HomeMy WebLinkAboutPermit Building 2002-10-4
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: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09117/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
SITE ADDRESS: 6655 Aaron Ln
ASSESSOR'S PARCEL NO.: 1702341112700
PROJECT DESCRIPTION:
TYPE OF WORK Single Family Residence
TYPE OF USE: New
Lot: 93, Subdivision: Levi Landing, Addition: 2nd, Land Use: Single Family Dwelling,
10// 'A'L
Zoning: LDR, !I/", .10IA,.....'!!!...
I"/') ')'/e 'VIe. ' \'.. ,
_\\o'l'l~~O,)O O;(jJ:t CiliOI') S'qO'O~'i!;o~"'l.-I', Phone Number: (541) 686-9458
:.9Q y, BS<. ce17!. 'Plea "<:iv,
C'.:){,. 01, 007 191:,.. 01/ '}: · co.
./'Lt?; il/Ot,"tch vUIO"OS. -i~O'-"t'>.:
Contractor Info~ioti.Cl- ~blqil') ;"1'0: I'U1e/;OOt) ~0~ 1("
"'&nf~:. ;.o~Qlt9110~~4" C?~{:~~~{e
. ~~~~f) 19, II}. iJ,p"7.c ~c?:. ' (j;
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-??:;> ~tv 1M &AJI). &86
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. 01)
Owner: Bruce Wiechert Custom Homes Inc
Address: 3375 Park Hills Dr Eugene OR 97405
Contractor
Bruce Wiechert Custom Homes Inc
Bruce Wiechert Custom Homes Inc
Steves Plumbing
Comfort Flow Heating CO /tOr.
Peter Stoppani rJ..'I_ Ie/:'.
. I BUlL~~:~)~~VlATION ,
C,;oS'///' / S.
1 4ft! ~~'tf~(;, 1t4/./. 1 Lot Size:
R-3 y ~ t~}f~,& ~~ 18.00 Sq Ft 1st Floor:
U-1 TyPP4VJ..~ /SFbl9y~~~,le5-~. Sq Ft 2nd Floor:
VN Water TYPltr/a 484AI Pt~ ~ lA_ Sq Ft Basement:
Range Type: ~ 't{)OId'diiyt?~'YI~t Garage/Carport
3 Energy Path: 4>p}t l' 4'0 Ft Other:
VII mpervious Surface Area:
Contractor Type
General
Plumbing
Mechanical
Electrical
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Phone
(541) 686-9458
(541) 686-9458
(541) 342-3765
(541) 726-0100
(541) 688-7720
6,100
1,520
440
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Floodplain
3
Yes
32.00
43.00
I ~BLIC IMPROVEMENTS I
Fully Improved
Sidewalk Type:
Downspouts/Drains:
Curbside 5'
Curb and Gutter
I ~ aluation Description I
$ Per Sq Ft Square Footage
Value
Date Calculated
Page 1 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status:
Issued
PERMIT NO: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09/17/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
DweIlinl!s
Garage
V Wood Frame
Garage
$74.60
$19.60
1,520.00
440.00
$113,392.00
$8,624.00
$122,016.00
10/07/2002
10/07/2002
Total Value of Project
Fees Paid I
Fee Description Amount Paid Date Paid Receipt Number Received By
Multiple Permit Discount - 2nd -$30.00 10/0412002 1200200000000000020 dIm
One to Four Outlets $4.00 10/04/2002 1200200000000000020 dim
State Surcharge - Mechanical $4.06 10/04/2002 1200200000000000020 dim
8% Administrative Fee - Mechan $4.64 10/04/2002 1200200000000000020 dim
Dryer Vent $6.00 10/0412002 1200200000000000020 dim
Address Assignment $8.00 10/04/2002 1200200000000000020 dim
Hood and Exhaust $9.00 10/0412002 1200200000000000020 dim
Gas Fireplace $9.00 10/0412002 1200200000000000020 dim
Mechanical Issuance $10.00 10/04/2002 1200200000000000020 dim
MWMC Administrative Fee $10.00 10/0412002 1200200000000000020 dim
Less than 100,000 BTU $12.00 10/0412002 1200200000000000020 dim
State Surcharge - Electrical $13.58 10/04/2002 1200200000000000020 dim
Backflow Prevention Device $14.00 10/04/2002 1200200000000000020 dim
8% Admin Fee - Electrical $15.52 10/04/2002 1200200000000000020 dIm
Vent Fan to One Duct $18.00 10/04/2002 1200200000000000020 dim
State Surcharge - Plumbinl! $18.76 10/04/2002 1200200000000000020 dim
8% Administrative Fee - Plumbi $21.44 10/04/2002 1200200000000000020 dim
Residential Improvement MWMC $34.83 10/04/2002 1200200000000000020 dim
Wiring Footage Each Add'l 500 $38.00 10/04/2002 1200200000000000020 dIm
State Surcharge For Building P $44.15 10/0412002 1200200000000000020 dlm
Temporarv: 200 Amps or Less $50.00 10/04/2002 1200200000000000020 dim
8% Building Administrative Fee $50.45 10/0412002 1200200000000000020 dIm
Planning Plan Review $55.00 10/04/2002 1200200000000000020 dIm
New Curbcut $75.00 10/04/2002 1200200000000000020 dlm
New Sidewalk $76.96 10/0412002 1200200000000000020 dim
Wiring Footage 1,000 Sq Ft or $106.00 10/04/2002 1200200000000000020 dim
SDC Administrative Fee $143.68 10/04/2002 1200200000000000020 dim
Residential - Reimbursement $160.87 10/04/2002 1200200000000000020 dim
Two Bathrooms $254.00 10/04/2002 1200200000000000020 dim
Residential Sanitary MWMC $332.86 10/04/2002 1200200000000000020 dim
Sanitary Sewer SDC Improvement $335.80 10/04/2002 1200200000000000020 dim
Sanitary Sewer SDC Reimburseme $441.80 10/0412002 1200200000000000020 dim
Building Permit $630.65 10/0412002 1200200000000000020 dim
Residential - Improvement $709.81 10/04/2002 1200200000000000020 dim
Residential - Single Family - $847.69 10/0412002 1200200000000000020 dim
S.F. Residence - WiIlamalane $1,000.00 10/04/2002 1200200000000000020 dim
Total Amount Paid $5,535.55
Fees Paid Prior to 10/2/2002
Page 2 of 4
Status:
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09/17/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Same As Plan Review
2nd Driveway/Overwidth Appl Fe
Total Fees Paid Prior to 10/2/02
$100.00
$35.00
$135.00
09/17/2002
09/1712002
10641
10641
Engineering-Res
I Plan Reviews I
09/27/2002 Appr VJ Traffic is reviewing overwidth
application 9/27/02.
09/18/2002 Appr LH
09/24/2002 Appr LM Needs to pick up LDAP. FEMA
elevation certificate required.
09/27/2002 Appr BB
Initial Review-Res
Planning-Res
Structural-Res
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.!.equired Inspections'
1 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
2 Footing: After trenches are excavated.
3 Foundation: After forms are erected but prior to concrete placement.
4 Post and Beam: Prior to tloor insulation or decking.
5 Floor Insulation: Prior to decking.
6 Shear Wall Nailing: Before covering sheathing with finish materials.
7 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
8 Wall Insulation: Prior to cover.
9 Ceiling Insulation: Prior to cover.
10 Drywall: Prior to taping.
11 Undertloor Plumbing: Prior to insulation or decking.
12 Rough Plumbing: Prior to cover and including required testing.
13 Water Line: Prior to filling trench and including required testing.
14 Sanitary Sewer Line: Prior to filling trench and including required testing.
15 Storm Sewer Line: Prior to filling trench.
16 Final Plumbing: When all plumbing work is complete.
17 Undertloor Mechanical. Prior to insulation or decking and including required testing.
18 Rough Mechanical: Prior to Cover
19 Final Mechanical: When all mechanical work is complete.
20 Temporary Electric: Approval required prior to Utility Company energizing pole.
21 Rough Electric: Prior to Cover
22 Electric Service: Approval required prior to utility company energizing service.
23 Final Electric: When all electrical work is complete.
24 Sidewalk - Setback: After forms are erected but prior to placement of concrete.
25 Curbcut - Overwidth: After forms are erected but prior to placement of concrete.
Page 3 of 4
CITY OF SPRINGFIELD
Status:
Issued
Building/Combination Permit
PERMIT NO: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09/17/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
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 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
Date
Page 4 of 4
Status:
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09/17/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6655 Aaron Ln
ASSESSOR'S PARCEL NO.: 1702341112700
TYPE OF WORK Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Lot: 93, Subdivision: Levi Landing, Addition: 2nd, Land Use: Single Family Dwelling,
Zoning: LDR,
Owner: Bruce Wiechert Custom Homes Inc
Address: 3375 Park Hills Dr Eugene OR 97405
Phone Number: (541) 686-9458
Contractor Type
I Contractor Information'
Contractor License
Bruce Wiechert Custom Homes Inc
Bruce Wiechert Custom Homes Inc
Steves Plumbing
Com fort Flow Heating Co
Peter Stoppani
Expiration Date Phone
(541) 686-9458
(541) 686-9458
(541) 342-3765
(541) 726-0100
(541) 688-7720
General
Plumbing
Mechanical
Electrical
I BUILuH'l~ U'H<ORMATION,
# of Buildings: 1 # of Stories: 1 Lot Size: 6,100
Primary Occupancy Group: R-3 Height of 18.00 Sq Ft Ist Floor: 1,520
Secondary Occupancy U-l Type of Heat: ,'orced Air Electric Sq Ft 2nd Floor:
Yrimary Construction Type VN Water Type: Gas Sq Ft Basement:
Secondary Construction Range Type: Electric Sq Ft Garage/Carport 440
# of Bedrooms: 3 Energy Path: Path 1 Sq Ft Other:
Impervious Surface
" r.p~.
I DEVElLOPMENT
I
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Floodplain
3
Yes
32.00
REQUIRED PARKING
Total:
Handicapped:
Compact:
43.00
I PUBLIC
-
I
Street
Storm Sewer Available:
Special Instruction:
Fullv Improved
Sidewalk Type:
Downspouts/Drains
Curbside 5'
Curb and Gutter
Notes:
Desc ription
Type of Construction
I Valuation Description I
$ Per Sq Ft Square Footage
Value
Date Calculated
1 of 2
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: 02-01120-01
ISSUED: 10/04/2002
APPLIED: 09/17/2002
EXPIRES: 04/04/2003
VALUE: $ 119,405.00
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
Total Value of Project
Fees Paid I
Amount Paid Date
Receipt Number
Received By
Total Amount
I Plan Reviews I
Enl!ineerinl!-Res 09/27/2002 Appr VJ Traffic is reviewing overwidth
application 9/27/02.
Initial Review-Res 09/18/2002 Appr LH
Planninl!-Res 09/24/2002 Appr LM Needs to pick up LDAP. FEMA
elevation certificate required.
Structural-Res 09/27/2002 Appr BB
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 Required Inspections I
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. /./
Dat: /
to) l/j 0 (/
2 of 2
I
,CITY OF SPRINGFIE1~ SYSTEMS DEVELOPMENT CHL",6~E WORKSHEET
JOURNAL OR JOB NUMBER: 02-01120-01
NAME OR COMPANY: Bruce Wiechert Custom Homes, Inc,
LOCATION: 6655 Aaron Lane
TAX LOT NUMBER: . 17023411 tl 12700
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS: 1 - BUILDING SIZE: 1485 SF LOT SIZE:
1, STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIQUSS.F. COST PER S.F.
x
3006.00 $0.282
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS s.F'1 x COST PER S.F. x DISCOUNT RATE
0.00 $0.282 50%
I ITEM 1 TOTAL - STORM DRAINAGE SDC
2. SANITARY SEWER - CITY
A. REIMB URSEMENT COST:
NUMBER OF DFU's I x COST PER DFU
20 $22.09
B, IMPROVEMENT COST:
NUMBER OF DFU's COST PER DFU
x
20 $16.79
, ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3. TRANSPORTATION
A. REIMBURSEMENT COST:
ADT TRIP RATE NUMBER OF UNITS
x
9.57 1
B, IMPROVEMENT COST:
ADT TRIP RATE NUMBER OF UNITS
x ..
9.57 1
I ITEM. 3 TOTAL- TRANSPORTATION SDC
4, SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's COST PER FEU
x
1 $332.86
B. IMPROVEMENT COST:
NUMBER OF FEU's COST PER FEU
x
1 ,.' $34.83
MWMC CREDIT IF APpLIcABLE (SEE REVERSE)
SUBTOTAL OF MWMC REIMBURSEMENT, IMPROVEMENT & CREDIT
MWMC ADMINISTRATIVE FEE
I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ,
I SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5. ADMINISTRATIVE FEE:
SUBTOTAL I' ADM. FEE RATE
$2,873,66 . XI 5%
6100
SF
=,
$847.69
=1 $0,00
=r $847.69
x
COST PER TRIP
$16.81
x NEW TRIP FACTOR I
1.00 =1
x
COST PER TRIP
$74, I7
x
NEW TRIP FACTOR
1.00 =1
=1
," =1
TOTAL SANITARY ADMINISTRATION FEE: ,
'TOTAL TRANSPORTATION ADMINISTRATION FEE: 1
Steve Templin,
SDC COORDINATOR
9/27/2002
=,
$441.80
=,
=1
$335,80
$777.60
$160.87
$709.81
$870.68
=,
$332.86
=, $34.83
=1 $0,00
= I $367.69
=1$10.00
= r $377.69
=r $2,873.66
$143,68
93,56
$50,12
TOTAL SDC CHARGES = $3,017.34
DATE
CI')
~
Q
o
u
~
~
0001
CI')
~
Cl
~
~
I
1:11070
1091
I 1092
I .1
.I
1093 ...J
II 1094
III
"I
I t
1055
1056
1079
1078
"
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) '."
NO. OF FIXTURES DRAINAGE
'. ,
( # NEW - UNIT ,.. FIXTURE
FIXTURE TYPE # OLD ) x EQUIVALENT = UNITS
BATHTUB ( 1 0 ) x 3 = 3
DRINKING FOUNTAIN' { 0 0 ) x 1 = 0
FLOOR DRAIN C- O 0 ) x 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. ( , 0 0 ) x 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. ( 0 0 ) x 6 = 0
LAUNDRY TUB ( 0 0 ) x 2 - 0
CLOTHESW ASHER / MOP SINK ( 1 0 ) x 3 = '3
CLOTHESW ASHER - 3 OR MORE (EA) ( 0 0 ) x 6 = 0
MOBILE HOME PARK TRAP (1 PER TRAILER) ( 0 0 ) x 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. ( 0 O. ) x 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. ( 0 0 ) x 3 = 0
SHOWER, SINGLE STALL ( 1 0 ) x 2 = 2
SHOWER, GANG (~UMBER OF HEADS) ( 0 0 ) x 2 = 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN ( 1 0 ) x 3 = 3
SINK: COMMERCIAL BAR ( 0 0 ) x 2 = 0
SINK: DOMESTIC BAR ( 0 0 ) x 1 = 0
WASH BASIN ( 0 0 ) x 2 = 0
LAVATORY ( 3 0 ) x 1 = 3
URINAL, STALL / WALL ( 0 0 ) x 5 = 0
L. TOILET, PUBLIC INSTALLATION ( 0 0 ) x 6 = 0
TOILET, PRIVATE INSTALLATION ( 2 0 ) x 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU's*
( 0 0 ) x 20 = 0
TOTAL DRAINAGE FIxTURE UNITS =, 20
*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
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEP ARA TEL Y
YEAR
ANNEXED
1979 OR BEFORE
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
CREDIT RATE PER $1,000
ASSESSED VALUE
$4.92
$4.83
$4.77
$4.64
$4:47
$4.30
$4.09
$3.78
$3.41
$2.98
$2.52
YEAR
ANNEXED
1990
1991
1992
1993
1994
1995
1996
1997
1998-
1999
2000
CREDIT RATE PER $1,000
ASSESSED VALUE
$2.06
$1.64
$1.45
$1.31
$1.13
$0.97
$0.82
$0.63
$0.41
$0.22
$0.04
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
.0.000 x $0.04 =,
0,000 x $0.04 =,
TOTAL MWMC CREDIT =,
$0.00
$0,00
$0.00
.:.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 (3
INSPECTION REQUEST: 72 - '"
OFFICE: 726-3759
,
''0(,' 0'
1. LOCATION OF I~~LA"" T
bbgS ~~O'"
';"o"~' h~Cb'
'('0 ~Cb ~ ~
LEGAL DESC~~jpNl?, . ~v\'O
Lo t '1'3 ~~ 'iL, ~ '0 c."rfo.. 1'\ J\dJ~ '"
~c ,~16 ~
JOB DESCRIPTION')'I>~~P k, ~\
N~ v 1"(.0"'-"'::,11 vC:"f\ J ('\.
ELE" JCALPERMIT APPLICATION
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
S UI:11
$106.00
.IXO
~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days,
1000 sq. ft. orIess
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
l
1L
$ 19.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY
ElectricalContractorSCOfp0l11 E/ee.
Address 9t 7 /:::CIJ e )11 A f e
City 6 e Phone 606-
, J
Supervisor License Number cl
B. Services or Feeders
Installation, Alterations or
Relocation:
$ 63.00
$ 75,00
. $125.00
$163.00
$375.00
$ 50.00
Signature of Supervising Electrician
20 amp
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above
$50.00 fI1cIJ
$69.00
$100.00
Addressf)51&"
City G.i.'0'~- Phone
OWNER INSTALLATION
The installation is being made on
property lawn which is not intended
for sale, lease or rent.
LV.:!:
p(J..o\~~
19~o - OJ l-ICi
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit
$43.00
Each Additional Circuit or with Service
or Feeder Permit
$ 3.00
OWIlers Signature:
E. Miscellaneous (Seryice/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
;JeI ltJ/.fDL
R~(#dD
zf/~
Minimum Electric Permit Inspection Fee is 545.00 + Surcharges
\Q4.00
.m
1.~~. \0
4. SUBTOTALOFABOVE
7% State Surcharge
8% Administrative Fee
TOTAL