11090149 CITY OF CUPERTIN.OBUILDING PERMIT.
BUILD.ING..ADDRES
_ S: 10900:N'TAN.TAU AVE- CONTRACTORi.'DEVCON P ER11I1T.N0;.1109�h49
CONSTRUCTION INC.
OWNER'S NAME:'CUP.ERTINO CROSSING LLC 690'GIBRALTAR,DR DATE ISSU(D`:OI,/05/2012
OW,NEWSTHONE: 4088629799 dLIIL`PITAS,"CA.95035 PHONE NO:'(408)942-8200
LAY LICENSED CONTRACTOR'SiDECLARATION JOWDESCRH'TION 'RESIDENTIALU C011 MERCIA J:1
License Class Lie.# APPLE-:FIRST.FLOOR'-,COIV M'T.1(51;092SQFT)O_F.FICE
SPACE,INCLUDES LABi STORAGE,BREAK.AREAS
Contractor, Date- "CONFERENCES SPACE S
I;hereby affirm:thatI;am licensed under t1e;,proyisionsofCfi"i►pter;9 "
Code:and.that.my license isin,full.forceanil,effec SIIIELD.FOR;CHAMBERS-ISSD 5TION,OF RA'DIO.FREQUENCY
comm,eneiti with Seetibu 7000 of.Dtvision 3 of the Business,&Professions 4/18/12 DEFERRED'#2,`INSTALLA•
t• 73Y,12'
I h"ereby'affirm under'penalty�of perjury one 6 the4ollowing two!d'ecfarations:
Fhave,and will inaintain a certiticatetofconsentto self insurcjbo 'Workers.
Compensation„as provided for by Sec1ion'3700 of the=Labor'Code;,fortlie
performance,ofthe%workfocWhich this permit is.issued. `Sq.,Ft;Flooi•°Area: valuatioo:!_W5 6000
`I:have and will,inaintain Worker's Compensation Insurance,asprovidedfor'by
Section 3,700 ofthe"LaborCodejok-the performanceCofth'e workfi&which this
- AP-1YNamber:3{609029.00,` Occupancy Type:.
,perrrirtls:i'ssded.
APELICANT.CERTI FICATION
I certify.that I have:re P y with all city and d state that the above information is PERNIIT EXPIRES IF WOW IS'NOT•STARTED
this applicaiion4an -
m 1 y county ordinapces and.state Iawssrelating -
'to building construc ion,and hereby°au thorize•representatives offlvs.city'.to enter WITHIN'180 DAYS OF PERMIT ISSUANCE OR
upon'the-above mentioned°property for inspectio"n"purposes (We)agree°to save 1$O D` 'YS FRONT L" T CtALLED:INSPECTION:
P g
:indemnify and keep harmless the City of Cu ertino a ainst habihties_ judgments,
costs and;expenses`which`rnay accrue against,saidlCity in consequenccrof the 3
Issued'b Date:
grantifi�4,this permit. Addition applicant understands,and will comply Y ,. -
with�iiI not seEtre� ioris,perth�C_upe_rtino,Mp_m_cipal Code',Section
9.18.
- _ _ inspected p.. RE-ROOFS:
Signature Date All:roofs.shall be ins ected for to'any rooting material being installed IfraFroof i`sl
installed without_tirsi obtaining an inspection,Lagree'to remove all.new`materials.'.for,
inspection:
❑
OWNER-BUILDER DECLARATION
> "
I hereby affirm,ihat I-am exemptufrom the Coo'trac_tor'-§License Law forone' Signature,of Applicarit�
of -Date:,
the followingtwo reasons:
ALL ROOF COVERINGS TO BE.CLASS"A”OR BETTER
I,as owner of the°p_roperry;ormy employees�With wages18 their sole;,compensation;
will do the work,and the structure isnot intended or:offered for.sale(Sec.,7044,
Business&,Professions Code)
I',as owner ofthe-property,ainiexclustVely contracting'- ith licensed contractors to
HAZARD OU S,MAT ERIA LS`DISCLOSURE•,
.construct the projed,(Sec:4044,,Busness&:Professions Code):, I"have read the.hazardous materials requirements under Chapter 6:95,,ofthe• .
penalty p l y California Healthy&.Safety Code,Sections 25505,25533,andt25534 I will
I hereby
affirm uncle_r enalt of 6 ur one of the following,three. maintain compliance with th ,Cupertino Municipal Code,Chapter 9 12 and`the
Health&zSi fety'Code,Section 25532(a),.shodld l store4)r'hao8le hazardous
I have andwill maintain,a.Certificate of Consent,to(self,insure;for Worker's nfaterial: Additionally;�should I use equipment or.devices*hich emiftiazardods.
Compensation,". ,p- y � � 11 etined by the,Bay-Area AiriQuality Management Distnet,I
performance of he work for whichth s�,perm �s issued.Lab for the w Ilcmatn amacompl anee with the�Cupertino�Municipal Code,",Chapter 9.12;aod
I have and.will maintain'Worker's:Compensation,Insurance,ias.provldedfor.by the,Ilealth&$afety.Coile,,Secfio _' . - 5534:
permit isaissued. _ ode;for ttie performance of the work for which`this '
Owner or authi"rued,age _ Da_te_: 3"'
I certi that in the erforma
Section 3700 of the Labor C
fy p - nce;of the,work forwhich!this"permit is;iss-ued,I shah r
not,,empl6y4nyT0 rson in`any mannerso as to.become,sufijectto the Worker's'
Compensation.laws of Califo-mia: If,after rrrakiiig'this certificate,ofexemption,f .,CONSTRUCTION LENDINGFA'GENCY_
becomeisubicet.to,th&Worker's'.Compensaiion provisions of the Labor Code;l must; I hereby affirm thar.there i construction lending' forttie"performance,of .
s a constru
forthwith comply with such provisions onthrs permit shall beAeemed'revoke& works?for which this permit isassued(Sec.3097,Civ C')
- ` 'Leniler's•Nanie _
APPLICANT CERTIFICATION Lender'i:,e ss
certify that Lhave°read this.applicafion and'slatethat•:the�above£information"is
correct.I1agtee10 comply=with all'city?and;courity ordinances and state,iaws.relating"
to build ing,consfruction,and"hereby,authorizeSrepresentativesxof this city,to enter
uporrthe above mentioned,property foninspection'purposes (We),agreeaio,save
indemnify and'keep-hay 14.ssithe:.City ofCupertino"against Liabilities judgments; ARCHITECT'S DECLARATION
costs,and'expenses wtiI !may;accrueFagainstsaid Gity�in'kconsequence_of"tile 1 understand;my plane°shalt be used as public records.
granting of this permit.Additionally,.the�appIicant,understands AM4III comply -
p g P- p P Licensed Professional .
'witfi all non
CITY OF CU_PERTINO
FEE ESTIMATOR—BUIL DING'.DIVISION .
W. 1AIDDRESS:, 10900 N.Tanfau Bldg',#8 DATE: 04/1'8/2012 REVIEWED BYi Sean
BP#: / / *VALUATION:. $0: ,
PERMIT"TYPE:: Building PermitPLAN CHECK TYPE: Alteration /'Addition,/ Repair
PRIMARY P•ENTAMATION
U,SEs Commercial Building � 'PERNIITTYPE: 1GENCOM;.
WORK Deferred submittal #2: Iristallation Offrequency shieldsfor charriber"s.
SCOPE
;Gl�'4�7 !Tari C�:I,<<c•; �. r�'rr_u;,.f: I frrvr 2_yicc� f.,rta�.:.I�.aw C r::c%
Plumi" Permit lei;, L r.r. Perm!'!Pcu(?
O;7rer ,l; ,'i.%rsj" r1Ntc°r!'i„ril%lr.rfz C)'rer Li t !n s` ,
NOTE: This estimate does not:include fees due tbywh"er Departments(re Planning,Public,Works,Fire,Sanitary.Sewer District,School
District;eta). Theses ees 8re:based bn.-diet relirriina a,:in ormation available a)i"),e onl,an"estimate. Contact'therDe t. or addn`'l�in
FEES ITEMS(Fee Resolufion 17-053 Ef. LLLL FEE Q.TY/FEE; 1VIISC;ITEMS
Plan Check Fee: Hourly Only? Q Yes No: $0:00 0 hours Plan,Check„Hourly
Suppl. PC Fee: 0 Reg. Q OT 0;0; firs $0.00 $260.00 1STnzNcx;
PNIE Plan Check, $0.00
Permit,.Fee. $0.00
S,uppf.•Insp,,'Fee:o-Reg. O DT 0,.0 11rs.
TM.E;Unit.Fee: 1$0',QO
'!'ME.Permit Fee:
C;btas•lrrrcii�}rr `7ci���'
:Cllrcir?isl1' i''e/`ee
Work Without,Per_init,? 0 Yes No 00
Ad:vanceA Pl`annim,,Fee: $Q.,00 Select:a:Non-Residential
Building or Structure
i
Stt:ony:Motion Fee: $0.00 Select.an Adtiiinistrative'.Item
Bl`d�_.�Stds'Commission Eee' $0.00
R �bn a
- � h a
us $0 $2 _ $2:60,00—
Revised: 04101`/2012.
CITY_OF CUPERTINO BUILDING.:PERMIT
BUILDING:ADDRESS: 109WN,TAN fAU AVE,, CONTRACTOR: N-WON CONSTRUCTION PERMIT NO: 11690149
INC
,OWNER'S NAME: CUPERTINO CROSSING LLC_ 690'GIBR_A'LTARDR, DATE ISSUED:01/05%2012
OWNER'S PHONE: 4088629799 MILRI"I4S;CA.'95035 . P.HONF:NO:;(40e)942-8200 -
❑ LICENSED CONTRACTOR'S DECLARATION gU1LDIN6PERMIT INFOs;.BLDG � ELECT
r
LiccnseClass. � Lic.#!. 9 - i� T
�C
MECH RESIDENTIAL COMMERCIAL--
Contractore tC Datc.!� 1t _
hereby-affirm-that I,am licensed under the provision ;of Chapter-9. - JOB,DESCRIPTION APPLE ..FIRST;f;I�00R-COMM"f.l(51,092SQFT)OFFICE-
(commencing with Section 7000)of Division 3 oG�the Business&'.Professions SPACE,INCLUDES LAB,STORAGE,BREAK AREAS&
CES
Code and.thatmy license is in full force and effech..,
CONIERE,NCESI'A
1/23/22012-DFI tl1=DEFLRRED,SHELVING SYSTEM IN STORAGE LAB ROOM 1:17-
hereby'affirm'under penalty of perjury one.of the.following;two declarations: .ISS
ULD .
1 haveand will maintain a certificate ofconsem to self-insure for Workers;.
'Compensation,-as provided,for by Sectiori 3700 of the Labor Code,for the .
performance.of the work for,which this penni't is;issued:.'
I.haveland will maintain Workers Coil,pensatton'Insurancc„as provtdedfor by 'Sy Ft Flooi-Area: °' Valuation:$2500000
Section,3700 of tlie,Labor Code;for,th'e perfor'inance of the woik foi:Much this
permit is issued.
„ APN NuRiber::3.1609029.00 Occupancy Type:
APPLICANT CERTIFICATION ,
[,certify that;l-have read this application and s'taie that'the;above;in_formation is
correct. 1 aeree to"comply with all cityand'countysordmances and state laws.relatim,
u on,the above muitioned` ro ert lor.iionLe representativcslot this city,to�entci PERMIT EXPIRES'IF WORK ISNOT STARTED,-
to building construction and hereby autl
p p p y pss,'pectibfi purposes-(We)agiec f&s'ave
indemnify and keep harmless iheCity of Cupertino against liabihties,;jadgiilents, WITHIN: 1"80 DAYS,OF PERMIT.ISSUANCE'OR.. .
costs,.a,nd expenses.which may°accrue againstsaid City�nconsequciice of"tlic - I80,,D'AYS'FROM LAST CALLED INSPECTION
granting ofthis permit. Additionally:the applicant„understands and.,x ill comply
/
with all<non-pomtsour '� ons.per the Cupertino Municipal Code Section
9.,18. Issued by,:'. Date: '
Signatur - Datc
❑ QlVtil ILDF;R DECLARATION` RE-ROOFS:
All roofs shall he inspected priorto.ally%ro6fing material being installed, lf;a':roof is'
1'herebyaflirm that lam exempt from the Contractor's-,License law for.one,ofiostalled witliout'fi'rst obtaining,an mspcction,(agree to remove all new materials for
the following two reasons. inspection:
1,assowner.of the-property,nor Fny employees wit.v ,as,'their
sole-compensation,
wages
will do the==.work,and the structure is not intended or offere'd,forsale(S'cc:7044, Signature of Applicant;_ Date:
Business'.&',Professions,Cod6,),.
,as:o ict r of t oe4pr Sec exclusively contracting with”licensed 'contractors to
P P' Y
p 1 ( 7044 Business&Professions Code), AUI.•ROOF COVERINGS TO'BE CLASS"A"Oil BETTER
.1 hereby`afiii-m'u'nde"r penalty'of perjury one of the following three
declarations:; _ HAGARDOUS'imXTERIALS DISC
-, LOSURE
I have and will maintain a'Ccrtificate ot`Consent,to self-insure for-Woiker's1'have read the hazardousxmatenals`requii emcuts under Chapter6 95�of""the
Compensation,as -3700 ofthe,Labor Code,forthe Cahfbrnia,l le:ilth,&Safety:Code _Sections 25 O5,25533,and 2553x.-,I willernaintaim
performance°of the work-lorwhicli this:penntt is.issued. aOmpliance with the,C'upertino Municipal Code,Chapter 9 12>and the Health
I have and will maintain Worker-'s,Coinpe nsation,lhsurancc;,as piovided for by Safety.Code;Section 25532(a)yshould:I store or handle hazardous material.
'Section 3700 ofthe Labor Code;,for lhe'perfonnanceof the work lor':which this Additionally U
should 1 usequipmenf.or devicesvr
hieh errut hazardous air
contaminants as`�delined by'the Bay'
Air Q'uahty" la'nage hent District'[will'.
permit:is issued. maintain compliance with the Cupertino Municipal Cude,-Chapier 9112 and.the
1 certify that in the performance of,the:work for which ihis`permrt is'issued,l shall health&'SafetyiCode,Sectigns.25505,25533;;and 2553.4:
not employ any person in'anymannerso�s to:bccoriie:'subjectto the'NJotkers
Compensation'laws ofCalifornia If after making this certificate of;cz%mphon I' Qw. r:or an a i:' "
ecome subjecLto the Worker's Compcnsalion provisions.of the Labor Code.I must
Da
forthwith comply withsuch provisi'ons.or this permit shall,be deemed_ revoked.
G� CONS"I'RUCTION:LENDIN AGENCY
APPLICANT CERTIFICATION','— � I hereby.�a-ftirni that tlicre is=.a,eonstruction lending agency for the performance,ol'work's .
I certify that I have read tliis applicati6fina`ndstate.tliat'tlie above information is for which this permit is issued(Sec.3097,Civ C.)
correct. I agree to comply with all city-.and county orduiaiiccs drid state laws relating Lender's Name _
to building construction',and,hereby,autlforize,representatives of this,city,iu enter
upon;the,above;mentioned property.for,.inspection purposes.(We)'°agreelto save Lender's Address
indemnify and.keep harmless'the City ofCupertino against liabilities,judgments.
costs,and,expenses-:which mayraccnie against said_City'in`consequpencc of,the.
ranti'n of this emit,Addiuonall thea !icanfunderstands;alidwill_comply �Al2CII1IlC"1'S_DECLA'RA"['ION
with all.non-06iiitsoiirce regulations`per t1ie,Cupertino Municipal-Codc,Section I understand my.plans bC uL&d as=public records.
Licensed.P'rofessional
Signature Datc'
CITY OF CUPERTINO'BtIILDING"PERMIT
B_UILDING,ADDRESS- 10900N'TANTAIJ-AVE" CONTRACTOR:(DEVCON:CONSTRUCTION PERMI1,NO:'i1090149
INC
'OWNER'StNAME:'CUP,ERTINOCROSSING„LLC 690:GIBRALTAR;DR, DATE ISSUED:01/0,512012
O,WNER'S-PHONE:.4088629799 MILPITAS,CA:95035 PHONE NO:,(409)942-8260
LICENSED CONTRACTO�RJtS DEC/LARATION BUIL_DI_N_ 6P_E_RM_ IT INFO: BLDG ELECT { PLUMB
License Class `� Lic.=# ,�'`7( �U.
.'MECH RESIDENTIALCOMMERCIAL
Contractor _VC6VU Date ! .
I<herehy;affirm that;l am licensed under the,provisions;of Chapter,9 JOB.DESCRIPTION:APPLE,-FIRST FLOOR-COMM T.I..(51;092SQFT)OFFICE'
,(commencingwiih,Sec-tion`7000)_o-f Divisiom3;of the.Business�&�Professions SPACE;,INCLU-_ ”' B;.STORAGE BREAK AREAS&
Code and that my licenseis`in full force and effect. CONFERENCE SPACES
Thereby.affirm under penalty of perjury'�one.ofth'e followiiig1'two declarations:
I Have,and'will;mainiain;`a�.certificate ofconsenisto,self-insure'for^Worker''s
Compensation,as;provided,for"by'Section 3700-6f the Labor-Code,for the
performance of the'work,for whicliAhislpermit'is,i'ssued.
Fhavesand will maintain,Worker's Cumensation,lnsurance,as provided,for 6y
Section`3700 of the LaborCode;for the performance of the work for whichthis Sq.Ft Floor Area: Valuation:$2500000
permit is_.issued:
APPLICANT CERTIFICATION APN`Number:3_I_'609.029:00 Occupancy Type:
t._certify-t-hat_I have read-th"isapplication and state-that the above uiforft afion is
correct:
1 agree to:comply withall,city and county,ordinances'and,statelaws relating --
to liuilding construotion,and hereby authorize represantati'ves of this?city to enter
upon tfie,above'mentioned,property for inspection purposes.,,(Wej agree to save pERMI_T.EXPIRES IF WORK ISNOT'STARTED
indemm 'and keep_Harmless the City-of;Cupertino,agamst;liabihties;judgments,
fy
costs,:and'�expenses°wfiich may accrue against said City rn;eonsequence of the WITIIIN1$0 DAYS OF PERMIT.ISSUANCE OR
granting of this permit. Additionally.•the a ppliediittunderstands and:will complyjHO DAYS°FROM LAST CALLED INSPECTION
with non=point source regulations,perth ,Cup"ertmo Municipal Code,Section
9;18:
3
Issued hy.:. Date:-. Z l�t=
SignafuDate �
❑ OWNER-BUILDER ON.
RE`ROOFSi
1 hereb.`af grm'that Lam,exem t from the Contract - All roofs shall be trispectei prg rto any rroofing,mgaterial being installed.Ifa roof is
y p or s;License Law for one of
the followm 'two reasons: installed without frs666taimu an inspection,I a ree'to remove all new materials for°
1,as owner,of the property,or my employeeswith wages as theu;sole,compensation, inspection:
wi.11 o the,work,and the stricture is+not intended or,offered for„sal'e:(Sec..-7044,
Business&'Professions-Code) Signaturesof.Applicant] Date:
!,+as•ownerof the property,am exclusively contracting with licensed contractorsto
construct'the project(Sec.7044;,Business;&,Professions Code). ALC:ROOF COVERINGS T.O BE CLASS"A"OR BETTER
I hereby affirm under,penalty of perjury on_e,of the following three:
declarations
I'have and will r'dintain,a.Certificate of Consent to self-insure for.Worker's HAZARDOUS.MATERIALS:DISCLOSURE
Compensation;as,provided'forby'Section"3700 oftfie Labor Code,,for.the l have read the hazardous materials requirements underlChapter'6:95:of the
performance ofthCwork for'whIi p Camf I ence Iwtthh,&iCk cty ode,Sect ions'25505,25533;and,2553,4 I will,mamtain
ich this ermrt is issued: ty-
J have and will;niamtam;W,orker•-s Compensation Insurance,;as provided:for,by . P P no Municipal Code Chapter 9 12 and the Health&c
Section 37.00;ofthe,Labor Code,for the.performance•of the woik4or.whichthis Safety Code Section 25532(a)rshould'I store o_r,handle liazardous�matenal:
Additionally should 1 use'equipment,or devices whieh emit hazardous air
permd is issued.- eontaminaots.as defined lythe Bay Area Air Quality,Management District)will,
1 certify ihat,in.the'performance of the work.for whichdhis permit is,issded,Ishall maintain compliance with itivCupertiuo I1lunic�pal Code,Chapter_9:12,and'the
,not er loy an -...._ y bj ty
p y y-,person m.an "manneraowas to become'sub'ect to,the;'Worker'_s Health&YSafe ,CodW-Sectuis:25505,25533;and'35534.
California If,after making this certificate ofexemption;I
become subject tothe Worker's Compensation provisions of the LaborCode I',must ize
O or autH' Dater.
forthwith,comply with,such provisions;orthis permitshall be deemed,revoked.
APPLICANT.CERTIFICATION QONSTRU;ION_LENDING AGENCY
certify that.'I'liave•read this application and state that the above information;is I hereby affirffiAaf,there is a construction Iending agency for the performance of Hork's
correctA agree toicomply wiih(all'City and county ordinances and state Iaws,relating for which this,permit,is issued(Sec.3097,'Civ C)
to building construction,and here-bv,auihorize representatives of thi"s;city,to•ent&� Lender's Name,
upon,the�above,mentioned property'tor'inspection purposes.(We)agree to save;
indemnify,and keep harmless the City'of Cupertino:against liabilities,judgments_; Lende_r,s Addiess:
costs and'ezpenses;whichinay accrue agai'rfsst said-City,in consequence df the
gt
, g p d-'` nally;,,the.applicam understands and will,c reply
wi hallin nth'point ourceregulatiensper the Cupertino,Municipal Code,Section ARCHITECT'S DECLARATION
9.18. I understand myplansshall lie i7`sed as public+records.
Signature- Date Lieeosed Professional
STl� T� �LT I+J TIN
FEE
I!A I`..:K._.,- 011 IV(� F.DISI
iDI2E55 10900 ►.tantau ave. DATE' 0112312012E REVIEVEI) Y':: 'bob s'.
VA
APN: [iI'#: > I�J. TIO[v:
0
v
PERNII'T 'PE. Bu�Iding Permit J.-PLA CHECK TY.ft Alteration /Repair
_ ... _. _
PR"t 'lAR-8" - pENTAM TION
USE:, SFD or'®upleX' IGENRES,
PERMIT TYPE:
NVORK_ dbfe[-red s[ie in'q�s ste'rfl,
SCOPE
t
f
a - '
#- � 3 � � h i.'5�:+ � ��y �SI E 4
a 1� h
LJ
]VOTE.' This csdin e does,not'inelude fees`dhe'to other Departhwnts(i.e:manning;Ablic Work-s.,Fire, Sanitary Sewer Disf iet,Sdiool
District,etc.). These:ees areibased'on tire. relirriiian in orniation.dvaiia67e=and,a-. nly_4kn-estih'We._Co►etact the,Depy, or,addnTin o;
EEE ITEMS (Pee.a'esc:'liiio!r11_b 053 Eff. '.3"1i, FEE QTYMFX: MI5C ITEMS
Plan-C Beck Fee: Hourly Only? (Q Yes No $0:00 hours P1ar',Check;Hourly
Supp[:PC Fec ' ,d R'eg Q EST 0,0: his T ,QO $520.00 JSfLN:C'K
PME Plein Check: $0.00 "
Permit Fee: Hourly Only? Q I,es Q.N® $0:00.
SUpp['. Insp. RezQ Reg. Q OT Q,Q his $0 00
PME,Unit'"Fee: $0:00
PNIE Permit"Fee: $0':00
Work W.it[toutPertnit? Yes ® ;Nci
® ®. $0`.00.
bv'arwe�i Pla 1`L=ne° 1 e C
$0,0'0' 4,
hours Inspections
t $520.00; 1 STINSP Inspection,Hourly
-St $0.0Slect,i� n � Adbninisi:radve Item
31_ `°¢ds t tst�;, �.tss:�rrt I=" e:, $0.00
j v S l T47T AL'S $Q TOTA FEE
�$1,040001��; $1.040:00
Revised: 111':9/20'12
- CITY OF C;UPERTIN
FEE ESTI"1VIATOR-BUILD_ING DIVLSION
ADORESS. '10900 n.tantau ave.,1st floor DATE: 09/20/20.11 REYIEWED,BYi 'bob s.
APN BP#: ^VALUATION:; $2,500;000
*PE RIVIITTY PE: Building,Permit PLAN CHECK TYPE: Tenant Improvement'
PRt'MARY PENTAMATION
USE: Corii`mercial.Building PER1VIT''TYP.•E:' 1 B 1.I
WORK it comm office s p ace_ includes lab stora a break areas conference's o aces.
SCOPE,
TYPE..OF FLR,AREA,
OCCUPANCY TYPE:. CONSTR s.f: PCTEES PCFEE ID BP FEES BPFEE ID
B (Tenant Improvements) II. I-,I-B;IU,U-B 51„092 $5,29085' 1•BTIPLrNCK $18,790.4.7 IRTHNSP
TOTALS: 51,;092 $5;290 85 �� $18,790.47
ars. F
MECH;HOL�ftLY' 3 � Yes 3 No; PLUMB,HOURLY ELEC;HOLfRLY ®3Yes
�
NOTE-:,This,estimate�does not�include fees,duelo other Depts(i.e:Public Works,SanitaryxSewer."District;School District,etc.):
These ees?are Based on hie, reliaiiridr in ormation'available,and,are onl,an estimate. Contact.the=De t- or addn'l;in o:
FE'E"ITEMS,(I ee_°Resohrtion 11-4)53,L( 'li't'11 FEE QTY/FE MISC ITEMS
P1anCheck Fee: $5,290_.85 Select a Misc Bldg/Structure
_
' Suppl.PC'Fee:;, Reg. ,Q O,T. 0.0 'hrs $0:00 or Element,.of a,Building
PME Plan.Check: $0:00
Permit'Fee: $1-8,190:47
Suppl:,In"sp. Feet Reg. .®_OT 0:0 hrs '$0.00
PME Unit,,F'ee: '$0:00
PMEPerm it°Fee: x$0.00
Work Without Permit? 0 Yes' &No $0.00 0,
Advanced Plannib� $0'.00 Selecuallon=Residential „
Building:dr•S tit c Lure
;St"rofie.Motion Fee: 1BSEISr1%IICQ $526.00Selectan Administrative-Item.
/.
Bldg'Std's"Cbr-imission_1!ee /'BCBSC $100.00
SLiBTOTALS 24 706:32' $0,.00 '" " TOTAL FEE: $24 7Q6.32:
a.
Revised: 09/02/201"1 ,”