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12110085CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19349 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERNUT NO: 12110085 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 1711 DELL AVE DATE ISSUED: 06/19/2014 OW R'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379 -5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ License Class Lic. # MAIN STREET- SHOP 1 CONSTRUCT OF A NEW ONE STORY RETAIL BUILDING SHELL 5,930 SQ FT — nQ REV # 1- ADD ROOF WALK PADS TO PLANS (RFI 504) - ISSUED 9/25/15 Contractor -Dat4� t 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: 1. 1 have and will maintain a certificate of consent to self - insure for Worker's . Sq. Ft Floor Area: Valuation: $732540 Compensation, as provided for by Section 3700 of the Labor Code, for the of the work for which this permit is issued. APN Number: 31620109.19349 Occupancy Type: =?atrmance e 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 PERMIT EXPIRES IF WORK IS NOT STARTED 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 WITHIN 180 DA SAP IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 D OM L AL LED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 'd costs, and expenses which may accru9 agains City in consequence of the ss granting of is ermit. Ad 'tionall the I" ant understands and will comply with all non-poi so ce re is pe a Cu ino Municipal Cope, Sec ion 9.18. �} �J Signature "r `° " Date LX51 RE- ROOFS: v t 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 ❑ OWNER- BUILDER DECLARATION inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: t I, as owner of the property, or my employees with wages as their sole ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) HAZARDOUS MATERIALS DISCLOSURE 2. I, as owner of the property, am exclusively contracting with licensed contractors to I have read the hazardous materials, requirements under Chapter 6.95 of the construct the project (Sec.7044, Business & Professions Code). California Health &Safety Code, Sections 25505, 25533, and 25534. I will maintain I hereby affirm under penalty of perjury one of the following three declarations: compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & 1. I have and will maintain a Certificate of Consent to self - insure for Worker's Safety Code, Section 25532(a) should I store or handle hazardous material. Compensation; as provided for by Section 3700 of the Labor Code, for the Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will performance of the work for which this permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the of the work for which this Health 8ASafety Code, ecti 2 ; 5,25533 and 25534. .°� performance permit is issued. O er r' e ge J 3. I certify that in the performance of the work for which this permit is issued, I shall Date: 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 I hereby affirm that there is a construction lending agency for the performance of work's must forthwith comply with such provisions or this permit shall be deemed for which this permit is issued (Sec. 3097, Civ C.) revoked. Lender's Name Lender's Address APPLICANT CERTIFICATION 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 ARCHITECT'S DECLARATION to building construction, and hereby authorize representatives of this city to enter I understand my plans shall be used as public records. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Licensed Professional 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 CONSTRUCTION R ADDITioN I I AT TFRATION /TT In I DFVTQTnM / nUrU Dun nDTc—AT --T— 12110085 PROIECTADDRESS Shops 1 19349 Stevens Creek Blvd APN# OWNERNAMEMain Street Cupertino Aggregator LLC PHONE (650)344 -1500 E -MAIL STREETADDRESS 2882 Sand Hill Rd, Suite 241 CITY, STATE,.ZIP Menlo Park, . CA 94025 FAX CONTACT NAME Paul Hansen PHONE (408) 442 -2.121 E -MAIL phansen@shcmllc.com STREETADDRESS 2882 Sand Hill Rd, Suite 241 CITY, STATE, ZIP Menlo Park, CA 94025 FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT 11 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTR ACTOR NAME Mark Avila LICENSENUMBER B336974 LICENSE TYPE BUS.LIC# 5655 COMPANYNAMESouth Bay Construction E -MAIL mavi-la @sbci.corn FAX (4.08)379 -2156 STREETADDRESS1711 Dell Avenue CITY, STATE, ZIP Campbell, CA 95008 PIIONE (408)379 -55 00 ARCIITECT /ENGINEER NAME Ken Rodrigues LICENSE NUMBER C12,818 BUS. LIC # COMPANY NAME Kenneth Rodrigues & Partners, INC E-MAILkenr@krparchitects.com FAX (650)960 -070.7 STREET ADDRESS 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 A4.3 -- RFI #504. EXISTING USE PROPOSED USE - CONSTR. TYPE #STORIES USE 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: ODETACH ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑YES SECONDSTORY OYES BEING ADDED? ENO ADDITION? ONO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECE .:- PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME? ONO By my signature below, I certify to each of the following: I am the property owner o o the pr er's behalf. I have read this application and the information I have rov -ded is correct. have read the Description of Work and verify it is ac I agree to comply with all applicable local r ordinances and state laws relating to b g c s ctio u h ize`regresentatives of Cupertino to enter t - -den 'feed pro erty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED pLAhl CAFCK TXPE ' l2OTJTfNGSLIP ouEx TIotlrrrx . [] $iTILnINGPLAIY REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building permit for new building. Cl .EXPRESS - -PLANNING PLt1N REVIEW ; Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �STNAAI�D Cl.PjtsLicwoxt?cs - form if any Hazardous Materials are being used as part of this project.' ice, gEpl,:- _ Copy of Planning Approval Letter or Meeting with Planning prior to -MA 6$t SANITARPSE4VERDI submittal of Building Permit application. °FNV1RONXZNTALHEALTH BldgApp_2011.doc revised 06121111 IV M-1 CITY OF CUPERTINO FFF FRTIMATOR — R1TTT.111Nf iI1V14Z1(l1V NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School TL,. ,. F ,. L.. ,..7 sL,. FEE ITEMS (Fee Resolution 11 -053 Eff 711113) ADDRESS: 19349 STEVENS CREEK BLVD DATE: 0812812015 REVIEWED BY: MELISSA Plan Check Fee: Hourly Only? 0 Yes 0 No APN: 31620109.19349 BP #:12110085 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY Commercial Building USE: g Tin ivil / Religious activities BQ zone? Yes No PENTAMATION 1 GENCO i PERMIT TYPE - WORK REV # 1 - ADD ROOF WALK PADS TO PLANS RFI 504 SCOPE R _.o NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School TL,. ,. F ,. L.. ,..7 sL,. FEE ITEMS (Fee Resolution 11 -053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 0 No $0.00 ._2_j hours Plan Check, Hourly $286.00 1STPLNCK Suppl. PC Fee: (E) Reg. 0 OT p.o hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. O OT R _.o hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 dn'linisircifive Fee: 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure � _ t:` u�e?11�c?c 'rarnc?rttc;�t�r�rt- I�ees; Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 7BTTALS $o.00 $286.00 TafiAI� » $286.00 Kevisea: utiuzrzu-io CITY OF C><.T]PIEII TINO BUILDING PERMIT BUILDING ADDRESS: 19349 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110085 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 06/19/2014 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379 -5500 ❑ LICENSED CONTRACTOR'S DECLARA ION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL t� IWAFN STREET- SHOP 1 CONSTRUCT OF A NEW ONE License Class y Lic. # STORY Contractor � Date RETAIL BUILDING SHELL 5,930 SQ FT I hereby affirm that 1 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: 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: $0 performance of the work for which this permit is issued, l 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: 31620109.19349 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l have read this application and state that the above information is PERMIT ]EXPIRES IF WORK 1« NOT STARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITHIN ®���� ®� PERMIT �������� OR building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 1180 DAB' 118 LAST CALLED 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 Issued b Date: y with all non -point source regula ons r he Cupertino Municipal Code, Section RE- ROOFS: 9.18. p 16q I t Signature Date l� t 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) 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 1 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 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municip Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Section s 255053 a 5534. Section 3700 of the Labor Code, for the performance of the work for which this 0 permit is issued. Owner or authorized agent: Date: 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 1 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 l 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. l8. Signature Date E I • CONSTRUCTION PERMIT APPS CATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE e CUPERTINO, CA 9501.4 -3255 (408) 777 -3228 ^ FAX (408) 777 -3333 ^ buildincecupertino.org i ❑ NFW CON3TRI ICTION ❑ ADDITION ❑ ALTERATION I TI ❑ REVISION /DEFERRED ORIGINAL PERMrr n PROJECT ADDRESS J APN 9 ) LP 2- 0 c) l OWER NAME 566 � r b�5 �� PHO1&5- , - q,4 • I�O1) E-MAIL STREET 5��WU Shares �L k., �l � CITY, ST I FAX J cx� 2�U cvooJ C c CA q'fUtD.S' •.3y • 0 C.0,5,? CONTACT NAME PHONE - 1705- v--on� L r1 r� r(c}� � e� ✓��\.Com e n n&.-Ph LP50 K� sTRE1A4 N Vv hts rli` tl )2-J, cS � 4e_ ?� CITY, nA-ZIP n VleY� Cif "I qoy FAX - `� (06 0'7 9 ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTR,ACTOR ❑ CONTRACTOR AGENT ❑ ARCHrrEC`r ❑ ENGINEER ❑ DEVELOPER CI TENANT CONTRACTOR NAME LICENSENUMBER LICENSETYPE BUS.LIC� COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARC HITECT/ENGiNEER NAME LICENSE NUMBER BUS. LTC 4 COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Cohl u, e-� uF a r)f-N cane s40 M4 ,q 1 1 M i (d l)I 5►� J 1 51'13b EXISTINGUSE PROPOSED USE CONSTR. TYPE STORIES USE TYPE OCC. SQ.FT. VALUATION (S) MSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKlPORCH AREA GARAGE AREA: LIDETACH ❑ ATTACH #DWELLINGUNrrS: IS A SECOND UNIT ❑YF-S SECOND STORY 0—YES -ADDED? []NO ADDITION? ❑NO PRE - APPLICATION ❑ 1'FS ff YES, PROVIDE COPY OF ° IS THE BLDG AN [I YES �RECEIVED.BY � , ' , � ?' a `,, TOTAL VALUATION: PLANNING APPL [] NO PLANNWG APPROVAL LETTER EICHLER HOArE? ❑ NO ,ik I' M3 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 Rork and verify it is accurate. I agree to comply With all applicable local ordinances and state laws relatin b 'lding construction. authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Sign azure of Applicant/Agent: Date: SUPPLEMENTALINFORNIATION QUIR.EDx�'cHFCZ,T�>:�v ROUrucsilp, New SFD or Multifamily dwellings: Apply for demolition permit for "� �y W ' �"�d> T covnrsR e BUU existing building g�0�7 (s }. Demolition permit is required prior to issuance of buildtn, R s nlr Gpr� REtw ; , permit for new building. ❑ E'EKTRESS s ` x r ❑ PLAhTIhG PLOT RE \��V1 � s `e 5,V F. ii hx*,M Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑` srv�Dn v ❑ PUSLIC1ioRKS _ form if any Hazardous Materials are being used as part of this project. X p r❑� K LARGE. ;n S FIRE DEPTa Copy of Planning Approval Letter or Meeting with Planning prior to l, ❑a submittal of Building Permit a PP 11Cat10n. 0 11 SJOR ux l SANITARY SE11 ERDISTRIM ' �,rn EM1 `�1ROM1I�NT'?,LHE1lT'H......._. >� ,�`��t�;...r,,.. ..•, ...._, k,...❑ I. B1dJApp_2011.doc revised 06/21/11 CITY OF cCUP EIl8TINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 19349 scb DATE: 11/15/2012 REVIEWED BY: Mendez PC FEE ID APN: ]B]P #: "VALUATION: $732,540 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction ]PRIMARY USE Commercial Building Civil / Religious activities in B zone? 0 Q � Yes � No ]PENTAMATIION 1 SHELLBLDG PERMIT TYPE: d WORD shell main street shop 1 SCOPE Suppl. Insp. Fee:C) Reg. () OT OCCUPANCY TYPE: TYPE OF TYPE FL,R AREA s.f.) PC LEES PC FEE ID BP FEES BP FEE ID Shell Bldgs II- B,III- B,IV,V -B 5,930 $8,706.80 IOSPLNCK $5,893.70 IOSINSP F' %B'Y. i!SF. $5,893.70 Suppl. Insp. Fee:C) Reg. () OT 0 0 )filr) la 1'i7 $0.00 hm;t'. Fee, PME Unit Fee: l, j iii. �iti), PME Permit Fee: h,�p F'Fe; Construction Tax: 1BCONSTAXC $16,485.40 AdntiniSrrezrive Work Without Permit? Yes (E) No $0.00 TOTALS: 5,930 $8,706.80 ;.� ��; $5,893 70 Strong Motion Fee: IBSEISMICO 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 relirnina information available and are only an estimate. Contact the De t for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff. 711112) FEE QTY/FEE C.'?:r'Ck Plan Check Fee: (,;'f£'.f.' ?; Select a Misc Bldg /Structure or Element of a Building Su 1. PC Fee: o Re OT PP � g• � 0.0 ;�iC'Cit. r :'J'i ?➢di Fee" $0.00 l ?i,wnb. 1 ee ?;'fir;'. {''('f'„ „s °r "Y F' %B'Y. i!SF. $5,893.70 Suppl. Insp. Fee:C) Reg. () OT 0 0 )filr) la 1'i7 $0.00 hm;t'. Fee, PME Unit Fee: l, j iii. �iti), PME Permit Fee: h,�p F'Fe; 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 relirnina information available and are only an estimate. Contact the De t for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff. 711112) FEE QTY/FEE 1V1<IiSC ITEMS Plan Check Fee: $8,706.80 Select a Misc Bldg /Structure or Element of a Building Su 1. PC Fee: o Re OT PP � g• � 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,893.70 Suppl. Insp. Fee:C) Reg. () OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXC $16,485.40 AdntiniSrrezrive Work Without Permit? Yes (E) No $0.00 Advanced Plaaain Fee: IPLLONGC $1,601.10 Select a Non - Residential G Building or Structure 0 Strong Motion Fee: IBSEISMICO $153.83 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $30.00 v `SUBTOTALS: V32,870.83 TAL FEE: $32,870.83 Revised: 04/29/2013 Building Department City OfCupertino % 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 CC U p E R7 0 M© Fax: 408- 777 -3333 CONTRACTOR /SUBCONTRACTOR UST JOB ADDRESS: 19349 Stevens Creek Blvd - Shop 1 PERMIT # 12110085 OWNER'S NAME: Sand Hill Management PHONE # GENERAL CONTRACTOR: South Bay Construction BUSINESS LICENSE #5655 ADDRESS: 1711 Dell Ave CITY /ZIPCOD.E: Campbell, CA 95008 *Our ma nicipa9 code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSIPIECT90N(S) WILL BE SC.HEDUT,ED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRAC'T'ORS HAVE OBTAINED A CITE' OF CUPERTINO BUSRN1ESS LICENSE. I am not using any subcontractors: Signature PDense check applicable subcontractors and complete the following irnformation: Date V SUBCONTRACTOR BUSINESS I` AHE BUSINESS 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 Plastering 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 Owner / Contractor Signature 5/12/15 Date