued. Owner or authorized age Date: 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, I 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date 0 Building9Departg�aent City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 F78-777-3333 CONTRACTOR / SUBCONTRACTOR LffST JOB ADDRESS: 19369 Stevens Creek Blvd - Shop 3 PERMIT # 12110087 OWNER'S NAME: Sand Hill Management PHONE # GENERAL CONTRACTOR: South Bay Construction BUSINESS LICENSE #5655 ADDRESS: 1711 Dell Ave CITY/Z].PCODE: Campbell, CA 95008 *Oaar nnunicipal code requires ail businesses working in the city to have a City of Cupertino business license. NO BU R LIIDIINO FINAL O!8 FINAL OCCUPANCY ANSP1ECTIION(S) WILL BE SCHEDULED UNTIL '1i'H6+ GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY Off' CUIPERTIINO BUSnH>`� 1.799 LICENSE. I= not using any subcontractors: Signature ]Please check alpp lieable s ubcontracturs and complete the rollownng inffon-mation: Date V SUIBCONTRAC70R BUSINESS NAME 1B>USINIESS LICENSE # Cabinets & Millwork X Cement Finishing Techcon 23513 X Electrical Redwood Electric Group 21108 X Excavation Doyle's 35611 Fencing Flooring / Carpeting Linoleum / Wood X Glass / Glazing Classic Glass 25840 X Heating The Trillo Company 29816 X Insulation Central California Insulation 557 Landscaping X Lathing Cen Cal Plastering 33021 X Masonry American Tile & Brick Veneer 35158 X Painting / Wallpaper G&G Painting 34391 Paving X Plasteri.ng Cen Cal Plastering 33021 X Plumbing Fresno Plumbing & Heating 32000 X Roofing Statewide Roofing 23509 Septic Tank X Sheet Metal The Trillo Company 29816 X Sheet Rock South Bay Interiors 25499 Tile Gin %/ul� Owner / Contractor Signature 5/12/15 Date