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10080108I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 19620 STEVENS CREEK BLVD STE 290 CONTRACTOR: FRED CHAN PERMIT NO: 10080108 OWNER'S NAME: BERKELEY, CA 94709 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. it MECH RESIDENTIAL r COMMERCIAL Contractor Date 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 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 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, 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 JOB DESCRIPTION: COMM'L Tl- NON-STRUCTURAL OFFICE(2232SQ MECHANICAL IS BEING DEFERRED. Sq. Ft Floor Area: 1 Valuation: $16000 APN Number: 36906010.290 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Date I Issued b Date: -5;—r -or— LD 19 OWNER -BUILDER DECLARATION I 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 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty 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. 1 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, l 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. JA APPLICANT CERTIFICATION 1 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, 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 upertino Municipal Code, Section 9.18. p Signature Date 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 5505, 25533, and 25534. Owner or authorized agent: -- ate: CONSTRUCTION LENDING AGE1Y 1 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 Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY OF CUPERTINO BUILDINGrNME BUILDING ADDRESS: 19620 STEVENS CREEK BLVD STE 290 CONTRACTOR: CHAN PERMIT NO: 10080108 OWNER'S NAME: BERKELEY, CA 94709 1PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. # Contractor Date I hereby affirm that 1 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: 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 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, 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. Date IP OWNER -BUILDER DECLARATION I hereby affirm that 1 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 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 construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three II— I 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. D.2 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, 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. q Signature Date MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: COMM'L TI- NON-STRUCTURAL OFFICE(2232SQ MECHANICAL IS BEING DEFERRED. 8/23/10 DEFERRED #1 SUBMITTAL -MECHANICAL - 9/9/10 DEFERRED #1 !SSD Sq. Ft Floor Area: I Valuation: $16000 APN Number: 36906010.290 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued �� Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I 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 I 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. Owner or authorizedagent: p q Dater —! D CONSTRUCTION LENDING AGENCY 1 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 Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY 0 C11"FIRTINO 13 t € (.1)1.N ( : PERMIT BUILDING ADDRESS: 19620 STEVENS CREEK W .VD STE 290 ICO,, \( I (>Ii.!'REB-eH-AN OWNER'S NAME: ❑ LICENSED CONTRACT'OR'S DECLAR: fON License Class Lie. H Contractor Date _ I hereby affirm that I am licensed under the provisions of r !I❑ptcr 9 (commencing with Section 7000) of Division 3 of the Businc• :.F Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the folio , .. r.vo declaralions: I have and will maintain a certificate of consent to self -insure Worker's Compensation, as provided for by Section 3700 of the Labor c :r. for the performance of the work for which this permit is issued. or N, lm:h ,h s I have and will maintain Worker's Compensation Insurance. ;1 rovided I'm by Section 3700 of the Labor Code for the nerl'ormance of the ,+ :'or vvhiclt 111 REVISION TE ISSUED: 09/09/2010 PHONE NO: BUI I ! � I , I' 110117 EN FO: BLDG F ELECT I PLUMB I r' r r MECII RESIDENTIAL COMMERCIAL .loft a `( It 1! 1 1' IN: COMM'L TI- NON-STRUCTURAL OFFICE(2232SQ MEC \! IS :WING DEFERRED. 12/1/ -PI" I'S `)Nifl-II-.VISECONFERENCE ROOM. WALL M0: % I I{: VSFOIZMEI2- ISSD 1/5/11 Sq, t Valuation: $16000 permit is issued. f /%1'N ' Wi : 16010.290 Oce upancy Type: APPI,ICANT CI:RTIF►C'.%TION r— I certify that I have read this application and state That the ahO :nlorm:u for i.1 1, 1 I 1 1 I`EXP I R ES I F WORK IS NOT STARTED correct. I agree to comply with all city and county ordinance . 1 .tate laws rclatine ' 1 I i ! i 1180 DAYS (1F PERMIT CSSUANCE OR to building construction, and hereby authorize representative, :his city to enter upon the above mentioned property for inspection purposes. ('+`•,') agree to save I w1I !: l l `s FROM LAST CALLED INSPECTION. indemnify and keep harmless the Cily Of Cupertino against li:+' i.ics, judgnlcl.ts, costs, and expenses which may accrue against said City in COP ;IICncC oI d,c granting of this permit. Additionally, the applicant understan+l +lid will comply with all non -point source regulations per the Cupertino Muni( : i Code, Sccuon 9.18. Signature _. Dalc_ loo !tic OWNER- BU11.1)E11 1)I.CLAIZ.A I'ION G)rm It ol, •. I hereby affirm that I am exempt from the Contractor's I : "e L:m ff•I mle of the following two reasons: or N, lm:h ,h s I, as owner of the property, or my CmpIO, res with ,,ages :1< 11 11C Col Ipl iI .al ion, will do the work, and the structure is not intended Or offered is<ur(I shall Business & Professions Code) •C \\ u, Gr I, as owner of the property, am cSclusi IL-k� c011micling with I d C,,Ill mi iris to construct the project (Sec.7044. llusines< & Prol'essions Cod, ,hO- . + n)ast I hereby affirm under penalty of perjur, line of the follo,• rev declarations: I have and will maintain a Certif ienic of CnnsCIit t .elf -i„<,., : \'„rkwr'• Compensation, as provided for by Section :;700 Ofthc Lahoi loo !tic performance of the work for which this pei nit is is.l,cd. G)rm It ol, •. I have and will maintain Worker's CompCn.ation I ;<urarrcc. id,:l fo ' Section 3700 of the Labor Code, for the prlnrnnut, c of the , or N, lm:h ,h s permit is issued. r. certify that in the performance of the ,vu k for „'1 . h this is<ur(I shall not employ any person in any manner so :+s to become suhicr •C \\ u, Gr Compensation laws of Califbrni;l. 11', ahc Iiraki;: !!lis Cc 1C,. ; ,I 1. I become subject to the Worker's Cornpcu;,;i;Iv1I Illi :sion: 1, ,hO- . + n)ast forthwith comply with such provisions Or this pciw:l shall I,, ,rd r+,. { rJ APPLICANT CI Wl II Ir \TION 1 certify that I have read this application ;It![] state '1•,,t Ihr ah, G)rm It ol, •. correct. I agree to comply with all cityan. , otim r , dinar; r !ate .;.. !,+;ht,' to building construction, and hcrchy aut1 i lzc rgpr cnw,ki c ,, :: IC1 upon the above mentioned prop, l t, for i . , .,: 1 la. epos r. indemnify and keep harmless tl.t, Cit\' o. cr. ,+, ••:.;tine costs, and expenses which may :Iccruc :r•; 1i ( :1), is !IC granting of this permit. Additionally, the Il;wIIC:llll I'11d1r)•: a.' 1'! with all non-poin ource r lations per the Cul•cl i,no Vmii. ocl, . I; •. i )n 9.18. Signature _ Datc Dale: LL -1(001:.S: All r, pcelcd prior tO arnv roof in' m;rteri;d tieing installed. If a roof is insw I obtaining an ,II�11,:c1ion, I a, --ice to remove all new materials for inspr Sign. nC Hue: 'II •OF COV I-AlIN(;S "f0 BF CLASS "A" OR BETTER 1.\%.\ND0I � 1I:RI:\I,.S UIS('t.OSURE IIla, ,.!:Irdousmalerial.rcquirenwitisunder Chapter 6.95ofthe ('ali' 1 +: SafctcCode, Srrlions2550I,,25533,and 25534. Iwill nisi. , c with the Cnperlino Municipal ( ode, Chapter 9.12 and the I Ical, de, Section 2j'� t?(a) shonW I store lir handle hazardous mal+ Illy, should I Il.r equipment or dc, 'ices which emit hazardous ;lir I dclinrd by u:l• \rc;l Air Quality Management District I will I '+ riance „ith Ithc ( i,pertino \lunicip;il Code, Chapter 9.12 and II+e I' C wit'. Scctio2 - (. m 1 =;534. 1'JJ I 01, II I agcnt�' Date: I rl �f CON<I PINC.\(;t:NCY xi� i• .na;+. for the performance of \:•: Ill;Dl r!,\P\TION .I. .1 , , CITY OF CUPERTINO j IM -0, FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: f.. +.' J ti K ! J ff d '" �. '?I.ii 1 � 'P � y'^� � � "�,• �, "yJ 1 k. '-� `� .�. " } � •,1 �I�'1LI l..I�tf �,! ADDRESS: FLR AREA s.L DATE: REVIEWED BV: PC FEE ID APN: BP#: 'VALUATION: $3i;00II� ^PERMIT TYPE: Building Permit 3,889 PLAN CHECK TYPE: I Tenant Improvement PRIMARY Commercial Buildingirrf!•+�, USE: IBTIINSP 1 r OOP .,,,RL1. i APPLICATION 16 T1 TYPE: WORK i llzry, C!rr!,, 7t c'c. Imp. SCOPE $0.00 $0.00 n E) Work Without Permit? 0 Yes 0 No _.. OCCUPANCY TYPE: f.. +.' J ti K ! J ff d '" �. '?I.ii 1 � 'P � y'^� � � "�,• �, "yJ 1 k. '-� `� .�. " } � •,1 �I�'1LI l..I�tf �,! TYPE OF CONSTR. FLR AREA s.L PC FEESII I PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-13,111-B,Iv,v-B 3,889 $2,132.80; IBTIPLNCK $2,966.04 IBTIINSP U;hr•,' We,(h. 'nsp. PME Permit Fee: $0.00 i llzry, C!rr!,, 7t c'c. Imp. i'h . "I h1 q) r dt' $0.00 $0.00 n E) Work Without Permit? 0 Yes 0 No Phimi, J,r,rl. l' i'p'. Ir. "' .r . hnp �•,.. . Stronp- Motion Fee: IBSEISMICO $ 3, 3C`� Select an Administrative Item TOTALS: 3,889 $2,132.80 is $2,966.04 NOTE: These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff T-1/10) • 'I'` N. ti r ! w. �� ,G �'F�D�21$"yid ��y 4 � hs. .a .4> ..4 r ? ti {"SUt�1f .1:1�0l Y :.t r /X. �,. �`-• �. Pi'm lf�,'!'l: F0.0 hrs � I, lI lll �hwif, Mir Jwc I �'. i�'�' �J�:/l) C heck• :_1i 1, 1'.'Yn,rr r'.': Suppl. Insp. Feer Reg. 0 OT 0.0 l "!l:/nh. P.:rnl!/ $0.00 $0.00 U;hr•,' We,(h. 'nsp. PME Permit Fee: $0.00 OIr:c! I'rwul; llzry, C!rr!,, 7t c'c. Imp. i'h . "I h1 q) r dt' $0.00 $0.00 n E) Work Without Permit? 0 Yes 0 No Phimi, J,r,rl. l' i'p'. Ir. "' .r . hnp �•,.. . NOTE: These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 09-051 Eff T-1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee:$2,132.80 Select a Misc Bldg/Structure 0.00 or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT F0.0 hrs PME Plan Check: $0.00 „233 S'. Permit Fee: Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 $0.00 PME Unit Fee: PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 $0.00 n E) Work Without Permit? 0 Yes 0 No Plannino Fee. PLLONGRNGC $9 .25 Select a Non -Residential Building or Structure 0 Stronp- Motion Fee: IBSEISMICO $ 3, 3C`� Select an Administrative Item Blde Stds Commission Fee: IBCBSC 'I4 $607 ,9.8 ° TOi.FEE:�O .$6,079.81 'A Revised: 8/12/2010 CITY OF CUPERTINO R FEE ESTIMATOR - BUILDING DIVISION U OCCUPANCY TYPE: ADDRESS• Ct&/ I DATE: REVIEWED BY: BP FEES BP FEE ID APN: BP#: a OQ -VALUATION: 1$20,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: TOTIL FL 00R ,4RL 4. PENTAMATION 1DS PERMIT TYPE: 19 WORK Llc . Insp. Fee: SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.t. PC FEES PC FEE ID BP FEES BP FEE ID Deferred Submittal (Not R-3) II-B,111-B,IV,V-B 3,889 $4 . 8 /DEFPLNCK $496-69 /DEFINSP 011er Plumb Insp.Li Other /.lec . Insp. AIcch. In.y. Fee: Plumb, hn p. Fee. Llc . Insp. Fee: PME Plan Check: $0.00 �8 Permit Fee: 14VO.6S Suppl. Insp. Feed Reg. O OT TOTALS: 3,889 1 $4,091.58 $496.69 MECH, HOURLY 0 Yes -CNo PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY Q Yes (D No Wcch. Plan Check Plumb. Plun Check F_lec. Plan Check Vlech. Permit Fee: Plumh. Permil Fee. h4<c. Permir Fee: Other Mech, Insp. 011er Plumb Insp.Li Other /.lec . Insp. AIcch. In.y. Fee: Plumb, hn p. Fee. Llc . Insp. Fee: NOTE. These ees are based on the preliminaty in ormation available and are only an estimate. Contact the De t or addn I info. FEE ITEMS (Fee Resolution 09-05/ Eff. 711110) FEE QTY/FEE MISC ITEMS Plan Check Fee: 8 a Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 �8 Permit Fee: 14VO.6S Suppl. Insp. Feed Reg. O OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constrziclion Tm Acoustical Fee: 0 Yes (E) No $0.00 Q E) Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: PLLONGRNGC $0.00 Select a Non -Residential Building or Structure Q i Travel Doctunctilution Fees: Strong Motion Fee: /BSEISMICO 07"/0 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC �yg� SUBTOTALS: $ $0.00 TOTAL FEE: , as 9173 Revised: 8/17/2010 a�9 ,, 7-3 FEW CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E f 7/1/10) ADDRESS: 19620 stvns crk blvd. #290 DATE: 12/16/2010 REVIEWED BY: bobs. U1c�cl�. Permit Fc u. APN: BP#: 'VALUATION: j$1,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: g I'U7'r1L FLOUR AR'E.4. PENTAMATION PERMIT TYPE: WORK revise new conference room add wall mounted transformer SCOPE $0.00 NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E f 7/1/10) 17.'c/J. Plan ("1, (.lr i'i - ,. r'loir Cfi e:J, 1 7ecr Plan C;.. U1c�cl�. Permit Fc u. Phi,; Foo . l ;' OtlrcT AkLA h..s11 OAyer Ahrmh Insp Oilier- Ekc.. Irtsp. ,1fcxfr_ flap. Pce: /'lcrnr,�. ilq,.- Fac C. Insp, Teo NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E f 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: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT FO.OThrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiraclion Tin- Acoustical Fee: © Yes (F) No $0.00 Q E) Work Without Permit? Q Yes E) No $0.00 Planning Fee: $0.00 0 Trus el Doumnentalion Fc".- Strong Motion Fee: IBSEISMICO $0.50 1 # $760.00 AA AA Revision IREv U ( Bldg; Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $760.00 TOTAL FEE: $761.50 Revised: 12/07/2010