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Home My WebLink AboutPermit Building 2005-3-11 I, ..._~AillJl~GF'I~ ... . 1. '=<' It J Status Issued , CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00147 ISSUED: 03/11/2005 APPLIED: 02/04/2005 EXPIRES: 09/11/2005 VALUE: $ 203,248.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6066 Orchid Ln ASSESSOR'S PARCEL NO.: JASPER MEADWS 2 AD Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Jasper meadows 2nd add lot 111- Single family residence, SAME AS COM2004-01525 6049 Orchid Owner: ' Address: HAYDEN ENTERPRISES 2622 SW GLACIER PL #110 REDMOND OR 97756 Phone Number: 541-461-5091 I CONTRACTOR INFORMAnUl~ , Contractor Type General Electrical Mechanical Plumbing Contractor " HAYDEN ENTERPRISES THORNTON ELECTRIC INC PACIFIC AIR COMFORT INC JET HEATING INC VN License Expiration Date Phone ATTErJ>i1W1J. 07/29/2007 541-501-4332 follow r3'i~~9 Oregon 'aVl'(t~{f.p'Q,6 541-686-4151 Notjfjcatic~lJ1~fdoPted by tft$'~/~.olk~t~~1 ~o541-672-951 0 in OAR QJ~~~..n~!- Those~~~1l5"'ot ~~t~T03-363-2334 BUILDING INF(jRNfA:lFIDNt'ob~~i~ l~ro~gh OAR 952-001: L.dlllng the center. N opl.es Of the rules by # o~ Stories: nUmber for the 0 2~~t~~~~lePhone HeIght of Structure Center iit[~ rsWk ~if)letWion Type of Heat: Forced Air l;~fO-3~-BBI~. Floor: Water Type: Gas Sq Ft Basement: Range Type: Electric Sq -ft Garage/Carport Energy Path: Path ISq-Ft Other: Sprinkled Building: n/a .. Occupant Load: 6,233 1,008 1,005 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 400 3 I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: 2 Handicapped: Compact: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 20.40 9.20 19.80 10.50 0.00 Overlay Dist: # Street Trees Rqd: 1 Paved Drive Rqd: Yes % of Lot Covetfaet ICE: 22.50 THIS PERMIT SHALL EXpmE_I~ Tr~~ :~\!O~:..' _'H' U" '!~ Ltu UI\lUtti IrH\) ru.,illl 10 "JV I PUBLIC IMPROVEM]:,~, '~ CEO OR IS ABANDOi~ED FOli Fullv Improved ANY 180 OA'tSf1.l1'fro\9!ype: Yes DownspoutslDrains: Curbside 5' Curb and Gutter Street Improvements: Storm Sewer Available: Special Instruction: Notes: No hook-up to City Infrasturcture until Public Improvements accepted by the City; Storm drainage piped to curb face 2/8/2005 CAS Pal!e 1 of 4 "-~$~lill~~~I~~: , =-:.""'~:".":,:,"L.~... ., ",.""'__.... ....... CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00147 ISSUED: 03/11/2005 APPLIED: 02/0412005 EXPIRES: 09/11/2005 VALUE: $ 203,248.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Dwellin2s Gara2e Tvpe of Construction V Wood Frame Gara2e $ Per Sq Ft or multiplier $96.00 $25.00 Square Footage or Bid Amount 2,013.00 400.00 Value Date Calculated Description Total Value of Project $193,248.00 $10,000.00 $203,248.00 02/04/2005 02/04/2005 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Same As $100.00 2/4/05 1200500000000000154 -Mechanical Issuance Fee- $10.00 3/11/05 1200500000000000318 + 10% Administrative Fee $145.47 3/11/05 1200500000000000318 + 7% State Surcharge $101.83 3/11/05 1200500000000000318 3 Baths One & Two Family $306.00 3/11/05 1200500000000000318 Addressing Assignment $31.00 3/11/05 1200500000000000318 Building Permit $903.65 3/11/05 1200500000000000318 Curbcut Permit $80.00 3/11/05 1200500000000000318 Dryer Vent $6.00 3/11/05 1200500000000000318 Exhaust Hoods. $9.00 3/11/05 1200500000000000318 Furnace - up to 100,000 btu $12.00 3/11/05 1200500000000000318 Gas Fireplace $15.00 3/11/05 1200500000000000318 Gas Outlets 1-4 $4.00 3/11/05 1200500000000000318 Heat Pump $12.00 3/11/05 1200500000000000318 Plan Review Major - Planning $103.00 3/11/05 1200500000000000318 PW Disc - 2nd Permit (Street) $-30.00 3/11/05 1200500000000000318 Residence Wiring 1000 Sq Ft $106.00 3/11/05 1200500000000000318 Residence Wiring Ea Addtl 500 $57.00 3/11/05 1200500000000000318 Sanitary Sewer - Improvement $493.56 3/11/05 1200500000000000318 Sanitary Sewer - Reimbursement $649.08 3/11/05 1200500000000000318 SDC MWMC Administration $10.00 3/11/05 1200500000000000318 SDC MWMC Improvement $865.31 3/11/05 1200500000000000318 SDC MWMC Reimbursement $82.03 3/11/05 1200500000000000318 SDC Sanitary/Storm Admin $121.75 3/11/05 1200500000000000318 SDC Transpo Admin $63.85 3/11/05 1200500000000000318 SDC Transpo Improvement $772.49 3/11/05 1200500000000000318 SDC Transpo Reimbursement $175.13 3/11/05 1200500000000000318 Sidewalk Permit $80.00 3/11/05 1200500000000000318 Storm Drainage Impervious Area $664.33 3/11/05 1200500000000000318 Vent Fan $24.00 3/11/05 1200500000000000318 Willamalane Single Family $1,000.00 3/11/05 1200500000000000318 Total Amount Paid $6,973.48 Pa2e 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00147 ISSUED: 03/11/2005 APPLIED: 02/04/2005 EXPIRES: 09/11/2005 VALUE: $ 203,248.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Planninl! Review Public Works Review 02107/2005 02/07/2005 02/07/2005 I Plan Reviews I 02107/2005 APP 02/25/2005 APP 02/08/2005 APP SKG TAJ CAS No hook-up to City Infrastructure until Public Improvements accepted by the City; Storm drainage piped tc curb face 2/8/2005 CAS same as RJB original Structural Review 02/07/2005 03/07/2005 APP DJB 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. lJeouiredJnsnections I Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Erosion/Grading Inspection: After all erosion measures are in place. 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. Post and Beam: Prior to floor insulation or decking. 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. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. 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. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. 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 Pal!e 3 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00147 ISSUED: 03/11/2005 APPLIED: 02/04/2005 EXPIRES: 09111/2005 VALUE: $ 203,248.00 225 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' located at the front of the property, and the approved set of plans will remain on the site at all ai:la~ . 5/15 #' /' .. ,/ / Owner or Contractors Signature DllJ'e Pae:e 4 of 4 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~lty of Springfield Official Receipt ?":t~!?elopment Services Department Public Works Department Job/Journal Number COM2005-00 147 COM2005-00 147 COM2005-00 147 COM2005-00147 ~ COM2005-00147 I". COM2005-00 147 COM2005-00 147 COM2005-00 147 c'bM2005-00147 COM2005-00147 COM2005-00147 COM2005-00 147 COM2005-00 147 COM2005-00 147 COM2005-00 147 COM2005-00 147 COM2005-00147 CbM2005-00 147 COM2005-00147 COM2005-00 147 COM2005-00147 , ~ COM2005-00147 CbM2005-00147 COM2005-00 147 CbM2005-00 147 CbM2005-00 147 COM2005-00147 COM2005-00 147 COM2005-00147 COM2005-00 147 Payments: Type of Payment Check Cash 3/11/2005 RECEIPT #: 1200500000000000318 Date: 03/11/2005 Description Addressing Assignment Willamalane Single Family Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit (Street) 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 Plan Review Major - Planning Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace Heat Pump -Mechanical Issuance Fee- Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 7% State Surcharge + 10% Administrative Fee Paid By HAYDEN ENT HAYDEN ENT Item Total: Check Number Authorization Received By Batch Number Number How Received djb djb 15406 In Person In Person Payment Total: Page 1 of2 2:58:35PM Amount Due 31.00 1,000,00 80.00 80.00 (30,00) 664.33 649,08 493.56 175.13 772.49 82,03 865.31 10.00 121.75 63.85 103.00 903.65 306.00 12.00 24.00 9.00 6,00 4.00 15.00 12.00 10.00 106.00 57,00 101.83 145.47 $6,873.48 Amount Paid $6,873.44 $0,04 $6,873.48 ,. ~ otice to Permit Applicant Soils stabilization required for subdivision sites Name ofownerJ}A-~_) fNJ.-Dl)?/./15~ Permit: (/!YJf2'aJ5-t)c!?#7 Address of Project: ~"C'}Re:#/J) !-.AJ. Subdivision ~~/lft14JJ/~ 2.~~) pW6~ S - ~r /11 Tax Map: Tax Lot: The building site at the above address is located on property that has soils prone to shrink-swell or other potential movement. Excavations, placement of fill materials and drainage for this site must be done under the direct supervision of a properly licensed Professional Engineer or Architect to verify the stability of the resulting building pad and the site. ' The owner, or the owner's qualified agent, is responsible to obtain the services of the appropriate professional engineer or architect (design professional). The design professional shall provide direction for the stabilization methods to be used for the building pad (and surrounding site, when site stabilization is also necessary). The geotechnical report, which was prepared for this subdivision, may be utilized to provide appropriate guidance for the methods of stabilization and required compaction for the specific site. The engineer or architect shall prepare a report to be submitted to the City stating how the soil stabilization is being accomplished, including requirements not yet completed (if any). A signed and stamped report from the engineer or architect must be received and approved bv this office before footine or foundation inspection approval will be flranted bv the Citv Buildinfl Inspector. ACKNOWLEDGEMENT: The undersigned acknowledges the forgoing requirements for soil stabilization, including excavation, fill, soil compaction and drainage, as provided in the geotechnical report for the subdivision. ' The stabilization will be accomplished under the direction of a licensed pro~al engineer or architect as noted above. . pr /' Signatu~L/ Datey;/pr Name ~I 1- .i?rP'oc.. K Affiliation to owner ' . ' . CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN, ORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS I. STORM DRAINAGE . DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. ' x COST PER S,F, CHARGE 2143,00 $0.310 = $664,33 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. x COST PER S.F. x DISCOUNT RATE I, 0,00 ' $0.310 50% COM2005-00147 Hayden Homes 6066 Orchid Ln Jasper Meadows2nd Lot 111 SINGLE FAMIL YRESlDENCE 1 BUILDING SIZE (SF' 2498 . .. . ITEM 1 TOTAL - STORM DRAINAGE SDC 2, SANITARY SEWER - CITY A REIMBURSEMENT COST: NUMBER OF DFU's x 27, I, COST PER DFU I $24,04 B. IMPROVEMENT COST:, I NUMBER OF DFU's x I 27 $18,28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3, TRANSPORTATION' A REIMBURSEMENT COST: I ADTTRIPRATE x I 9.57 B. IMPROVEMENT COST: . ADT TRIP .RATE I x 9.57 I = I $664.33 $1,142.64 NUMBER OF UNITS x I COST PER TRIP 1 I $18.30 I ,NUMBER OF UNITS' x I 1 ITEM 3 TOTAL- TRANSPORTATION SDC =, 1. SANITARY SEWER - MWMC A REIMBURSEMENT COST: INUMBER OF FEU's I x I 1 , , ' B. IMPROVEMENT COST: NUMBER OF FEU's Ix 1 I ICOST PER FEU I $82,03 , ICOST PER FEU I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATNE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I = I SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) 5. ADMINISTRATNE FEE: I SUBTOTAL x 'I ADM, FEE RATE 1= , $3,711.93 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: ' COST PER TRIP $80.72 $947.62 $957.34 LOT SIZE (SF): DISCOUNT $0.00 x INEWTRIPFACTOR I 1.00 x INEWTRIPFACTOR I },OO 6233 $664.33 ,rfj ~ 18 u ~ ~ ,t-< rfj ...... C1 ~ 1070 I $649.08 1091 , ' $493.56 1092 i; $175.13 1093 $772.49 = $82.03 1094 l 1054 1055 l1054 1056 $3,711.93 -~.. . -.--. $865.31 $0.00 $10.00 CHARGE $185,60 Cheryl Slaymaker PREPARED BY 2/8/2005 DATE TOTAL SDC CHARGES 121.75 $63:85 =, $3,897.53 J 1079 1078 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FlXTURES x UNIT EQUN ALENT = DRAINAGE FIXTIJRE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS iBATHTUB 2 0 3 = 6 IDRlNKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC, 0 0 6 = 0 ILAUNDRY TUB 1 0 2 = 2 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER STATION / ETC, 0 0 1 = 0 I RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 I SINK: SINGLE LAVATORY /RESIDENTIAL BAR 2 0 1 = 2 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 27 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$l,OOO I ANNEXED ASSESSED VALUE BEFORE 1979 $5.29 1979 $5.29 1980 $5,19 1981 $5,12 1982 $4,98 1983 $4,80 1984 $4.63 1985 $4.40 1986 $4.07 1987 $3,67 1988 $3.22 1989 $2.73 1990 $2.25 1991 $1.80 1992 $1,59 1993 $1.45 1994 $1,25 1995 $1.09 1996 $0.92 1997 $0.72 1998 $0.48 1999 $0.28 2000 1 $0,09 2001 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? 2 (Enter] for Yes, 2 for No) BASE YEAR ] 979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0,00 x $5.29 = I $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0,00 x $5.29 0 TOTAL MWMC CREDIT $0.00 = 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX~ (541)7~6-3689 ELECTRICAL PERMIT APPLICATION ':. .<~:19,.0ij, ~ ~0~ City Job Number 0'-> --OO/LFt-- Date 'bra! ':;1) ~1).9 , .:;; 0' ..ora 3. ~~~lal~:r~~ Q'i.2: <9 1. ho66 o ('cAt ~ LI1. J e1..sper N~s Z IhM ;H-~ ~6 i€Jr /II LEGAL DESCRIPTION JOB DESCRIPTION S-J~~ ~1r'I)/~ ~Jj~;! f 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 j)/o,teU/?J,,,- j B12jKJ:::.. Address ~ [1, .-5&;(04 l.) City &e:r Phone f)~ -m;:)7 Supervisor License Number 10 /7 S., Expiration Date I (J..... 1- 010 Constr. Contr. Number 1/ Ie? 3~ / Expiration Date /f"J-j_;r') 0 Signature of Supervising Electrician i2f;~~ Owners Name ~Cl:A._ ~\ I. --..... I Address \.:::> .e.: r:>--;:. )S. X- ~ City , '-),?^ :> \ .'1J 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 A. Service Included 1000 sq, ft. or less , , '. .Each,.,.a.>d.. ditional 500 sq. ft. o.r, . t"2 h", PottlOIl.thereof ., - \ r .,' ! r \ ,,.?- ~ _. ',".. _ _',. r <:.',,~,.,', _1, ;'_' ,"-- l:C "r I;: ~__~-, ,~. - ,~- ; : Each cMahufact' d Home ()f" ,\ I;) i~ J T ,.,Modular-DWelling Senhd;'~r',,', ....,'~ 'FUR $5'0,00 F d ': ,'. 'f \l.Jvl,LU 1,.0 ,,~e, ~r" U,.' ,k' B.' 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163,00 $375.00 $ 50,00 c. Installation, Alteration or Relocation $ 50.00 $ 69.00 $100.00 200 Amps or less .,....,---." 201 Amps to 400 Amps ..,:r:--- 401 Amps to 600 Amps . Over 600 Amps or 1000 Volts see "B" D. , " 0c10P e Iii'S are s New ~f\~!tjot1-.or.E2~reJl~io"iRY;iPail'et" 9r:'2.-00~' '. \ \ e0\.U' \I 0"'';\\ ;) One qt!Q~i~\,,::ti,CJ,~ \,::\,'-0010 t\lr0\JQ \I~ iM~,~ '0'1/ Each 1\~~lial:rQ:1f~t or'oN\n caples 01 t ne Service,Oj\B\9~<:l.eJ'\.Pe\1nh 0 0. 1l\~Gt'?' t\le te~,~~t' 0\1 uv . ,8 center. ,\ "Notlhca I E. Pump Of 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 4. 7% State Surcharge 10% Administrative Fee Ib'S ,00 11 i t./ I itA I 10 i) J qlJ,7-1 TOTAL Shared Drive(T:)/Building Fonus/Electrical Penuit Application 1-03,doc