S2227 —APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING.-ELECPRICAL Plitt I No. 2227 2„L7
BUILDING DIVISION APPIACXFION/PERMIT PLUMBING.-MECHANICAL
BUILDING PROJECI'IDEN'I'IFTCATION_
BUILDING ADDRESS,. SANITARY NO. APPLICATIONSUBMIITT L.DATE
(5 S3 X416 .
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OIVHE 'S NAM I;IIONF.: CONTRACTORS NAME: LIC NO
�rJyV/ ✓� N/C ^ CONTROLM
ARCIITECrIENGINIiER: FIC NO: ADDRESS:
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CONTACT` PIIONIi: . BUILDING PERMIT INFO
€r✓ - (3EN ❑ Cgnsullanl Fees Paid by Applicant(Initial) G: BLDG� Ii1.EC1'i PLUMB Cu
LICENSED CON'FRACI'OR'S DECLARATION QTY. ELECTRIC PERMIT FBeYJ,/ LrJ✓
1 hereby affirm 1 ren licensed..,let pro...in.,of chapter 9(mmmnnning JOB DESCRIPTION
Matz w;m Swdon701O)ofDi,i,i n3oflhe B......... Profes,bn,Cafe.andnry Bcanui. RF_SIDENTIAL:
Won PF,RMITISSUANCE I 0
Fes.. in full force and affect. El Mill ❑KITCHEN REMODEL<-U License Class Lick APPLIANCES-RESIDEN'1'IAI, UDI"1I ON ❑PLUMPING RIs PIPE
I-Z W Date Com unno
ARCUITECTS DECfARAT10N ❑MULTI-UNIT El STRUCTURAL
Z p at Z 1 undcrs'and un pluns'hall be used as puhlic records PANELS MODIFICATION
OZ�� UI"f0200AMPS ❑INTERIOR ❑CHIMNEY REPAIR
a NG; Licensed Pr afr,notial 2D1-1000AMPS IMPROVEMENT DSWIMMING POOLS
a C rya]Q ncrcny alYvm,hay i R-B ILDFR DECLARATION the instant's License Luw fonhe OVER IOMAMPS ❑BATH RESIODFUREPAIR El DEMOLITION
c3 6 U Edlowing reason.(Section]1131 S,Business and Pmas.inns Code:Any city or county SIGNS ELECTRICAL ❑OTIII?H
W a in which incomes a pito contract.alterimprove,demolish,or repair any structure AQP/���ts.,
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