12070195Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS:
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PERMIT # 12-076 r 5
OWNER'S NAME: dsp
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PHONE # . 9i 36(o
GENERAL CONTRACTOR: S;E�
BUSINESS LICENSE # 3SO O
ADDRESS:
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CITY/ZIPCODE: S'A'k l
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ur , ip l ®quir s all busi e--sssai,wkin in t city to have a City of Cupertino business license.
O ULD ALEDR INA UCC�UYA Y 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
Please check applicable subcontractors and complete the following information:
Date
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
1A VI ofewil3
S vo
Electrical
.S'�.� PeVp ryiln
3 S i
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
I Q
Lathing
Masonry
Painting / Wallpaper
15 �-r .Pt V0 d m yl
Paving
Q /H
Plastering
Plumbing
S'-C—.T— Z4 VA &
-3 Sim
Roofing
S�.L bA V.- 214m) -r
Septic Tank
Sheet Metal
Sheet Rock
Tile
Da ✓A 4 1'''kn
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Date