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HomeMy WebLinkAbout24905 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPERTINO BI ILUING-KLLC I RICA], PERMIT NO. APPLICATION/PERMIT PIUMn NG-MECHANICAL 2 4 9 0 5 BUILDING DIVISION BUILDING PROJECT IDEN'TIF'ICATION BUILDING /ADDRESS `: SANITARY NO. APPLICATIONSUBMITTALDATE UNITa LOT of 2 OWNERS NA PHONE: CONT'RACTOR'S NAME: LIC NO: -c f l fF - N/C CONTROL G' `7! S > -OC AR IITECI"NGINEER: LIC NO: ADDRESS: ❑ 9 �KIgoiCONTACT: PHONE: BUILDING PERMIT INFO 5l QTY. ELECTRIC PERMIT FEE 4aV �� " BLDG ELECT PLUME MECH —�_Z0 PERMIT ISSUANCE R E LICENSED CON'I'RACTOR:S 14CLARA-1'ION APPLIANCESRESIDENTIAL MM�yJOB IIFSCRIPI]ON pyz, Thereby ofm that jviiiol 3 oftlinscdinss and Isnotesions Comr9(commencing with 4100 111( ]t100)of DivisionJof NC Puniness and Professions Code,and my license isin PANELS �F,�yz dal force:mA effc Fye LlcenseC N Cana UP T02(1) AMPS , w?y Uam Cnnuanor �— 201-10110 AMPS SQ.FT.FLOOR AREA E/SQ.ET. z 0 c" ARCHITECTS DECLARATION OVER 1001)AMPS Q Z..,p l understand my plans shall be used as public retards. F-sei F W SIGNS ELECTRICAL Q E j Licensed Professional © n, �y�6 OWNER-BUILDER DECLARATIONkL N SPECIAL CIRCUIT/MISC. DNC owu I hereby affirm that I am exempt from the Comraclor's License Law for the n13 u-m hollow,reason.Section 9031.5.Business and Pmfassinn.v Code:Any city or county TEMP.METER OR POLE INS'1. �;