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08080233 CITY OF CUPERTINO >A BUILDIING rplvlSION PERNIIT CONTRACTOR INFURMAT40N � - BUILDING ADDRESS: PERMIT NO. 1 '_' 49 RAINTREE SPRING CT PRINCIPLE ROOFING & 08080233 OWNER'S NAME: PERMIT ISSUE DATE SI!:I'AU J:I.FN HWA AND SITYUE CHIN 10160 STERN AVE 08/29/2008 NE: (408) 898-7298 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INPO BLDG BLECT PLUMB MECH 0 0 0 3C9 LICENSED CONTRACTORS DECLARATION IObDesGn Description F 1 hmcby alTinn Nal l am li¢vN undo ProvWou of CNpur 9(mmmcncine p .Z with se Lion7")ofDivision3afihaBusinossudNareWoniCode.wdmylicemcis ROOF OVER-LAY OF 19SQ CLS A, ORG ROOF PERMIT < in full force end effect. r9 / I-3.fes I S S'D pwa=Z License Clea (- Lk.A b--I H i/ 'ARCHRECTStractor DECLARATHI PREVIOUSLY 2/7/8 #08020046 d I understand in,Plans NNI W u,M as public mc.rW J P asci licensed Pmfessiond 5 OWNER-BUILDER.DECLARATION ContrON i q 1 hereby affirm that 1am 1. .attempt from the Contractor,License Lew for the my O O which ac moon.(Section mom.Business and Pro(euinno Cade:Any city os..my 9 r which acquires a issuance.aim re moment,the due I Applicant for sac demnilll t or mash ed almocal .. 't Priormiunsedpalsu regs due thovisisof far mchpenni't Liceo rile nse g 't that hehllcrnseJ Punumtuthc Provisions of the Contncmrilicense leve(GaPur9 Sq.Ft.Floor Area Valuation 9 (comm=in,with Section 7000).(Diviiion 3 of the Businessland I'mileaumas Cars)Or l $4200 — dot he u m empt rhemfrem and the bash farthe alleged assumption.My violation of Section 70713 by any appliam fore permit subjects the applicant to a civil penalty ofNumber Occupancy Type not mom Wan five hundred dollen(33001 3 6 6 5 4 0 3 8 . ❑1,u owner of the Noperty,a my wplowu with ween u the'v vele emmpensetion. aid Pr the work,and the he Contractor, ra rot Intended ora w do(arcate(Sec.]011,Bud r of and Professional who Wilds Cade:Ton mthur err, nd who Law dos rot apply lt rt owner of Required Inspections is Own ertywyesmpro ideal awe thamrovemets doncuchwmk himcelfll forughhf. awn a sur,me uiprevided that vete improvements am not year of completion.dfarM for ode o. hawser We bui the w improvement 4 halt within opl war ofimprofor We owplr- Wilder will haw the buNen of proving Out he did not build or improve for purpose of O 1,u owner or the property.an combatively contracting with licensed mntruton he construct the parallels(See 70M,Business and Pmfosdons CWcJ The Contrumrs U. " cane,Law does not apply to an owner of property who solids or improves shemom.and. who mmumma for such p,.Jees wish a eom usio(s)licensed portant as the Contractor, License Law. m 0 laasempt under5e. .B is P C ror this mann Owner Data WORKER'S COMPENSATION DECLARATION I barely Oman under pointy of Perjury ono of We following dnolaruimtc I haw ant will a dnuin acutiRau of Co..,in self-Lucre for Workers Compen• oation.u provided for by Section 3700 of the Mbar Code,for the Performance of tho work for which this permit i,issued. ❑1 haw and will maintain Worker,Complication Issuance,as myulmd by Section 7700 of dm Dilor Code,for the perfbar.of she work far which this permit IS cawed. ' My Warksur,C sup ma Insurwce carrier and Policy number am: Carrier. 90�"`L Poliry No.: �N CERTIFICATE OP EKEMMON FROM WORKERS' COMPENSATION INSURANCE (This seMon pled out be completed if the perm It is fa one hondmd doB,n(e 100) or lea) 1 certify thus in We perrormmm of due walk for which this permit is issued.I,hN not employ any person in my mer erm as to become mbject W tis Warlmri CamPewtian L we of Glifamis Dau Applicant NOTICE TO APPLICANT.If,&fur making this Ceelncau of Esemption.You should become subject in the Waher,Compensation previsions of the Mbar Coda you mus ,J O foMwlth comply with such providom or this permit Milli be deemed revoked. y CONSTRUCTION LENDING AGENCY IMmby am.than them ha lanstararion hndingagene,for she Performance:of C> she wars sur which this Permit It issued(Sec.3093,Civ.G W Q Lender,Name , z lenders Address UQ I cadfy that 1 Mw mad N.appllcWon nth sois the ab u thove Informed.h U.^ contact.I agreecomply W m ply wish city and lately cordialness and malaw mall lamission,so , Q rV' Wilding construction.and homily sumorlm mprmanuhms alums city us Older upon tie W above-moManed property for inspection purposes. p), (We)agme in taw,indemnify and keep harmlw the City of Cupertino against rn Iiabiliba judgmenu.cosu and expenses which may in any my attne sli add Clry fJ Z in camequarme of the gnnung of this Pommy y ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE R! ULATIONS. o 8/�/� h � Re-roofs Signature ofA limon oau HAZARDOUS MATERIALS DISCLOSURE Type of Roof Willftto Cape orfutureWildinganmpaptsoreor and Health and as dented by We 32(a 0 an Mums I Code.Chapter 9.12,and the Htalth mod Safety Call. 0you zss3zh)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yas Nu w 11 the applicant or ratans building o up,nt use gwpmemt or device which If a roof is installed without first obtaining an inspection,I agree to remove it havAAow air conuminsns as sued by W Bay Arc,Air Quality Management all new materials for inspection. atrict7 I--]Y. No IhawmWCoda Swdcm Z3lWm33&rdnuuMcr Chapur h.93ofde Wilding I nhXWthdrmilay ave.Sxtivshat iti m"ciM1JdN.l inden ,ft BNe t.fthe bfj 2.9 Ods dao rot mmenty naw a ural this to h my rcaponsihllity m rotiry de wt.f de mauimnu u which an=W postaliss met pdla uveeaf•Ccnine.0 of Occupancy. Slgnatureof Applicant Date 1— 08/W,-,l Comerw ikatimmecd goal FData All roof coverings to be Class')?"or better ' CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pltg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN 36654038 . 00 DATE ISSUED. . . . . . . : 08/29/2008 RECEIPT # . . . . . . . . . : BS000005943 REFERENCE ID # . . . : 08080233 SITE ADDRESS . . . . . : 11549 RAINTREE SPRING CT SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SHIAU JIIN HWA AND SITYUE CHIN ADDRESS . . . . . . . . . . : 11549 RAINTREE SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5123 RECEIVED FROM . . . . : DERECK LOI CONTRACTOR . . . . . . . : DERECK LOI - LIC # 27564 COMPANY . . . . . . . . . . : PRINCIPLE ROOFING & ADDRESS . . . . . . . . . . : 10160 STERN AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408) 898-7298 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- IBSEISMICR VALUATION 4, 200 . 00 0 . 50 0 . 00 0 . 50 0 . 00 IRGROOFRES SQ FEET 19 . 00 247 . 00 0 . 00 247 . 00 0 . 00 ---------- ---------- ------- ------ TOTAL PERMIT 247 . 50 0 . 00 247 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 247 , 50 MC --------------- '.TOTAL RECEIPT 247 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601. ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS .. 605 FINAL REROOF ttan�� -01 I�J6 41cy4 CITY OF CUPERTINO p�OOo?33 ` REROOF ®CUPER wO PERMIT APPLICATION 164ab) z�3'y /gam APN '2 Date: 2& (p5 cj©3� D O ag 2 9 od Building Address: / 15-49 R tiu� S, Owner's Name: Phone #: U,VA.) Contractor: Phone #: L4ay) Sly — ;7TJjj !a /6o Sfi�er/ i Fax #: Cupertino Busi ess License #: Contractor License #: 3 � Type of Roof Covering: Existing: Proposed: ❑ ilt-Up Roof ❑ B Up roof d Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: agve" e jr�b`z�.lL N"4/ SA"�- Residential Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: I Have Read, Understand and Will Comply.with Cupertino's Tear-Off Policy: ® � r Signature _ Revised 6/16/08 alo CITY OF CUPERTINO REROOF CUPkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B /a 1RER00FRES Re-roof Residential B 1SFDWLR00F r 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B IBUSLIC Business License B Revised 6/16/08 Community Development Department Building Division City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City, the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. ea) Spark arrester installation. 5. If plywood is installed, a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of I/4 "per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: U/iN Job Site Address: ircC Roofing Company Name: �y P22 � / �— Applicant's Signature: 1 Date: Greg Casteel Building Official Revised 07/30/08 Green Building Plan Check Index of.Green Building Points/Categories A. Category Example of an Index or Table of Green Plan Sheet or Page Points Building Points Categories that must be shown and referenced on the Project Plans See below B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 72points 11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2 E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points 4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points 5. Tankless W.H., (Note/Spec.) A-2 2 points 11. A 2500 Gal. Tank, (Note/Spec L-1 10 points G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point 3. Energy Star Refrigerator, (Note/Spec. A-3 1 point P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS1 40 points • • Plan Review Process Work Book Page-12-Revised 3/25/08 Green Points Rating System for Remodeling Projects Due to the diversity of remodeling project types,assigning a"total points'value to a project to be considered environmentally friendly is not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with ease of implementation and relative low cost. These measures can be used as a starting point for"greening'your project. INPUT ReSDUTCOS Energy 1AWHeafth Sne 1.Recycle Job Site Construction 8 Demolition Waste' t 65'/°=1 point;75°h= 2 points;60%=4 points up to 4 Resource pts 0 L Salvage Reusable.Building Mate els 4 Resource pts y--yes 0 3.Remodel for Mixed Use,Adaptive Reuse,and Historic Preservation 4 Resource pts y--yes D 4.Protect Native Soil 2 Resource pts y--yes 0 5.Minimize Disruption of Existing Plants&Trees 1 Resource pt Y--yes 0 B.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0 7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0 (6.Design Resource-Ejfcien(Landscapes and Gardens _ 4 Resource pts y=yes 0 9.Reuse Materials/Use Recycled Content Materials for Landscape Areas 2 Resource pts y=yes 0 10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0 11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yesi 0 1 1 1 B.Foundation 1.Incorporate Recycled Flyash in Concrete • 25%Recycled Flyash=2 points;Add 1 point for every 10% increase of Flyash,up to 5 points up to 5 Resource pts0 2.Use Recycled Content Aggregate 2 Resource pts y=yes D 3,Insulate FDundation/Slab before backfill 3 Energy pts y=yes 0 1 1 1 C.Structural Frame 1.Substitute Solid Sawn Lumberwth Engineefed Lumber J 3 Resource pts' y=yes 0 2 Use FSC Certified Wood for framing (For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pis. 0 3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y--yes 0 4.Use Web Floor Trusses 2 Resource pts y--yes 0 5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0 6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y--yes 0 7. Use Engineered Studs for Vertical Applications 2 Resource pts y=yes D B. Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0 9.Use Structural insulated Panels(SIPS) a.Floors 3 Energy pts y=yes 0 b.Wall 3 Energy pts y=yes 0 c.Roof 3 Energy pts y=yes 0 10.Apply Advanced Framing Techniques 4 Resource pts y--yes D 11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y--yes 0 12f,Use OSB – — a.Subfloors 1 Resource pt y=yps 0 • b.Sheathing 1 Resource pi y=yes 0 1 1 1 . xter or m s 1.Use Sustainable Decking Materiels a.Recycled content 3 Resource pts Y--yes 0 • b.FSC Certified Wood 3 Resource pis y--yes 0 2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAOMealth pt y--yes 0 3.Install House Wrap under Siding 1 IAO/Health pt y--yes 0 4.Use Flbar-Cement Siding Materials 1 Resource pt y=yss D 1 1 1 E.Plumbing 1.Install Water Heater Jacket 1 Energy pt Y--yes 0 2.Insulate Hot and Cold Water Pipes 2 Energy pis Y_—Yes 0 3.Retrofit all Faucets and Showerheads with Flow Reducers a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0 b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0 4.Replace Toilest with Ultra-Low Flush Toilets (1 point each,up to 3 points) Up to 3 Resource pts. 0 5.Install Chlorine Filter on Showerhead 1 IAO/Health pt y--yes 0 6.Convert Gas to Tankless Water Heater 4 Energy pts Y_—Yes 0 7.Install Water Fill ration Units at Faucets (2 points each,up to 4 points) Up to 4 IAO/Health pts. 0 B.Install On-Demand Hot Water Circulation Pump 4 Resource pis y--yes 0 1 P.eiecrncar 1.Install Compact Fluorescent Light Bulbs(CFLs) -(6 bulbs=2 points,10 bulbs--3 points,12 bulbs=4 points) Up to 4 Energy pts. 0 O 2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to 5 points) Up to 5 Energy pts. 0 3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. D 4.Install High Efficiency Ceiling Fans with CFLs (1 point each,up to 4 points) Up to 4 Energy pts. D 1 1 1 G.Appliances 1.Install Energy Star Dishwasher 1 Energy pt Y--Yes 0 2.Install Washing Machine with Water and Energy Conservation Features 1 Energy pt y=yes 0 3.Install Energy Star Refrigerator 1 Energy pt y=yes 0 4.Install Built-In Recycling Center 3 Resource pts y--yes 0 i 1 H.Insulation 1.Upgrade Insulation to Exceed Title 24 Requirements a.Walls 2 Energy pis Y--yes 0 b.Ceilings 2 Energy pts Y--yes 0 2.Install Floor Insulation over Crawl Space 4 Energy pts Y--yes 0 3,Install Recycled-Contant,Fiberglass Insulation with No Added Formaldehyde 3 IAO/Haalth pis y--yes 0 4.Use Advanced Infiltration Reduction Practices 2 Energy pts Y_—Yes 0 5.Use Cellulose Insulation a.Walls 4 Resource pts y--yes 0 It.Ceilings 4 Resource pts y--yes 0 6.Alternative Insulation Products(Cotton,spray-ioam) a.Walls 4 Resource pts y=yes 0 D.uetlings 4 Resource pts y=yes 0 'INPUT ReSDUMeS Energy n ows I1.Install Energy-Efficient Windows - • a.Double Paned 1 Energy pt y yes 0 b.Low,Emissivity(Low-E) 2 Energy pis y yes D c.Low.Conductivity Frames _ 2 Energy pts y=yes D 2.Install Low Heat Transmission Glazing - 1 Energy pt y=yes D 1 1 f J.Heating Ventilation and Air Conditioning `.Use Ducl Mastic oon All Duct Joints _ _ 2 Energy pts y_yes 0 2.Install Ductwork within Conditioned Space 3 Energy pts Y--yes D 3.Vent Range Hood to the Outside 1 IAQMealth pt y--yes 0 4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes D 5.Install Solar Attic Fan 2 Energy pts Y_—Yes 0 6.Install Attic Ventilation Systems 1 Energy pt y=yes 0 7.Install Whole House Fan 4 Energy pts Y--yes 0 B.Install Sealed Combustion Units a.Furnaces 31AQ/Health pts y=yes 0 b.Water Heaters 3 IAQ/Health pts y=yes - 0 9.Replace Wall-Mounted Electric and Gas Heaters with Through-the-Wall Heat Pumps 3 Energy pts y--yes 0 10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0 11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0 12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Fumace 2 Energy pts yeses 0 13.Retrofit Wood Burning Fireplaces a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes 0 b. Install/Replace Dampers 1 Energy pt Y--yes D c.Inslall'Airtight Doors 1 Energy pt y=yes 0 14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0 15,Install High Efficiency Filter 41AQ/Health pts y=yes 0 16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Heallh pts y=yes 0 17.Install Separate Garage Exhaust Fan 3 IAQ/Hsalth pts y--yes 0 1 t 1 K.Renewable Energy and Roofing 1.Pre-Plumb for Solar Water Heating 4 Energy pts yryes 0 2.Install Solar Water Heating System 10 Energy pts y--yes 0 3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes D 4.Install Photovoltaic(PV)System (1.2 kw=6 points,2.4 kw=12 points,3.6 kw=1 B points) Up to 1 B Energy pis 0 6.Select Safe antl Durable Roofing Mater al's_ _ _ 1 Resource pt y=yes 0 7.Install Radiant Barrier 3 Energy pts yryes 0 1 1 1 L.Natural Heating and Cooling 1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0 2.Install Overhangs or Awnings over South Facing,Windows 3 Energy pts y=yes 0 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 1 1 • . n oor r ue ty an n s es 1.Use Low/No-VOC Paint 1 IAO/Hsalth pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y--yes 0 3.Use Low/No VOC Adhesives 3 IAO/Health pts y--yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AO/Health pts yryes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y--yes 0 7.Seal all Exposed Particleboard or MDF 4 IAO/Health pts y--yes D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0 10.Install Whole House Vacuum System 3 IAO/Health pty--yes 0 1 1 1 N.Flooring 1.Select FSC Ce tified Wood Flooring 8 Resource pts 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts 0 3.Use Recycled Content Ceramic Tiles 4 Resource pis 0 4.Install Natural Linoleum in Place of Vinyl 5 IAO/Heallh pts D5.Use Exposed Concrete as Finished Floor 4 Resource pts 06.Install Recycled Content Carpet with Low VOCs 4 Resource pts 0 1 1 1 Total Points Available: 1 1401 1301 57 Total Points Project Received: 1 01 01 0 G:detalprogslgmenbulldingguidelineshemodeleNgmenpointsflnal212Mpmisded.ds Community Development 10300 Torre Avenue ?✓ Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 4UPEkTINO Building Department JOB ADDRESS: PERMIT # l /6-49 s 2-'),3 OWNER'S NAME: i j / l PHONE # GENERAL CONTRACTOR: err, 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