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Home My WebLink AboutPermit Building 2005-5-11 . .. CITY OF ~rKll~u.l'lELD . Building/Combination Permit PERMIT NO: cOM2005-00490 ISSUED: 05/11/2005 APPLIED: 04/26/2005 EXPIRES: 11111/2005 VALUE: $ 60,077.00 'i" Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2512 MAlA LP ASSESSOR'S PARCEL NO.: 1703251404600 Springfield TYPE OF WORK: Manuf Home w GaragelCarport Private Lot New Residential TYPE OF USE: PROJECT DESCRIPTION: Maia Park lot 23 - Manfactured home with awning/carport Owner: BILL SHORT Address: 303 S. 70TH PL SPRINGFIELD OR 97478 Phone Number: 541-746-4911 1 CONTRACTOR INFORMATION I Contractor Type General Electrical Plumbing Contractor HARRISON JACOBSON INC RALPH W BROWN HARRISONJACOBSO~INC License 66447 63137 66447 Expiration Date 05/07/2007 02/1512006 05/0712007 Phone 541-689-7762 541-729-1500 541-689-7762 .1"BUII:.D1NG INFORMA nON I ",-y:-'<- 0', # of Units: 1~ #' \\S# of Stories: 1 Lot Size: Primary Occupancy Group: ~f!,'!3~,<-~ &-<v Height of Structure Sq Ft Ist Floor: Secondary Occupancy Group: <S-.J:? 0~ Type of Heat: Electric Sq Ft 2nd Floor: Primary Construction Type ~'v ~.lhrj!:-'S Water Type: Electric ..sS~ Ft Basement: Secondary Construction TYP,i: ~'<; ~ Range Type: , Electric 0'::' .~ ~f.G.!'ragelCarport . # of Bedrooms: 'N<{,' if- ~~ ~ 0 r;])' Energy Path:' <b.,-l\!:,~~~Ot~r: ^"",-" ()'<-~ 1f ~ 'S iv~ Sprinkled Building: nfg'> ~ <b 04:.supallt Load: _''-J ,.. '" 0.."- ....v. . Q '.C$ ~<U 3.." 0\ ~VJ ",,0 ;- '",-,<-~",-y:-~*~~ <V'?--' I. DEVELOPMENT INFORMA T\oN~I;-'~0" O~ ~0 '<b~vc.f' ~r'0~\ ,'fi &'-<:)4, <b" ~ ~ ~ ;.}U:QUlREDPARKING v~ ~b~~.~<b#~ . F~ontyard Setback: ~ 20.00 Overlay Dist: (j-flJ ,!p A..~ ;$" o~ .~.~ Ifl)lal: . .' 2 SIde 1 Setback: 5.00 # Street Trees RlJ-~~' bO~' ~.!:, G ~d'3> .;;f a;cVii.andicapped: Side 2 Setback: 6.00 Paved Drive Rgd? r;, 'Ii <be:' <;::,<;::',.,1f \(e,\:><:' ~ Compact: Rearyard Setback: 20.00 % of Lot CoyeJal:.e? !:'v ~"~~ ,M#'{)<;::,<$ . Solar Setbacks: 0.00 ~' ,j .t}C iD'l; ~'1J- of 00 " " ~ .C'", 0\ .. (), _~ '..':J I PUBLIC IMPROviMEN,fS.t .!:'~;-:-& #' .~ s:s- # ~ (J0 , F II I d ~ G ~'~Idewalk Type: u V mprove ,:;) Yes ~ 1I0wnspoutslDrains: 5,227 1,620 336' Street Improvements: Storm Sewer Available: Special Instruction: Curb and Gutter Notes: Storm drainage piped to curb face 4/2912005 CAS Paee 1 of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Bid Amount Foundation Onlv Manuf Home Use Bid Amount Use Bid Amount Manufactured Home Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Addressing Assignment Foundation Permit GaragelCarport Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Feeder Manufactured Home Placement Manufactured Home Service Plan Review Major - Planning Sanitary Sewer - 1st 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement .SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - Ist 50 Feet Water Line - Ist 50 Feet WilIamalane Manuf Home Private Total Amount Paid Initial Review Plannlne Review 04/28/2005 04/28/2005 . I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 $1.00 $1.00 Square Footage or Bid Amount 5,577.00 4,500.00 50,000.00 Total Value of Project ~ Amount Paid $74.88 $58.76 $41.13 $3.00 $31.00 $68.40 $76.20 $30.00 $45.00 $50.00 $160.00 $50.00 $103.00 $45.00 $420.44 $552.92 $10.00 $865.31 $82.03 $124.40 $63.57 $772.49 $175.13 $881.02 $45.00 $45.00 $1,000.00 $5,873.68 Date Paid 4/26/05 5111105 5/11/05 5111105 5111105 5111105 5/11/05 5111105 5111105 5111105 5/11105 5/11/05 5111105 5111105 5111105 5111/05 5111105 5/11/05 5111105 5111105 5111105 5111105 5111105 5111/05 5111105 5111105 5111/05 I Plan Reviews I 04/28/2005 04/29/2005 APP SKG APP TAJ Paee 2 of 4 . CITY OF ~rKlNu1<lJ!,L1J Building/Combination Permit PERMIT NO: cOM2005-00490 ISSUED: 05/11/2005 APPLIED: 04/26/2005 EXPIRES: 11111/2005 VALUE: $ 60,077.00 Value Date Calculated $5,577.00 $4,500.00 $50,000.00 $60,077.00 04/26/2005 04/2612005 05/1112005 Receipt Number 1200500000000000506 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 2200500000000000567 r . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005-00490 ISSUED: 05/11/2005 APPLIED: 04/26/2005 EXPIRES: 11111/2005 VALUE: $ 60,077.00 ',l Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 04/28/2005 04/29/2005 APP CAS Storm drainage piped to curb face 4/2912005 CAS Structural Review 04/28/2005 05/1 0/2005 OK RJB 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. I 1l'~~n<nprt\lliLl Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are instailed. 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. Framing Inspection: Prior to cover and after aU rough in inspections have been approved. Shear Wail Nailing: Before covering sheathing with finish materials. Drywail: Prior to taping. ManufHome Set Up: When installation of aU piers or stands Is complete. Final Manuf Home Set Up: After ail required Inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc. have been Instailed. Final Building: After all required Inspections have been requested and approved and the building is complete. Water Line: Prior to mling trench and including reqnired testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. 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. MH Service: Approval required prior to utility company energizing service. MH Pedestal: Approval required prior to utility company energizing service. Final Electric: When aU electrical work is complete. Paee 3 of 4 . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2005-00490 ISSUED: 05111/2005 APPLIED: 04/26/2005 EXPIRES: 11111/2005 VALUE: $ 60,077.00 " Status Issued 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 carefuily 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. J1l~/L sltl/~- Owner or Contractors Signature Date Paee40f4 Gf . DEVELOPMENT ~ERitlCES DEPARTMENT o 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 www.ci.springfield.or.us MANUFAeTURED HOME SET-UP AGREEMENT As required by the City of Springfield Development eode; [ understand and agree that with the approval of . the attached pe"'lits~ne of the following manufactured homes will be placed at '2..<-=; I "2- . ,^^:>.A '" '-'"f-' . . Springfield, Oregon, eity Job Number ~ .,~'\ - ri1;),,-/"; 0 Type.I-MimutactUred Home.') .' . Sltisectional (double wide or wider) unit with an enclosed noor area of not less than 1,000 square feet, that has a nominal roof pitch of 3 feet in height for 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 performance standards which reduce heat loss to levels equivalent to the performance standards required for single family dwellings at the time of construction. initials Ty]JeJ1 Manufactured Home: .' . A unit~tless than 12 feet in width enclosing a minimum noor area of 500 square feet, that has 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 beeti'certified by the manufacturer to have an exterior thermal envelope meeting performance standards which redli",heat loss to levels equivalent to the performance standards required for single family dwellings at the time of construction. initials I further state, by my'signature below, that I have been provided with the following information: Manufactured Home Blocking, Water Line eonnection, Street Tree Standards, Sanitary Sewer Connection, Electrical eonnection, 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 the perimeter enclosure, enclosed at the perimeter with stone, brick or other concrete or masonry materials approved by the Building Official and with no more than 24 inches of the enclosing material exposed above grade. . . "t/~iIA_iL Signature S' /11 /aJ~ Date I . . .1 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT" DRAINAGE FIXTURE UNITS I (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES) NO. OF FIXTURES DRAINAGE J UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 I I DRINKING FOUNTAIN 0 0 1 = 0 I IFLOOR DRAIN 0 0 3 = 0 I /INTERCEPTORS FOR GREASE lOlL I SOLIDS 1 ETe. 0 0 3 = 0 I INTERCEPTORS FOR SAND 1 AUTO WASH 1 ETe. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 leLOTI-IESWASHER 1 MOP SINK 1 0 3 = 3 I ICLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 I IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 II IRECEPTOR FOR REFRIG I WATER STATION I ETe. 0 0 1 = 0 IREeEPTOR FOR eOM. SINK 1 DISHWASHER I ETe. 0 0 3 = 0 I ISHOWER. SINGLE STALL 1 0 2 = 2 I I SHOWER. GANG CNUMBER OF HEADS) 0 0 2 = 0 ISINK: eOMMERCIAURESIDENTIAL K1TeHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 I URINAL. STALL I WALL 0 0 5 = 0 ITOILET. PUBLle INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 2 0 3 = 6 MIseELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 .EDU (Equivalent DwellinK Unit) is a discharKe eQuivalent to a sinKle family dwellin,g unit (20 DFlJs) set at 167 AA1lons per dav_ MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE r--- YEAR L ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 eREDIT RATE/$I,OOO ASSESSED V AWE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 IS LAND ELGIBLE FOR ANNEXATION eREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. eREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 eREDIT FOR LAND (IF APPLICABLE) VALUE 11000 eREDIT RATE $0.00 x $5.29 ~ I $0.00 eREDIT FOR IMPROVEMENT (IF AFfER ANNEXATION) VALUE 11000 eREDIT RATE $0.00 x $5.29 = I o TOTAL MWMC eREDlT = $0.00 I CITY OF S.FIELD SYSTEMS DEVELOPMENT IRKSHEET JOURNAL OR JOB NUMBER: C0M2005-00490 NAME OR COMPANY: Bill Short LOCATION: 2512 Maia Loop TAX LOT NUMBER: 1703251404600 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF: 2124 LOT SIZE (SF): I. STORM DRAINAGE . -I- I rJl Lt.l Cl 0 U 0:: 5235 Lt.l f-< rJl (3 ~ DlREeT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x! eOST PER S.F. eHARGE I I 2842.00 I S0.310 I = I $881.02 RUNOFF ROUTED TO DRYWELL DESIGNED AND eONSTRueTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I eOST PER S.F. I x I DlseOUNT RATE I I I 0.00 I I SO.310 I I 50% = I DISCOUNT $0.00 ITEM I TOTAL - STORM DRAINAGE SDe $881.02 $881.02 1070 2. SANITARY SEWER -CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x COST PER DFU I 23 I $24.04 $552.92 11091 B. IMPROVEMENT COST: I NUMBER OF DFU's I x 1 23 I S18.28 $420.44 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $973.36 3 TRANSPORTATION A. REIMBURSEMENT eOST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 9.57 I I I S18.30 I 1.00 , $175.13 1093 B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I eOST PER TRIP x INEW TRIP FACroRI I 9.57 I I I I S80.72 I 1.00 S772.49 1094 . ITEM 3 TOTAL - TRANSPORT A nON SDC = I $947.62 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I S82.03 = $82.03 11054 B. IMPROVEMENT eOST: I INUMBER OF FEU's I x ICOST PER FEU I I I I S865.31 = $865.31 11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) SO.OO 11054 MWMe ADMINISTRATIVE FEE $10.00 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDe = , $957.34 I I SUBTOTAL (ADD ITEM5 1,2,3, & 4) = , $3,759.34 , I S. ADMINISTRA TIVE FEE: I SUBTOTAL x ADM. FEE RATE 1= CHARGE I S3.759.34 5% I S187.97 TOTAL SANITARY ADMINISTRATION FEE: 124.40 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: S63.57 11078 Cheryl Slaymaker 4/29/2005 TOTAL SDC CHARGES =1 $3,947.31 PREPARED BY DATE 225 Fifth S~reet Springfield, Oregon 97477 541-726-3759 Phone I : Job/Journal Number , : COM2005-00490 GOM2005-00490 eOM2005-00490 COM2005-00490 . COM2005-00490 , :"COM2005-00490 . COM2005-00490 . COM2005-00490 C;OM2005-00490 COM2005-00490 COM2005-00490 eOM2005-00490 COM2005-00490 . eOM2005-00490 " COM2005-00490 COM2005-00490 i COM2005-00490 : COM2005-00490 CbM2005-00490 COM2005-00490 eOM2005-00490 , COM2005-00490 'l;,COM2005-00490 . cOM2005-00490 . eOM2005-00490 COM2005-00490 Payments: Type of Payment CreditCard '.. .. . I ; ,. .\ ,. , 5/11/2005 -j:~~."" i u.... . ~ t ~~- Rty of Springfield Official Receipt .velopment Services Department Public Works Department . RECEIPT #: 2200500000000000567 Date: 05/1112005 Description Addressing Assignment WiUamalane ManufHome Private Manufactured Home Placement Manuf Home State Issuance Storm Orainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SOC Transpo Reimbursement SOC Transpo Improvement soe MWMe Reimbursement SOC MWMe Improvement SDC MWMe Administration SDC SanitarylStorm Admin SDe Transpo Admin Plan Review Major - Planning Garage/Carport Sanitary Sewer - 1st 50 Feet Water Line - 1 st 50 Feet Storm Sewer - 1st 50 Feet Manufactured Home Conn - Plmb Foundation Permit Manufactured Home Feeder Manufactured Home Service Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By WILLIAM B HARRISON Item Total: Check Number Authorization Received By Batch Number Number How Received JMP 077070 In Person Payment Total: Page I of I II:48:56AM Amount Due 31.00 1,000.00 160.00 30.00 881.02 : 552.92 . 420.44 175.13 772.49 82.03 865.31 10.00 124.40 63.57 103.00 76.20 45.00 45.00 45.00 45.00 68.40, 50.00. 50.00 . 3.00 41.13 58.76 $5,798.80 Amount Paid $5,798.80 $5,798.80 SPRINGFIELD r ~ )-; Date -5 It '/0 .1- , 1, 3. I COMPLETE Fjf~EDULE BELOW '0 . tt.:';j, vt9/ "O'~.or. ~ . ,()\ ().- A. I New Rt~id~ tial ~ingl;~d'~!i:~ti-Family per dwelling unit. "0 - :~ :O-;'--I!'V6 Service Incl~ ~"90;' ">/i), U! 61 &0" JOB DESeRIPTlON 1000 sq. ft. or les5"b;" ~~, 1... $106.00 ,A,}, t, ./. '~...,..,. ~ en Each addinonal 500 ~~,Jt. 0 ,::R" "''-''""'1.,,, TIt T :;C-t1IC E"" ,fitfr... c:. l"\l.; -'L. portion thereof ~<-? &".s't&410 I' '~~~ Permits are non-transferable and expire if work is Each Manufacl'd Home or ., ~ not started within 180 days of issuance or if work is Modular Dwelling Service or 0.00 Suspended for 180 days. Feeder "'-. "'- 2. I CONTRACTOR INSTALLATION ONLY I B. I Services or Feeders -Installation, AI~tions or Relocation: Electrical eontractor ~ ~ 200 Amps or less $ 63.00 7 t . f 201 Amps to 400 Amps $ 75.00 Address /0 C(2- 7~ ",.' :~~ 401 Amps to 600 Amps $125.00 ~ "7 "'<;;..~v~O\ 601 Amps to 1000 Amps $163.00 eity C-c.-.-::-1>.' Phone I' Z4f.~lSoo Over 1000 AmpsNolts $375.00 t7 ':(\'(-..... <;;..'(.."",," \Ij'~ Reconnect Only $ 50.00 ~\.- <;;..'P ~S ~:\)y.<;"\) Supervisor LicenseoNumber'O\\~~\-\l-9'~'B ~ S '\\'\;v ~\ '0""~"('- ....:., ox..~ ov'V /.,,'(.. \ ,.;;:,. Expiration Bate\c...' ,,\\.." ",/)J . C/.Jr "\\\~\\\'V~0~\J\..) <v eonstr. eontr. Number"l ,,(\ 'V~ ?: I 5 7 I:;"'c4. ,- Expiration Date i'-\' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION eity Job Number c.t> """ 'Z. 00 r- 0 0 4 <70 I. I LOCATION OF INSTALLATION 2 '5" I '2- Vltt A- tA- l-(-' LEGAL DESeRIPTlON 170~2 5/1{ D l( hCO A/()~ Signature of Supervising Electrician ~'-W~ II c:; l..~ f- 70f-1... Address r<;- rf 30"3. S S~r~ Owners Name eity Phone 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 ~ ~~~~ IOD c. I Temporary Services or Feed~o 0'" ~~ ~ Installation, Alteration Q"'~-;'~o.-tl;ti~ ~,. ,s' - 't~ fQ' \:)" ~ 200 Amps or less 00'. ~0C$ ~0 C; >,,'V Go'Q $ 50.00 A:O'1f-""~0 201 Amps to 400 ~Y'",~0 ~0" ~<?- ~v .,<::' $~9.00 40 I Amps to 6~m;i 0 <,V ~ 0', "S''''.f'~-~ 00.00 . 0q,~0,':o.C; ,C$" v 0' .~'v Over 600~)iJf 'VUu\..y.olt~~SB'\1 ~\l'SVe: D. ~r <ii"GlrC!!Us'~ _(,0 ,,-0" ,"$.~ ~\ . _" fQ' ~. ..",'iJ ,->' !\; ~ A~~~~,Qn& F&1'~!~ ger ~~el ~ ... .J"~s::s.\ ~0 q; s:> u~!€mglil b'V !l>--' 0~ 0<,0 'br:::J $ 43.00 Ea~\#'d~b~!)~~irslii~ ,,:.j,tn "5 S~ic<:rr~~'a~'f\~1I~0<'~ / $ 3.00 ~OL$>~ rt>-f:J'<::' E. I Miscella~_~Service/feeder not included) -Each Installation I , Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 SUBTOTAL OF ABOVE 10 {::;> 7l.(t. /060 17Lfr:3 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T)/Building ForrnslElectrical Permit Application I-03.doc