408 Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
C DF Fax(408)777-3333
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Building De artment
JOB ADDRESS: PERMIT #
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OWNER'S NAME: PHONE # D o
GENERAL CONTRACTOR ��o,, FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring. Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date