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12120035 CITY OF CUPERTINO BUILOI'NG PERMIT `BUILDING ADDRESS;,20735 STEVENS CREEK•BL'VD• CONTRACT.OR;'C+&;L,CONSTRUCTION. PERMIT NOr 12120035 OWNER'S-NAME, ALLAN LAU 934POCATELL'O,AUE DATE ISSUED:03/04/2013 OWN.ER'S PHONE. 4082053496 SUNNYv!ALE;,CA 94081'. PHONE NO:(408)781-2464 ❑ L'ICENSED,CONTRACTOR'S,DECLARATION. JORDESCRIPTION: RESIDENTIAL El COMMERCIALE] License,Class Lic.;# / PARIS BAGUETTE-SUI.T,E`A/B—COMM.T.13,190 SQ FT �. CONVERT EXISTING RESTAURANT TO BAKERY`. Contractor_ Date ij er Icomm nc ng w t aSect on-7000e of Div sion,3,'of the B,u of Chaptero •) � ,mess&',Professions Code and that mylicenseis in full force and effect. 'I lieretiyaffirm.ander penalty of;perjury one:of ihe`followiog-two de'cl'arations: I have and,will.maintaina certificate of consentto;self;insure'for'Wo-r_ker's, ,Compensation;as;provided,for.by Section 3700:of the Labor Code,forthe performance ofahewwork for which_this permit',is issued. Sq.Tt FloorArea: Valuation:$200000 `I have and.wilLmaintain Workers Comperisation•lnsurance„as provided forby 8ection,,3700 ofthe,Labo'rCode,.for the perfomia&e of the work;forwhich this APN-Number:.32-632054:00 Occupancy Type: germ it,is;issued� APPLICANT`CERTIEICA7;l ON, I certify that,I have read application and sate fhatthe above”informatiowis PERMIT`EXPIRES IF WORK,IS NOT'STARTED correct; l.agree to;complywith all city.and county ordinances and,state laws_relating WITHIN;.180 DAYS OF PERMIT ISSUANCE OR to building construction and hereby"authorize representatives of this crtyto enter 'upon die-above,mentioned property for mspection•purposes. _(W6),agree to-save 180 DAY ROM LAST CALLED W$ CON. ;indemnify and keep harmless'theCity of Cupertinohagainstli'abilities,judgments, costs,and,expenscitwhich may accrue,againsffsaid City in consequence,ofthe ;graming'of this permit Additionally;„the•applicant understands and will.comply Issued by: Dat with all,non-point _g SI per tti,Cupeitino�Mumcipol.'Code;Section 9;18. - RE-ROOFS: ,SignatureDate ; '3 All roofs shall be inspected,pnor to any roofing�material being installed..If a•roof is installed without firstaobtaining�an�inspection,I agree,to remove all new matenals"vfor inspection. ❑ OWNER;BUILDER"DECLARATION Signature of Applicant: Date: `thereby affirm that I amiexempffrom`the Contractor's Lreense:Law for one of the following two",reasons: ALL ROOF COVERINGS TO`BE CLASS"A"OR BETTER ,I,asownerof the prop"'erty,ornivemployees'with.wages.as,theii Sole compensatibn, _ — will&the-worlc;•an&the'structure is notintended'or,offered1orsale4Sec.7,044, Business,&Professions Code) 'I,as owner'of the property,am.exclusively contracting wiih'licen_sed,contractorsAo HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec:7044Business'&Professions Code)'.. I have readthe hazardods materials requirements under Chapter 6.95 of the California,Hcalth&Safety Code,Sections 25505„25533,'and 35534.",I will `I hereby.affirm under penalty of perjuryoncW the-following-three maintain compliance with the Cupertino Municipal Code_,Chapter',9.12 andthe: declarations: Health&:.Safety Code;Scciion•25532(a);should,l store or,handle hazardous 1 have and will,mainiain;a Certificate ofConsent toself=insure for Worker.', material. Add ti'onallyshould.[use equipment or deviceswhich emit hazardous "Compensation,i§,provided,for-,,by�Section 3700'of the Labor Code,for the air-contaminaots,as defined,by the=Bay Area AirQaality'Management Districtill performance ofthe•work for which;this.permitris,issue& Will:maintain;compl ince with the;Cupertlno,Municipal Code,Chapter 942'-and ;I,have and�wdl':rtiainta�d Worker,'s Corripensation�,lnsurance„as prov,ide8 for by t_he;Health&Safety cod e„Sect_ions>25505,25533;,and 25534., Section 3700 of the.Labor;Code,for;the,performance;of the;work for which°this Owner or authorized agenti• �� 'permitis=issued. I certify ttiatin the performance of the,work�for,which:thisrpermihis,Lissued,'hshall 'hot'employ,anyperson m;anymarmef.so'as to,become'subject to;the`Workei's, Copensation laws,ofCalifornia: If„after;making,thig+certificate-dfexemption;;1 CONSTRUCTION LENDING AGENCY m become;subjecttb the Workei's Compensation provisions'of th-e L-aborCode,I.musf I"hereby,affirm th_at•there is a-construction4ending agency for the;peiformanc_e of forthwith-comply with such p,ovisionsior this permitshall fie deemed revoked : work's for whichdlSis permit>is issued'(Sec.3097,CiVC) _. Lenders Name APPLICANT`CERTIFICATION, Lender's Address I certify thai'l haveread'tliis:applicdiiep and state that-the above informahon,iss correct;I agree to�comply with all city and county ordinances and,state laws•relati_ng to building construction,and hereby authorize retire of tfiisEci to e p ty rite,' upon,the:above mentioned property+for,inspection purposes (We)agree to gave: indemnify and-keep harmless the City of Cupertino:against•liabdi'ties,judgments;, ARCHITECT'S DECLARATION costs and!expenses•whrohrnay accrue against said.City.in consegiience;of the I,understand my,plans shall be use&as publics ecords.- granting of this permit.Additionally;the,applicant understands and will"comply, with,"all`,non-point'so"urce regulaiions,per:the Cupertino,Municipal Code;,Section Licensed Brofesgional 9:18. Signature Date CITY OF CUPERTIN.O HFEE ESTIMATOR-BUILDI_NG�DIVI_SI:ON k " � ADDRESS: 20735 S'CB DATE: 1,2/07/2012 RE-VIEWEDBY: MENDEZ APN: BP,#: -VALUATION: $200.;000 x:TERMITTYP..E: Building P&tnit PLAN CHECK TYPE: Tenant Improvement PRIMARY - PENTAMATION. USE: Commercial Building PERMIT TYPE: 1ATe WORK PARIS BAGUETTE COMM. TJ 3,190 SQ FT- CONVERT EXISTING.RESTAURANT TO BAKERY SCOPE -"- TYPE OF 'VCR AREA, O CCUPANCY'TYEE:; CONSTR. s:L PC FEES' PC FEE ID BP FEES ,BP FEE ID A(Tenant-Improvements) 11-B,III-B,IV;V=B 3,190 $2;4,00.66 1ATIPLNCK $1,636,19 ]ATHNSP TOTALS: 3,190 $2',4,00 66 $1,636.1931 Ow p 014 --d� �, .��* c aaxply �, � M1ECH,H®URI�Y I es Ng PLUMB,H®URL�YYesQ No` EEC,H®URLY,' Yes' Q No` ���� 3 r �� ti;ech: 1'I r. C,".ricck- Pllwnb, Platz C keck Elect. Platz Check' 1lac/i..l'�>fnfil Fee:.. � Plumb:Permit Fere, k"Iet'. P',vwiit Fee, ()t/ter•zh'ech:Insp.. Oiliri.7?(unzli rr,sp... Utlrer=f.lec?Irs . tdc:Gh:hasp:.F're: PIi.;Ci;li.•Tiisp.I'c�e_ ii'Iec. Insp.Pee: NOTE:This,,estimate does not include fees due?o,other Departments•(i.e.,ilanriing,,Public Works,,Fire,Sanitary Sewer District;School Distriet,'eta`. These ees,ari?:based,on,the' ?eliinin`a ,fin ormation.availabicandare,onl wivestim"ate Contact the De t• oraddn3In o: FEE ITEMS (F!.&Resohdion 14,nQ5 , 711%121 FEE QTY/FEE MISC;ITEMS Plan CheckFee $2,400:66• Select a;Misc Bldg/Structure pp g. 0 his, or Element of a Building Su "'1i PC Fee.. Re OT 0.0 $0.00 PME.Plan•Check:' $0.00 Perrnit Fee";q $1;636.:1,9 Suppl.vInsp..Fee-.0 Reg: .0".OT 0,0 hrs" $0.00 PME Uriit Fee: $0.00 'PME.Pernii'tTee: $0..00 <;nnslrrlcic�,n,.12� A(hnirristrafive Fee: Work Without Perris V Y;es (F) No $0.00 G Advanced.Planning:Fee.. $0.00 Select a Non-Residential 0 7i tire}!Dodi nerlu(ori 1 e es Building:or,Structure O Strong.NlotionTee: IBSEISMICO $42.00 ;S'elect an Administrative Item Bldg Std's Goininissi6h—Fee' IBCBSC $$.00 . , STBTOTAI;S $4 $OTOTAL FEE ,086.$5 00 $4,086:85 Revised: 10/01/2012 CITY Of CU•PE_RTINO BLT.ILDING PERMIT BUILDING-ADDRESS' 20735 STEVENS CR EK'BLVD CONTRACTOR:{C&'L CONSTRUCTION PERMIT NO: 12120035 ;OWNER'"S NAME <ALLAN'LAU �9300CATELLO.QVE' DATE ISSUED::03%04`/2013 OWNERS PHONE: 4082053496" SUNNYVALE,CA 94087 PHONE'NO:(408):781-2464 .. . ' .❑ LICENSED CONTRACTOR'S DECtiARATION JOB'DESCRIPTION'."RESIDENTIALE] COMMERCIALE] License;'Class Lic:_# Po _IZZW S BAGUETTE-SUITE A%B-COMM.TX3,190 SQTT' + CONVERT EXISTING RESTAURANT TO�BAKERY `ContractorC'', � iV'&1T Date _ s3 �y DE_F'#°1=-INSTNEL W.ALK-IN COOLERIFREEZER_ISSUED Fhereb affirm that I am licensed onder,theprovisronsi f Chap y-_ - � � eri9 540/1013 ' (commencing with+Secti6n'7000)of.6ivisi6n,.3,,of the'Busmess&;Professions Code ai d that,my,lieense,is:in full force and effect. i ereby Ahr.in under,penalty.of perjury:one of;thifoli6Wing:two declarations:. Lhayeand;401 maintaifi,wcertificate of,consent:td,s--elf-insure,forWorker's Goinpensation,as-,provided,for bySecfiom3700 of'the Labor Code,forthe performance of the work.foi':whicfi this'perrnit is:,issued. Sq.Ft Floor-Area: Valuation:$200000 U,have,and-will maintain'Worker'.s�Compensation,Insurance,as provided.for by, pe ons;00 of M. Labor Code tfor=the performance d,tfie!work for which thi''s APN Number:3263-2054:00 Occupancy Type:• APPLICANT CERTIFICATION -1 certify that I havearead'thisiapplication and state thatiheiabove,rnformation is PERMIT EXPIRES IF WORK IS:NOT`STARTED bcorrect Ilagree to cornply,wiih all city,and coumy ordinances and state,laws relating to budding•construction,and'hereby authorize repiesentatives:of tfii'scity to,:enter W'ITRIN 180'DAYS RMIT:ISSUANCE,OR ' apon the above mentioned„property for inspection puiposes (We):ag�eeJto;save 1'8b`DAY :LAS LED INSPECTION. iiudemiiifyand keep harmless the City of Cupertino-�against liabilities;'judgments; costs,and expenses.which'rnay+accnie,agamsf said CRy'in'consequehce of the S / 3 granting of this permit. Additionally;tfie;applicani undersfands.and,will comply .Iss y� Date: with•all.non point=sourcerregulations per;theCupertino Municipal;Cod'e,.Section 9'18. RE-ROOFS: Signature Date _ ” `� installed roofsw[tout inspecte npng air `to anyI tion,.g agree fol being`installed..If a,roof is remove:all new materials for inspection. ❑' "OWNEWBUILDEWDECLARATION Signature of,.Applicant: . Dater hereby afrirm,that.I,am exempt from-the'Contractor's`Lieeos"e Law.for one of fhe following two reasons: ALL R-OOF COVERINGS`TO-BE CLASS"A"OWBETTER I,as owner.ofthe,pioperty,,For my,employees.with=wages asjhe.ir�sole compensation, will do the woik;and'the structure;is;not intended onoff-e-red.forsale(S&70.44, 'Business&Tr-ofess ons�Code) ,,as�owper ofthe,property;,ani ezclusivdy.contractingawith licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct'the,project:(Sec.70,44,Business&;Professions';Code). I have:read the,haMrdoas;inateri'alVrequirements;under Chapter 6.95 of the 'California Health&xSafety.Code,Sections,25505,25533,and 25534 twill I hereby>affirmpnder'pen_alty of perjury oneiof'the;followtng three maintainycomplianee wit h%the Cupertino"Municipal Code,Chapter 9.12�and the declarations: Health'.&,Safety,Code,=S,ection 25532(a)should Lstoretor handle;hazai dour lhave and•will maintain.a,Certificate of Consentto selfrinsure"for Worker's material. Additionally,should I""use equipment'or devices which emit hazardous, Compensation as,provided,foc>by°Section 3700 of the.Labor.Code,for the air contaminants asidefined by.the Bay,Area,Air Quality Management District I perforniance of the'work',for which,this pe-rmitJs issued:. �willirii'a`intain compliancewith,the Cupertino Municipal Code,Chapter,9:12 and I have andmill mamtain`Worker s Compensation-lnsurance;as provided,for by the.Health,&Safety Code;;Sec6ons 25505;:25533 534. Secti6n37,00 of thetLabor Code for the perform_ance,o_f the work.for which,this - pennit is issued Owner orauthorized agent: Date: 146rtifyihat*fthe performance:ofthe:work for;which this',perrni6s,issued,I shall noremploy any person in any4manner so as to;become subject to the Worker's Compensation;l'aws ofCalifornia,-If-,*r making=this-bertificate of,exempt ion,.I CONSTRUCTION_LENDING AGENCY, become subject to the Worker's Co forthwith'•comply with such;provisions or this permit`stiall be deemed revoked. work's for which this permit'lis issued,(See.3097;Civ C:y for he'perforrriancepf ni ensation, provisions of the Labor Code,I;must [hereby affirm,that,lhere is a construction.l ng agent Lender's Name: ) APPLICANT^CERTIFICATION ;Lend'er's Address l.certifyttiat Ittiavc;read this ap"plication"and state ihaMhe,abovediitorrriation is correct I'.agree;to comply with all city and county ordinances and state laws relating tto buiIding construction and hereby authorize representatives of this city twenter, upon the above mentioned property fou inspection purposes (We);agree tosave indemni ,and keeb'harmless�the'Cit ofCu Cupertino against liabilities ud rrients, ARCHITECT'S DECLARATION �' p� Y p g J- g.• ,costs,and;expenses which'niay accme�against,Said CfWin,consequepce ofxhe' l understand my.plans•sBall,lie used,as"public record&, ;granting=oftliis•permit.Additionally,theapplicant'understandsiand'Wil I comply with all non poirifsourceregulations per the Cupertino Ivlunicipal'Code,.Section Licensed Professional `9'.l 8._ . . Signature Date CITY'OF C-UPERTINO BUILDING PERMIT BUILDING•ADDRESS:,20735 STEVENS CREEK'BLVD CONTRACTOR:C&LiCONSTRUCTION `PERMIT`NO:'12120035• OWNER'S_NAME: ALLAN10 1.93.4 POCATELLO AVE DATE-ISSUED:03704/2013 OWN_EWS PHONE:.4082053496 SUNNYVALE,CA 94087• P.HONE'NOr(408)°7812464 O LICENSED:GONTRACTOR'S'DECLAR'ATION. JOB DESCRIATIQN: RESIDENTIAL COMMERCIALO License;Class.. Lie:.#' ' ,. 33� PARIS-BAGUETTE-SUITE A/B-.COMM.'T.L3,190 SQ,FT J CONVERT EXISTING`RESTAURANT TO BAKERY Contractor ('O`4 rUGfirm Co_Date- ��� i'� _ l 1 hereby affirm that I a m.licensed'und'er,the provkionsrof Chapter 9 7 lJ re -'rise " (commencing-with;Section.7000)'of Divii1on,3:of the,Business&Professions Code aod;that my`license=is in full force and effect._ (,���A S4q,V I C..; O U J_ 4-,y u cqiv 1 hereby°affirm underpenalty of;perjury'oueof the16116wiog two declarations: 11 ' I q h?'I ng $V lS,t.toY1 S Thave.,and willmaintain.a,certificate of.consent to�self'insure for Workei's: 'Comp ensation,,as-provided for by-Sect,iori.3700 of the L"aboi,.Code;'TSi the ;peiforifianceof them6rk forwhich this permit.is issued'.. Sq._Ft,Floor Area: 'Valuation:$200000 I have and,will;maintain;Worker's Compensation Insurance„as pro.v.ided forby Section 3700''+of the Labor'Code,for the,perfornrance,ofthe work;forxwhich'this permitis is"sued. APm N,Nuber;-32632054_.00 Occupancy Type: APPLICANT CERTIFICATION I certify thativhave:read this applicationand'statejhafihe above,information is PERMIT EXPIRES.IF WORK`IS NOT STARTED correct:l agree to complywith.all,.city and,couni ordinances and state laws>relating to building construction;and:hereby authorize representatives of tfiis c�ty`to enfer WITHIN�;180 DAYS OE'PERMIT ISSUANCE OR 1 -_ upon the.above�mentioned property,for inspection purposes (,We)agree to save 180.DAYS 'CALLED INSPECTION. indemnify and keep harmless`the City'ofCupertinoagain"st'liabilities,judgments, ,costs and expenses which may accrue agamsysaid Ci Jn consequence ofthe ,grantmg0this;perrnit. �,kdditidr ally,,the�applicani understands and will.comply Stied by:,�- � Date: 'with all non-point sour.'ceregulations'per the:Cupertino;Muniapal,Code;,Secti-on 9.1"8. - E- Sgnatur ie -~ D /?-,G /3 All:roofs shall be inspected prior to an o00Finaterial being installed Ifa roof is S - _- installed.without.first obfaining,amirfspection,I agree toremove all.ne.w'materials;for inspection. D' OWNER-BUILDER'DECLARATION Y P + Signature of Applicant; Date: there b afCGrm.that;I,am exem-t.from°the�Contractor:s.License'i a}v;for one:of the following Nwwreasons: ALL,ROOF;COVERINGS'TO BE CLASS"-A',OR BETTER 1„as owner of the property;,or;my employees with'kwages as„their=sole compensation, will,do'he work,;and"thestructureAs:not`intended oroffered.for sale(Sec 7044; Business"&Professions Code) I;,&owner of flie:property;wii,exchusively;contracting;with licensed'contractors to HAZARDOUS MATERIALS'DISCLOSURE constrnct,the�project;(Seci7044-Business&Professions Code)., I have'read^the hazardous',materials'req uirements-,un der,Chap ten 6:95;of the Califoroia.Health&'Safety Code;Sections 25505,25533,:and:25534, Twill' 1_'herebyaffirm Synder penalty of perjuryaone of the following?three main tai n"compliance,with„the;Cupertino_Municipal Code,Chapter,9.121and the declarations: maternal. Additionally,should IS se equipment orrdev ces which emit h zardous- ore,or,hanlehazardous I;have,and will maintain a1CertificateFof Consent to self=ihsure!for Worker's Compensation,;as pmidedfor'by Section-3700:of the;Labor Code,;;f0vthe- air,contaminants as-idefined byythe.Biy Area Air Quality Management,District h perfonnance;ofthe wo&forwhich this permitis:.issued. will maintain compliance:with.ihe.Cupertino.Municipal Code,Chapter 9.1.2 and tihave and.will maintain Worker s�Corrrpensation Insurance as provided.for by the flea lth.&;Safety Code,•Sections 25505,,25533,anT25534. section-3700of,the,Labor,Code for the,performance of thework,for which.this ermit is issued. Owneror authorized agent: Dater , I�certify that,in.the`perforinance of`the'woikJq which this peris issued,Lshall got employ,any,.pe-rson'in any'niannerso as,to become subject to the Worker's Compensation laws of California if,after making this certificate of exemption,I CONSTRUCTION'LENDING AGENCY become.sublact-to the:Worker's,Corripensat�onprovi'sions ofatie:LaborCode;,l must ;1 herebviaffrm that:there-is'.a,coiistruction lending.agency for'thepeiformance:of f6hhwith'cornply'wiih such,piovisions orchis.permit�shall'be�deemedrevoked. work'skfor=which"this permit is,iss6ed,(Sec.-309.7,Civ C.) . _ Leoder's'.Narrie APPLICANT CERTIFICATION 'Lender's,Address, 7 cert fythatThave read this application;and.state that,the',aboves`information is correct.Pagrce,to comply(with all city-and,county ordinances and,state laws;relating to building_construction,,;and;hereby authorize representatives_s_f[tits city4o enter upon the above menhonedproperty;for inspection purposes (We)agree to save. `indemnify,.and keep:.harmless the City,of Cupertino agamstaliabilities,judgments, ARCHITECT'S-DECLARATION costs;and',expenses which,may accrue against said,Citylinconsequence of the 1 understand'-.my plans shall'be used as public records. granting,ofthis perinit.Additionally,the,applicant'understands';and`will comply with all:non pom.tsource�regulations per.the Cupertino Municipal Code;Section Licensed Professional ;9.18:. ;Signature- 'Date CI_TY.OF CUPEIMN.Q . FEE"TIMATO:R-BUILDING DIVISION ADDRESS: 20735$TEVENS`CREEK BLVD. DATE: 0:4/12/2013 . REVIEWED BY:: MELISSA APN: 326 32 05.4 - BP# *VALUATION': $0 a�W `` -*,PERMIT TYPE:. Building,Permit .PLAN CHECK TYPE;,. Alteration /Addition/Repair " aPRINIARY Commercial Bu PENTAMATION ildingfGENCOM.. USE;, PERMIT TYPE: . " "WORK; #.1 DEFERRED,-SUBMITTAL;FOR WALK-IN COOLER%FREEZER INSTALLATION FOR PARIS SCOPE,. BAGUETTE , W � NO � ;tilecar:'l:7ciyi_("1ieck phthr6,:11"lari C;geek, 1, ec_ Plazz.C;`heck OTher .11arcYa.hzs�., Qdr_e�r.T','.�gml./n,cjr ,Udl'er Glee:InsP., tlech Insh.t°'ee 'Plrzrrrli.. lars�. /c�e< f f<;::. Imp lFee: NOTE This'estimateVb s^nbt includefees'due,to'•other-:Departments(t ea Planning;Public and dre+ t,.etG e,i _W;orks,-Fire;Sanitary Sewer'District;Sc/zool District,. . Tkeseeswre based on_,the, relimina in ormad6nvvailable only an estimate:. Coiztdct.'the De tf or addn'-'lin"o. F1VI EE•ITESyfI ee'Resolulzbn T1-0 i3 Eff 7/1,12) FEE QTY'/FEE MISC ITEMS. �. Plait Clieek.Fee: Hourly Only? 0 Yes � No. $0.00 hours° :Plan Qheck,.°Hourly, `Su_PPl• PC Fee:`- 0 Reg. � OT" 0.0 hrs $0.00 $2661.00 1sTP%Ncx PME Man.Check: $0,:00 Permit-Fee: $0.00 °S'uppl:;.In_"sp'. Fee Q Reg: 'Q,OT FQThTS $0.0.0 PNIE Unit-Fee: $O,:OQ - :PME P.ermit.Fee: . . $0.00 G6nsir7.i ion�'7irc,: :�1'�lih.ir�istr�rtiwe:Fe��',• Work`Without•Permit? O,Yes' ') No: $6.00 ;Advanced Planning Fee: $0.00 Select a Nori=Resderitial Ti-cr,5'T . t,0zruzrteratul«zzr 1IVCS. Building,or Structure. 0 . - Strong•::Moti'on Fee:., $0.00° Select an Adminisirat'ive Iterry BId :StdS Cominission;"Fee. $0.00' ' SUBT'OTALS:- $ $ 0TOAL,FEE 266.00 0:00, 2.66:0• Via. :$ •_ .. Revised: 04/0'1,'/201'3, . _ CITY,OF CUPERTINO FEE.ESTIMATOR�- BUILDING DIVISIO-N ADDRESS:=,20735 STEVENSCREEK BLVD7 DATE: 03/26/2013 REVIEWED BY': MELISSA .APN:r :326'3 . Q54 054 BP#.: -VALUATION: $0 PERMIT TYPE: Building.Permit PLAN CHECK TYPE: Alteration / .Repair PRIMARY . PENTAMATION SFD,orDuplex., 1GENRE& USE: EER'MIT TYPE: A WORK "REVISION-4 1*"°.REVISE BATHROOM BAKERY& SERVICE LAYOUT: S rRUCTURAL.& SCOPE ELECT,RICAL'LI:GHTING.REVISIQNS r 's >• + � ,, stir: �e � � i � �' x .a � SII lfeclt. flan+C'Yic;ck Phurtli; PlanCltec! Flee, l,'!an(`hack titecit.Perririt Fe'; PG;mh, Permit Fire: I ler..•..Perinit Fee. Oihcr Ale c�li:•Insf�: C>lher'Plirna?r In:rp. OtJrc�t Elec. /nsp. Afeclii%nsj?_'ee. Plur{rl r':fi�si�..F-c c': L le'c. %ns�z 1.'ei NOTE:This,estimate does not include fees due`td dther.Departments.(I.e.,Planning,Public Works,Fire,Sanitary Sewer District,School Nstrict,etc . ,7hese ees areshased,o4 ihe� relimina, ;info rmation availahle'and+are onl .an.estimate: Contactfthe De t or addn'-14in o: FEE.ITEMS(Fee Re;"dlutionIl-053,EJT 71,11H), FEE QTY/FEE MISCITEMS. Plan CheckTee: Hourly Only..? C)Yes M No! $0.00 0 hours: Plain,Check,Hourly Sup0l.TCFee: '� Reg. p'OT ' p.0 hrs $0.00 $266:00 ISTPLNCx PW'Pleari`Check: $0:00 Permit'Fee;_ $Q.00 Suppl. Insp:'.Fee,S'Re.g. Q OT 0;0 hrs $0:00. P-ME UniiTee; $0.00 PNIE'Permit Fee:, $Q.00: C�nslt.zrcticin 1�.anT_T_ Ad)niWstrwive Fee: Q Work Without;P.ertnit? b Xes '&No $0.00 0 "Advanced PI'a"nnin�LFee_ $0.00 Select Non=Residential /�rcriel J�nctrlr�c�7tcalt01.1 fees: 'Building or Structure _.. Strong Motion Fee: $0.00 Select.an Administrative,Item B1dg Stds Cornmjssion.F'ee: $0.00' mss_ SUBT®TALS $0.00 $266.00' TOTAL,FE`, $266'.00: >. K M .. ,_ate Revised' 01/01/2013