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tITY OF ClfJPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEI,TINO
APN# Date: /
Building Address:
/a SS /da1�
Owner's Name: Phone#:
C� Ge ZSS--323/
Contractor: V License#:
Contact: Phone#:
Applicant/Co tractor: rn�
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Bung Permit Info: /"/
-9-1dg—D Elect Plumb Mech
o escription:
Residential: / Commercial:
Sq.Ft.Floor Area: $/Sq.Ft.:
Archite�ngWeer: Valuation: a�
NTD
Type of Construction: Occupancy Group:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permit sq.foot BUILDING
BBOILERI Boiler<=100,000 Btu MECHANICAL
BBOILER2 Boiler> l OOK to 500K Btu MECHANICAL
BBOILER3 Boiler>500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS Boiler>1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con.Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm.Housing Mit.Fee BUILDING
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