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PLEASE NOTE:
A pre -application .conference is required prior to submittal on all
applications. The purpose of the pre -application conference is to
determine if the application is ready for submittal.
Please call your project manager to schedule a time for the review of
your application materials. We suggest you allow enough time prior
to the application deadline to prepare additional information or make
changes in case any are needed.
Please bring this form to the pre -application meeting for a signature.
Include this form in your application submittal.
Application Request. / Jeyj10AINanco +D 44-e 101-01, 5wal
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Comments: 3 5
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Signed (planner) C9 �iyv� Date
As a part of the application review process, City of Cupertino -employees may visit your site in order to take
photographs, slides and/or videotape. These materials may be shown at a city meeting.
slwet 1 of 10
PRE -APPLICATION FORM
Community Development Department
10300 Torre Avenue (408) 777-3308 / Fax (408) 777-3333
CU PE RTI NQ
Cupertino, CA 95014 planning@cupertino.org
http: / /www.cupertino.org/ planning
PLEASE NOTE:
A pre -application .conference is required prior to submittal on all
applications. The purpose of the pre -application conference is to
determine if the application is ready for submittal.
Please call your project manager to schedule a time for the review of
your application materials. We suggest you allow enough time prior
to the application deadline to prepare additional information or make
changes in case any are needed.
Please bring this form to the pre -application meeting for a signature.
Include this form in your application submittal.
Application Request. / Jeyj10AINanco +D 44-e 101-01, 5wal
-r psi c�v,fi�
Comments: 3 5
0 " ,�flj U Qt- -7iV
�a6a56S
Signed (planner) C9 �iyv� Date
As a part of the application review process, City of Cupertino -employees may visit your site in order to take
photographs, slides and/or videotape. These materials may be shown at a city meeting.
slwet 1 of 10
TWO STORY RESIDENTIAL PERMIT
Community Development Department
10300 Torre Avenue (408) 777-3308 / Fax (408) 777-3333
Cupertino, CA 95014 planning®cupertino.org
http://www.cupertino.org/planning
CUPERTINO
Property Owner Phone (w) Phone (h)
M uh5en
Street Address Fax Cell
I U 310 D,- - 11,1 b- 3U%3 Li
City, State, Zip Code E -Mail
Project Contact Person Phone (w) Phone (h)
i�l U C
Street Address Fax Cell
S � r✓l.l !n. S rn �I vwt
City, State, Zip Code E -Mail
Project Address APN
Brief Project Description
Project Data
Existing Proposed
2 Net Parcel Size
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Building Square Footage
6 -7 C1. 16 First Floor (includes garage and accessory structures)
—7 06 -VZ Second Floor (includes first floor area > 16 feet in height from floor to rafters)
Ha -o4
°� % Ratio of Second Floor to First Floor Area (45% maximum)
% Floor Area Ratio (45% maximum)
I certify that the foregoing statements are true and correct to the best of my knowledge. I understand that a misrepresentation of any submitted data may
invalidate an approval by the Planning Department. I have discussed this application with the Public Works staff and I understand the public improvement
requirements associated with this proposal. I have read and understand the ordinances and design guidelines affecting this project in the City of Cupertino.
Applicant's Signature Date
I declare under penalty of perjury that I am the owner of said property or have Power of Attorney (attach copy) from said property owner and that 1 consent to
the above-described application and I authorize City staff to visit the site in order to take photographs, slides and/or videotape that may be shown at a city
meeting.
ignature rent Property Owner's Name Date
Sta use only: (Do not write below this line)
Application accepted cn by
Application type: Level I (F.A.R. S 35%0 Level II (F.A.R. > 35%)
Page 1 of 6.
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