HomeMy WebLinkAboutPermit Building 2004-10-15
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Status
Issued
CITY OF SPRINGFIELD'"
Building/Combination Permit
PERMIT NO: COM2004-01129
ISSUED: 10/15/2004
APPLIED: 09110/2004
EXPIRES: 04/15/2005
VALUE: $ 542,688.00
Q
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6280 Aster St 6280
ASSESSOR'S PARCEL NO.: 1702343400900
Springfield TYPE OF WORK: Four-Plex
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Two Three Plex Units
Owner: ADELAIDA D WULLSCHLEGER LIVING TRUS
Address: 6251 MAIN ST APT 1 SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Contractor
APAZ
ESSEX GENERAL CONSTRUCTION 54531
REYNOLDS ELECTRIC ~~ 17252
STATEWIDE MECHANICAL ~~C,) 5:::,\ 148558
STATEWIDE MECHAN!~J\~ ~"'(:\S ~ 148558
~y>>tiit~;~lniF6~ATION I
':0~\; ,\'\" ~\}\'
# of Units: ~\t~. ~\~ ~\)'X..~"~W.~Stories: ""'." 2 Lot Size:
Primary Occupancy Gro~ii: ~Y..,~ ,~~ '0 \)~ \S, ~eight of Structure, ,22.00 Sq Ft 1st Floor:
Se~ondary Occupa?cy Gro"u~\\;\\)~\.,('.~\) ~<.".~\:j Type of Heat: ,., Elect~ic ~"Sq Ft 2nd Floor:
Primary ConstructIOn Type~'0 ~<.".V~~ Water Type: Elec!r~~ ,\0 -v~~~asement:
Secondary Construction TYP~\)~ \~\) Range Type: ' El~~~o~ ~~~~rage/Carport
# of Bedrooms: 'f..~ ' 13 Energy Path: ~ ~'Pl8In~'O ~ ~er:
Sprinkled BUildin~~p~ ~'\ ~~~'o~()~~~~~;~~ ,~oad:
I DEVELOPMENT =~{~~<:f~~~ o\\e-'O~~~G~U~
.c<V~( ~'OC";) ~~ .~\\) G(f<~ .~'O ~o~ REQUIRED PARKING
:S:' ~..y. v'O ,<:S \~ 0\.'0' ':i-~'\ ~~.
, Ove~I~cJ)'is~o~ ,()()\ 0'0\'7). ~ ~ ~ '0~ fj;1".'?J Total:
# Str~<(?tJf~s~tl~'().'\ e~\.'O ''!-..'O~o ~;!)'?) Handicapped:
Pave<fljr~~4Y K''O G '00 ",ro<:S Compact:
% of L.tR- ~<<!l~.er~~ 'o~ '\\" ~\C";)
<:s'~" '0\ ~\.e
G .,~'C ve
License
Expiration Date
Contractor Type
Architect
General
Electrical
Mechanical
Plumbing
11/10/2004
02108/2005
08/03/2005
08/03/2005
Phone
541-744-2046
541-342-4509
541-343-7297
541-461-8973
541-461-8973
3,024
3,248
294
'-"', '
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Pae;e 1 of5
~
.
..
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
$82.00
$1.00 "
Square Footage
or Bid Amount
6,484.00
11,000.00
Apartment HODS V Wood Frame
Pavine Use Bid Amountd ,
Total Value of Project
~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01129
ISSUED: 10/15/2004
APPLIED: 09110/2004
EXPIRES: 04/15/2005
VALUE: $ 542,688.00
Value
Date Calculated
$531,688.00
$11,000.00 ,
$542,688.00
09/20/2004
09/20/2004
Fee Description Amount Paid Date Paid Receipt Number
Plan Review CommlInd/Public $1,107.05 9/3/04 1200400000000001310
-Mechanical Issuance Fee- $10.00 10/15/04 2200400000000001297
+ 10% Administrative Fee $324.58 10/15/04 2200400000000001297
+ 7% State Surcharge $219.15 10/15/04 2200400000000001297
Addressing Assignment , $62.00 10/15/04 2200400000000001297
Annexed 1979 or Before $-67.79 10/15/04 2200400000000001297
Backflow Device $14.00 10/15/04 2200400000000001297
Building Permit $1,969.65 10/15/04 2200400000000001297
Dryer Vent $36.00 10/15/04 2200400000000001297
Fixture $770.00 10/15/04 2200400000000001297
Paving $115.20 10/15/04 2200400000000001297
Plan Review CommlIndlPublic . $1,303.51 10/15/04 2200400000000001297
Plan Review Fire & Life Safety $802.16 10/15/04 2200400000000001297
Sanitary Sewer - 1st 50 Feet $45.00 10/15/04 2200400000000001297
Sanitary Sewer - Improvement $2,193.24 10/15/04 2200400000000001297
Sanitary Sewer - Reimbursement $2,885.24 10/15/04 2200400000000001297
SDC MWMC Administration $10.00 10/15/04 2200400000000001297
SDC MWMC Improvement $4,450.16 10/15/04 2200400000000001297
SDC MWMC Reimbursement $421.88 10/15/04 2200400000000001297
SDC Sanitary/Storm Admin $6.41 10/15/04 2200400000000001297
SDC Sanitary/Storm Admin $532.21 10/15/04 2200400000000001297
SDC Transpo Admin ' $-7.06 10/15/04 2200400000000001297
SDC Transpo Admin $284.70 10/15/04 2200400000000001297
SDC Transpo Improvement $-62.97 10/15/04 2200400000000001297
SDC Transpo Improvement $3,254.74 10/15/04 2200400000000001297
SDC Transpo Reimbursement $-14.28 10/15/04 2200400000000001297
SDC Transpo Reimbursement $737.79 10/15/04 2200400000000001297
Storm Drainage Impervious Area $132.06 10/15/04 2200400000000001297
Storm Drainage Impervious Area $2,385.14 10/15/04 2200400000000001297
Storm Sewer - 1st 50 Feet $45.00 10/15/04 2200400000000001297
Storm Sewer Each AddtI 100' $56.00 10/15/04 2200400000000001297
Temp Power 200 amps or less $50.00 10/15/04 2200400000000001297
Vent Fan $72.00 10/15/04 ' 2200400000000001297
Water Line - 1st 50 Feet $45.00 10/15/04 2200400000000001297
Water Line - Each Addtll00' $28.00 10/15/04 2200400000000001297,
Paee 2 of 5
,
CITY OF SPRINGFIELD I
\. Building/Combination Permit
Status Issued PERMIT NO: COM2004-01129
225 Fifth Street, Springfield, OR ISSUED: 10/15/2004
541-726-3753 Phone APPLIED: 09/10/2004
541-726-3676 Fax EXPIRES: 04/15/2005
541-726-3769 Inspection Line VALUE: $ 542,688.00
Willamalane Apartments $5,536.00 10/15/04 2200400000000001297
Total Amount Paid $29,751.77
I Plan Reviews I
Fire Department Review 09/13/2004 09/27/2004 OK GRG Plan Review: two triplex
apartments, one with a garage. Job
#COM2004-1129. Occupancy
Classification: R-1. Construction
type: V-No
Provide address numbers in
contrasting color from the
background positioned plainly
visible and legible from the street or
road fronting the property (1998
Oregon Structural Specialty Code
502 and 1997 Springfield Uniform
Fire Code 901.4.4).
Provide fire extinguishers with a
minimum rating of 2-A:10-B:C
every 75 feet of travel distance.
Option: Locate fire extinguishers
inside each unit. The top of the
extinguisher(s) shall be between 3
and 5 feet above finished floor
(Springfield Uniform Fire Code
1002.1).
Smoke alarms shown on Plan Sheet
A10 in Symbol and Description
boxes but not on the floor plans.
Smoke detectors shall be installed
per Oregon Structural Specialty
Code 310.9.1.4 with hush features
required per ORS 479.297
Paragraph 2.
Initial Review 09/08/2004 09/10/2004 APP LLH
Plannin2 Review 10/07/2004 10/07/2004 APP EMM
Plannin2 Review 09/13/2004 WE Sarah 'Summers is planner for Site
Review. Final Site Plan was
incomplete. New plan to be
submitted (which means building
plan should be changed also to
reflect). Development Agreement
will need to be signed.
Pa2e 3 of5
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01129
ISSUED: 10/15/2004
APPLIED: 09/10/2004
EXPIRES: 04/15/2005
VALUE: $ 542,688.00
I.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Public Works Review
10/06/2004
APP SB
09/1312004
Structural Review 09/10/2004 09/14/2004 WE TCM
Structural Review 10/07/2004 10/07/2004 WE JMP
Structural Review 10/08/2004 10/08/2004 PEND TCM
Structural Review 10/11/2004 10/11/2004 APP TCM
Structural Review 10/11/2004 10/11/2004 WI JMP
Structural Review 10/13/2004 10/13/2004 10 JMP
SDC fees added. and corrected.
Curbcut and SIdewalk permits
added. No encroachment required.
LDAP Application required before
issuance.
Waiting for engineering calulations,
and foundation change on point load
footings.
See attached reminder of
outstanding items faxed to Art Paz.
Received requested information
from Paz, review pending.
Revisions received comply with
requested data.
Waiting for approval ofLDAP.
Virginia says she will finish the
LDAP approval for Art Paz to pick
up this morning.
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.
Site Inspection: To be made after excavation but prior to setting forms.
Erosion/Grading Inspection: After all erosion measures are in place.
Vfer 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.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
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.
Firewall: Located and constructed according to plans.
Final Building: After all Conditions have been completed as required on Development Agreement.
Final Fire Department. After all requirements of the Fire Department have been met.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Grading: After gravel is in place but prior to placing concrete.
Final Paving: After paving is complete.
Vnderslab Plumbing: Prior to filling the trench and including required testing.
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.
Paee 4 of 5
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01129
ISSUED: 10/15/2004
APPLIED: 09/10/2004
EXPIRES: 04/15/2005
VALUE: $ 542,688.00
...
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: 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 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.
oi~rsSre ~
Of;/? / s-: ~ ~
Date
/
Pa2e 5 of5
ATTACHMENT A
CITY Of ,NGFIELD SYSTEMS DEVELOPMENT CHARGE V
JOURNAL OR JOB NUMBER: C0M2004-01129
NAME OR COMPANY: WULLSCHLEGER APARTMENTS
LOCATION: 6280 & 6282 ASTER
MAP & TAX LOT NUMBER: 17 02 34 34 00900
DEVELOPMENT TYPE: TWO TRI-PLEXES
NEW DEVELOPED AREA (S.F.):
EXISTING DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SURFACE (S.F.):
. .
SHEET
221
6,748.70
ITE:
lTE:
LOT SIZE (S.F,):
.31 ACRES
4,288
L STORM DRAINAGE
IMPERVIOUS SQ. IT,
8,120
$ 0,310 PER SF
x
TOTAL STORM DRAINAGE SDC:'
;2, SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's
B. IMPROVEMENT COST:
NUMBER OF DFU's
(SEE REVERSE SIDE)
120
x
$ 24.04 PER DFU
x
$ 18.28 PERDFU
120
TOTAL LOCAL W ASTEW A TER SDC:' $
5,078.48 I $
3, TRANSPORTATION
BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
6.000 x 6.59 x $ 18.30 PER TRIP x NTF 1$ 723.51 I
B. IMPROVEMENT COST:
6.000 x 6,59 x $ 80,72 PER TRIP x NTF 1$ 3,191.77 I
EXISTING
A. REIMBURSEMENT COST:
0,000 x 0 x $ 18.30 PER TRIP x NTF 1$
B. IMPROVEMENT COST:
0,000 x 0 x $ 80,72 PER TRIP x NTF 1$
TOTAL TRANSPORTATION REIMBURSEMENT SDC: $
TOTAL TRANSPORTATION IMPROVEMENT SDC: $
TRANSPORTATION SDc:1 $ 3,915.291 $
4, SANITARY SEWER - MWMC
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 6,000 x $70.31 PER FEU
B, IMPROVEMENT COST:
NUMBER OF FEU's 6.000 x $741.69 PER FEU
EXISTING:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0,000 x $0,00 PER FEU
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.000 x $0,00 PER FEU
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
1$ 421.88 I
1 $ 4,450,16 I
1$
I $ I
$
TOTAL MWMC REIMBURSEMENT FEE: $
TOTAL MWMC IMPROVEMENT FEE: $
MWMC ADMINISTRATIVE FEE: $
TOTALMWMCSDC:' $ 4,814.241 $
'"
SUBTOTAL (ADD ITEMS 1,2,3, & 4) , $ 16,325.21'
5, ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE)
$
16,325,21 x 5% $ 816.26
TOTAL TRANSPORTATION ADMINISTRATION FEE: $
TOTAL SEWER ADMINISTRATION FEE: $
steveVc W. f;,eCluolrij f;,ClrVceS 10/6/2004
c%ffi~dn~fj>m~ullPc~eger Triplexes, 6280 & 6282 Asl(ei1Fs
TOTAL SDC CHARGES
$2,885.24
l $
17,141.47
1 JULY 2004
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIX11JRES x UNIT EQUIVAlENT = DRAINAGE FIX11JRE UNITS
(NOlE: FOR REMODELS, CALCULAlE ONLY TIlE NET AuUIIIONAL FIX11JRES)
WULLSCHLEGER APARTMENTS
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC.
INTERCEPTORS FOR SAND/AUTO WASH/ETC.
LAUNDRY TUB
CLOTHES WASHERfMOP SINK
CLOTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (1 PER TRAILER)
RECEPTOR FOR REFRIGERA TOR/W A TER STA TION/ETC.
RECEPTOR FOR COMMERCIAL SINK/ DISHW ASHER/ETC.
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: COMMERCIAL, RESIDENTIAL KITCHEN
SINK: COMMERCIAL BAR
SINK: WASH BASIN/DOUBLE LAVATORY
SINK: SINGLE LA V A TORY /RESIDENTIAL BAR
URINAL, STALUWALL
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INSTALLATION
MISCELLANEOUS:
FIXTURES
NEW OLD
6
o
o
6
o
o
6
o
6
12 0
o
o 0
12
NUMBER OF EDU'S*
UNIT
EQUNALENT
3
1
3
3
6
2
3
6
12
1
3
2
2
3
2
2
1
5
6
3
TOTAL DRAINAGE FIXTURE UNITS=
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day
DRAINAGE
FIXTURE
UNITS
18
o
o
o
o
o
18
o
o
o
18
o
o
18
o
o
12
o
o
36
120
o
o
120
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY
YEAR RATE PER $1,000 YEAR RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 or before $5.29 1992 $1.59
1980 $5.19 1993 $1.45
1981 $5.12 1994 $1.25
1982 $4.98 1995 $1.09
1983 $4.80 1996 $0.92
1984 $4.63 1997 $Q.72
1985 $4.40 1998 $0.48
1986 $4.07 1999 $0.28
1987 $3.67 2000 $0.09
1988 $3.22 2001 $0.05
1989 $2.73 2002 $0.00
1990 $2.25 2003 $0.00
1991 $1.80 2004 $0.00
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $12.81 X 5.290 $67.79
IMPROVEMENT (IF AFTER ANNEXATION DATE) X $0,00
CREDIT TOTAL $67.79
com2004-01129,Wullschleger Triplexes, 6280 & 6282 Aster.xls
1 JULY 2004
. 225 Fjfth Street
. .
I Springfield, Oregon 97477
; 541-726-3759 Phone
.~~~;~
Ilk.
r:ty of Springfield Official Receipt
velopment Services Department
Public Works Department
Job/Journal Number
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
COM2004-01129
Payments:
Type of Payment
Check
10/15/2004
RECEIPT #:
2200400000000001297
Date: 10/1512004
Description
Addressing Assignment
Willama1ane Apartments
Temp Power 200 amps or less
Plan Review CommJInd/Pub1ic
Plan Review Fire & Life Safety
Building Permit
Paving
Fixture
Sanitary Sewer - 1st 50 Feet
Water Line - 1st 50 Feet
Water Line - Each Addtl100'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl100'
Backflow Device
Vent Fan
Dryer Vent
-Mechanical Issuance Fee~
+ 7% State Surcharge
+ 10% Administrative Fee
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 Transpo Admin
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC Transpo Admin
SDC Sanitary/Storm Admin
Annexed 1979 or Before
Paid By
ADELAIDA D.
WULLSCHLEGER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
jmp
2228
In Person
Payment Total:
Page 1 of 1
lO:39:39AM
Amount Due
62.00
5,536.00
50.00
1,303.51
802.16
1,969.65
115.20
770.00
45.00
45.00
28.00
45.00
56.00
14.00
72.00
36.00
10.00
219.15
324.58
2,385.14
2,885.24
2,193.24
737.79
3,254.74
421.88
4,450.16
10.00
284.70
532.21
132.06
(14.28)
(62.97)
(7.06)
6.41
(67.79)
$28,644.72
Amount Paid
$28,644.72
$28,644.72
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541\~z~9
~ 'I') Otz,.,
ELECTRICAL PEIJ.M.IT APPLICATION :Oro~ ~IJ. ~".9,o
City Job Number ~4. 0 \\ ~ (1 Date' 0 - LS -04:- 6~/, 'I 0' 0'0~%C'1
. J\ 8 ~, ~~
1. 3.
\Q
200 Amps or less
20 I Amps to 400 Amps
40 I 'Amps to 600 Amps
, ~\J~'t:- 60.1 Amps to 1000 Amps
:\'>.~ ~\)~ver 1000 AmpsNolts
. ~ \' ~ {;) ~ Reconnect Only
~0<V<(.<v~~<v \\)
\ \,\: A)..\S :-..(\~Y,; C.
\'I.,?-"" 0.. \' ~v-
G,' :\ S\' :\)'V' ~~
Expiration Date ,,.(\.~'V:.... ~ _ \\~ \c... ~
-~~ ~ - <(.'v' ;,~. \J'<" ~\),
I~""):S ~\:'! \) ~
Constr. Contr. Numb~t'...(\\\J~~ ~.....1 <(.Y:.
i ~\)' ~~v~ (;j .
Expiration ate (J\J ,....1 \ <Q
~""
7' of Sup""i,iog El<ctrici""
,
L\~D2.~4
(tAco
J9B DESCRIPTIO. N
\"Offi1\ ~ll')O(
Perm~ \llnsferable and expire if work i
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Address
City
\
'\
Owners Name A . \. )u1lcgt.}\~
Address l.o~.~f\ #- \
City ~'(lr:( Phon, ?, "'8 - 'VC1 G
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. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B.
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
~f:D
$ 43.00
$ 3.00
Pump or 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.
mJP
~..~O
S.bo
'5~
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application I-03,doc