Engineering Permit Application
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Permit Service Center
2120 Milvia Street, Berkeley, CA 94704
Main Tel: 510.981.7500 TDD: 510.981.7474 Fax: 510.981.7505
Clear Form
Scheduling Inspections: 510.981.7444 Eng. Inspector: 510.981.7440
Email:
Planning@ci.berkeley.ca.us
Engineering Permit Application
SHADED AREAS FOR STAFF USE ONLY
APPLICATION #
_______________________
STREET ADDRESS/ UNIT # (if applicable)
TENANT NAME
TOTAL PROJECT SQUARE FEET
VALUATION ($)
APPLICATION GROUP:
NEW
ADD
DEMO>DEM
REMODEL>REM
REPAIR>REP
Contractor Name
Phone#
Fees For Engineering Permit (Mark Quantities)
Qty
Fee Description
Fee/Units
Address
State Lic#
Base Permit Fee for each permit
$105.00
type except Const. Park
Bus Lic#
Refundable Deposit – As required by
City, ST
ZIP Code
$1,247.00
Engineering Inspector
Subtotal
SEWER, SANITARY (Must be a lic. Sewer contractor)
Property Owner Name
Phone#
Sidewalk Inspection
$112.00/hr
Trench Inspection
$112.00/hr
Subtotal
Address
CONCRETE AREA
Flatwork per 100sf
$25.00
City, ST
ZIP Code
Curb Gutter per 10 Lin Ft
$25.00
Subtotal
CONSTRUCTION PARKING
Applicant/Contact Person
Phone#
Base Permit Fee
$30.00
No Parking Sign
$10.00
Time Zone/ Metered Area (weekly)
$55.00/wk
Address
FAX#
Time Zone/ Metered Area (daily)
$11.00/day
Subtotal
City, ST
ZIP Code
MISCELLANEOUS
Miscellaneous Permit Inspection
$112.00/hr
Subtotal
SEWER, STORM (Must be lic. sewer contractor)
Misc. Comments (Brief Job Description) Attach Dimensioned Site Plan
Sidewalk Inspection ST/DR
$112.00/hr
Trench Inspection ST/DR
$112.00/hr
Subtotal
TEMPORARY RIGHT OF WAY USE
Monthly Fee
$200.00/mo
R/W Inspection Fee
$112.00/hr
$6.15 x ______Curb LF. x _____ mo.
Debris Box (Property Owners ONLY)
$90.00 ea
Subtotal
Total
# of Stories_____
Single Family Residential
Multi-Family Residential
Commercial
NOTE: If this is a fax-in permit, complete the Permit Application Information on the reverse side of this form.
Rev. 6/04
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Parent category: Business