HomeMy WebLinkAboutPermit Electrical 2007-11-28
11/28/07 WED 11:45 FAX 5417263689
CITY OF SPRINGFIELD
@001
ZON ec
INITIALS N fV\
. DATE \ l- ~)-fn
· SOURCE f.Y\..JQ~
225 FIFIH S~1U!,)!,r . ~GFmLD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-368?
ELECTRICAL PERMIT APPUCATION
City Job Number (G)""", ZOo 6 - 0 I SOS- Date
1.
~I 't K.ftAs,c WAy
I
LEGAL DESCRIPTION:
J703ZZZ0
07000
JOB DESCRIPTION:
Ho1el- c/e-c..k.iLA!
:Permits are non-transferable and expire if work is
not started within 180 days of issuance Or if work is
Suspended for 180 days.
-? 2.
Electrical Contractor ::::fi4 /U/2c3: ('{;;:C~. /A/C
11- 28-200-,
-)3.
A. '
Service Ioclud .
1000 sq. ft. or leTJi'S PERMIT SHAL~ EXPIR~'IbTHE WORK
Each additional GddIl{ftiRllED LJNDEfJ I HIS PERMIT IS NOr
portion thereof COMMENCED OR IS :ARAMNED FOR
Each Manufact'~~Mnl&O DAY PERIOD.
Modular Dwelling Service or
Feeder
$55.00
B.
200 Amps or less
201 Amps to 400 Amps
Address I2.fJ//O 1tt?a>C KO "__ 401 Amps to 600 Amps
, . 601 Amps to 1000 Amps
cityVfll!l;; CtLt. Phone SYI-826' -7$3fJ Over 1000 AmpsNolts
Reconnect Only
z-O $ 70.00 / l/O C>
$ 83.00
Ii $138.00 /6X
$180.00
I $413.00 _'f /3.l)p
$ 55.00 I
Pump or irrigation $ 55.00
Sign/OutlineLigbting I. $ 55.00 --..SS;()()
Limited Energy/Residential $ 28.00
Limited Energy/Commercial -.if. $ 50.00 '20 O,.()()
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
t?V7 L-f
AI, clmON: Or8~ ta. L
1ollow ru'es adopted by t~~~~~ 1./ 81 I
Notification Center. Those.~~tree b 01 40
InOAR952..Q()1-0010thro.~a1. _ '309700
0090. You may obtain copies of the rules by 173.97 z!....
calling the center. (Not~~fel~~hone ., . .; . ~ _ _ -. .......
number for the Oregon Utility N~~:)lBuilding FonnsIEl~ctnc,,! Pemut Application 7.Q7.doc
Center is 1-800-332-2344). .
Supervisor License Number ~3 J <7 S .
Expiration Date I D -0/ - 219/0
Constr. Contr. Number /.2 tJ ;Z If ..s-
E^l'~a~;on Date 02. - /j ,- 200 RJ
1 rum 0 Supe . 1. Electrician
"v .
Ii , / V...z-~ --
awn""N..., · s)l~Ak CdILf .
Address 81.(~ '"Ee-(+I;~e ~ S+~- ~z..
City Sf^~, {;~J. PhoneStll. 7i/ b" g",,,'I
OWNER INSTALLATION
The installation is being made on property I Own whi.ch
is not intended for sate, lease or r6Ilt.
Owners Signature:
Inspection Request; 726-3769
(nstaUation, Alteration or Relocation
- --.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps Or 1000 Volts see ''B'' abore.
D.
t 55.0{)"
i- --,
i $ 76.00
l!:110.0o.
New Alteration or Extension Per Panel :
One Circuit . $ 48.00
Each Additional Circuit or with CN::"Z',' ,$ 4.00
Service or Feeder Permit ~,_
.38og Of)
. j
o~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 919 Kruse Way
ASSESSOR'S PARCEL NO.: 1703222007000
Springfield TYPE OF WORK: Hotel/Motel
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: 6 story 153 unit hotel- Holiday Inn Hotel
Owner: SYCAN B CORP
Address: 840 BEL TLlNE RD STE 202
SPRINGFIELD OR 97477
Phone Number: 541-746-8444
I CONTRACTOR INFORMATION I
Contractor Type Contractor License Expiration Date Phone
Architect JENSEN FEY ARCHITECTURE 425-216-0318
General MEGA PACIFIC CO 63108 01/1612008 503-238-3772
Electrical FUTURE TECH INC 120245 02/11/2008 541-826-7538
Mechanical COMFORT FLOW 460 06/27/2009 541-726-0100
Plumbing STATEWIDE MECHANICAL LLC 148558 08/03/2009 541 ~461-8973
Sewer EGGE SAND & GRAVEL LLC 541-485-1515
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
153
A2
Rl
IA
liB
I BUILDING INFORMATION I
,~~ OregO Lot Size:
Not~i1l!/~rh:Jfjttf8~'a'N reqUires yo Sq Ft 1st Floor:
In O~~l~er. ThoY the Oregon ~ ~ Ft 2nd Floor:
00901"Wh~~0010 thflse rules are se Utilll!( Ft Basement:
ca/~VA'JfWtf>btaln coO~9h OAR 952~o~ Ft Garage/Carport
numtil,~~2er. (No{'~es of the rUle tMq Ft Other:
SPCi]~/~fbQ1s9tlh Ut"l~he telephonB ~ccupant Load:
rer Jo <f 9S - I t(y A'~w.' e
I DEVELOPMENT INFORifk,~j~I'''auoll
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IM~FNTS I
THIS PERMIT SHAl Sidewalk Type:
~~HORIZEO UNOE~'J~"s~WbRK
ANY ~~~: ~~/S A8";cio~~~~6~ NOT
100.
Notes:
Page 1 of8
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Addressing Assignment
Air Handling Unit Up to 10,000
Backflow Device
Building Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Non-Residential
Fixture
Furnace - more than 100,000
Furnace - up to 100,000 btu
Gas Outlets 1-4
Gas Outlets 4+
Heat Pump
Plan Review Plumbing (30%)
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl100'
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtll00'
Vent Fan
Water Line - 1st 50 Feet
Water Line - Each Addtll00'
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Temp Power 200 amps or less
+ 10% Administrative Fee
FLS Safety Systems Review
+ 10% Administrative Fee
+ 5% Technology Fee
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
I Valuation Description'
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
8,000,000.00
Value
Date Calculated
Total Value of Project
$8,000,000.00
$8,000,000.00
11/27/2006
~
Amount Paid
Date Paid
Receipt Number
$17,056.42
$10,496.26
$10.00
$4,724.48
$1,887.63
$3,020.21
$31.00
$72.00
$70.00
$26,240.65
$12.00
$27.00
$9,492.10
$8,638.00
$90.00
$12.00
$4.00
$32.00
$216.00
$247.50
$45.00
$42.00
$10,000.00
$45.00
$224.00
$1,896.00
$45.00
$42.00
$10.00
$5.00
$8.00
$100.00
$171.00
$1,710.00
$601.40
$300.70
11/27/06
11/27/06
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
2/23/07
4/6/07
4/6/07
4/6/07
4/6/07
10/1/07
10/1/07
11/29/07
11/29/07
1200600000000001687
1200600000000001687
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
1200700000000000198
2200700000000000491
2200700000000000491
2200700000000000491
2200700000000000491
1200700000000001259
1200700000000001259
2200700000000001754
2200700000000001754
Pal!:e 2 of8
Status
Issued
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Low Voltage - Commercial Indus
Perm Serv/Fdr 1000 amps/volts
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 401 to 600 amps
Sign - Outline Lighting Each
$481.12
$3,808.00
$200.00
$413.00
$1,400.00
$138.00
$55.00
11/29/07
11/29/07
11/29/07
11/29/07
11/29/07
11/29/07
11/29/07
2200700000000001754
2200700000000001754
2200700000000001754
2200700000000001754
2200700000000001754
2200700000000001754
2200700000000001754
Total Amount Paid
$104,119.47
I Plan Reviews I
Fire Department Review
07/27/2007
Deferred submittal for fire sprinkler
system by JND Fire, Inc
Planninl!: Review
11/30/2006 11/30/2006 APP SKG
11/30/2006 12/13/2006 APP EMM To be built per approved Site Plan
Review DRC2006-00037.
11/30/2006 12/26/2006 WE JMP Received 12/12/2006. Left a voice
mail request for the emergency
lighting details, exiting plan, and
boiler BTUs and locations.
Initial Review
Structural Review
SUB Review
12/12/2006
01/03/2007
APP JF
Public Works Review
11/30/2006
01/04/2007
APP JHJ
Added revised SDC's (JHJ)
Fire Department Review
11/30/2006
01/31/2007
OK GRG
See attached document for Fire
Department Plans Review
comments.
Plumbinl!: Plan Review
02/06/2007
02/06/2007
WE SKG
See attached document for 7
plumbing items
Structural Review
01/30/2007
02/21/2007
APP RWC
Initial Review
07/27/2007
07/27/2007
APP LLH
Deferred submittal for fire sprinkler
system.
Fire Department Review
10/01/2007
1 % 1/2007
OK GRG
(Plans Review completed on
9/29/07).
See attached document for Fire
Department Plans Review comments
for the sprinkler/standpipe
submittals.
Pal!:e 3 of8
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
l..JleouiredJnsnections I
SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
SUB Final: After all required energy inspections have been requested and approved.
SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover.
SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
SUB Ceiling Grid: Interior Lighting
SUB Exterior Lighting
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
. Foundation: After forms are erected but prior to concrete placement.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation:, Prior to cover.
Ceiling Insulation: Prior to cover.
Roofing: Prior to installing any roof covering.
Drywall: Prior to taping.
Firewall: Located and constructed according to plans.
Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to
plastering.
Masonry:
Reinforced Gypsum Concrete: When Class B gypsum concrete is mixed and placed. Provide inspection/test
results to City Building Inspector.
Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to
City Building Inspector.
Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector.
Provide results to City Buiding Inspector
Pal!e 4 of 8
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Roof SheathingfNailing: Before covering sheathing with finish material.
Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to
placement.
Ceiling Grid: After drywall approval but prior to cover.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector.
High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection
results to City Building Inspector.
Special Inspection: Weld Inspection: To be done during construction by a State Certified Special Inspector with
approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield.
Special Inspection: Ultrasonic Inspection: To be done during construction by a State Certified Special Inspector
with approval from the City of Springfield. Copies of inspection results shall be provided to the City of
Springfield.
Special Inspection: High Strength Bolting Inspection: To be done during construction by a State Certified Special
Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of
Springfield.
Special Inspection: Metal Deck Welding Inspection: To be done during construction by a State Certified Special
Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of
Springfield.
Special Inspection: Reinforcing Steel Mill Certificate Inspection: To be done during construction by a State
Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be
provided to the City of Springfield.
Special Inspection: Moment Resisting Steel Frames Inspection: To be done during construction by a State
Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be
provided to the City of Springfield.
Special Inspection: Masonry - Placement Inspection of Units and Reinforcement Inspection: To be done during
construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of
inspection results shall be provided to the City of Springfield.
Special Inspection: Masonry, Mortar, Grout, and Reinforcing Steel Certificates Inspection: To be done during
construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of
inspection results shall be provided to the City of Springfield.
Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Structural Masonry: To be done during construction by a State Certified Special Inspector. Provide results to
City Building Inspector.
Sprayed On Fireproofing: To be done during construction by a State Certified Special Inspector. Provide test
resports to City Building Inspector.
Fire Department Sprayed On Fireproofing: Prior to Cover.
Fire Department Sprinkler System: Prior to cover. Hydro pressure test, fire line flow test.
Pal!:e 5 of8
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Underground Sprinkler System: Prior to cover. Hydro pressure test, fire line flow test.
Fire Department Alarm System: Fire Department Alarm System Acceptance Inspection. This inspection must be
requested and approved prior to requesting any occupancy approval.
Fire Department Water Supply. Inspection to assure water supply is available on site for construction. This
inspection is required prior to any combustible construction.
Fire Department Access. Inspection to assure access is available to site for construction project. This inspection is
required prior to any combustible construction.
Final Fire Department. After all requirements of the Fire Department have been met.
Fire Department Temporary Occupancy: All Fire and Life Safety Systems must be tested, accepted and
operational prior to requesting this inspection.
Final Building: After all Conditions have been completed as required on Development Agreement.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Grading: After gravel is in place but prior to placing concrete.
Final Paving: After paving is complete.
SUB Concrete Slab: Prior to and following pour.
SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
SUB Final: After all required energy inspections have been requested and approved.
Underslab Plumbing: Prior to filling the trench and including required testing.
Underground Plumbing: Prior to filling the trench and including required testing.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Line to Septic Tank: Prior to filling trench and required testing.
Storm Sewer Line: Prior to filling trench.
Grease Trap: Prior to Cover.
Final Plumbing: When all plumbing work is complete.
Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Underslab Mechanical. Prior to insulation or decking and including required testing.
Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Paee 6 of8
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726~3676 Fax
541-726-3769 Inspection Line
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Ufor Electrical Ground: Install ground rod at footing and call for inspection in conjuction with footing and/or
foundation inspection.
Underground Electric: Prior to cover
Underslab Electric: Prior to cover
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Low Voltage: Prior to cover.
Sign Electrical: After connection is made but prior to energizing
Pedestal: Prior to cover.
SUB Ceiling Grid: Interior Lighting
SUB Exterior Lighting
SUB Special Inspection: See Plan Review or Inspector Notes for instructions.
Curbcut - Close & Repair: After forms are erected but prior to placement of concrete.
Curbcut - Overwidth: After forms are erected but prior to placement of concrete.
Encroachment: After item(s) have been removed to inspect condition of public right of way.
Sign Location: To verify the location of the proposed sign.
Sign Footing: After excavation and forms are in place, but prior to concrete.
Sign Attachment: Method of mounting the sign to a structure or pole. Method of attachment of bolts or welds.
Sign Electrical: After connection is made but prior to energizing.
Sign Final: After all required inspections are conducted and approved and the sign installation is completed.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Pae:e 7 of8
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-01505
ISSUED: 02/23/2007
APPLIED: 11/27/2006
EXPIRES: OS/29/2008
VALUE: $ 8,000,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa2e 8 of8
225 Fifth Street
Springfield, b~egon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2006-01505
COM2006-0 1505
COM2006-01505
COM2006-0 1505
COM2006-0 1505
COM2006-01505
COM2006-0 1505
COM2006-0 1505
COM2006-0 1505
Payments:
Type of Payment
Check
CreditCard
Job/Journal Number
COM2006-0 1505
COM2006-01505
COM2006-01505
COM2006-01505
COM2006-01505
COM2006-0 1505
COM2006-0 1505
COM2006-0 1505
CO M2006-0 15 0 5
Payments:
Type of Payment
Check
CreditCard
cReceint 1
RECEIPT #:
Date: 11/29/2007
2200700000000001754
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 401 to 600 amps
Perm Serv/Fdr 1000 amps/volts
Add, Alter, Extend Circ Ea Add
Sign - Outline Lighting Each
Low Voltage - Commercial Indus
Paid By
GOPURA LLC
FUTURE TECH INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 1173 In Person
djb 029083 In Person
Payment Total:
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Perm Serv/Fdr 200 amps or less
Perm Serv/Fdr 40 I to 600 amps
Perm Serv/Fdr 1000 amps/volts
Add, Alter, Extend Circ Ea Add
Sign - Outline Lighting Each
Low Voltage - Commercial Indus
Paid By
GOPURA LLC
FUTURE TECH INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
djb
1173
In Person
029083 In Person
Payment Total:
Page 1 of I
1 :26:36PM
Amount Due
300.70
481.12
60 I .40
1,400,00
138.00
4 I3 ,00
3,808.00
55.00
200,00
$7,397.22
Amount Paid
$6,993.78
$403.44
$7,397.22
Amount Due
300.70
481.12
601.40
1,400.00
138.00
413,00
3,808,00
55.00
200,00
$7,397.22
Amount Paid
$6,993,78
$403.44
$7,397.22
11/29/2007