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Job Address
owne ail Addres Zip Phone
1.
Contracto Mail ddros Zip Phone
2. � '
•
3. Class of Work: ❑ COMMERCIAL SIDENTIAL ❑ New ❑ Addition Iteration ❑ Repair ❑ Replacement
Describe Work: _&;
4.
�Rlww,4ma_)
6F 61
PLUMBING PERMIT FEES '
Comments:
Modular Home ......................$50.00
Type of Fixture No.
Kitchen .............................. $12.00 x
Bath.....Residential/Single Stall $12.00 x ` / • ® U
....................Multi -Stall $25.00 x
Rough -In Bath ........................$8.00 x
Additional Sinks .....................$6.00 x _ _ �Q • 00
Slop Sink/Laundry Tray/Drain ..... $6.00 x
Water Heater .........................$10.00 x
Notice
Outside Water Faucet ...................$6.00 x
I hereby certify that I have read and examined this
Drinking Fountain ........................$6.00 x
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or
Backflow /Grease Trap 15.00
p
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
Water Service .......................$15.00
state or local law regulating construction or the
Sewer
performance of construction.
........ .........................$15.00
Groundwork .........................$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
Sprinkler System (Commercial)..$30.00
Gas /Water Piping System
(Commercial) ........................ $50.00
6
r a®-
Signature f Contractor or Authorized Agent
Permit Issuance Fee .................$25.00 9
Total . 00
�}
Current License on File _ es ❑ No ❑ N/A
Date
Comment:
WHEN PROPERLY VALIDATED (1N 1HIS SPAUh) IHIS IN YUUX F ,KMII
Approved By: :?
Rev. 2008 -10
Application Date:
ICI
LIS
I,� ♦ ♦ ♦ ♦ N ,
f p`0
Permit Fee: $ ®U
Job Address �
Owner ail Addres Zip Phone
1.
Contr � Mas xess Zip Phone
2. /d(ti
3. Class of Work: O COMMERCIAL ESIDENTIAL O New O Addition Iteration O Repair O Replacement
Describe Work:
4. &-- L04 a
MECHANICAL PERMIT FEES'
Heat Pump Tons
Central A/C Tons
Furnace /Heat Pump /Air Conditioner (Per Unit)
Furnace BTU/H
Up to and including 100,000 BTU / 3Ton ... .........................$15.00
# of Units A/C
Furnace /Heat Pump /Air Conditioner (Per Unit)
Furnace
Over 100,000 BTU / 3 Ton .................... .........................$25.00
Completion Date:
Refrigeration Units /Coolers/Lines /Compressor — Commercial
(New or Replacement) (Per Unit)
Boiler Chart
BTUFee
................. ............................... .........................$15.00
Up to 100, 000 ....... .........................$15.00
100,000-500,000 .............................. $30.00
500,000 -1, 000 ,000 ........................... $40.00
1,000,000 -1, 750, 000 ........................$60.00
Over 1, 750, 000 ...... ........................$100.00
Boiler (use BTU Chart to left)....................
Appliance Vent / Fans ........................$10.00 G
Notice
Duct System ......... .........................$15.00
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
Gas /Air Outlets 5 x $6.00
provisions of laws and ordinances governing this type of
.................First
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
.........Additional x $1.00
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
Radiant Heat Systems /Gas /Water
performance of construction.
Piping System ....... .........................$50.00
Modular Home ............................... $50.00
Signature of COntractor or Authorized Agent
Permit Issuance Fee............ cJ
..............$25.00
Tot • ®U
h---2kd
Current License on File '®;Pes O No O N/A
D ate
Comment:
WHEN PROPERLY VALIDATED (1N "1'HIS �SYAUh) 1HIS 1N YU VhKIVII I
Approved By: /
f Rev. 2008 -10
6
101 BE" N 1A UM
Application Date: ® e,2 ® / 0
Permit Fee: $ o
Job Address ®u // 01 il
owne ail Addr s Zip Phone
1.
n � it Address � Zip Phone
2 ontr
C :
3. Class of Work: O NEW RESIDENTIAL O O NEW COMMERCIAL REMODELING /ADDITIONS O UPGRADE SERVICE
Describe Work:
4 'a
�" l�i
5.Current License on File �Pt Yes 0 No O N/A. Completion Date
ELECTRICAL PERMIT FEES
Service Fee = (Amp Fee + $5.00 per branch circuit)
Upgrade Existing Service .............$25.00
1 -100 Amp Fee .......................$25.00
Temporary Service.................... $15.00
101 -200 Amp Fee .......................$35.00
Fire Alarm System............ ......$15.00
"'
201 -300 Amp Fee .......................$55.00
301 -400 Amp Fee .......................$75.00
Signs ( each) .............................. $25.00
401 -500 Amp Fee .......................$95.00
Miscellaneous Apparatus .............. $15.00
501 -600 Amp Fee .....................$115.00
601 -700 Amp Fee .....................$135.00
Commercial /Multi Family and All Upgrades:
701 -800 Amp Fee .....................$155.00
801 -900 Amp Fee .....................$175.00
# of Circuits x $5.00
901 -1000 Amp . ........................$195.00
Amp Fee
IF OVER 1000 Amp
l 1000 Amp Fee ..................$195.00
Amp Fee + Circuit Total
Each additional 100 Amps ......... $20.00
New Residential: (Finished Area)
Single /Two Family Dwellings
Notice
16 sq.ft.x.063 °?
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
Modular/Manufactured Homes ....... $50.00
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or
Other: (alterations, additions and modifications)
not. The granting of a permit does not presume to give
Receptacles /Switches/Lighting Fixtures (110 volt only)
authority to violate or cancel the provisions of any other
# of Apparatus x $1.00
state or local law regulating construction or the
..........
performance of construction.
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors..... x $3.00
Signs ure of Contractor or Authorized Agent
`� O
Permit Issuance Fee.. .$25.00
Total
2
D
Comment:
WHEN PROPERLY VALIDATED (1N THIS SPACE) THIS 1S YOUR PERMIT
Approved By:
Rev. 2008 -10
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[] CITY OF BLAIR
BUILDING INSPECTIO R
❑ WASHINGTON COUNTY
LOCATION OF INSPECTION - 7 L
NAME OF OWNER V ° r r `' r C
r
j NL
DATE INSPECTION REQUESTED r d r '� a �
Q TIME INSPECTION REQUESTED 6 r, PERMIT NO
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL PARTIAL
kASSED
FAILED
COMMENTS:
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑ PARTIAL
❑
❑
COMMENTS:
ELECTRICAL,-'H' , ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
PARTIAL
❑
'
❑
COMMENTS:
MECHANICAL ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL NqARTIAL
ZASSED
FAILED
COMMENTS:
PLUMBING: ❑ GROUNDWORK- ❑ � ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑ R SSURE TEST _
❑
COMMENTS: /"� .z,L��,�,,,,.,e,(�✓!�RC,ckG✓l __ ['511 StcL� Aek D6v-vv- .
❑ OCCUPANCY
NOTES/REMARKS:
CONDITIONAL OCCUPANCY GRANTED
CL'
. t
PFA
C
FAXED OPPD\BURT REA
If
� g DATE OF INSPECTION MADE: 4 1 6 TIM
C 6 qj cave 1kt jZ, �'U �Qc� +0 C 0 9t,
TO CONNECT SERVICE:
B
5 faced Lc-j-