DIR-2002-20b
PLANNING PERMIT APPLICATION FORM
Community Development Department (408) 777-3308
10300 Torre Avenue Fax (408) 777-3333
Cupertino. CA 95014 planning@cuperUno.org
http://www.cupertino.org/ planning
Property Owner
Address
Phone
Fax
E-mail
.
Project Contact Person
Address
Rlll.~l (, -Ti~C \ ~)
~b~"'7' Holl~t-./;~ L ~.
Sill"') T(1(!; (It <1 ~-o {
2\b(S St('vf/I....S Cv~e:Lt iZ.lWA.
Phone
Fax
E-mail
('\0{) 773l:11$i
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Project Address
APN _ ~ ~ _ _ ~ Zoning General Plan Designation
_ _ _- ~ ~ - _ _ ~ Attach separate sheet for additional APNs if necessary.
Description of Project Describe in detail your proposed project. Attach separate sheet ifnecessary,
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Existing
Proposed
Land Use
Parcel Size
Dwelling Units
Density per Gross Acre
Building Square Footage
Lot Coverage (Percentage)
Paving Area (Percentage)
Landscape Area (percentage)
Floor Area Ratio (FAR)
Building Height
Parking
Regular
Compact
Handicapped
Hours of Operation
Number of Employees
Net Gross
Net
Gmss
.
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1 certifY that the foregoing statements are true and correct to the best of my knowledge, I understand that a misrepresentation of any submj!ted data may
invalidate an approval by the Design Review Committee. Pianning Commission Dr City Council of this application, 1 understand that the application may be
withdrawn if I Dr my authorized representative is not present at the scheduled meeting(s), or if a written request for postponement has been presented to the
Pianning Commission Dr affected review board, I have discussert,.this"lfpj5TicatlonWff.h the Public Works staff and I understand the public improvement
· requirements associated with this proposal. ) ("'" ..' I
Applicant's Signature ~... ... .~.:;,~,...,)2Y.~:(:"".. ". ... .:,:::~::~ .... .~~te.. ...... (.0' Z +, 0 '2_
I declare under p ty of perjury that I am the owner ofll;aid property or have Power of Attorney (attach copy) from said property owner and that I consent
to the above-des . lion.
Dale
Signature
Date
Staff use only: appIlcation accepted by
Oelobsr, 2000
on