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Tenant Improvement - 06-09-060 - 291 E Shore Drive Ste 210 - 10/17/2006 City of Eagle Zoning/Building Permit Permit#: 06-09-060 Mechanical#: M-4271 Fees: Permit Fee $630.00 Plan Review $409.00 Development $0.00 Special Fee $0.00 IECC Fee $100.00 ACHD Fee $0.00 Mechanical-Res $0.00 Mechanical-Com $187.65 EM2 Fee $0.00 -------------- Total Fees $1,326.65 Less Deposit $100.00 Less Foundation Only $0.00 Balance Due $1,226.65 Property Owner Carmen, LLC Owner Address 291 E Shore Dr #200 Owner City State Zip Eagle, 10 83616 Issue Date 10/17/2006 Foundation Only Issue Date Builder Name M/H Development Builder Address 291 E Shore Drive Ste 200 Builder City State Zip Eagle, 1083616 Builder Telephone (208) 939-8466 Builder Registration # EXEMPT Subdivision Mixed Use Sub No.3 Block 4 Lot 12 Property Address 291 E Shore Drive Ste 210 Type TI Deposit Receipt# Issue Receipt# 4.001409 4.001431 Foundation Only Receipt# SqFtLiving 1800 SqFtBmnt 0 SqFtGrg 0 SqFtPorch 0 Value Of Imprmnt $63,900.00 Eagle Water 0 EM2 Water 0 Eagle Sewer 0 Development 0 ACHD 0 Notes: Northwest Insurance Brokers Tenant Improvements City Clerk/Authorized Personnel Builders Signature Said structure andlor use to conform to specifications and plans submitted and must be in full compliance with ordinances of the City of Eagle subject to inspection permits and fees as required. Tuesday, October 17, 2006 Page 1 of 1 '" w '-' OJ W '-'