The URL can be used to link to this page

Home My WebLink AboutPermit Building 2004-7-27 . . . , e,... CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00893 ISSUED: 07/27/2004 APPLIED: 07/19/2004 EXPIRES: 01/27/2005 VALUE: $ 2,000,00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5660 DAISY ST 36 ASSESSOR'S PARCEL NO.: 1702334401439 Springfield TYPE OF WORK: Manufactured Home on Private Lot New Residential Contractor Type Electrical Manuf Home Inst Plumbing TYPE OF US~~~ ,\~.:~\S~~'\ ( "\,. , ,c.,. ~ \\ ..t...\' rM. ALLEN RANDOLPH A & JUDY E .J.~~ ~~~'~ ~\,pfione Number: PO BOX 70491 EUGENE OR 97401 \, <Vr- ~S ~ f;:)~<V'v . ~ ~': f' '\. . 1'\~ r~:" ~'\ "O\.\~'i<"'. ";S)~, I co~'C~~";~'lN N ~ ~ ~ ~ x..\) k.~ Contractor "'\ ~'\'0~<v~\) <V~ ~ License RALPH W BROWN ~ ~~ <o~ 63137 MICHAEL A WHEELERS M~~ ~OME S 91504 MIKE WHEELER MH SET UP 91504 484-1417 PROJECT DESCRIPTION: Replacement MH on private property Owner: Address: VN Expiration Date Phone 02/15/2006 541-729-1500 05/14/2005 541-928-0995 05/14/20~ \ 541-979-8709 ~J .~.'L t\.' I BUILDING INFORMATION , .~eo" -\:)~ "o~~. ~ o~ 0.... ~<;:) . e(S. eC$ e C:) !l: 'O~ # of Stories: . ~otQ~~~ ~<,j ~0o" 0 Height of Structure o~'" ~sq-~~~~\V ~o~. ~, 1,026 Type of Heat: Forced Air Er00'OS~q<~ gro~~~~.# Water Type: ~1 r6~~ "\~~ ~e~~' o~ Range Type: ~~~ ~~'~t$Q F~!Wl~~~,gto'Yt Energy Path: ~~ \~0 (jJ ~ ~~~~lhtW~ !lti Sprinkled Buildinl!t ~o~ &.~~<;:) ~ ~~ ' : ..~. (''/j 'l~ ,,'6 ("'~ 6;. ,.N' I DEVELOPMENT INFO~ :..>~ ~0 v.;s-0 ViI..,:" ~~~ ~,o\ ; REQUIRED PARKING ~ dJ ~flJ r.P Overlay Dist: '# Total:, 2 # Street Trees Rqd: 0 Handicapped: . Paved Drive Rqd: Yes Compact: % of Lot Coverage: 21.40 10'" # of Units: Primary Occupancy Group: Secondary Occupancy Gr~up: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 10.00 10.00 17.00 0.00 I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: All Hookups private and will go to private infrastructure Notes: Pal!e 1 of 3 , , -~~",,"~~.~D,I', l . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00893 ISSUED: 07/27/2004 APPLIED: 07/19/2004 EXPIRES: 01127/2005 VALUE: $ 2,000,00 ...? Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line l Valuation Description I Description Tvpe of Construction $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 2,000.00 Value Date Calculated Total Value of Project $2,000.00 $2,000.00 07/19/2004 Foundation Onlv Use Bid Amount ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $29.25 7/19/04 1200400000000001103 + 10% Administrative Fee $30.00 7/27/04 1200400000000001146 + 7% State Surcharge $21.00 7/27/04 1200400000000001146 Manuf Home State Issuance $30.00 7/27/04 1200400000000001146 Manufactured Home Conn - Plmb $45.00 7/27/04 1200400000000001146 Manufactured Home Feeder $50.00 7/27/04 1200400000000001146 Manufactured Home Placement $160.00 7/27/04 1200400000000001146 Plan Review Major - Planning $103.00 7/27/04 1200400000000001146 Storm Sewer - ht 50 Feet $45.00 7/27/04 1200400000000001146 Total Amount Paid $513.25 I Plan Reviews I Initiat Review 07/19/2004 07/19/2004 APP SKG Plannine Review 07/19/2004 07/21/2004 APP TAJ Public Works Review 07/19/2004 07/21/2004 APP MS 7/22/2004 - No SDCs Structural Review 07/19/2004 07/21/2004 APP DLM 7/21/2004 - All infrastructure is private and hookup will be private. See documents for plan review comments. To Request an inspection call the 24 hour recording at 726-3769, All inspection 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. ManufHome Set Up: When installation ofall piers or stands is complete. Final ManufHome Set Up: After all required inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc. have been installed. Manuf Home Plumbing: After home has been connected to water and sewer. MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. , Storm Sewer Line: Prior to filling trench. Paee 2 of 3 , , _~!7!"!!I~!!a;.~f. ~ '- . .' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00893 ISSUED: 07/27/2004 APPLIED: 07/19/2004 EXPIRES: 01/27/2005 VALUE: $ 2,000.00 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 ofany 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. (j(jjJ Own/.. or Contract - Pal!e 3 of 3 7- 21 -0'1 Date '225 ~ifth Street ' Springfield, Oregon 97477 .' 541-726-3759 Phone Job/Journal Number COM2004-00893 COM2004-00893 COM2004-00893 COM2004-00893 COM2004-00893 COM2004-00893 COM2004-00893 COM2004-00893 Payments: Type of Payment Check 7/27/2004 . av of Springfield Official Receipt "elopment Services Department Public Works Department RECEIPT #: 1200400000000001146 Date: 07/27/2004 10:59:08AM Description Manufactured Home Feeder Plan Review Major - Planning Manufactured Home Placement ManufHome State Issuance Manufactured Home Conn - Plmb Storm Sewer - 1st 50 Feet + 7% State Surcharge + 10% Administrative Fee Amount Due 50.00 103.00 160.00 30.00 45.00 45.00 21.00 30.00 $484.00 Paid By RANDOLPH ALLEN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 2960 In Person Payment Total: $484.00 $484.00 Amount Paid Page I of 1 . , ' .,.. CITY OF .N~FIELD SYSTEMS DEVELOPME.ORKSHEET JOURNAL OR JOB NUMBER: COM2004-00893 ' NAME OR COMPANY: Allen Randolph LOCATION: 5660 Daisy # 36 TAX LOT NUMBER: 17023344 Tax Lot 01439 DEVELOPMENT TYPE: Replacement ofMH NEW DWELLING UNITS 0 BUILDING SIZE (SF; 0 LOT SIZE (SF): 1. STORM DRAIN A.GE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. x I COST PER S.F. CHARGE 0.00 I $0.310 = $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. x I COST PER S.F. x I DISCOUNT RATE 0.00 I $0.310 I 50% - ITEM I TOTAL - STORM DRAINAGE SDC 1 $0.00 , DISCOUNT $0.00 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's x o B. IMPROVEMENT COST: NUMBER OF DFU's x o COST PER DFU $24.04 $18.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = 1 I $0.00 ...-" " -, 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE x 9.57 B. IMPROVEMENT COST: I ADT TRIP RATE x I 9.57 = 1 - 1 I NUMBER OF UNITS x I 0 COST PER TRIP $18.30 x I NEW TRIP FACTOR I 1.00 = 1 x r I , = I, x NEW TRIP FACTOR 1.00 I NUMBER OF UNITS' I 0 COST PER TRIP $80.72 $0.00 I "IJ"EM 3 TOTAL - TRANSPORTA TJON SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's x COST PER FEU o $82.03 B. IMPROVEMENT COST: NUMBER OF FEU's x COST PER FEU o $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = 1 SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE = I $0.00 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMlNISTRA TION FEE: " $0.00 I I $0.00 -- ~. . -... CHARGE $0.00 Matt Stouder 7/22/2004 TOTAL SDC CHARGES PREPARED BY DATE - , = = 1 = , = , , I =, 4792 1 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 #D1V/O! #DIV/O! $0.00 (/) W Cl o U ~ ~ - (/) >-< o ~ 1070 "j 1091 1092 1093 1094 1054 1055 1054 1056 ,I, 1079 1078 . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us . . Permit #: COM ZOO .0 <6'13 Address: 5"bbO bA-lS V Issued by: "b a .:;i .5 b Date: 7/Z. 7/0 V . Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~ 1. ~2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~ 3A. My Lg~eral contractor is f)1IILe- LM 'Y:P^,,>Wl61L I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. w ffe:-6-z,e:fL.. (Name) 7/.)"C l{ (CCB #) OR ,~ 3B. I will be my own general contractor. In hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. In change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. cl;;JA I<< f (Signature ~fp~rmit applicant) 1 .. 7... 1. -tJt (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 12-09-03 . ' . A~tn~~ ~)~~ @UIllt ([J)wnn ~eIIDeJr~n (C@IIDtJr2al~~@Jr? \: .. \ ", ,. j , , ~NIFO!RMAT~Ou\r NOT~CIE TO IP!ROIPIEIRTY OWNlElRS ABOJJT- CONSTIFUJ)(CT~ON lRIES[P>ONS~lBiUl~IES , . I , NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the I Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. ~, ----- -.-=.. . =- ._-----------~--~~-~ == If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. EmjpllloyeJr IRe~jpl@Iffi~rrlbJ1ill1irrrre~ You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. ;\s the employer, you must comply wWIn. tlhle foDlowing: Olregollll's Withholding 'fax lLaw: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will.be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment lflllsurance 'fa,,: As an employer, you are required to pay a'tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/fOlTIlsnav.htmll for the appropriate forms. .~ J',' " , , . " Workers' Compensatiolll JInsUll'alrnce: As an employer, you are subject to the Oregon Workers', Compensation Law, and must obtain workers' compensation insurance for your. employees. .If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Conswner and Business Services at 503-947-7815. , - U.s. llntenal Revenue Service: As an employer, you must withhold federal income tax from employees' wages: You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Re~JP>OIl1l~fibiHntie~ 2JI1ldl AJre2~ of COIffi~eJrJI1l~ Code Compliance: As the permit holder for this project, you are responsible for resolvirig any failure to meet code requirements that may be brought to your attentiop through,inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. . ' \. \ '. ' J Time: Make sure you have sufficient time to supervise your employees. \ Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner .doc 12-09-03 . . SpeF,IIELD ~ 225FIF]"H STREET SPRINGFIELD, OR 97477 (541) 726-3753 . FAX (541) 726-3689 www.ci.springfield.or.f.ls DEVELOPMENT SERVICES DEPARTMENT , ' MANUFACTURED HOME SET-UP AGREEMENT As required by the City of Springfield Development C6de,'I understand and agree that with the approval'of , the attached permits, one of the following manufactured homes will be placed at " ", b 0 "i:S2.<. r:""1 .dI\ 3 '" ) Springfield, Oregon, City Job Number ~ USb4 _ oe ~v ' ~ ~' c~~e I Manufactur:d HQJl1~ , , ' A multi sectional (double wide or wider) unit with an enclosed floor area of not less than 1,000 square feet, that has a nominal, roof pitch of 3 feet in height f6r each 12 feet in width, that has no bare metal siding or roofmg, and that has been certified by the manufacturer to have an exterior thermal envelope meeting perf~rmance s~dards .which redu~e heat loss to le.vels equivalent to ~wformaD.ce .s~~dards required ' for smgle faml1y dwellmgs at the t~e of constructIOn. ,',' ~ mlnals ><' N ~ 'AT-l'~ CTYPe,II Manufacture~ A unit of not l~ss than 12 feet in width enclosing a minimum floor area of 500 square feet, that h~ a nominal roof pitch of2 feet in height for each 12 feet in width, that has no bare metal siding or roofing, and that has been'certified by the manufacturer to have an exterior thermal envelope meeting performance standards which reduce heat loss to levels equivalent to the performance ~ds required for single ' family dwellings at the time of construction. ' ~'initials X' I further stale, by my signature below, that I bave been Pro~ith the fol16wmg infonnarioo: Manufactured Home Blocking, Water Line Connection, Street Tree Standards, Sanitary Sewer Connection, , Electrical Connection, and Minimum requirements for permanent steps. " ' I also understand that the manufactured home shall be placed on an excavated and backfilled foundation not to exceed 6 percent slope within 10 feet of th~ perimeter enclosure, enclosed at the perimeter with stone', brick or other concrete or masonry materials approved by the Builq,ing Official and with no more than 24 inches of the enclosing material exposed above grade. ' , ',- .'~ Signature I 7~)l~et) Date , , , " '. &; D , ' 0 0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · Fq?/~~26-3689 "'0 . iT. \5; ELECTRICAL PERMIT APPLICATION () ,vq( ,1)0' ~.o/'% ' City Job Number ,",,'1- ttO c6 q ~ Date -:LIlt:, /O~. C%,... ~I),'. &.s lJ:;q.s.s -I-J . . t,.rl) 1'1), "&' qo . ,*,\"I'''~'ll'~''~''f"..~:B'?~~""., "$'~}:;'~'''''~''i'Jo'~/'~(,q~~.?,~ ;d:\)~-;l!:':<.\'" ':~'\t51''.\!~;I' 3 ~;COM.RIJETE, cE.;' ',' ,EB:.e ",\~ l\ "'1':~ , ',~ . 1t~~.{"'''2''b.~,i&I;iffi,~'%~..'f.b~,~~"-...."",...."., ',:" "-t.l'2~~5'.' &b.;;,~J't . ~~.lI:{j;j~lY.!.,",. , I)ql. "::... ') I~" ~& ~{;"t;:t'V1'l~~'~h-'~'.\1:""'~""iW;~ii":::;' "~i;:::.~:",~~.~,;!i~~~;~~i;!Y~J?~!i:W~I" ,.. A. 'Ne~~Resiae'ntiar;t.~Siii(ile::"',:M - . . '.f~~1':::dfWIllli~~f111iit~ " ,,:.A~~~~-"'Y).:f~..~~~~~o~~.~""'~~1..:'":;.~ '''z._ ~ ~ '!1.:.t"'1:~U~~~l';i{.(A ,,'?:,~~..~'rk.,\I'\.JX~., ~ J 1-02 l 'j''icf 0' ~;J't LEGAL DESCRIPTION, .u.. );Zt,o fJIAJ~~ SJ; ~1", JOB DESCRIPTION' 1000 sq. ft. or less (J I. 1 1.. , / Each additional 500 sq. f()<<~ /f.e.;p ~I- ~/-"- frt~lIt.f7;tf:JTl1ftd 1'f)J*1.<..;. portion thereof '\~~ ~ ~\)\ Permits are non-transferable and expire if work is Each ~Ja~~\i.~~%~ not started within 180 days of issuance or if work is Mt~~P~~~t~~ or / $50 00 >0 .00 Suspe~~ed. for 1~0 _days,", _ . \~~' ~ S~~ \~ .~(JCJ. ,~' . I ~~~"f"'~~\:>l'9'1'Jl!'il.~~'\li't\l'@\jital$,~~''''15~.': ~~-e;'. \\\t\ Q. ~~4~~..;,t~~r~~i~:,,~;\,~,,)(,!,,~~\~ijl,~'f.r.;~~i~~'~fW' 2 lIiiJ'JfJN!ER!A€1JORiINSTAIlEfblCJN/O ,. ; \'1~'ts. ~~m:.~~'~~tFeeders~":.'WistallatJ()n~Alter:atJOI!,s~!i:J~,eloclltJon~:,:I&' . ~(;iiJjt&~~:!lzl~";f4J.~itt~if~"1i:..: ':0~~ ~~~\J<c(J~~' : '~:~.~~'f.M.tl~.\l:.\'i?.!i.~T:l..~..ti.;~'L~~&"il~~~,t;' Electrical Contractor .! ~ . tj \ ~ (J~~ Amps or less $ 63.00 , "Y" ~~'{ \'0 201 Amps to 400 Amps $ 75.00 Address / c.> 4' 2- ?,..f<,lA/'-. ~ 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts o..\O't)~ ~ ' $375.00 Reconnect Only ~~." ~~\.....A't\ $ 50.00 .oA~ ...o..Ot' 'lA\ \\~F . C ~~~'~:;~!ll~~~~..~;m. '. n~1 ~~:" ~~$~~~C09\6.~6\,6 n~~\~ $50.00 \o~~~~tfRPfu i~\~~~~'. $ 69.00 ~o\~~~~~~~~~~~ $100.00 \~~~~?~00\!~0 ~~. ~~olts see "B" above. .' MS.~m~ ~\~ft I ~,~~, :,.1l"k .., .3 ~ "": h ~.<<'~ Il ~&~ Alte;ation or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit . " ~:~.f!'I''S.'" ).~...,,(~.1.~'~~~~. :U1;Q.::~._-~~~:i.'}.3~.~.A':~~~ft-'l'!\I,'~~,w.~..~ :'~J~~ . 1. ~LOCA1TONoORXINST.AI5I:JArjl0N~M"'" ~~~\~'r0f~;'A~~;;'\rt'~}'\;~~tf&1t)J{.wj,;t~\:o1'\!i-Ji?AW~*iilii~n:i~~. City Phone ,72.-f '~/~ 00 Supervisor License Number Cf cfS ~-s Expiration Date 1& /1 /(J~ ( 13 ('$ 7 .~ -45 I c..... Constr. Contr. Number 10-/1 /~Y' ( , Signature of Supervising Electrician Expiration Date , ~ Owners Name ;(AlJOOt.J>JI ~. Address ....Q,n ~ ' 7t!J4 CJ / City E7./4dJ~ 1111lPh~ne -#~ ~ /4-/7 " ~... '" OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Service Included "" $ 19.00 $ 43.00 $ 3.00 fm~~11~fW'?~~i:?}~4'4~t"~;1.~!i~W?~w:d'~m~~~~~~~~~~~~t.:~!t~~,~"~\;~r~.~~~f\iC\14~~'~ E '~'1\i'1i"'''~'' I)"h"'....,"""',"-....(S;:."vA~'t'"'...Z'\;i.>;,.ti.;""''' "''''.r "..",. 'l"""'''d' )h'E...'.I!C:.''-'I''C\ ..~t"~ll~~t."'''',.. . ~i"1", sce aneous:: erVlce ,Jeeuef:;nOri~UlC uue 'i.:":'" '3C 1;' ns a a IOn. ~~~~~~~~~it~~t&::cllt.:;.~~~~~t.~'{'~t>>'~~'~\~b~VW-J~~~~w'~.l1'%'.\~..ri';'li~~iGA!d Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges """""'U~~'~"_i!1j, 'A','W"'?(!";;"~' ' ^"':;:': :>Il'",.~,. ' ""'.'__"::t:lM.'. "..1"""':'><.., ",..,..y"\,, "~"'",."" . ~1<'M'.. t-, ~'."(cj,,,,,,,,, 't-~y, ."".... ,,,,,,,,~,,,,,,,,,,,,,'''''';'t'''':,''~',,,, '.-'~.~lr:" .':'~'. _. '. 4.' ~SrrB.1;OTAL"f)EM130ME 1tJ;'.\ii\N;,,,,,.~""\.""'7;;U""'~"'''''''';.M~:''\o-:<l!''l;;,\'' :-1 ~~~j~1'~.U~~'ti4~~~~"t~'~.bIi&b1. ,< '~iao ~i~ <;;00 7% State Surcharge 10% Administrative Fee TOTAL ~/S:-O Shared Drive(T:)IBuilding Fonns/Electrical Pennit Application 1-03.doc