BLD-2024-0509_ApplicationCONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
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PROPOSEDROOFTYPE, `BUILT-UP ROOF*AASPHALTSHINGLES OWOODSHAXES OWO00%uNGLFS OOINER �1
'Provide a signed copy of the CupertaWs Tear -Off Policy SF J, � � "SQUARES 1.
By my signature below I certify to each of the following. I am the property owner or authorized aged to act on the property owner's behalf. I
have read this application and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree
to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to
enter the above -identified property for inspection pu I acknowledge and authorize all information contained On this application form
to be made available for public record. O 4
Signature of Applicant/Agent Date:
SUPPLEMENTAL INFORMATION REQUIRED
'New SFD)Second Dwelling Umts/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction.
'Commercial Buildings: Provide a completed hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
'HOA-Provide a letter of approval from the Home Owner's Association