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11010111-EXPIREDCITY OF CUPERTINO BUILDING PERMIT CONTRACTOR: --T B� PERMIT NO: 1 10101 11 BUILDING ADDRESS: 10655 MARY AVE ,tea DATE ISSUED: 05/12/2011 OWNER'S NAME: CUPERTINO LOC-N-STOR LLC Lt�r �• PHONE NO: OWNER'S PHONE: 4082527867 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Lic. # �S I �1" REPLACE 3 EXISTING ANTENNAS, ADD TOWER License Class EQUIPMENT, Contractor } e1'S�L)►k�F Date AND EQUIPMENT RACK. I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: 1 have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Valuation: $15000 performance of the work for which this permit is issued. Sq. Ft Floor Area: I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32606050.00 Occupancy Type: permit is issued. {{ rte,/ APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST / ED INSPECTIO indemnify and keep harmless the City of Cupertino against liabilities, judgments, j I r costs, and expenses which may accrue against said City in consequence of the Issued by: Date: 1 granting of this permit. Additionally, the applicant understands and will comply with all non -points ce regulations per the Cu Ino Municipal Code, Section 9.18. r RE -ROOFS: Signatur Date % I All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant:_ Date: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) HAZARDOUS MATERIALS DISCLOSURE 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. will maintain compliance with the Cup tiro Municipal Code, Chapter 9.12 and the Health &Safety Code, Sectio O5 3, a 135534 I have and will maintain Worker's Compensation Insurance, as provided for by i Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: e: Z �� permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, atter making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, l must I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address - I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional_ 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10655 MARY AVE _.__ I PERMIT NO: 11010111 OWNER'S NAIVE: CUPERTINO LOC-N-STOR LLC L"Ll3ce-4 Af—k.15W I DATE ISSUED: 05/122011 I OWNER'S PHONE: 4082527867 I,L_3 T" CO IPHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class[i r — _( /_T_ Lic. q U IPS �l Contractor 6N h4k. Ofpro, i C6:: -m Date �. I hereby affirm that 1 am licensed under the provisions of C apter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and eReeL 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit- Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. _ Signature*_ /I — ^Date S 7 ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the snucmre is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penally of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgmems, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: REPLACE 3 EXISTING ANTENNAS, ADD TOWER EQUIPMENT, AND EQUIPMENT RACE. Sq. FI Floor Area: I Valuation: $15000 APN Number: 32606050.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FFRO�M LAST CALLED INSPECTION. Issued by: t../" Date: Rh; ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Dale: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code. Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ow,,rr��eer or authorized agent: hfV��,n�an jC Ir Dale: CONSTRUCHON LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097. Civ C.) Lender's Name ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION / 1)590� APPLIANCE / EQUIP TYPE ADDRESS: 10137 Myer Place DATE: 05/04/2012 REVIEWED BY: Sean UNITS APN: BP#: -VALUATION: $1,000 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex - USE: $44 PENTAMATION 1REAP2 PERMIT TYPE: WORK Electrical panel Chan eout 125 am SCOPE. APPLIANCE / EQUIP TYPE FEE ID Plumb. Plan CheeA QTY UNITS BP FEES Elec. Permit Fee: IEPERMIT Services 1ERT<200 Other Elec. Insp. 0.0 hrs $44.00 125 Amps $44 Permit f ger: Supp/.hicp Feu PME Unit Fee: $44.00 PME Permit Fee: $44.00 Coli<nvrcnmi Tax: Administrative Fee: 1ADMIN $41.00 Work Without Permit? O Yes 0 No $0.00 TOTALS: Travel Documentation Fee: 1TRAVDOC $44.00 Strong Motion Fee: IBSEISMICR NOTE: This estimate does not includejees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn7 info. FEE ITEMS (Fee Resohdion 11-053 Eff 7/1/11) Alech. Plan (.h,rck Plumb. Plan CheeA Elec. Plan Check 1 0.0 1 hrs $0.00 ;tdreb. Pv"))il Fes Phonl, Permit Fee: Elec. Permit Fee: IEPERMIT Ocher dle�h. Imp, 011ie, Plumb fall"Li I Other Elec. Insp. 0.0 hrs $44.00 liech. imp. Fec: Phanh. hisp. Fee: Elcr. lase. Fee: NOTE: This estimate does not includejees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn7 info. FEE ITEMS (Fee Resohdion 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Plan Chock Fee. .Cupp/. PC f eu PME Plan Check: $0.00 Permit f ger: Supp/.hicp Feu PME Unit Fee: $44.00 PME Permit Fee: $44.00 Coli<nvrcnmi Tax: Administrative Fee: 1ADMIN $41.00 Work Without Permit? O Yes 0 No $0.00 dr/rnnaed Planning Fees: Travel Documentation Fee: 1TRAVDOC $44.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item BI&I, Sids Commission Fee: IBCBSC $1.00 sF;.=• - SUBTOTALS: 1 $174.501 $0.001 TOTAL FEE: $174.50 Revised: 04/01/2012 6 ITEMS OF 6 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN 31623054.00 DATE ISSUED.......: 05/04/2012 RECEIPT #.........: ES000016718 REFERENCE ID # ...: 12050058 SITE ADDRESS .....: 10137 MYER PL SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: counter COPY # : 1 OWNER ............: JOYCE ROBERT J AND KATHLEEN ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2336 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 174.50 --------------- 174.50 VOICE ID DESCRIPTION -------- ---------------------------- 103 UFER 505 FINAL ELECTRICAL REFERENCE NUMBER -------------------- amex VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL RECEIVED FROM ....: B JOHNSTON CONTRACTOR .......: BRIAN JOHNSTON LIC # 23411 COMPANY ..........: JOHNSTON ELECTRICAL CONTRACTOR ADDRESS ..........: 1302 LINCOLN AVE STE 204 CITY/STATE/ZIP ...: SAN JOSE, CA 95125 TELEPHONE ........: (408)266-0236 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT ---------- THIS REC NEW BAL ---------- ---------- -ADMIN ----------------------- HOURS 1.00 ---------- 41.00 ---------- 0.00 41.00 0.00 1BCBSC VALUATION 1,000.00 1.00 0.00 1.00 0.00 1BSEISMICR VALUATION 1,000.00 0.50 0.00 0.50 0.00 1EPERMITFE FLAT RATE 1.00 44.00 0.00 44.00 0.00 1ERT<200 UNITS 1.00 44.00. 0.00 44.00 0.00 1TRAVDOC FLAT RATE 1.00 44.00 0.00 ---------- 44.00 0.00 ---------- TOTAL PERMIT ---------- 174.50 ---------- 0.00 174.50 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 174.50 --------------- 174.50 VOICE ID DESCRIPTION -------- ---------------------------- 103 UFER 505 FINAL ELECTRICAL REFERENCE NUMBER -------------------- amex VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 7T7-3228 • FAX (408) 777-3333' buildina(g)cuoertino aro CUPERTIN0 1-1�.c�1.Mrnlm PLUMBING I- ka; ANUCAL. IRTI..W tl Jl (0 PROIECf ADDRESS^ 1�/� 1 Ve` �3 OWNER NAME a/ PFDNE ybv� & MALL STREET ADDRESS CTTY. STATE ZIP FAX - PHONE E-MAIL CONTACT NAME SrREETADDRESS CTTY.STATE ZEP FA% ❑ OWNER ❑ owNmalmDFR ❑ OwNEYAma . CONRACTOR, ❑ CON[RACIOR AODYT ❑ ARCIDEcr ❑ nawauSx ❑ UEVEIDPER ❑ TENANT CONTRACTOR NAME M SCNUMBEI 45 cUo� LICENSETYPEGLO BUS-UCW2• L � COMPANY NAME O • w � � l..;�6 &�' FAX Z 6 6 STREET ADDRESS` yl. aT CTTV.STATEZW CA S SNE -V D2 L N -L 4>4 ARCNEcr/ENGBEEYR NAME IICIEN.SE NUMBER T BUS. LIC W FAX COMPANY NAME &MALL SIRFET ADDRESS Cr Y. SrATE ZIP PHONE USE OF .Dunim ❑ MIR.TLPAMD.Y IROBSCTINWLLwAND ❑ YES PRorecrw ❑ YES BTNE BLDG AN ❑ YEB FICTBBI HOW NO BUBAWG. ❑COWERCTAL UTwANREMFRPACEARPA NO FID®]DtR NO DFSCRIDON OF WORK ,L // TOTAL VALUAMON: D RECEMED BY: E BymyalahaebelOW.lOGUS'toeachofthefoDowmg I=me owoaamalmiada®cItmadOIIthe RAY Sbehdf IhavefWdOILS application and the hdonnaboo I have provided a iaied. I 6wwpTmo of Wok RRd vorify R is I to comply with all applicable local admanoes and Scale IBM Iela>mg to bdWn coraft RYIod _ T TvoaFCup"no to cua the popedy for o>spcd— WNP—s SillmhBe ofAppliad/Age / SUPPLEMENTAL 11001 MATIONMUIRED OtiflmumONLY OV TRRCOUNTER Gr}d TY ❑ EXPRESS m ❑ STANDARD Z¢ ❑ LARGE 0 ❑ AWOR MEPMiscApp_2011.doc revised 0621111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10655 MARY AVE CONTRACTOR: ,nom PERMIT NO: 11010111 OWNER'S NAME: CUPERTINO LOC-N-STOR LLC _ DATE ISSUED: 05/12!2011 OWNER'S PHONE: 4082527867 PHONE NO: 0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RE ENTIAL COMMERCIAL License Class� _ , /_'/0 Lic. # 16 y "` REPLACE 3 EXI ING ANTENNAS, ADD TOWER �' �" EQUIPMENT, Contractor l el -<AU 41Z425 Date AND EQUIP NT RACK. I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Floor Ares:Eff I&P Valuation: $15000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by !qylt Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32606050.00 Occupancy Type: permit is issued. / APPLICANT CERTIFICATION I certify that I have read this application and state that the above information iso/ PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state lawsp6lating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city tq'enter upon the above mentioned property for inspection purposes. (We) agreed save 180 DAYS FROM LAST EDINSPECTIO . indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequenEe of the Date: granting of this permit. Additionally, the applicant understands andhvill comply Issued by: with all non -point si9KIce regulations per the Cu ino Municipode, Section 9.18. Signatu Date ' 11Z r RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio 05 , Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: I 71t 1 permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of Califomia. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date �,�,,�,�,�� CITY OF CUPERTINO MAW FF.F. F.cT1MATOR — BUILDING DIVISION ialADDRESS: 10655 mary ave. Phnnb. Plan c DATE: 01/20/2011 REVIEWED BY: bob s. Phmrh. Pernril Fee: APN: BP#: 'VALUATION: $15,000 *PERMIT TYPE: Building Permit Suppl. PC Fee: (F) Reg. 0 OT PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building $0.00 T07' :11. ; ,; ; ,; ,; IRtEAI PENTAMATION TELECOMFAC PERMIT TYPE: WORK lace 3 existing antennas add tower equipment, and equipment rack. SCOPE �re $0.00 ]VnTR. 'T6 6 —1— fho—Umi»nmf in!nrmatinn avaitahte and are ank an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E . 7/1/10) htech. Plan Cheek Phnnb. Plan c 1:'-wc. Pluci Ch, ;V -h. Permit Fee Phmrh. Pernril Fee: Elec. Permit Fee: fl�her' 4/crh_ lrir.h 0 1 U[he:rElec. hisp. Suppl. PC Fee: (F) Reg. 0 OT Plumb. hup. Fce: EYec. Gas/. 11rc ]VnTR. 'T6 6 —1— fho—Umi»nmf in!nrmatinn avaitahte and are ank an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E . 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME ;flan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee{' Reg. 0 OT 0.0 hrs $0.00 PMIS Unit Fee: $0.00 PME Permit Fee: $0.00 CorrVruction Ttn Aco� stical Fee: 0 Yes 0 No $0.00 0 0 Wo, k Without Permit? 0 Yes (F) No $0.00 Pla, ming Fee: $0.00 # $3,039.00 Antenna - Telecom Facility 1ANTT TCELACellular, Attached to Bldg 0 0 I'ru 'e/ 0ocumentution Fees: Str )ng Motion Fee: IBSEISMICO $3.15 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $4.15 $3,039.00 TOTAL FEE: $3,043.15 Revised: 9/22/2010