04100150 (3) CI'T'Y OF CUPE[Y"F
Bu1LDINc DIVIs1oN PSR CONTRACTOR INFORM
BUILDING ADDRESS: PACIFIC NORTHSTAR MECHANIC ILERMITN'04100150
10465 MARY AVE 4 A
WNCR'S NAME: PERMIT ISSUE DATE
CASA DE ANZA HOA 10381 N PORTAL AVE 10 21 2004
PHONE: SANITARY NO. CONTROL N0.
(408) 568-0287
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELF.LT PLUMB MF.CH
0
at" LICENSED CONTRACTOR'S DECLARATION
p1 hereby affirm Thal 1 am flamed under provisions or Chapter 9(commencing lob Description
Zw withScnion7N JafDivisionJhfheBusinvsantlPmrcssinnsCoJ .andmyliccnuis
=�i inmBfomeandrff`� x REVISION- -IN HOUSE USE ONLY
Lire.
11,2
Z;� DP �n. l-fir Cynerectar NO NEW PERMIT ISSUD/ ORIG. 403090187/
ARCHITEored.'C li ATION #03090188/#03090189/#03090190/#03090191/
I understand my plans shall W used as public acnNs
OyU
; ff Licensed Pmfcssienal
ioOWNER-BUILDER DECLARATION
0 0 1 hereby affirm that 1 on cxcmpt from the Cantons Co e:Any c Law for the
p o following moron.(Section 7031.5 Business and professions Code:Any city or manly
I
m which requires a permit a ennsuom, he,intpmve,demolish,or repair any structum
poor sit its issuance,also regmrvthe applicant forsuch permluu Glc aligned eetemcm
I¢� that he is licensed purwanl to the pravisionsof the Contractor s Lt. law(Chaplcr9 Sq. Ft. Floor Area Valuation -
ca- (commencing with Sethi on 7070)(if Division 3 of the B usiness and Professions Code)or
to that he is exempt Ihetefrom and the basis for Ne alleged exemption.Any violation of 0
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(SSjKIU
o I.is owner of the pmpeny,m my employees with wages as Hai sole compensation,
will do Be work,and Lee structure is not intended or offered for sale(Sec.7044.Business 32652075 . 00
and Professions Code:The Contractors License Law does not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own Can ployccs.provided that such improvamcoU are not intended or offered for sale.If. .\
however.the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not Wild or improve for purpose of O
sale L
a1 1,as owner of the property.am exclusively contracting with licensed contractors 10
construct the project(See.7044.Business and Professions Code:)The Crout ctor's Li. `a e .
ave Law does not apply to an owner of property who Wilds or improves Breach,and.
who contracts for such projects with a comraclor(s)licensed pursue at to the CanOaaor's
Liecme law.
❑1 am exempt under Sec. .B&P C for this reason
tuner Dare
WORKER'S COMPENSATION DECLARATION
I hereby affirm under Nbi of perjury one of the fallowing declarations:
❑I have and will maintain a certificate ofconseal to self-in.me for worker.Compan-
seion,as provided for by Section 37M of the labor Code,for the performance of the
work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance as required by Section
3700 of the labor Code,for the performance or the work for which this permit is issued.
My Worker's Compensation Insurance Cartier and Policy mummMr�a¢�:�y O ����
Carrier: 5 f'ia�C ...� Palicy N,: 16-6 (,t�v/
WRTIPICA OTE FFE EMPr10N FROM WORKERS'
JCOMPENSATION INSURANCE
Old.scction need not Mchmpletcd if it a permit is furore hundred dollars($100)
or Its') \ .
1 certify that in the pe formamc of the work for which this permit is issued.I shall nut
employ any person in any turner so a Or become subject to the Workere''Campensatihn
Laws of Celifofnia.Date
Applicant
NOTICE TO APPLICANT:If,after making this Cenificam of Exemption,you should
become subject to use Worker's Compensation previsions of the tabor Code,you must
.,;f: forlhwi in comply with such provisions m this permil shall be deemed evoked. _
Z CONSTRUCTION LENDING AGENCY
"r+ I hereby affirm Nat there is a construction lending agency for the perromance of
RiBid work for which this p.it is issued(Sec.3(197.Civ,C.)
W Q Under.Name
0.
J 2 Underi Address
U)Q 1 ccnee Nat 1 have read this application and sate that the above ws halation is
L4 Come".ldin 1 agree to comply with all city and county ntaiwncea and stab laws relating to
OU huildingeotioned ioh and forebyection re2psesentatiKs or this City to enter upon Ne
shove-mentioned props costs
for inspection purposes.
F 0. (We)agree to save,indemnify and keep harmless the City of Cupcnino against
ret inbORCL CRCg or
nhecola ayy expeves which may many war accme againn said sly
C)z mchnuyucncc of the gmntirf'uf this pertnil.
'-" APPLICAt{T UND RST DS AN it COMPLY WITH ALL NON-POINT Issued by: Date
SOURCEY:GU A IONS
1 L Re-roofs
Ignatur dfAp c HAZARDOUS MATERIALS DISCLOSURE Oat Type of Roof
/1/ ill the applicant or future building occupant store orhandlchaaarduusmocrial
as Ce(limd by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
0,6Section 25532(.)1
f ❑Yes All roofs shall be inspected prior to any roofing material being installed.
Will mea applicant or future building Occupant use equipment If a roof is installed without first obtaining an inspection,I agree to remove
pp s pan y pr Qu fit Mann ement g P
emit haasrdnus air contaminants u JcpncJ by the Bay Arca Air Quality Management
District? all new materials for inspection.
'
❑Ye:
I hove read the houfdnus materials requirements under Chapter 6.95 of the Califor a
nix Health&Safety CWd rSceJ.. 55f15,25533and25534.1unarsundmatiflM Wilding
does not'uRentlY haat a mane a it is my respumibility w notify Low occupant of the
reyuim mtwhiehmtr WmepnorvtissaanaoraceNBcacaraapanrg Signature of Applicant Date
Own/oaRYcri,Cdr,1h1 D,re All roof coverings to be Class "B" or better
o �, ,
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Building iom S. MA
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Date M—Iq-04- By UK<-
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• • 43551 Mission Blvd.,Suite I 10 6CU-W- TO
Fremont,California 94539 Mir-.TAL A'AKI.
(510)438-9632
Fox(510)438.0689
Drawings to:dravvings@imimdeng.com
(4'� 7G{ •
�,ztr!,�P *CITY OF CUPERTINO V
• CUP TYOF O PERMIT APPLICATION FORM
APN # Z 6, _ 2- o ��� Date:/o — i
Bu ss- �
, y� Mailing Address (if different from building address):
Owner' Name:u"I Phone #:
z (1-10) o
Co ractor: License #:
,,c o z-a
Contact: Phone: Cupertm Business License#:
AA r PS i C Fax: Hob-35 3 -3q'7
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: ��
Residential ❑ � L{omInerc�a
Sq.Ft. Floor , $/ t.: VJ
�'` � � `l
Cost of Projec : Occ anc Group:
P Y P:
Type of Construction: Please check this box-if the project is a
second-sto addition: ❑
Project Size: Standard ❑ are Major ❑
Quanti Fee ID Fee Descri tion MMECHANICAL
Group
BAPPLOTHER Other Appliances
BBOILERI Boiler<= 100,000 Btu
BBOILER2 Boiler> 100K to 500K Btu
BBOILER3 Boiler> SOOK to 1M Btu
BBOILER4 Boiler> 1M to 1.75 M Btu
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/ uasi BUILDING
BCONSTAXBQ Con. Tax for B Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
", BENERGYADD
C1000 Elec 600V<= 1000A ELECTRICAL
C1001 Elec 600V> 1000A ELECTRICAL
C200 Elec Svcs 600V<=200A ELECTRICAL
RGY Energy BUILDING
Ener Add Multi BUILDING
STIGA Investi ation fee BUILDING
o � C�7 ' 15
�r,�- 035 =/� � �b'3 ��• s� •
(6: WITY OF CUPERTIN(S
CITY OF PERMIT APPLICATION FORM
CUPERTINO
IMF Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOM 4P New Comm Plumb PLUMBING
BOVERTHAE Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREN AIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BRENDST PP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heatin MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2 of 3
WITY OF CUPERTINOO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Sips, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE _ Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE PlumbingPermit Issue PLUMBING
PPLBG Plumbing Fees foot PLUMBING
ZADDCHG Address Chane BUILDING
•
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CITY OF CUPERTINO
BUILDING DIVISION PERMITCONTRACORIN .•ORMATION ,
BUILDING ADDRESS: JOHNSTON ELECTRICAL CONTRA TN04110102
NER'S NAME: PERMIT ISSUE DATE
OW
GILBERT WONG 1840 ALMADEN RD li-I 1-1
IFONE: SANITARY NO. CONTROL NO.
(408) 266-0236
ARCHRECIYENGINESt' BUILDING PERMIT INFO
BLDG EIPCT PLUMB - MECH
°00 LICENSED CONTRACfO 'S ECIARATION O O -- O
wF 1 by affirm Nal I em liamcd urL vision:of chapter Y(commencing Job Description
_Zr� with Secti )of Division 3 of the BusLrssaM Prufeaiots Code.orad my license is - --- — —"-
^�' imm�rome error 6f' ELECT. SERVICE UPGRADE
S�? Liccna C tie L '� Lie,N l,Ls2
e w Dam Co -
�! 7 gRGHRECI'S DE ')_1911
dentanda ,n shall he �eAsrn m records
0'U
---�� �—_
3 0 Lic Pm2ssionel
S OWNER-BUILDER DECLARATION
I barony eRrm Nal 1 em exempt from dm Contractors Licenm Law for the
00 following mason.(Section 71)3 1.5,Business and Pmressimet Code:Any city or county
K m which require•permit w cot. her.impmn,demolish.or ropair my gmcu.
rZi prior N its issuemc,also requires Ncsppliant for such Partin.fileesigncd sltmmant
c Nal he is Bcenud Purwam tome Pmvisiam of dm Conlncwri ua<nm hw(ch.pmy9•- Sq.Ft. Floor Area - Valuation --------
ta~ (comm cncingwiNS fion]BBO)of Division3ofthc Busi mdNafessiam Cadc)w --
5.$ that be,u hems for therefrom and Ne hfor the alleged exemption.Any violation of ti
Section 7031.3 by arty applicant for a permit subjects the influent ro a cvil pen/a�tyof
not mom Nn fin hundreddalwm(M). ' i > el0 0 Occupancy Type
❑I,as owner of the property,or my employees with wages as their ante compensation, J Pr
willde Nework,end Nenructom4notin addorofrr forwe(Sec.]DII uairrss _
and Pmrnsions Code:The Contractors License Law don not apply to an a oh i'•' Required Inspections
progeny who builNorimprovn Bermn,andwlm daessmhwmkhimadf or WouIn
o employcn,pmvidedth l=himpronmo UmnutimmndedmoBemdforsalell' �—
however.Ne building err improvement is sold within one yeu of completion,Ne owmr- -
builder will ben Ne burden of proving that M did mot Mid or improve for Purpose of --
ale.). \� `\
❑1,as owner of a Sac.property.,B eadudnld convecting with lamad edonummeas i- v _
cone La the es not (Sec.]004,Business and nyProfessionsWilds
Cade:)Them Matter'.Li-
come Iry does notapplyben owner olpmpeny who builds or improv thereon,and
who facts for such projects with acanuator(s)Iiamed punmnttoNc Canuutars '
0
License Lew.
❑Tem exempt under Sec. ,B&PCfor this rayon
Owner Data
AhWORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of Ne following declarations:
1 hen and will maintain a CeruOam of Comem to self-imam for Worker'Compens-
ation,as provided for by Section 3700 of Ne"Wr Code.for Ne performance of tis
.,it for which this permit is issued.
❑1 hen and will maintain Workers Compensation Insurance.as required by section "-
3]00 of Ne Ube,Code.for Ne perfarmenee of the work for which this permit is issued.
My Worke Ca Penation"m ah"cert'"and Policy number art:
C br. icy
CERTIFICATEOF EM ONFROMWORKEPT
COMPENSATION 114SURANCEO O S d0 OI a/
(Rus section need not be cuspidal if the permit is for one hundred dollars ISIWo'
or lea.)
I cenify Net in Ne performance of dm work for which this permit is issued,1 shell not
employ any person in my mannan as b become subject to the Woryert Compemeuon
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making Ns Cenificam of Exemption,you should
become abject to Ne Workers Compensation provisions of the UM Code,you mug
.,O forthwith camPly with such",is.or Ns permit"I W named revoked.
z .r CONSTRUCTION LENDING AGENCY
res
(-+5 1 itchy affirm Nu them is a cmvuuction lending agency for Ne performance of
C Me work for which this permit is issued(Sec.3097,Civ.C.)
6Wi A Landers Name
Lenders Address
U Q I comfy Net I hove read Ws aimliation and sum Nn Me above information s /
^F correct.I agree to comply with 91 city and county ordinances and state laws slating 10
DU building construction.and hereby euthorire reprtsentativa of this city to enter upon the
ahovc-mentioned Pmpcny for inspection purposes.
F y (We)agree cave,indemnity and keep humless the City of Cupenino against
res Iiabilitim.judgmcnu,eosuendex a w.whichmeyinaywgaccmeagainstaid City
of
U z APPS ANTeUNDERSJANDS lo,of AND mL COMPLY WITH A NO OINT
S ERPOLLATIOWS Issued by: Date
// �7 l fl Re-roofs
S naso 9 A icmrycontrecmr IDale
HAZARDOUS MATERIALS9CLOSURE Type of Roof
Will t e applicant or rumm building occupant store or handle huardous materiel
as defined by Ne Cupenino Municipal Code.CTapmr 9.12,and the Health and Safety
Aftede,Secuon 25532(a)7 '
❑Yes ❑ All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit havardous air conuminants m Encd by Ne Bay Area Air Quality Management all new materials for inspection.
District,
❑Yes
I ban real the WiaNdsus materials rtfrinar nts under Chapter 6.95 of the Califon
nue Health&Safety Code,ScSuom2=5.25533 and 8534.1 undersand lhuif ding
does not curtemly none mount,Nat i�my rmpomibility m nouly IMS spam f nm
mmmcnu which abc me wiaaaa arae as ry' Signature of Applicant Date
d
Owners ed.,lot —�� Date - - All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEf�TINO
Building Department
JOB ADDRESS: PE
42f1 Airw� r2 �#
ll� ( oa
OWNER'S NAME: W G PHONE #(-YdC
GENERAL CONTRACTOR: FAX
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the followinginformation:
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
�1> Coior Signature Date
08/24/2004 11 :46 FAX 406 777 3333 CITY CUPERTINO 4t001/003
CITY OF CUPERTINO
CUPEkTINO PERMIT APPLICATION FORM
APN# 3 / 0 Z o/ Z— Date; g
Building Address: Mailing Address if differ from building address):
0
Owner's Name: Phone#;
letvyz- o c(e f -3l - $038
Contractor: License#:
S c I 95 b8
Contact: Phone: I(o%-?4(b-o7,36 Cupertino Business License#:
>% Fax; LiOV-2(4-1o33 2&q 11
Building Penn' Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Job Description: 5v4f./ltIS vWq(ef4pE
Residential Commercial El
Sq.Ft Floor S/Sq.Ft.:
Cost ofP jest*4 °�- Occupancy up:
Type o Construction: Please chec this b if the ject is a
second-sto a
SProject Size: Standard Lar e ❑ Major❑
oanti Fee ID Fee Descri tion Fee Group
BAPPLOTHER Other Ann1inne^e MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOU,ER3 Boiler>500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/OfVComm/ asi BUILDING
BCONSTAXBQ Con. Tax fora Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDIIVG
BELEC1000 Elec 600V, 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svca 60oV—200A ELECTRICAL
BENERGY Ener BUILDING
BENERGYADD Ener Add Multi BUILDING
BINVESTIGA Investi atioa fee BUILDING
�s� 7 3r
" SvlmCITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEIIaTINO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
PBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfin MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREM 3USWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMFURNOV Relo Fumace > l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BRENDMC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2 of 3
CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEIITINO
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Sips, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Insection BUILDING
BSW1M Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
/ EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
_ MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPL BG Plumbing Fee sq foot PLUMBING
ZADE Address Change BUILDING
3 of 3