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07050142CITY OF CUPEk INO CITY OF CUPERTINO PERMIT APPLICATION FORM 'N # tt `I r Date: t , e ld_ailing Address (if different from building address): Building Ar1rirP`cs: Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > IOOK to 500K Btu MECHANICAL Owner's Name: Boile- > 500K to 1M Btu Phone #: BBOILER4 Boiler > IM to 1.75 M Btu Lice�lse #: BBOILER5 Bciler> 1.75M Btu MECHANICAL -- - -- -- -- -- _-- -- -= ` Phone: Cupertino Business License#: J,_ `�}^ Fax: s Building Permit Info: ` BUILDING BCONSTAXH hotel and Motel BUILDING Bldg ❑ Elect ❑ Pi zmb ❑ Mech ❑ Job Description: Residential r b Commercial ❑ Sq.Ft. Floor Area: BELEC1001 Sq.Ft.: Cost of Proje^*'" BELEC200 Occupancy Group: ELECTRICAL BENERGY Energy BUILDING BENERGYADD Please check this box if the project is a Type of Construction: second -story addition: El Investigation fee BUILDING rl R/fnirr n .rolect size: 6ianaaru u Lal r,%, Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > IOOK to 500K Btu MECHANICAL BBOILER3 Boile- > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > IM to 1.75 M Btu MECHANICAL BBOILER5 Bciler> 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 Con stax - Resi/Mobile BUILDING BELEC1000 Elea 600V <= 1000A ELECTRICAL BELEC1001 El.c 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 A3