HomeMy WebLinkAboutPermit Building 2004-1-21 (2)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY 01< ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01287
ISSUED: 01/21/2004
APPLIED: 12/30/2003
EXPIRES: 07/21/2004
VALUE: $ 132,782.00
SITE ADDRESS: 4043 Douglas Dr
ASSESSOR'S PARCEL NO.: 1802061110600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: SFR
Owner: BRUCE WIECHERT
Address: 3375 PARK HILLS EUGENE OR 97405
Contractor Type
General
Electrical
Mechanical
Plumhing
Phone Number: 541-686-9458
I CONTRACTOR INFORMATION I
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
L & E ELECTRIC INC 105475
COMFORT FLOW 460
STEVE R JOHNSON 65065
I BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Expiration Date
09/16/2006
03/30/2004
06/27/2005
03/12/2004
Phone
541-686-9458
541-933-2653
541-726-0100
541-342-3765
1
R-3
U-l
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
3
1 Lot Size:
21.00 Sq Ft Ist Floor:
Gas Sq Ft 2nd Floor:
Electric Sq Ft Basement:
Gas Sq Ft Garage/Carport
Path 1 Sq Ft Other:
. '! ~__~nn lAW redmp.s~.~~face Area:
I DEVELOPMENT'Wl!O'RMkjdONl tY the oreg; 's~t:t';rt
,ell! C nl,er Chbse rules a ~~RED PARKING
\lotitlcatlon e . 0 thrqugh OAR 9.. -
overWI'f\:952-001'-OO~, 'cople's of th'e mb'taf. l 2
# Str~ 6e"f~cJnay obtain . toe telerJ:lmfllkapped:
Paved' '(ja~n.~d:he center. (Not~Sity Noti\~J.iiplIl:t:
% of L~~eage!r the.O~~~;~~~~_2344).
(;ol"'l1'o.r I~ -
6,570
1,350
440
18.00
10.00
11.50
19.00
0.00
I PUBLIC IMPROVEMENTS I
Fullv Improved Sidewalk Type: Curbside 5'
Yes DownspoutslDrains: Curb and Gutter
NO SEWER HOOKUP OR OCdBB;nr~UNTIL PUBLIC IMPROVEM~.m;J'LANS ARE
ACCEPTED BY PUBLIC WO~I'I~~li1ll~aOO~bl1 ft~ ~utw&ilr.'pro{\,ment projects).
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Paee 1 of4
"
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01287
ISSUED: 01/21/2004
APPLIED: 12/30/2003
EXPIRES: 07/21/2004
VALUE: $ 132,782.00
Status . Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54 I -726-3769 Inspection Line
I Valuation Descriotion ,
Description Tvpe of Construction
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
132,782.00
Value
Date Calculated
Total Value of Project
$132,782.00
$132,782.00
12/30/2003
l..Fpp<, PIilIJ
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $437.39 12/30/03 1200200000000002668
-Mechanical Issuance Fe..... $10.00 1/21/04 1200400000000000087
+ 10% Administrative Fee $1l9.69 1/21/04 1200400000000000087
+ 7% State Surcharge $83.78 1/21104 1200400000000000087
2 Baths One or Two Family $254.00 1/21/04 1200400000000000087
Addressing Assignment $8.00 1/21/04 1200400000000000087
Building Permit $672.90 1/21104 1200400000000000087
Curbcut - Overwldth Appl $35.00 1/21104 1200400000000000087
Curbcut Permit $75.00 1/21104 1200400000000000087
Dryer Vent $6.00 1/21104 1200400000000000087
Exhaust Hoods $9.00 1/21104 1200400000000000087
Furnace - up to 100,000 btu $12.00 1/21104 1200400000000000087
Gas Fireplace $15.00 1/21/04 1200400000000000087
Gas Outlets 1-4 $4.00 1/21/04 1200400000000000087
Heat Pump $12.00 1/21/04 1200400000000000087
Plan Review - Planning $59.00 1/21/04 1200400000000000087
PW Mull Disc - 2nd Permit $-30.00 1/21/04 1200400000000000087
Residence Wiring 1000 Sq Ft $106.00 1/21/04 1200400000000000087
Residence Wiring Ea AddU 500 $38.00 1/21/04 1200400000000000087
Sanitary Sewer - Improvement $361.41 1/21/04 1200400000000000087
Sanitary Sewer - Reimbursement $475.44 1/21/04 1200400000000000087
SDC MWMC Administration $10.00 1/21104 1200400000000000087
SDC MWMC Improvement $214.23 1/21/04 1200400000000000087
SDC MWMC Reimbursement $314.63 1/21/04 1200400000000000087
SDC Sanitary/Storm Admin $104.80 1/21104 1200400000000000087
SDC Transpo Admin $53.75 1/21/04 1200400000000000087
SDC Transpo Improvement $727.42 1/21/04 1200400000000000087
SDC Transpo Reimbursement $164.89 1/21/04 1200400000000000087
Sidewalk Permit $75.00 1/21/04 1200400000000000087
Storm Drainage Impervious Area $902.99 1/21104 1200400000000000087
Temp Power 200 amps or less $50.00 1/21/04 1200400000000000087
Vent Fan $18.00 1/21104 1200400000000000087
Willamalane Single Family $1,000.00 1/21104 1200400000000000087
Total Amount Paid $6,399.32
Paee 2 of 4
r
.
. CITY OF Sr n...lliGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01287
ISSUED: 01/21/2004
APPLIED: 12/30/2003
EXPIRES: 07/21/2004
VALUE: $ 132,782.00
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Initial Review
Plan nine Review
Public Works Review
12/31/2003
12/31/2003
12/31/2003
I Plan Reviews I
12/31/2003 APP
01/13/2004 APP
01/05/2004 APP
RJB
TAJ
VRJ
NO SEWER HOOKUP OR
OCCUPANCY UNTIL PUBLIC
IMPROVEMENT PLANS ARE
ACCEPTED BY PUBLIC WORKS
( See Ron Sather on status on public
improvement projects). Applicant
has applied for overwidth driveway
permit, permit Is in review by PW
Transportation, 1/5/2003.
Structural Review
12/31/2003
01/02/2004
APP 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.
Up.nnirp.tUnsnection~ I
1 Erosion/Grading Inspection: After all erosion measures are In place.
2 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
3 Footing: After trenches are excavated.
4 Foundation; After forms are erected but prior to concrete placement.
5 Post and Beam: Prior to Ooor Insulation or decking.
6 Floor Insulation: Prior to decking.
7 Shear Wall Nailing: Before covering sheathing with finish materials.
8 Framing Inspection: Prior to cover and after all rough In inspections have been approved.
9 Wall Insulation: Prior to cover.
10 Ceiling Insulation: Prior to cover.
11 Drywall: Prior to taping.
12 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
13 Final Building: After all required inspections have been requested and approved and the building is complete.
14 UnderOoor Plumbing: Prior to insulation or decking.
. 15 UnderOoor Drain: Prior to cover or placement of concrete.
16 Rough Plumbing: Prior to cover and including required testing.
17 Water Line: Prior to filling trench and including required testing.
18 Sanitary Sewer Line: Prior to filling trench and including required testing.
19 Storm Sewer Line: Prior to filling trench.
20 Final Plumbing: When all plumbing work is complete.
21 UnderOoor Mechanical. Prior to insulation or decking and including required testing.
22 UnderOoor Gas: After line is installed and required testing and capped If not attached to an appliance.
23 Rough Gas: After line Is installed and required testing and capped If not attached to an appliance.
24 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.
25 Rough Mechanical: Prior to Cover
Paee 3 of 4
.
. CITY OF SPRIrliu1<u<..LlJ
Building/Combination Permit
PERMIT NO: COM2003-01287
ISSUED: 01/21/2004
APPLIED: 12/30/2003
EXPIRES: 07/21/2004
VALUE: $ 132,782.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
26 Final Mechanical: When all mechanical work Is complete.
27 Temporary Electric: Approval required prior to Utility Company energizing pole.
28 Rough Electric: Prior to Cover
29 Electric Service: Approval required prior to utility company energizing service.
30 Final Electric: When all electrical work Is complete.
31 Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
32 Curbcut - Overwidth: After forms are erected but prior to placement of concrete.
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 witb
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 a y structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors a employees who are In compliance with ORS 701.005 will be used on this project.
I further agree to ensure 'at all requi d inspections are requested at t tl that e ch address is readable from the
street, that the permit ca d is cated t the fro roperty, and the approved' et of pl' 's will remain on the site at all
J4,~::.u~ if 1j 17 Y
Paee 4 of 4
225 Fifth Street -"
Springfield, Oregon 97477
541-726-3759 Phone
JoblJournBI Number
COM2003-0 1287
COM2003-01287
COM2003-01287
COM2003-01287
COM2003-0 1287
COM2003-0 1287
COM2003-0 1287
COM2003-0 1287
COM2003-0 1287
COM2003-01287
COM2003-01287
COM2003-01287
COM2003-0 1287
COM2003-0 1287
COM2003-01287
COM2003-01287
COM2003-01287
COM2003-0 1287
COM2003-0 1287
COM2003-01287
COM2003-01287
COM2003-01287
COM2003-0 1287
COM2003-01287
COM2003-01287
COM2003-01287
COM2003-0 1287
COM2003-0 1287
COM2003-0 1287
COM2003-01287
COM2003-0 1287
COM2003.01287
Payments:
Type of Payment
CreditCard
_~'....al'lllLD'
Wi: ""<~'-'.""-.~"~'!.
" i
~'''~.-: :
., ...~-- j
>;/M_'" _.
-',-. .',-.-...' ~
Receipt #: 1200400000000000087
Description
Building Permit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family
Furnace - up to 100,000 bin
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Gas Fireplace
-Mechanical Issuance Fee-
Heat Pump
Sidewalk Permit
Curbcut Permit
Curbcut - Overwidth Appl
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
Plan Review - Planning
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
BRUCE WIECHERT CUSTOM
HOMES
Check Number
Received By Batch Number Authorization Number
djb . 000280 063759
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 01/21/2004 2:11:46PM
Amount Paid
Item Total:
672.90
8.00
1,000,00
254,00
12.00
18.00
9.00
6.00
4.00
15.00
10.00
12.00
75.00
75,00
35.00
(30,00)
902.99
475,44
361.41
164.89
727.42
314,63
214,23
10.00
104.80
53.75
59.00
106.00
38.00
50.00
83.78
119,69
$5,961.93
.
.
How Received
In Person
Amount Paid
$5,961.93
Payment Total:
$5,961.93
. .
CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN_RKSHEET
JOURNAL OR JOB NUMBER: Com2003-01287
NAME OR COMPANY: Bruce Weichert Homes
LOCATION: 4043 Douglas Drive
TAX LOT NUMBER: 1802061 11110600
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS I 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. I CHARGE
I 31 13,75 $0,290 = I $902.99
RUNOFF ROUTED TO DRYWELL 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 $0.290 I I 50% I ~ $0.00
ITEM I TOTAL - STORM DRAINAGE SDC $902.99
2, SANITARY SEWER. CITY
6420
I~
ICI.l
~
Cl
o
U
c.::
~
CI.l
~
"
~
I
5902.99
11070
A, REIMBURSEMENT COST:
I NUMBER OF DFU's I x I COST PER DFU
21 I $22,64 5475.44 1091
8. IMPROVEMENT COST:
I NUMBER OF DFU's I x ,COST PER DFU
I 21 $17,21 5361.41 1092
tTEM 2 TOTAL - CITY SANITARY SEWER SDC = , 5836.85
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRJP RATE I x I NUMBER OF UNITS I x I COST PER TRJP x I NEW TRJP F ACTORI
I 9.57 I I I I $17,23 I 1.00 , 5164.89 1093
8. IMPROVEMENT COST: 'I
I ADTTRIPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRJPFACTORI
I 9.57 I I I I $76,01 I 1.00 5727.42 11094
ITEM 3 TOTAL - TRANSPORT AnON SDC = I 5892.31 J
4, SANITARY SEWER - MWMC I
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I I $3 14.63 = 5314.63 1054
B, IMPROVEMENT COST:
I NUMBER OF FEU's I x ICOST PER FEU
I I I I $214.23 = 5214.23 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) 50.00 I 1054
MWMC ADMINISTRATIVE FEE 510.00 11056
ITEM 4 TOTAL - MWMC SANITARY SEWER So( = , 5538.86
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = , 53,171.01
5. ADMINISTRATIVE FEI;;.
I SUBTOTAL I x I ADM, FEE RATE I~ CHARGE
I $3.171.01 I 5% $158,55
TOTAL SANITARY ADMINISTRATION FEE: 104.80 11079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $53.75 1078
~
Virginia Jurasevich 1/5/2004 TOTAL SDC CHARGES =, $3,329.56
PREPARED BY DATE
. . . -
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS
(NOTE, FOR REMDDELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB ~ 0 3 = 6
IDRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 I
IINTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0 I
ICLOTHESW ASHER I MOP SINK 1 0 3 = 3 I
ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 I
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I
IRECEPTOR FOR REFRIG I WATER STATION / ETC. 0 0 1 = 0 I
IRECEPTOR FOR COM, SINK I DISHWASHER I ETC. 0 0 3 = 0 I
ISHOWER. SINGLE STALL 0 0 2 = 0 I
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I
ISINK: COMMERCiAURESIDENTIAL KITCHEN 1 0 3 = 3 II
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 I
ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 1 0 1 = 1 I
IURINAL. STALL/WALL O. 0 5 = 0 I
ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 II
ITOILET. PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 21 I
"'EDU (EQuivalent Dwel1in~ Unit) is a dischanze equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day l
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED V AWE
55.04
55,04
$4.95
$4.88
54,75
54.58
$4.41
$4.20
53.88
53.50
53.07
52.60
52.14
$1.71
51.52
51.38
51.19
51.03
50.87
$0.68
50.46
50.27
50.09
50.04
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enler I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
o
o
1979
CREDIT FOR LAND (IF APPLICABLE)
V AWE I 1000 CREDIT RATE
$0.00 x $5,04
~ ,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
V AWE I 1000 CREDIT RATE
$0,00 x $5.04
o
TOTAL MWMC CREDIT
$0,00
=
~\\"
'O~O 0
~0 6~';
6'(;\'3-~C.\'3-{'\
~~e '?F>:>O
,:,'0 ~
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689~. ~ ,!",e ~
ELECTRICAL PERMIT APPliCATION ",..'1< N
A ~~
City Job Number UlI\I...9.oo "> - D l.::l~ '1 'Date , . ,~,o ,>,,0
"~./'\f'o~ ~\ -"i\(\<6 . .
3. FlJixlMP.iJEFjjftitEjjFe.~imEiB~"!.'*-",~;[",ji;:rP~~
~~.~",\,..",",_.~.",!ic~"~,,,~e"'i,"~~,..~,..iil
..,..\e .~o.
A. ~.f:;R1F<i.~fiii~sffil:je< To' 2P.~$"er ,dwellin 'Wn
Service Included
/ '
CITY OF Sp, .~GFIELD, OREGON '
\ ,
InstaUation, Alteration or Relocation
200 Amps or less I $ 50.00
I () 5 4 is ATTE!'JTION:C2011~gitM400q\mpllS you to $ 69.00
follow rules ad4q.lIIMhPsJt6t60~slO Utility $100.00
Expiration Date 3 - 3 L) - 0 If \!otification CenWer 1iO'61~Wlft!j,oti~lsfm "B" above.
Signature Of(J;U 'sing Electrician . ~~~.~~~2:a~:' "~ini:i"C;f~~
r. /Y n;J callinQtheceN~t\W!-t~!lltl!!'~l\lerPanel
101 r~ )U21!--.. nult1b~rforth~.I1i1UtllityNolification
. ~"n''''rJ!llqh~~~y, or with
n _ I? W' . \ ^ _ 1 C L. IL... Service or Feeder Permit
OwneIll Name' "') V'\) c..c.. \ e. ov ~ vT _ vS'1\7'" IT\JY'. ~
m7~"<Oi\""~~~"f"-'''\M'-(--~'fir'll'iittlM
"",,,,It I+i \\5> E. Jilo;~~~~~~lW"'l~c.;.~~er.n~!.'~F!~~~'tIl\.J!.".._~!l
Phone b g('-9Yf'~
1. t1;.F()G)t1;tOM(;jF@'ST..;4'i;r~ti!I:QN&.-~~~
Eii'1&...'c.,.'.' _":_€". ",~''''''''"l:l''''''''_~_i!'\'''''.d~~~~~
LJ 0 4'3 0 0 vt. k c; .i y
V
LEGAL DESCRIPTION
I~ .OJ. . 010. \I
JOB DESCRIPTION
101000
N G-W
~5
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 Il\e, ;;;;;;;rMGroRlTi\TSi)ffol7.'1.l'N01W~A!
.1::-;,;t.'l!."~li'~~"~
Electrical Contractor Lt:'c E/pI'Jrtc..
Address f;)95:l JOfU.J Acre;, ed
City 'S p ~I cl
Phone cJ33 -JS'1(J
Supervisor License Number
'-I/7Lj-5
Expiration Date
to-()1 ~Ot.j.
CoRSII'. Contr. Number
AddressS"!''1 ~-
City E V YYlf .
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
1000 sq. ft. or less
Each additional 500 sq. It or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
I
2-.
$ 19.00
$ 106.00
lOb
36
$50.00
B.lIEi"l:~.'~~~~~'l~. '
200 Amps or less $ 63.00
~~~I: ~:~~ AmiP~IRE IF TilE 'I:{}~;;~~
A ~m.18~' HIS PERtm I~ ~111l63.00
~l ~: ABANDONED FQR $375.00
C~ i $ 50.00
ANY 180 DAY ERlOD.
c. ~mR'~~tSac~MlF~~~j~~
--. """.'."L_ /i.....;..... ..,.~, .' .'.. '.. <- ,.
<;D
$ 43.00
$ 3.00
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidentiaI
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
/9i-f
/-7'5B
7% Stale Surcharge . ,;>
10% Administrative Fee I-- I C; '-1':.
TOTAL " -z.2b.1B
Shared Drive{T:)lBuilding FormsIE1ectrica1 P<nDit Ak.ticatiOD l-ll),doc