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i:\records\m;croflrn\targels\building.doc
Community Development RESI RICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
' Tigard,OR 97223 N RM.
Phos!(503) 639-4171
FAX (503) 684.7297 DAl t ISSUED 9_5
TDD Ne. (503)684-2772
CITY OF TIGARQ Inspection (.503)6?9-4175 ISSUED BY E � �>
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Address.— /� RESIDENTIAL--Restricted Energy Fee . . . . . . . . $40.00
(x&.1 C•l 72 (FC)RALi SYSTEMS)
City State Zip Check Type of Work Involved:
PtRM ITS ARC
NON-TRANSFERABLE EXPIRE IF
SOT STARTED WITHIN18 DAYS OF I SUANCE OR IF WORK IDS SUSPENDED OFOR ❑ Audio and Stereo Systems"
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION, ❑ Garage Door Opener"
C L / D� ❑ Heating,Ventilation and Air Conditioning System"
Contractor, �►,� S ype / t tV) ( �A� ( ! /�� ❑ Vacuum Systems`
Address Rosq ,�'( - C1,F�'�C Lr. ._ 1 C Other—
Date i.-r — COMMERCIAL—Fee for each system . . . . . . . $40.00
C1. (SEE OAR 918-260-260)
Property Owner o> c /y Q 1/t iL /' a t-2ii
Check Type of Work InvoLygd:
Contractor's Boardleg. No. �V(/,2_ — ❑ Audio and Stereo Systems*
-7 El Boller Controls
Phone# - S /_ � ❑ Clock Systems
3. OWNER APPI ICAT!(-)N ❑ Data Telecommunication Installations
?(y Fire Alarm Installation
0.. � ) <� ! El❑ HVAC
Prin Owner's Nate Phone No ❑ Instrumentation
Address
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit Is issued under OAR 918-320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(100 volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
❑ Protective Signaling
1, Only use electrical licensed persons to do Installations where required.(Certain
I residential and other transactions are exempt from licensing.These have ❑ Other
asterisks(').All others need licensing). —
n- 2. Call for an inspection when all of the Installations under this permit are ready
for inspection at 503-639-4175.
N 3. Purchase separate permits for all Installations that are not ready for Inspection Number Of Systeme
_ when the Inspector Is out to inspect under this permit. "No licenses are required. Licenses ate required for SII other Installations.
s— 4. Assume responsibility for assuring that all corrections required by the inspector
are done,and
�j 5. Assume responsibility for calling for a final Inspection when all of the corrections 5. FEES
are completed.
c-7
The person signing for this permit must he the applicant or a person a. Erte, Fees -
authorized to bind the applicant. —
b. 50A Surcharge(.05 x total above) $
Signature /`
#� TOTAL $ Ar
Authority if other than applicant
ENERC.AP.CHP
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CITY OF TiGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Covnr/Service
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing Meeh.
Plbg,Und/Fir/Slab Plbg,Top Out Insulation Flet
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: —_ _ "q `c c
Date: — I ct _ A.M. P.M. Entry: - —
Address: -
Tonant: Ste: MST:
BLIP:
Con/Own:. _ MEC:
PLM:
ELC:
THE F OWING CORRECTIONS AR�IRED: ELR:
J
In pect : Date:
—APPROVED _.DISAPPROVED/CALL FOR REINSP. C CO
ELECTRICAL PERMIT
F-'ERIYIIT #: EL96-0415
5/96
DATE ISSUED:C06/2
CITY OF � ���R®
COMMUNITY DEVELOPMENT DEPARTMENT PIARCEL: 2SI12CA-12400
S 1-1 31
JW�d.T1g4 rd, qo,1r ,972F1819 .193),J I'l
,�
SUBDIVISION. RENAISSANCE WOODS II ZONING: R--4. 5
BLOCF. . . . . . . LOT.. . . . . . . . . . . . . :48
Project Description : Instali ) iq one branch cir-cl.tit.
UNIT---- ---TEMP' SRVC/FEEDERS----- ------MISCELLANEOUS---- -
1000 SF OR LESS. . . 11) 0 'amp. . . . . . . : 0 PIUMPI RR I GAT ION. . . . : 0
EACH ADDIL 500SF. . . . 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . 0 401 600 amp. . . . . . . : v� SIGNAL/FIANEI.. . . . . . . : 0
MANE. HM/ SVC/F[)R. . : 0 601-vamps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
------SERV ICE/FEEDER—— ----BRANCH CIRCUITS—— ----ADI)IL INSPECTIONS—-
0 — 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSVIECTION. . . . . : 0
201 — 400 'Amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1. PER FOUR. . . . . . . . . . . 0
401 — 600 amp. . . . . . : 0 EA ADDIL BRNC;H CIRC: 0 IN P'LAN'T. . . . . . . . . . . 0
601 -- 1000 amp. . . . . : 0 —PILAN REVIEW SECI' I
1000+ amp./volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
[Reconnect only. . . . . : 0 SVC/FDR > = 2.:5 AMP'S. . : CLASS AREA/SPEC OCC. :
Owner-: FEES
IRON MANSETH type amo,_int by date v,e c p t,
lb595 SW 76TH AVE PIRMT $ 35. 00 CJS 06/25/96 96-2809iL'
5 P.CT $ 1. 75 CJS 06/25/96 96-2801 i.
TIGARD OR 97223
Phone #:
COTItt-aCtOr-:
THE ELECTRIC GRUJIL, $ E,. 75 TOTAL
4726 SE MILWAUKIE AVE
REUUIRED INSP,ECrIONS
PIORI-LAND OR 97202 Wall Cover- Elect' l Final
Phone #: 503-232-2499 Elect' l Set-vice
I-let] it. . : 43851
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ilre. Specialty Codes and all other Pet-mittee Signat uv-e
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 if work is suspended for more
than 180 days, Issued By
INSTALLATION
The installation is being made on property I own which is not intended for-
sale, lease, or rent.
OWNER' S SIGNA-IURE- DATE:
_.--------------------.---CONT ()P ING AI-L I N
SIGNATURE OF' SUPIR. ELEGIN: DATE.
I, ICENSE NO-
Call fov^ inspection 639--4175
AL
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit #
Date Issued /5,
Phone (503) 639-4171
CITY OF TlGARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Com,-late Fee Schedule Below:
Name of Development �7p�S�T/! ni63i� �Gr Number of Inspections per permit albwed
4
Address /SSSS Sum 76 Service included: Items Cost(ea) am
City/State/Zip ?��+� � �7z 4'�' 4a. Residential -per unit
1000 sq. ft. or less $11000
I4
Name (or name of business)!jAn/ 5 TH Each additional 500 sq.f,,or
portion thereof $25.00
Commercial J Residential :-mlted Energy $2500 _
Each Manui a Home or Modular
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b. Services or Feeders
Installation,alteration,or relocation
Electrical Contractor_ NF ELG'�T�%c to QOK R _ 200 amps or less $6C oa _ z
Address Y72G 5E 4yde' 20t amps to 400 amps $80.00 2
City State 02 Zips 2ta Z 401 amps to 600 amps $120$12000 2
601 amps to 1000 amps _—�
Phone No. 5773 Z3.z 2-1-/`7?q Over 1000 amps or volts " $34000 2
Job NO. 96—_Geos— Reconnect only $5000 2
contractor's license NO. ;2 4c. Temporary Services or Feeders
Contractor's Board Reg. No. '13Ss / ii,' /- Installation,alteration,or relocation
Signature of Supr. Elec'n 200 amps or lase _
201 amps to 400 amps
License No ��gr Phone No $700
_ — 401 amps to 600 amps $755.00
Over 600 amps to 1000 Vohs $10000
2b. For owner installations: see"b"above
4d. Branch Circuits
Print Owner's Name New atterabon or extension per pane
Address 9)The fee for branch circuits with
City State Zip
purchase of service or feeder fee.
Each branch circuit $5 oc
Phone No. _ b)The fee for branch circuits without
The installation Is being made on property I own which is purchase of service or feeder fee
First branch circuli $3500
not intended for sale, I@aS@ Or rent. $500 3J I
Each additional branch circuit $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included)
3. Plan Review :section (if required): Each pump or Irrigation circle $4000 _ 2
Each sign or outline lighting $4000
signal circuh(s)or a limited energy
Please check appropriate item and enter fee in section 5B. panel,alteration or extension $4000 -
4 or more residential units in one structui? Minor Labeta(10) $10000
Service and feeder 225 amps or more 4f. Each additional inspection over
System over 600 volts nominal
N Classified area or structure containing special occupancy the allowable In any of the above
�- as described In N E.C. Chapter 5 Per inspection $35 00
p Per hour $5500
►, In Plant $5500
-� Submit 2 sets of plans with application where any of the above --
CIO apply. Not required for temporary construction services. b. Fees:
5a Enter total of above fees $ 35••AV
J NOTICE I 5% Surcharge (05 X to fees) $ /• 7S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. Trust Account #
Mm�M
Balance Due $ 3 .75
of
[:.T-TY I IF T7141-1141.) Pl- -f, I P r f11 I I-if 1\1 I Rf I f• )111 NO. 1;-4t 1',-9?lO1)
1-IMUMf e 0. 00
(''I R I G GROUP (MIJUNI W:,'j. P-.-,
MILWAILIKIF AVE Vil l Y I'll NI Of 4 1 f.:. f IAC,
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15r,',45 SW -16M (0-4
OW JUNT 1OWD M
MECHAN I CAL
CITY OF T HERMIT #. . . .r' . . l � 4
. . MkC.:9C, 019v
COMMUNITY DEVELOPMENT DEPARTMENT DATE_ ISSUED:
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)839-4171
PARCEL: 2S 1 12CA-1240k1
SITE ADDRESS. . . : 15595 SW 76TH AVE
SUBDIVISION. . . . a RENAISSANCE WOODS II ZON1NCS: R-4. 5
LALOC K. . . . . . . . . . . LOT. . . . . . . . . . . . . :48
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 171
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT PANS. . . : 0
OCCUPANCY GRP. . : R3 VENTS W/O AF=PL: 0 VENT SYSTEMS: 111
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES------------ 0-3 HP. . . . : 0 DOMES. I NC I N: 0
: /ELE/ / / 3--15 HR. . . . : 1 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
F-I RE DAME'ERS?. . : 30--50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : it)
IVO. OF UNITS------ _.- AIR HANDLING UNITS OTHER UNITS. : 0
1 URINI ! 1.00K, BTU: 0 (= 10000 cfm : 0 GAS OUTLETS. : 0
FURN > =100K PTU: 0 > 10000 cfm : 0
Remarks : Install air conditioner,
Owner: -------------------------------------------------- FEES -_____.____ ._..... .._. . _..-
RON MANSETH type amount by date rec:pt
15595 SW 76TH AVE PRMT $ : 5. 00 JSD 06/25/96 96-290944
5PCT $ 1. 25 JSD 06/25/96 96•-280944
TIGARD OR 97224
Phone 4:
Contractor: ---_---_-.-----_-_-----_---_.---
D I RLC: f A I RE
3208 NW BIRDSDALE STE 10
GRESHAM OR 97010 ------------------------------.-----_--_..,,..,
Ahone #: $ 26. 25 TOTAL
Rey #, . 074486
-------- REUU1RED INSPECTIONS ------
This permit is issued subject to the regulations contained 0 the Mechanical Insp
Tigard Municipal Cnde, State of Ore, Specialty Codes and all other Final Inspection
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 if work is suspended for more
},hon 180 days.
001
I 'r r m i t t e e S i g n a t r_r r e ;/�
I s 9 U e d By :
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LL Ual1 for inspection 639-4175
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Obr:2(1:qr, 09:32 $503 684 7297 CITY OF TI(:,ARD x]002!002
-City of Tigard MECHANICAL PERMIT Planr*/Rec. #
13125 SW Hall Blvd, APPLICATION Permit # ol-c 96 -0195--
Tigard, OR 97223
(503) 639-4171
-----. ems o ew,00meni —
rable 3A Mechanical Code QTY PRICE AMT
Job l 7 J,,j -7 v( 1) Permit Fee 0- 0• 10.00
Addres.; . --
Tl`r4l�/1�' 1) 2) SuDpkmental Permit 3.00
w..m.a unnaer ----
urnace n 9rt.I•-`-----
�N YYI 5E 7-1-1 1) Incl. ducts &vents 600
(M1 CFurnace +
Owner 2) inol ducts &vents 7.50
—Floor Furnance
3) incl vent 6,00
UsOended heater, wa eater - — ---
4) or floor mounted heuter G.00
en not incl. In _—
C)cclthsnt fi) appliance permit 3,00
T ----�"
Repairheating, re Irf g;
(l) cooling, absorption unit 6.00
of ei or comp-Tiedt pump, air Gond,
7) to 3 HP; absorp unit to 100K BTIJ 6.00
oI er o�Come—i0-at Pum air con ,
Nw 91&0IiLE I 5o,+( /0 A) 3-15 HP;absorp wit: to 500 1 11.00
Contractor
oiler of comp, heat pump, air cond.
9) 15-30 HP; absorp unit .5-1 mll PTU 15,00
t3011er or comp, heat L p n pump, air cond.
10) 30.50 HP, absorp unit 1-1.75 mil BTU 22.50
I hereby acknow a ge that I hava red vs app Ica ion trial t bier or comp, heat pump, air con --
inrormation given is correct, that I am the owner or authorised 11) 50 HP; absorp unit 1 75 mil BTU 37.90
agent of the owner, that plans submitted are In compliance with Air handline; unit to
State laws, that I am registered with th9 Construction Contidutur's 12) 10.000 (:rM — 460
Board, that the number given is correct, (If exempt tram Stat: Air handliria unl - - —
registration, please give reason helow.) 1;+) 10,000 (:IM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connects
15) to a single duct 300
ent%t nn syTem not "!
15) included In appliance permit 4 50
ono serve y
17) mechanical exhaust - 450
° TSescnbe work 'newjU sods i'on aeration repair
rc -Commercta m or us na
N to be done residential 0 non-residential O 18) type incinerator 30,00
-CTiRinq use o �� ter i.e.. woo stove, water -' —
bu`ding Or property „. 19) heater, solar, clothes dryers, etc 4 50
•J Proposed use of 20) Gas piping one to four outlets 2.00
C4 buiidinq or property _
ii 711 -4*r outlet
(each) 2.00
J type of fuel -oil C) natural gas C7 LPG 0 electric
--
NOTICE - - — - — --- - — —
Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID -WORK OR CONSTRUCTION —
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR. 5'r6 SURCHARGE ?S
IF CONSTRUCTION OR WORK IS SUSPENDED OR --
ABANDONED FOR A PERIOD OF 1[10 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED. -
TOTAL
Special Condltions - - -- —
INSPECTION NOTICE
Citl of Tigard Building Departaent
13125 Sit Ball Blvd. Tigard, Oregon 97223
&4171
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
pont/Beam Struct. San. Bower Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulaf_icn -Plumb.
Plbg. Underfloor Water Line // Gyp. Bd. -Mach.
Date Requested: I 17� I �j Timet AM PM
Address:
Cj r j S / ,Permit 1I,' 7"7
Builder: —
THE FOLLOWING CORRECTIONS ARE RRQUIRED:
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Inspectors
DISAPPROVED APPROVED SU CT TO ABOVR
Call For Reinap.
CITY OF T I OAR®
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223&8199 (503)639-4171
PLUMBING (::'ERMIT
PERMIT #. . . . . . . : PL 111)4—0 2i
639-4171 DATE ISSUED: 12/30/94
PARCEL: 2S112CA-12,400
31TE ADDRESS. . . : 15595 GW 76TH AVE
IUBDIVISION. . . . : RENAISSANCE WOODS II ZONING, R-4. 5
'ILOCI
-1.. . . . . . . . . . .. LO"r. . . . . . . . . . . . . . 48
_LASS OF WORK. . :ADD GARBAGE OISP05ALS. . z MOBILE HOME SPACE7S.
FYPE OF USE. . . . .-SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . . 1
.ILCUP(-4NCY GRP. . -R3 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . ..
OURIES. . . . . . . . WATER HEATERS. . . . . . .* CATCH BASINS. . . . . . . :
1:7 1 X LAUIqDRY TRAYS. . . . . . . GF RAIN DRAINS. . . . . :
3INKS. . . . . . . . . . .. URINALS. . . . . . . . . . . . GREASE TRAPS. . . . . . . .
1—AVP,IORIES. . . . . . OTHCR F-1.XTURES. . . . .
1 Ub/S)HOWERS. . . . . SEWER LINE (ft ) . . . .
CLOSETS_ : WATER LINE (ft i . . . .
aHWPSHE RS. . . . : R�'-)11\1 DRAIN (ft ) . . . .
<emar-ks ,' sprinkler- system
Jwllerl: FEES
tOY MAUSEili type amol.tnt by date r-ecpt
:.5'595 SW '76TH AVE PRIYIT $ 15. 00 JG 12/30/94
5PC i $ 0. 75 JG 12/30/04
I G A R D UIQ
'rione #:
ontr,actor"i
.iW LANDSCAPIE
tbFl ABk."* L. 1HRIGAT 1UN
131 SW 44TH
1uH-'rL(4ND, UR 97c19
;hone It: ALL PHASES" t 15. *15 TOTAL
------- REQUIRED INSPECTIONS
1.i -
is permit is issued subject to the regulations contained in the RP/bacl,J low Pr,ev
igard Municipal Code, State of Ore. Specialty Codes and all other Fi na I I ti s,pec:t J,on
_�plicable 31ws. All work will to done in accordance with
)proved plans. This permit will expire if work is rot started
-ithin 180 days of issuance, or if work is suspended for more
.,ar 186 days.
nd r tore
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Cell for, inspection 6394175
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City of Tigard PLUMBING PERMIT APPLICATION_ Planck/Rec. #
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-417"
MINIMUM $,5.00 PERMIT FEE + ST. SURCHARGE
New Single Family Residences Only
e14)r�: U 5
_cr r' D 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job S f > �LiJ �, {�i ❑ 3 BATH HOUSE$225.00
Address carr ,. ZIP Fee includes all plumbing fixtures in the dwelling and the first 100 feet
07 C7 1 of water service, san'tary sewer and storm sewer. See fees below.
wm.ron •.rear,„., -•�-' FIXTURES CITY PRICE AMT
-7 Sink 9.00
L-Om
Ma.na Ann.aa Ph" Lavatory 9.00
Owner �' )'� Tub or Tub/Shower Comb. 9.00
crr,sa,a Up Shower Only 9.00
Water Closet 9.00
Nam.,a name.r bu mm) Dishwasher 9.00
Garbage Disposal 9.00
Occupant MaNq one„. Phi Washing Machine 9.00
Floor Drain 9.00
carr^,M. zip Water Heater 9.00
Laundry Room Tray 9.00
N.m. Urinal 9.00
' CF4,,d' ✓✓r�, Other Fixtures (Specify) 9.00
l >
Mtlng ndu.a. Phan. 9.00
Contractor
�c `-�) S L, f� � 9.00
1 cmps,ae L/*-n
zip 9.00
Sewer i st 100' _ 30.00
�ra,a R,,-1,~N.. CoyBua ra.N. Sewer -ea. Addit. 100' 25^0
'%(. C ,r1 I I Z Z 2-5-
Water Service 1st 100' 30.00
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authnr;zed agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
lMobile Home Space 25.00
give reason ow.)
Back Flow Prevention
Device or Anti-Pollution Device 1 900
Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new v addition Q altefation Cl repair 0 Catch Besin 9.00
to be done residential U non-residential Q Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of Rain Drain, single family dwelling 30.00
building or property _ _._ -
Residential backflow prevention
devices 15.00
N Proposed use of
v buile'ing or property '(Except residential backflow
Iprevention devices)
Q7
NOTICE 'Mlnlmum Fee $25.00 SUBTOTAL
LD --- _
-� PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED W!THIN 180 DAYS, OR IF 5 SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FO's A PERIOD OF 180 DAYS AT.ANY TIME AFTER WORK IS PI-A VIEW 25% OF SUBTOTAL
COMMENCED
�! TOTAL -
Special Conditions
Date issued by _