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Home My WebLink AboutPermit Building 2004-1-16 (2) " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRIN"'t<!J!,LlJ Building/Combination Permit PERMIT NO: COM2003-00427 ISSUED: 01116/2004 APPLIED: 05/30/2003 EXPIRES: 07/16/2004 VALUE: $ 151,736.40 SITE ADDRESS: 7281 Holly Street ASSESSOR'S PARCEL NO,: 1802021203800 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: . New Residential PROJECT DESCRIPTION: Single Family Residence Owner: RON HIGGINS Address: .4536 GLACIER DRIVE SPRINGFIELD OR 97478 . Contractor Type General Electrical Mechanical Plumbing Phone Number: 541-521-7006 I CONTRACTOR INFORMATION I Contractor OWNER STEVE HAUCK OWNER OWNER REQUIRED PARKING Overlay Dist: JTENT18~,fi"\',6gon l!lRlJI!:qUlres you to 2 # Street Trees Rqd: Pi '~. t d b~Uf'5i'1!B~ Utility Paved Drive Rqd: follow rules adOp e O';Dact. t f rt! "otiflce.tlon c~r. Thos [WOOs-are se e % of Lot Coverage:, OAR 952-~:lllbO~O \h.~ugh OAR 952'()()' 0090. You, may obtain' c'oples of the rules l . .0 1-.--.....--- I PUBLIC IMPROVEMENTS.,lIl1ng tfnetCtlh '';;eg' "~~'UtI;iiY N~tifl~aiion .' ber or e Street Improvements: Fullv Improved -. StdewalI<;:r~poon-332-2344). Curbside 5' Storm Sewer Available: Yes Downspoutsillrains: Curb and Gutter Speciallnstru<fJmICE: ' . Notes' THIS PERMIT SHALL EXPIRE IF THE WORK , AUTHORIZED UNOER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 160 DAY PERIOD. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: . SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: . License Expiration Date Phone 147618 04/30/2005 54 I -221-2665 BUILDING INFORMATION I I R-3 V-I VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: 402 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 3 2 24.50 Wall Heat Electric Electric Path 1 960 819 I DEVELOPMENT INFORMATION I 50,00 6,00 10,00 34.00 0.00 Paeelof5 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Dwellin!!s Dwellin!!s Gara!!e Tvpe of Construction V Wood Frame V Wood Frame Gara!!e . Fee Description Plan Review Residential -Mechanical Issuance Fee- + 100/0 Administrative Fee + 7% State Surcharge 3 Baths One & Two Family Addressing Assignment Annexed 1979 or Before Building Permit Copies - Ea Addtl @ 50 Cnts Ea Copy 1st @ 75 cents Curbcut Permit Dryer Vent . Exhaust Hoods Minimum/Adjustment Mechanical Plan Review - Planning Plan Review Residential Plan ReviewlResidential Hourly PW Mult Disc. 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family . I Valuation Descrintion I $ Per Sq Ft or multiplier $74,60 $90.60 $19.60 Square Footage or Bid Amount 1,779,00 123.00 402,00 Total Value of Project )?ppr. P'IiILI Amount Paid $454.29 $10,00 $129,87 $90,91 $306,00 $8,00 $-130,53 $734,65 $17,00 $1.50 $75,00 $6,00 $9,00 $12,00 $59,00 $23,23 $90,00 $-30,00 $106,00 $57,00 $402,96 $530,16 $10,00 $34,83 $332,86 $90,06 $47,82 $709,81 $160,87 $75,00 $706,69 $50.00 $18,00 $1,000,00 Date Paid 5/28/03 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 1/16/04 Pa!!e 2 of5 . CITY OF SPR11~unJ'.LU Building/Combination Permit PERMIT NO: COM2003-00427 ISSUED: 01116/2004 APPLIED: 05/30/2003 EXPIRES: 07/16/2004 VALUE: $ 151,736.40 Value Date Calculated $132,713.40 $11,143,80 $7,879,20 $151,736,40 05/30/2003 12/19/2003 05/30/2003 Receipt Number 1200200000000001337 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 1200400000000000064 . CITY OF SPRINGn1i.LU Building/Combination Permit PERMIT NO: COM2003-00427 ISSUED: 01/16/2004 APPLIED: 05/30/2003 EXPIRES: 07116/2004 VALUE: $ 151,736.40 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Amount Paid $6,197,98 I Plan Reviews I Initial Review Planning Review Public Works Review OS/29/2003 05/30/2003 06/10/2003 LLH AJD VRJ 05/30/2003 06/1 0/2003 06/13/2003 APP APP WE Public Works Review 06/18/2003 06/18/2003 APP VRJ Revised Plan Review - Pia 06/17/2003 Revised Plan Review - Pu 06/17/2003 06/17/2003 APP VRJ Revised Plans ReceivedIRo 06/17/2003 APP LLH Structural Review 05/30/2003 07/10/2003 WE DLM Structural Review 07/14/2003 07/14/2003 WE DLM Structural Review 08/11/2003 08/1112003 WI DLM Structural Review 08/14/2003 08/14/2003 WE DLM Structural Review 09/16/2003 09/27/2003 WE DLM Page 3 of5 Contacted Jack Fowler 6/13/2003 3:26pm, Site plan shows proposed structure inside PUE, requested revised site plan showing structure outside PUE, Plumbing fixtures were not on building plan, received updated building plans 6/17/2003, Revised Plot plan only Revised plot plan Waiting for structural corrections on truss dwgs, as well as engineering of beam and wall connection detail, See "Needinfo" in documents for details, Received revised engineering data from engineer; waiting for truss information. Received revised truss information. Advised by Public Works (Eric) that problems with LDAP may necessitate changes, Waiting for update information, Talked to Adam at Mortier Engineering, There is revised engineering data for this project, which has not been submitted to this office. They are waiting to resolve the issues with Public Works before submitting the new data, Will rene" plan review when the revised data arrives. Received copy of approved LDAP, Plans and calcs do not match building submittals. Called Adam @Mortier, He will have revised drawings conveyed to us, . . CITY OF SPRIN\.d'lt<..LD Building/Combination Permit PERMIT NO: COM2003-00427 ISSUED: 01116/2004 APPLIED: 05/30/2003 EXPIRES: 07116/2004 VALUE: $ 151,736.40 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 09/19/2003 09/30/2003 APP DLM Received revised drawings to match LDAP approved plans ( including revised building plnas and engineering calcs), 9/18/03 dim See documents for plan review comments. Structural Review Structural Review 11/2112003 11/14/2003 Plan review - second revision 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. 'Rp~ 1 Sidewalk - Curbside: After forms are erected but prior to placement of concrete, 2 Curbcut - Standard: After forms are erected but prior to placement of concrete, 3 Site Inspection: To be made after excavation but prior to setting forms. 4 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation Inspection, 5 Footing: After trenches are excavated, 6 Foundation: After forms are erected but prior to concrete placement, 7 Post and Beam: Prior to floor insulation or decking. 8 Floor Insulation: Prior to decking, 9 Shear Wall Nailing: Before covering sheathing with finish materials, 10 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 11 . Wall Insulation: Prior to cover, 12 Ceiling Insulation: Prior to cover, 13 Drywall: Prior to taping, 14 Final Building: After all required inspections have been requested and approved and the building is complete, 15 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill, 16 Underfloor Plumbing: Prior to insulation or decking. 17 Underfloor Drain: Prior to cover or placement of concrete, 18 Rough Plumbing: Prior to cover and including required testing, 19 Water Line: Prior to filling trench and including required testing, 20 Sanitary Sewer Line: Prior to filling trench and including required testing, 21 Storm Sewer Line: Prior to filling trench; 22 Final Plumbing: When all plumbing work is complete, 23 Rough Mechanical: Prior to Cover 24 Final Mechanical: When all mechanical work is complete, 25 Temporary Electric: Approval required prior to Utility Company energizing pole, 26 Rough Electric: Prior to Cover 27 Electric Service: Approval required prior to utility company energizing service, 28 Final Electric: When all electrical work is complete, Paee 4 of5 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: COM2003-00427 ISSUED: 01116/2004 APPLIED: 05/30/2003 EXPIRES: 07/16/2004 VALUE: $ 151,736.40 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 Pal!e 5 of5 1-/10-0'-( Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 COM2003-00427 Payments: Type of Payment Check . iaI. ....1po.Q. . WI.:r "c.c.....~ "-.'~"'i. c'~'. I . .... I . _ .. ~,' c..... ..'C- .or Receipt #: 1200400000000000064 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Plan Review - Planning Sidewalk Permit Curbcut Permit PW Mult Disc - 2nd Permit Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Annexed 1979 or Before 3 Baths One & Two Family Vent Fan Exhaust Hoods Dryer Vent Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Copy 1st @ 75 cents Copies - Ea Addtl @ 50 Cnts Ea Plan ReviewIResidential Hourly Plan Review Residential Building Permit + 7% State Surcharge + 10% Administrative Fee Paid By THE JOY OF BOOKKEEPING Received By djb Check Number Batch Number Authorization Number City of Spriugneld Official Receipt Development Services Department Public Works Department Date: 01/16/2004 8:44:22AM Amount Paid Item Total: 8.00 1,000.00 106.00 57.00 50.00 59.00 75.00 75.00 (30.00) 706.69 530.16 402.96 160.87 709.81 332.86 34.83 10.00 90.06 47.82 (130.53) 306.00 18.00 9.00 6.00 12.00 10.00 1.50 17.00 90.00 23.23 734.65 90.91 129.87 $5,743,69 . . How Received In Person Payment Total: Amount Paid $5,743.69 $5,743.69 .. A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENflW'ORKSHEET JOURNAL OR JOB NUMBER: com2003.00427 NAME OR COMPANY: Ron Hig~ens LOCATION: 7281 Holly Street TAX LOT NUMBER: 18020212 tl 3800 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF' 0 LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I, 2506.00 I SO.282 I = I $706.69 I RUNOFF ROUTED TO ORYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I DISCOUNT I 0.00 I I $0.282 I I 50% I ~ I $0.00 j! 8712 en W Cl o U pel ~ en G ~ ITEM I TOTAL - STORM DRAINAGE SDC S706.69 S706.69 1070 I 2. SANITARY SEWER . CITY A. REIMBURSEMENT COST: I NUMBER OF OFU's 1 x I COST PER DFU I 24 I I S22.09 S530.16 11091 B. IMPROVEMENT COST: I I NUMBER OF DFU's I x COST PER DFU I 24 I S16.79 S402.96 1092 ITEM 2 TOTAL - CITY SAN IT ARY SEWER SDC = I S933.12 I' -- 3. TRANSPORTATION A. REIMBURSEMENT COST: I I ADTTRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x I NEW TRIP F ACTOR I I 9.57 I I I I I S16.81 1.00 S160.87 11093 8. IMPROVEMENT COST: II I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x I NEW TRIP F ACfORI I 9.57 I I I I I 574.17 1.00 I S709.81 11094 ITEM 3 TOTAL - TRANSPORT A nON SDC ~ I S870.68 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I I S332.86 = S332.86 11054 B. IMPROVEMENT COST: I INUMBER OF FEU's I x ICOST PER FEU I 1 I I S34.83 = S34.83 11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) (S\30.53) 11054 MWMC ADMINISTRATIVE FEE SIO.OO 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SD< ~ , S247.16 I '- SUBTOTAL (ADD ITEMS I, 2, 3, & 4) ~ , S2,757.65 I 5. ADMINISTRATIVE FEE: ISUBTOTAL I x I ADM. FEE RATE I~ CHARGE I S2.757.65 I 5% I S137.88 TOTAL SANITARY ADMINISTRATION FEE: 90.06 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: S47.82 1078 Virginia Jurasevich 6/18/2003 TOTAL SDC CHARGES =, $2,895,53 PREPARED BY DATE H . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS II (NOTE, FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL AXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUIV ALENT UNITS I BATHTUB 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 I ICLOTHESWASHER/ MOP SINK 1 0 3 = 3 I ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 I IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12. = 0 I IRECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I IRECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER. SINGLE STALL 0 0 2 = 0 ISHOWER. GANG (]'lUMBER OF HEADSl. 0 0 2 = 0 IS INK, COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 3 0 1 = 3 IURINAL. STALL! WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 24 .EDU (Equivalent Dwelling Unit) is a discharl!;e equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDlT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1991 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT RA TE/$ I ,000 ASSESSED VALUE $4.92 $4.92 $4.83 $4.77 $4.64 $4.47 $4.30 $4.09 $3.78 $3.41 $2.98 $2.52 $2.06 $1.64 $1.45 $1.31 $1.I3 $0.97 $0.82 $0.63 $0.41 $0.22 $0.04 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $26.53 x $4.92 ~ , $ I 30.53 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $4.92 o TOTAL MWMC CREDIT = $ I 30.53 ~\~'6 \0\\0 0 . I ",,"f1""~<,0 ,,~ ,,~~,Q 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:.(541)726-36~~"'~.,00')"'t~)" :;,J~, ELECTRIC~'ERMIT~'LICATION . ,<,~\"o~.<'o\ ~'\ 00 City Job Number . Date \0\\0 .,<,0 ""e n. n \ .~\\:-~ ,'lJ.\- ~\(\'tJ I. I LOCATION OF INSTALLA170N '1 3, I COMPLEl"E FEE SfJ!lEDi!lLE ]Jl'L9,l-tV' .1 LE~~~~SCR~~?~~\1 . ~-\te& A,! NOwROSidential~S!ngr:~;;~~i~:~::~i)Y perdw~Ilillgunit. . I \ ~ IVUyL\ '"L 0 3 ~ro $106.00 JD(o.CD 5~ ,tJJ ". ' CI1Y OF SP:td'NGFIELD, OREGON 0 c9-\~1 ~ \ t\q}2- lLq '-Wtf Permits are non-t sferab and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, JOB DESCR[PTION 2. I. CONrRACT(jRINSTALI!ATION ONLYi.i EIectrica[ Contractor 57fE.V(;. /ffl.ucJL Address (3J.B 5 '-lb1b s+ City 9r;rclJ Phone aa" - Gllb6S ?c~..., .s Supervisor License Number .,.:)..J T "T'" Expiration Date J 0 - I - at..! Constr. Contr. Number I Lj l' b 1& Expiration Date (I-so - 05 Signature of Supervising Electrician il RatA- \.; Phone~' O~ERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-~769 Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof I ~ $ [9.00 Each Manufact'd Home or Modu[ar Dwelling Service or Feeder $50.00 B, I.S~rvices or.Feeders 2iiist~lt~tiOll, AlteratiOl;s o~ Reiocatio~t:, .1 200 Amps or less ,20 [ Amps to 400 Amps 40 I Amps to 600 Amps 60 [ Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. I Te,IjIpor.af.Y Services'Oi.fe,.Meis' t,;" l~t~\!!ll.PJtKMt~t@B(J)]1 Ri\IbCifillllres you. t.~ 1~6wl1tlbDreIl1dOpted by the Oreqon ~{t~Ro .-eJ) . ci) 'll5\\f~ 4IJor:ellilpsThOSe ru~..: ~~" _,,_ei~<9O iQ)~iilftl3-6lil);\"iQljl~ 0 thro~gl, ",n. . ~~ $1 oO-flO , . .. b~l;Iin cople.. vI tile rU18'lf ~60'6>~!~~}~~~,1t\l~~trm'~ho~e D. lj !~~~~<'f~fW,~0r~gnn Utm:;~~ti) f1catlan .'. New AIterlltion1or ExleRr.6lr:N~Pml1!IT . One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 E, Ifli\tlri~~o';'(Seryic"/~eed~rn~t i;,cliided) -Elich !Iist~IIatio~1 ^ ~... l ExpiRE IF THE IMM,", Pum\iliHiinJt.L1@) UNDER THIS PER' 'j ~M\JU Si~lIiU<N0@liOO IS ABA _ IVI I '& Mllii Li&iIOO l;\\~l81Wefll!'iW6'b. NDVlVtlJ tO~25,OO Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.I's'uBTOTALOF~O.VE '. ....c.. ...it.... ; ,..,"'.1."..:,)>0 . '" . ~ . i~':' .i1 Q.\3~ l<l.L{ I ~ Q,4:Q .~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding FormslElectrical Permit Application 1..Q3.doc