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01100075-FP 02,0 CCET Y OF CCI ? ER'1 HNO lla � 7i APN# _ a _ Date: J Building Addres • J� , � � C- v��o�S i Owner's Name: Phone#: Contractor: License#: Contact: Phone#: Applicant/Contractor: Fax#: Buil 'n ermit Info: Bldg Elect Plumb Mech Job scription: �A Residential: G �`�'I� o �iaq C Sq.Ft. Floor Area: $/Sq. t.: ArchitecVBngineer: Valuation Type of Construction: Occupancy Group: Quantity Fee ID Fee Description ]Fee Group BAPPLOTHER Other A liances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 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/Off/ComnVQuasi . BUILDING BCONSTAXBQ Con.Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V<= 1000A ELECTRICAL ' . BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL B EN1ERGY Energy BUILIIDEN G BENERGYADD _ Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm.Housing Mit.Fee BUILDING 417 1 of 3 f-2 Z,2 ' �° r CNTY OF CU?ERTHN® r APN# 3 -� Date: ! 1 0 j Building`Addiess: [ ' kbs-� a fess 2s-11" : 3iq Owner's Name: 5 _j �i.4 P7uv� l�-D� �`'s' '�V-5 Contractor: License#: Contact: )� r` G �Je Phone#: Applicant/Contractor: g Permit Info: BldgElec Plumb Mech escription: 1, Residential: ' {�d��/ &,drmm l� Commercial: Sq.Ft. Floor Area: v $/Sq.Ft.: Architect/EngineerW,4-5-,/,4, -D /y#A Q L Valuation: Type of Construction: ' Occupancy Group: Quant! ]Fee IIID ]Fee DesciH tion Fee Gaon BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 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/Off/Comm/Quasi BUILDING BCONSTAXBQ Con.Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V<= 1000A ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL B]ENERG Y Energy BUILDING NG BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 35" 30