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11222 SW COTTONWOOD LANE J ti rA) r.� in c, O rf C+ G E u a a r— m v I Mt i 11222 3W CO'1"1'OM)KX)D LANE r , a �; CITYOF T I G A R D MECHAWCAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00002 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/5/04 PARCEL: 1 S 134AC-02655 SITE ADDRESS: 11222 SW COTTONWOOD LN SUBDIVISION: ENGLEWOOD N10.3 ZONING: R45 BLOCK: LOT: 221 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: — EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VF-NTS W/O APDL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL_ TYPES 0 • 3 HP: 1 DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: 30 • 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITSCLO DRYERS: FURN >-100K BTU: <= 10000 cfm: — OTHER UNITS: 1 10000 cfm: GAS OUTLETS: Remarks: lw i,ill lirat I*nunli mi hantllrr. Owner: ---- --_-- - - .�. _ FEES YOUNT, PHILIP R + [DONNA MAE H Description Date Amount 11222 SW COTTONWOOD LN — --- TIGARD, OR 97223 I.MFC11] Pcrniit I rr 1/5/04 $72.50 (TAX] 81r6 State 1/5/04 `05.80 Phone: 503-590-7773 -- —_Total $78.30 Contractor: SPECIALTY HEATING r; COOL'^IG 1601 SE RIVER RD HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone: 503-640-3607 Heating Unt Insp Final Inspection Reg #: LIC 66578 This permit is issued Subject to the regulations contained to the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws All work will be done in accordance ,Kith approved plans. This permit will expire if work is not started within 180 days of issuance. or ti work is suspended for rnore than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. Issued By: Permittee Signature: -J -1) � - Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mecha a cation Rccetved Permit o.: Datt1B ;/:/—`� _�� Permit No.; (J Cil, :Y,,, 97r U 201 Planning Approval Buildingcoy ry131: SV Datc/B ' Pern+tDian t2avtewDat B :ga 3 C�� Permit No.. Phone: 5,)3-639-4171 Fa%9 Post-Review I.And Use Internet: Nww.ci.hgard.o K. 1 N OatNB : Casa No.: Contact uns.: eo Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Mcthod: l l Su !omental Information. TYPE'OF WO COMMERCIAL FEt:•SCHEFT i,F-USE CHEGif WST lJew,:Onstruction FI Demolitior) Mechanical permit fees*are based on the total value of the work :271 IOfl/alterati0n/re lacement n Other' performed. Indicate the value(rouncind to the neareet dollar)of all CATEGORX.'UF 41YSTRT1tiT+ION':.'�'''. mechanical materials,equipment,labor,overhead and profit. 1 4 2 Tamm dwellin Commercial/Industrial Value: S See Page 2 for Fee Schedule F] /ecce_sort'Building multi-Family — SM R Tlip iS'YS=MS l+=M'scz�ar ULZ,- Description Fee ea. Total PQast.e r Builder Other: Heauu Coolin _^J 0 Sf'm RTORMATIO Aijd%1 OCAwT10 _ Furnace-add-on air conditlonin " 14.00 ob !titr. ;i jdress: 2 L ? o �,W ouc�1 Gas heat pun 14.00 .- Suite#: Bld ,/Apt.#: Duct work 1400 Pro t;ct N I!me: H dronic hot waters tem i4.00 Cross stie et/Directions to Job site, Roaidentlal boiler (for radiator or h drY onic Ustem) 14.00 Unit heaters(fuel,not electric) in will.In-duct,s.ts en ,ctc:) 14.00 Flue/vent for any of above) 19 90 Subdivision: L 0 tt#: Re airtinits � 12.15 Tax Intra ,rarcel#: _ Other Fuel ApPliances Water heater 10.00 DESCRIPTIOIN OF WQRK t3tu fireplace 10.00 Flue vent(water hooter/gas replace) 10.00 Log lighter i•as 10,00 —`� Wood/Pcl.et stove 10,00 — — --- Wood fl a lace/insert 10.00 Chimnt cr/flueivent I o.00 PII.OPt]M-iOWNE TS1VA F` •:r :.: Other: Name] o v-", -��L Environmental lE:thttast&Ventilation Range hood/other kitcheri equipment 10.00 Address: �'"-►-�_ Clothes dryer exhaust _ 10.00 CiStiitt JZl : TZ 3 Single duct exhaust Phone:5t D } Fax: s APPT�IC._.•. (bathrooms,toilet compartments. ' t ;C _i' '4'� •E1S$ '•,.' utiU rooms _ 6.80 1v1iUThc: Attic/crawl s race fans 10,00 — Address: Other: 10.0u Cit / tate/Zi •� Nuel111.0 e __ _� (53,40 for first 4,Si•00 each additional) Phone: Fax: Furnace ctc. •« Email: Gras heat pump • COIVTRACICOE' ,. WallAus endcd/unit heater +• Water heater •• BUBlti855 ;18trie: z. C—1 c�fl r Fire lace •• Addtibss: I lr 01 3-4:` e f • Ran e __ .. City/Stat e'T�ipL 1 S �, -tet , co rhes d (gas) •• : � -i e t? ) Fxx: I =1_ U}d i3 -Clothes Other 1 L,t0_ S ��•�� Total: I , Authonzed �� /� Mechanical Permit Fees• SignsttirfL��t� C.. ���.� _ Date: ',Exf Subtotal: S N. Minimum Pemtit Fee 572.50 S D () l �`-` Plan Review Fee(251'•of Permit Fee) S (Please print name) State Surchyle_(8%of Permit Fee) S TOTAL PERMIT FEE S O Notice; This p omit xppllcstlon expires if a permit Is not obtained within *Fee methodology sot by Tri-County Building Industm Smice Hoard, tao day,,after t has been accepted as complete. "Site pian required for exterior MC units. 0Dsts\P,rmit fomtsWouPetmitApp,doc 01103 z •d SILO 865 EOG aut%eaH Rztetoadg dzttzt *o Eo uer SITE PLAN YL PL. i pl STREET �- < -- `� w Specialty Heating & Cooling, Inc. 9` 28 SW Tigard Street Tigard, OR 97223 Phone 50 3.620.5643 Fax .503 .598.0718 'Elillsboro Phone 503.640-3607 Fax 503.681 .0793 pd H t LO H6S ECS 9u t ieajj R'4 i e t vadg d21 :21 b0 EO uer CITYCITY ^F T I G /� n _� ELECTRICAL PERMIT LJ uH�[ PERMIT#: ELC2004-00015 DEVELOM',,1ENT SERVICES DATE ISSUED: 1/14/04 13125 SW Hall B�vd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S134AC-02655 SITE ADDRESS: 11222 SW _01-TONWOOD I N SUBDIVISION: ENGLEWOOD N0.3 ZONING: R-4.5 BLOCK: LOT : 221 JURISDICTION: TIG Project Description: Installation of(2)branch circuits. Jot)No. 2275 RESIDENTIAL UNIT_ TEMP SRVCiFEEDERS _ MISCELLANEOUS 1000 SF OR LESS: _ 0 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF HMI SVC/FDR: "301+amps - 1000 volts' MINOR LABEL (+.0): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 2.00 amp: WiSERVIC17 OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O S,RVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BKNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ _ PLAN REVIEW SECTION 1009+ arnp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR—225 AMPS:V _ CLASS AREA/SPEC OCC: Owner: Contractor: YOUNT,PHILIP R +DONNA MAE H HILLSBORO ELECTRIC 11222 Sbi COTTONWOOD LN 21185 NW EVERGREEN PARKWAY TIGARD OR 97223 HILLSBORO,OR 97124 Phone: 503-590-7773 Phone: 503-439-9666 Reg #: I:t.L 34-4399C FEES — LIC 114481 Still 4941S Deszription Date Amount Required Inspections j!:I I'mi I i I I ( I'cnn,t 1 I4/04 $53.50 —'— -- --� IAx1 8 State Surcharge 1/14/04 $4.28 Rough-in Elect'I Final Total $57.78 This Permit is issued subiect to the regulations amtained in the Tigard Municipal Code,State of OR Specialty Codes - d all other applicable laws. All work will be done in acco'Zice with approved plans. This permit will expire it work is riot started within 180 days of is,uance,or if work is suspended for more than 180 days ATTENTION Oregon law requires yuu to follow rule3 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR - 01-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-800 33 344 \� I&Issue By: Permit Signature:_ 17 gU --- �— OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for salo or w ,t OWNER'S SIGNATURE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N � �- / - /�^-- — ----DATE:_ LICENSE NO: — Call 639-4175 by 7:00pm for an inspection the next business day s i ,"H I LLSBORO ELECTRIC LLC. 5036013690 01/14/2004 11:''2 1 #693 P.001 ElectricalP@Irx>nit Application Received Electrical �• - A Dater O� Permit No.'G�� City of Tigard vPlanningAp Val Sign -" V Date/By: Permit No,: 13125 SW Hall Blvd. VO Plan Review - the. Tigard, Ozegon 97223 VOIION t, Uate/Fl _ Permit -- Phone: 503-639-4171 Fax: 503-�9�1Q6(6, Post-Review 'and Use 4 N r atd8 Internet: wvrw.ci.tigard.or.us 'Ja Case.No. _ Contact Juror. See Page 2 for 24 hour Inspection Request: 503-639-4171%GN Namc/Mc!hod: Su lementsi Information. .t4 Ot Gh _ TYr_c 01'WORK � PLAN REVIEW(Please check all that Nrw constructionDemolition Service over 223amps. Health-caro facility commercial [l Hazardous location Addition/alteratio dreplacemont LLJ_Other. ❑Service over 320 amps-rating of Ll 131jilding over 10,000 square feet, ---- -_ CA3:EGOR3f-O.E CONSTRUCwT40N? r-- ---{-.tt,Lfimily�dweWingy-------• four or,nore reeidentfa9-unitsin -� --1,& 21-FamilydwellingCommercial/Industrial System over 600 volts nominal ono structure ❑ -- ----- Building over three stories ❑Feeders,400 amps or more AccessoryBuilding --Family - L]Occupant.load over 99 persona ❑Manufactured structures or RV park Master Builder tokhcr:-:� ❑Egrest/lighting plan I (]Other: 'JOB SM INFO ' TIUN,and.L ON Submit_sots of piano with any of the above. w, _✓ The above are nota applicable to tem or■r con/eructlon service. Job site address: (q _ FEE*SCHEDULE — Suite#: Bld ./A t,#: �.�_ Number of I sillectlons_erpermit allowet ProjectName: Description _ �� Paa(ea.) Total — Now reside■tial•sin le or multi-family per �I Cross stmef/Directions to job site: dwelliat unit,includes attached garage. -- - 8eIncluded: 100000s19. .of In! 145.1 S ac addniona1300fl.or )rtion thereof 33.40 i_imned enprsy,refldmtlal 7 Subdivision: i-nt#: -- - - --- -- - ---- - Limited ever ,rem residential- .00 Tax ma / l mel#: 7ech manufactured home or modular dwelling - ,{.� service and/or feeder 90.90 D$SCRIP ONORWORK;. Services or fesdors Installation, rAlteration or relocatinn: 200 amps or less 80,30 - -- 201 ampa to 400 amps 106.85 ---- - _ 401 am o to 6 0 ampg; �-- EI PROP TY OWNER _=TENANT 601 amps to 1000 aMRe-- 240. 0 Name; LL�LI IL] 1' - I•Reconne00 amyl or volts ----- 454,65 --- S Address: LA dp Temporary services or feeders-installation, o aiteration, r relocation: Cit /State/ZiF:--T—im4 c ca, 7�,�,� 200 amps of less 66.85 1 Phone: Fax: zoistrips to 400 amps 00, m - 401 to 600 amps 131475 7 dUa1'WCANT '.''_ CONTA "f fEKSON " Branch circuits-new,Alteration.or Name: extension per panel. A.Fee for hunch circuits with purchase of Address: service or feeder fee,each branch circuit 6.65 4-;, 22 C1 /State/Zll : -- s Fee for branch cu'cults without purchase 3f ----- - service or fader fee,first branch / _46.8) �(. Phone: Fax: Hach additional branch circuit 6,63 O F-nail: Mise.(Servloe or feeder not included)- CON ICTOR ch um or irri ■tion circle 33.40 2 - F,7;,a*or outline liAhtins 53.40 1 Jul) NO: Sigttal ctrcult(s)ora limited energy rwnei, l-e _. ._ alteration,or extension Pao 2 2 $11511)CSS Name: IV {,#]'1(_r�.C�� Description: - Address: F vttY.rr� Pk,Nyt I l P I - ----- _ Cit /State/ZI t' G7^1 ) Each additional Inspection over the allowable in an of the above: �N l l�S� _..__131ei� Per ins tion --__ _ _�_ per hour(min. 1 hour) 62.50 I'lronax 't% I - CCB Lic. :►.3'-1 Lic. - c� --- y -� — -- r Eitactricil PectTiit"Erns*:_ ,: Supervising electrir,ian Subtotal i S — - signstorerequired: V ��_ Plan Review(25'/e of Permit Fees - -- I-rint Name:,3oe j# r Lie. #: y 1�j State Surcharge 8%of Permit Fee S Authorized1 rOTAL PERMIT FEL S Notice: This permit anpifcation expires!fit permit is not obtained within sigttattire: —_-__ Date: 100 days after It has been accepted as complete. *Fee methodolvi v-et by Tri.-County Building Industry Service Roard. _----�--(p-ease`rine risme)— i\l)ots',Permit Fumu\ElcPcrmitApp.doc 01'03 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Received 9'y Date Requested AM_ PM BUP Location —_2Z L4- Suite MECO — 06 C) 2— Contact Person /2� Ph(—) /<< ( ) Contractor -� {�/,�tv r���� _ Ph SWR BUILDING Tenant/Owner _—_�— CELC� Footing ELC Foundation Access: ,u. 0 7a �: 5 Ftg Drain �- ELR Crawl Drain Slab Inspection Notes: SIT _— — Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing -- Insulation Drywall Nailing -- ---- Firewall Fire Sprinkler - --- -- - Fire Alarm Susp'd Ceiling --- ---- — — — Roof Other: ___ — ------- -- — ----- Final PASS PART FAIL _-- ---- -- — - PLUMBING Post& Beam— Under Slab Rough-In Water Service — ---- — -- _— Sanitary Sewer Rain Drains — --- - ----- — Catch Basin/Manhole Storm Drain ------ -- - — Shower Pan Other: — Final -- PASS PART_FAIL Rough-In Gas Line Smoke Dampers -------- ---- -- -- — _ na - PART FAIL --- - -- ---- --- MTTRICAL Service — --- ---_�� .— — Rough-In UG/Slab -----_—_ -- Low Voltage ------- - --— - ------ -- - F rod before next PART FAIL Reins� �ction fee of$ re 4 '` inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection. RE: _ -- n Unrole to inspect-no access Fire Supply Line ADA �_ Approach/Sidewalk Date---- U — IntlpeMor--1 IJ '1• _Ext — Other: _ Final 4 DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST BUP Date Requested AM PM BLD _ Location / ( ��} - ti �10 1L,t�,l�� ���tu� Suite — MEC Contact Person /'�S b C�ecr ph Wll 7DG-3 PLM Contractor= ,� �(rL(��P ,.` Ph (e c( -7,) SWR BUILDING Tenant/Owner ELC Retaining Wall -- ELR Footing _ Foundation Access: � -�,� Ftg Drain FPS — Crawl Drain Inspection Notes — SGN Slab ----- Post 8 Beam _-----_ --- ---- --- -- SIT -- Ext Sheath/Shear Int Sheath/Shear - - ------ Fiaminy Insulation --- ------ -- _- -----— — Drywall Nailing Firewall -- --- - Fire Sprinkler Fire Alarm — Susp'd Ceiling �"- Roof --- Misc: _- Final - ---�� - — — PASS PART FAIL PLUMBING Post$Beam - _-- --- — Under Slab Top Out - -- - ---- -- -- Water Service Sanitary Sewer ---' Rain Drains Final _--- PASS PART _ FAIL. MECHANICAL Post& Beam -- - - -- - - - -- Rough In Gas Line --- - - Smoke Dampers Final --- - _ PASS PART FAIT_ P ELECTRICAL Service Rough In - ---- - ---- . UG/Slab Low Voltage -�— - -- -- -- Fire Alarm 94'- ART FAIL Backfill/Grading -- -- ------- — Sanitary Sewer Storm Drain ( J Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call for reinspection RE: J J Unable to inspect-no access ADA Approach/SidewalkDete 9 Other �` �Inspector Ext Final PASS PART FAIL j DO NOT REMOVE this inspection record from the job sKe. CITYO F T I OA R D _ ELECTRICAL PERMIT — PERMIT#: ELC1999-00645 DEVELOPMENT SERVICES DATE ISSUED: 10/28/1999 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134AC-02655 SITE ADDRESS: 11222 S','V COTTONWOOD LN SUBDIVISION: ENGLEWOOD NO.3 ZONING: R-4.5 BLOCK: LOT : 221 JURISDICTION: TIG Proiect Description: Install 2 br- circuits in single family dwelling. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amr.: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS _ 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 400 amp: 1st W/O SRVC OR FDR: 1 PER HUIIR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN P_N T: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only _i SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: YOUNT, PHILIP R + DONNA MAE H CONDIATT ELECTRIC 11222 SW COTTONWOOD LN 1734 NE 60TH COURT TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: Phone: 844-7063 ORIGINAL Reg #: SUP 4501 S LIC 109669 ELE 7.6-905C FEES _V i _ Required Inspections Type By Hate Amount Receipt Elect'I Service _ FRMT KJP 10/28/199 $42.85 99-319414 Elect'I Final SPCT KJP 10/28/199£ $3.43 99-319414 Total $46.28 This Permit is issued subject to the regulations contained in the Tigarr' Municipal Code, State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or I work :s suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC�t(503) 246-1987. PERMITTEE'S SIGNATURE ,1 r� Y ISSUED BY: OWNER INSTALLATION ONLY The instaCation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ DATE:_ _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:� � l ICFNSF NO ��5--- Call 639-4175 by 7:00pm for an inspection the next business day .r 27 99 10: 33» Conduit Electric 844-'7581 p. l CITY OF-W, D Electrical Permit Application r t 131260 BLVD, RECEIVED OCT 2, tc 1999 TIGAADOA RM 0e q Phone(5"101"171,x304 COMMON Ir gW'6k, a Datele0 Fax(��n639-4175 Incomplete or illegible will not be accepted C� 9. Job Addrlras: 4. Complete Fee Schedule Bi+fow: Name of Doy*.•menL.—_ Number of tnspeouona p Name(or narne of business) Y&U"- Service included: fie I Address I D'a j W cp±L V-)y'Joc&-__� 4a. Residential-per unit Ci /S ( civ''Yi( , OIL- 1000 sci.n or IHsb $11400.. ry laUaf�p� Each additional 500 sq.N.or .r commarciaf 13 Residential portion Thereof Limited Energy j�,00 •: Each Manul'd Home or Mrxlular < 2a. Con&Wor installation onlyDwelling Service or Feeder : (Afleeh a n of st current Ilowe") 4b.Services or Feedera Electrical C fticipr COrOW i UC✓� 2 L_ _ Inslvllal:on,alteration,or relocation Address I�1 Li 1.1E nt} (— 200 amps or Isla s o= K.1-�— — 201 amps l0 100 amps Ip0,00 + C. -A- ` ._ State Dp �l1 t?�� 401 amps to 600 amps $1aarD0 Phone No. t arc 3 601 amps to 1000 amps Job No Over 1000 amps or volts 11Rmoo Elec.Cont Lies..)O. CEV.Date_ c / Reconnect only OR State CCB Reg.No.- � rs Exp.Dete I aL 4c.Temporary Swvlces or Feede COT Buslness Tax or Metro No. xp.Date Instalr?Ucn,alteration,or relocation 200 amps or less _ :50.00 201 amps to 400 amps $75.00 Slgnelure of Supr.Elec n 401 amps to 600 amps $100.00 Over b0U amps la 1000 vulls, License No. 0 1 `L Exp.Date.-- o t l -- see•'b"above. } Phone No. ,T! gy`�-�c3 — 4d.Branch Circuits Nbw,alteration or extension per panty Zb. For ownie'r installations: 2)The lee for branch circuits with purr base of cervico or Print Owner's Nairne feeder fee. Each branch circuit $5.00 Address ------ b) The lee for branch circuits City State Zip- without purchase of Phone Na` —. .. -- -- service or feeder fee. ( 3 ca c1D r,isl branch circuit $36.00 The insdollatlort is being made on property I own which;s not Each additional branch circuit intended 110 sale,lease or rent. 4e.Miscellaneous (Service or looder not Included) Owner's Each pump or irrigation circle Each sign or outline lightingAux ---v_ 3. Pitas„<AMwpiw-W aftdon(N regUked):s Signal circuit(s)or a limited enerpy� w P31161,aNeralion or edension =10400 Minor Labels(10) Please dt� V Item and anter fsa In stiction 5B. �- 4 a 1lnowteslklart- urft In arse atrucWN 41.Each additional Inspection over SlttVflossoleadsrti5 amps or more the allowable In any of the above Spam am aw Vdla mmkld Per Inspection r Ctaaarad am or shlx lure containing special occupenr:y Per hour $65.01$ as dsw*W In N.E.C.Chapter 5 In Plant �_ $�