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Home My WebLink AboutPermit Building 2005-3-2 . CITY UJ' ~..RINGFIELD Building/Combination Permit PERMIT NO: COM2005-00159 ISSUED: 03/02/2005 APPLIED: 02/09/2005 EXPIRES: 09/02/2005 VALUE: $ 247,962.00 . Status Issued 225 Fifth Strect, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3369 Falcon Dr ASSESSOR'S PARCEL NO.: 1702193406300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Amblesidc 1st lot 97 - Single family residence Owner: Address: -:-"'''''''' RIVER VALLEY BUILDERS INC \.. 'v: Oreg POBOX 2041 i - .,,/,: dd onlaWre' CORVALLIS OR 97~~9 ~': ! _Jr :::ent~~te...~ by the dr~::~~ou to <-<)90 --'UUJ-n(!,,, .:-vc: rUle.. ,,~_ '~ul/cy cal'" YOL PEON'IRACT(i)RdNFORMl\'fIOllhl . tng tt " nUrn I" Center -Vf//es of th - -C.-uUl. Contractor ber for the O'~ (Note: the tel e 'i1!lliebje RIVER V ALLE'ftnnloWf-ifjNWtility Notetf3'4S66 G & E ELECTRIC INC 0-332-2344 /IC<s4f1l\8 MIDWAY MECHANICAL INC ~. 154166 MIDWAY PLUMBING INC 4687 Contractor Type General Electrical Mechanical Plumbing I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: 2 Height of Structure 28.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas NOnCE' Energy Path: Path 1 THIS PF . Sprinkled Building: n/a P~t1I, n,. ~^I HORIIIDEY.'ELOPMEi'l11lNFORMA1:ION I VlMENl;tD 0 ' "1/0 I'tRM '~, or, ANY lRO R IS ABA^'nn IT IS NOT 18.00 DAY PEfiR,v~rlay DistNED FOR 5.10 # ~ti"eet Trees Rqd: 6.20 Paved Drive Rqd: 31.30 % of Lot Coverage: 0.00 1 R-3 U VN 'PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Residential Expiration Date 04/1512005 09/15/2007 0113012007 0712512008 Phone 541-367-1618 541-967-7045 541-928-2423 541-928-7927 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 6,200 1,364 1,109 426 2 Yes 35.40 REQUIRED PARKING Total: 2 Handicapped: Compact: FuUv Improved Yes Sidewalk Type: DownspoutslDrains: Curbside 5' To Storm Sewer Notes: Storm drainage to system rear of the lot 2/14/2005 CAS Pal!e I of4 -r;'~~'.. ' I,.' ~~~. ' IP l i - ~ ,f' -< , _._ ....c,.~ --';I" . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00159 ISSUED: 03/02/2005 APPLIED: 02/09/2005 EXPIRES: 09/02/2005 VALUE: $ 247,962.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Dwellines Garaee Tvpe of Construction V Wood Frame Garaee $ Per Sq Ft or multiplier $96.00 $25.00 Square Footage or Bid Amount 2,472.00 426.00 Value Date Calculated Description Total Value of Project $237,312.00 $10,650.00 $247,962.00 03/0112005 03/0112005 L J(pp< tailU Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $657.09 219/05 2200500000000000151 -Mechanical Issuance Fee- $10.00 3/2/05 2200500000000000248 + 10% Administrative Fee $149.47 3/2/05 2200500000000000248 + 7% State Surcharge $104.63 3/2105 2200500000000000248 3 Baths One & Two Family $306.00 3/2105 2200500000000000248 Addrcssing Assignment $31.00 3/2105 2200500000000000248 Appliance Vent $6.00 3/2105 2200500000000000248 Boiler/Comp 3-15 UP $22.00 3/2105 2200500000000000248 Building Permit $1,046.65 3/2105 2200500000000000248 Curbcut Permit $80.00 3/2/05 2200500000000000248 Dryer Vent $6.00 3/2105 2200500000000000248 Exhaust Hoods $9.00 3/2105 2200500000000000248 Furnace - up to 100,000 btu $12.00 3/2105 2200500000000000248 Gas Fireplace $15.00 3/2105 2200500000000000248 Gas Outlets 1-4 $4.00 3/2105 2200500000000000248 Plan Review Major - Planning $103.00 3/2/05 2200500000000000248 Plan Review Rcsidential $23.23 3/2/05 2200500000000000248 PW Disc - 2nd Permit (Street) $-30.00 3/2/05 2200500000000000248 Sanitary S~wer - Improvement $493.56 3/2/05 2200500000000000248 Sanitary Sewer - Reimbursement $649.08 3/2/05 2200500000000000248 SDC MWMC Administration $10.00 3/2/05 2200500000000000248 SDC MWMC Improvement $865.31 312/05 2200500000000000248 SDC MWMC Reimbursement $82.03 3/2/05 2200500000000000248 SDC Sanitary/Storm Admin $126.72 3/2105 2200500000000000248 SDC Transpo Admin $63.33 3/2105 2200500000000000248 SDC Transpo Improvcment $772.49 3/2105 2200500000000000248 SDC Transpo Reimbursement $175.13 3/2105 2200500000000000248 Sidewalk Permit $80.00 3/2105 2200500000000000248 Storm Drainage Impervious Area $753.30 3/2105 2200500000000000248 Temp Power 200 amps or less $50.00 3/2/05 2200500000000000248 Vent Fan $18.00 3/2/05 2200500000000000248 Willamalane Single Family $1,000.00 3/2/05 2200500000000000248 Total Amount Paid $7,694.02 Paee 2 of 4 -IIfIrS?~I'foI!lllI!!I~' I ~. ',.,._~. .T_..",. .....__ . . CITY OF ~r1Ul'\jl:i1<u.LD Building/Combination Permit PERMIT NO: COM2005-00159 ISSUED: 03/02/2005 APPLIED: 02109/2005 EXPIRES: 09/02/2005 VALUE: $ 247,962.00 Status Issued 225 Fifth Strcet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plannine Review Public Works Review 02/10/2005 02/10/2005 02/10/2005 I Plan Reviews I 02/10/2005 APP 03/02/2005 APP 02/1412005 APP , SKG TAJ CAS Structural Review 02/10/2005 02/2612005 APP DLM Storm drainage to'system at rcar of the lot 2/14/2005 CAS Reviewed by Jason Bush 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. L....iI;r.'irIP1ri T~ Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidcwalk - Curbside: Aftcr forms are erected but prior to placement of concrete. Site Inspection: To be made after excavation but prior to setting forms. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to Ooor 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. Hold Downs Installed: Special Inspection performed prior to placement of concretc. Provide report to City Building Inspector. 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 iustalled but prior to backlUl. Underfioor Plumbing: Prior to insulation or decking. Underfioor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover 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. Underfioor Mechanical. Prior to insulation or decking and including required testing. Underfioor Gas: After line is Installed and required testing and capped if not attached to an appliance. Rough Gas: After line Is Installed and required testing and capped if not attached to an appliance. 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 Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Temporary Electric: Approval required prior to Utility Company energizing pole. Paee30f4 . . CITY OF SPRINGFIELD Building/Combination. Permit PERMIT NO: COM2005-00159 ISSUED: 03/02/2005 APPLIED: 02/09/2005 EXPIRES: 09/02/2005 VALUE: $ 247,962.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Iuspeclion Line By signature, I state and agree, that I have carefuUy examined the completed application and do hereby certify that aU information hcreon 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 furthcr ccrtify that only contractor ,.~.. loyees who are in compliance with ORS 701.005 will be used on this project. I furthcr agree to ensu~e at all quired ins eclio are requested at the proper time, that each address is readable from the street, that the permit d is 10 ated at the on fthe property, and the approved set of plans will remain on the site at all . es QUriilg ""'- n. t".;:;; ..- 2 __ cJ .5 ~ / Owuer or Contractors Signature .- Date Paee4of4 225 Fifth Street Springfield, Oregon 97477 541-726:3759 Phone . 8,....~._~,Q",FI~ ______ _ i. WiL .. \ i ___-_ Ii 1 Jiiity of Springfield Official Receipt .velopment Services Department Public Works Department ,I Job/Journal Number COM2005-00 1 59 COM2005-00 1 59 COM2005,OO 1 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005,OO 1 59 c'OM2005,OO 1 59 COM2005-00 1 59 COM2005-00 I 59 COM2005,OO I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 I 59 COM2005-00 1 59 COM2005-00 1 59 COM2005,OO 159 COM2005-00 I 59 COM2005,OO I 59 COM2005-00 I 59 COM2005,OO 1 59 COM2005-00159 COM2005-00 I 59 c;OM2005-00 1 59 COM2005-00 1 59 COM2005-00 I 59 COM2005-00 1 59 Payments: Type of Payment CreditCard 3/2/2005 RECEIPT #: 2200500000000000248 Date: 03/02/2005 Description Addressing Assignment Willamalane Single Family Temp Power 200 amps or less Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit (Street) Storm Drainagc 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 Residential Building Permit 3 Baths One & Two Family Furnace, up to 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee-- Boiler/Comp 3-15 HP + 7% State Surcharge + 10% Administrative Fee Plan Review Major, Planning Paid By RIVER V ALLEY BUILDERS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 066419 In Person Payment Total: Page I of I 2:25:05PM Amount Due 31.00 1,000.00 50.00 80.00 80.00 (30.00) 753.30 649.08 493.56 175.\3 772.49 82,03 865.31 10.00 126.72 63.33 23.23 1,046,65 306.00 12.00 18.00 6,00 9.00 6,00 4.00 15.00 10.00 22.00 104.63 149,47 103.00 $7,036.93 Amount Paid $7,036.93 $7,036.93 . ~I~ OF S&GFIELD SYSTEMS DEVELOPME~ORKSHEET JOURNAL OR JOB NUMBER: COM2005,OOl59 NAME OR COMPANY: River Valley Builders LOCATION: 3369 Falcon Dr TAX LOT NUMBER: 1702 I 93406300 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 1800 LOT SIZE (SF): L STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F. x I COST PER S,F, CHARGE I I 2430,00 I $0.3 10 1 = I $753,30 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 I 0,00 $0.310 I I 50% ~ I ITEM I TOTAL - STORM DRAINAGE SDC $753.30 I 5046 I" I~ I@ u <>:: LLl II- '" a ~ DISCOUNT $0,00 $753.30 I 1070 2 SANITARY SEWER, r.ITY A REIMBURSEMENT COST: I NUMBER OF DFU's I x I 27 B. IMPROVEMENT COST: I NUMBER OF DFU's I x 27 I $18.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC COST PER DFU $24,04 $649.08 1091 $493.56 1092 = , $1,142.64 J TRANSPORTATION A REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI 9.57 I I I I $18,30 I 1.00 I $175.13 11093 B. IMPROVEMENT COST: I I ADTTRIPRATE I x I NUMBER IOF UNITS I x I COST PER TRIP x I NEW TRiP F ACTORI I 9.57 I I $80,72 1.00 I $772.49 1]094 I ITEM 3 TOTAL - TRANSPORTATION SDC = , $947.62 I 4 SANITARY SEWER, MWM(: A REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I ] $82,03 = $82.03 1054 B. ]MPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I ] i $865.31 = $865.31 ]055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 I 1054 MWMC ADMINISTRATIVE FEE $10.00 I ]056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ , $957.34 J j SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ , $3,800.90 1 I 5 AOMINISTRATIVE FEE' l I SUBTOTAL x I ADM, FEE RATE I~ I CHARGE I $3.800,90 I 5% $]90,05 TOTAL SAN]TARY ADMINISTRATION FEE: 126,72 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $63.33 ) 1078 Cheryl Slaymaker 2/] 4/2005 TOTAL SDC CHARGES = $3,990.95 PREPARED BY DATE u_ . . . ,.. , DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIX11JRES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (Nom FOR REMODELS, CALCULATE ONLY TIlE NET ADDmONAL FIXTIJRES) NO, OF FIXTURES DRAINAGE ." UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 2 0 3 = 6 IDRlNKlNG FOUNTAIN. 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC, 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESWASHER, 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 1 0 2 = 2 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 ISINK: COMMERCiAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 IURINAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INST ALLA TION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 27 I .,:EDU (Equivalent DwellinJt Unit) is a dischar~e eqw':!!.ent to a single family dwelling unit (20 DFlfs) set at 167 ~Ions ocr day II MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I.OOO II ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXA nON CREDIT? 2 BEFORE 1979 $5,29 (Enter I for Yes, 2 for No) I 1979 $5,29 IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? 2 1980 $5,19 (Enter I for Yes. 2 for No) I 1981 $5,12 BASE YEAR 1979 1982 $4,98 I 1983 $4,80 CREDIT FOR LAND (IF APPLICABLE) 1984 $4,63 VALUE /1000 CREDIT RATE 198.5 $4,40 $0,00 x $5,29 ~ , $0,00 1986 $4,07 1987 $3,67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON) 1988 $3,22 VALUE /1000 CREDIT RATE 1989 $2,73 $0,00 x $5,29 0 1990 $2,25 1991 $1,80 1992 $1,59 TOTAL MWMC CREDIT = $0,00 1993 $1.45 1994 $1,25 1995 $1,09 1996 $0,92 1997 $0,72 1998 $0,48 1999 $0,28 2000 $0,09 2001 $0,05 ': ~_...': ;("~.'",~':~')",_", ~"'~ \'" "'~" .,.,',.~l~ '~'}"-""",''r''''''''''I'''', ".' Yi:;S ",~,./: :,eJl~'Q1};~~,...~GF~L~/q~R9~;':;'",~' :~._/'~ :" 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (DWl ZOO S- - 0 c I 5' ~ 1. \''LiiCAfiON.bEIf\iSTAi;Q'''''''ON~7)!i2i'J'f~ 3. ~,~,.,.v",,,,_."-,,"f""""-~.,~:di,,,~,,,'j;"~"'~""'" .' ~..:..J_~~'<""i\'s,'fl.+;.!bj '?'?6C1 ~k'~Y7~-V; LEGAL DESCRIPTION /7D2 I 9'"3l( ) B. ,~,s'?~f~~r~r~~~~:f~y~}~~'~~!i~:~;'.'A~~1fi~r~~~~~"~'~~lg~a'tiiD,:;~~J 200 Amps or less' $ 63.00 ,_./ 201 Amps to 400 Amps $75,00 ./ 401 Amps to 600 Amps $125.00 / 60 I Amps to 1000 Amps $163.00 Phone iresVG:lYt61000AmpsIVolts $375,00 Al1EN11 0' ~;e~~ ~~~h';O~egonsB~~ct Only... $ 50,00 " ",\loW Ie" a P Those rules are ,~JE.Ili"~" "~",-",, .~" ,ce', ...,." ""';"''',,"-l>:C,<',,' '~t;jj1t!l""..".;."w(;,,,~ Supemsor LIcense Numoer. ,,'~n Center. I 'h OAffS@ijl.. !1'U,rarY,Se,r".lces'!.r:,Feeder8' ;'3.....~',J,iJ~r_,r,',N,:;')"-..m Noll ~952,001,001u\nlu'd ltherulesOY Expiration Date i. "! ,.... ",,",v obtain COPlesho te\e~l\UllIbtion, Alteration or Relocation I UU;;1V. ':.., t \I"UI'" t e tinn. 5c-=> calling the cen er. on Utility NotillOO...."Ips or less $ 50,00 er ..~;f.:o' lnr theor~g ",;;,332-2344)201 AmPs to 400 Amps $ 69.00 center IS 1 I) 40 I Amps to 600 Amps $100.00 Ob~OO JOB DESCRIPTION It:l1Af '?OWi::-V'~ Permits are non-transferable and expire if work is ,. not started within 180 days of issuance or if work is Suspended for 180 days. ~;'''-'i'''''''''~:''~ ~.h",' ,'</",'L~/""',~tji'j-i"';;,-~:~::;:'~ :~::"~',]fL".I!~ 2.'X;O~'!lft<;J;~~~SI~!L1n~~9W.rJj Electrical Contractor Address City Signature of upervising Electrician w;::P~~:::~,'r '"'" ", ,_ a!, ;,:'.'i\,'l' 1:: .'''. . : ...",,"",' '. l. , ,',., ~, .'--, "..~'I"I.. ~Jf . Date ~g--o 5 ~ €t "Og, 'VVI1) r.~';-:::' ,~,' "J'.'m~::rr'j)prj5;i'~-'€I!JJi!4f'!JlJ.~'" ~"''0'~.'' ..ll1'~. ~q:;.~r'~~'1r--. " ". ,;;\!,':"" 'COMPEETE FEl'fSCn, 'BEI:.OWc ,~,-",!-~"" ':;';,r"., ',J;i' --, " ...""..,,.".,'n.;:'......,.,.,..,_',_,~,. -Sq'.;;w. $?~;.;jki;;.;i_~':' "; \. ''''',z.,d0.;:'''( D .?, Of "6 Cite or,- rsg, . ""ft. (;ry;";;?~SYI[!j:'FitP'f+'-., ....rj~.;;I! "':"~:-'f;fj:'t..,'!f!;&. :~J!:.I}(Js~~~Z,~ft-"''iT::;I/.";:'::,.':j';:.'j A. I;Ne,;',Res,iIentiill", . leo: ulti-Fa[]Jnyi.." il.\j1l'el!~ng)unit:~'\", ~...~..L.;1'~"l..~b'(,w~~"", "~.w.:;.;.;~.. .'-:";:!:$:t1.-~~~/ii;.;-;Ollow;' ::r""',,'-"',<,-- Service Included g"ilf"ro.3 "S6 "9 1000 sq, ft, or less """ Each additional 500 sq. ft. or portion thereof Each Manufac!' d Home or Modular Dwelling Service or Feeder $50,00 Over 600 A~ps or 1000 Volts se.7,"B" above, D t:'B.'~J' .....hryC~......'<{:~ts~. ~,:.~r.;.,t<1f1=<!:E.>:..,~"3,-:;;:~:;.L:;~~,...:.'>f;F'Ji;~-::7..':\:'..;,x....~,"._,~.'\:!;J~ j . !~" __r:a,~~,j }.r:~~l_ ., '.-:<">'~':'<;'<.1li::'+ti/'c...'<":,:'j"';"'i-';..,::~\,_""'~~,Yf.l. },;;:v~b);.j New Alteration or Extension Per Panel One Circuit $ 43,00 . L Each Additional Circuft o';(with ' Owners NVame ~2,~5{: ~0\~'~~~~'1'1 SuHN~~~~~:~:~Jh1,. "''Y'' '.',.. ."'~' ~., ~..OO, "'. '., Address I ~C) 'I I u'r?I',f:O \E~I'-MiSc'OJJaiieous (senice/feede, r~ not iIidiidedriEachIn'siallatiiin':J' -: : U ~,,~~~I:tlJ OR \S;'M;-I\~'tlol' -. ,n',' " .>, ..' .,.. "."" '~< City~~-e. r. Phone 7-z)G'~ 3,3\iR, PcRpuliip or irrigation ' $ 50,00 1\1" . - - ' Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4 fiSfuiroTAfo:FXB'oVE .~i" ;'. ,.,;:', ~;l ~ 0 :~. ,.- ::>,.'<O"\:;r. ~_w__<,,::~..r;,,.<:_~......,,;,,,~7">.oi-'~L'::L ~.:U r . Inspection Request: 726-3769 7% State Surcharge 10% Administrative Fee 7,0 TOTAL -<>~ ::> ~ 8 'S::- Shared Drive(T:)lBuilding Forms/Electrical Permit Application 1-03.doc