E25-259 Signed'LAW, nilun
JOB ADDRESS
605 STILLWATER RD
Affinity - temp electrical
CONTRACTOR
Jacobson Electrical
PO Box 238
Lolo MT 59847
Contact Phone # Fax #
Email Address
jacobsonelectrical@hotmaii.com
Use of Building Class of Work
Apartments New
Work Description
temporary electrical service
Electrical Permit No. E25-259
City of Kalispell
201 1st Avenue East, Kalispell, MT 59901
Phone: (406) 758-7730 Fax. (406) 758-7739
bldgdept@kalispell.com
OWNER
Affinity at Kalispell, LLC
120 W. Cataldo Ave., Suite 1
Spokane WA 99201
Contact Phone #
ARCHITECT OR ENGINEER
Cushing Terrell
Contact Phone # Fax #
Email Address
paulgoss@cushingterrell.com
Required Inspections are listed on
Page 2
Type of Service(s) Requested
Service gtY Total
Temporary Construction Service Fee 1.00 $25.00
Commercial, Industrial, Institutional, Public and
Multi -Family (3 units and up) permits are based on the
cost to the owner of labor and materials plus issuance
fee. The project value is listed under Qty above.
IMPORTANT - PLEASE READ BEFORE SIGNING
Issuance Fee $20.00
Total Fees: $45.00
plumbing or framing shall be covered anti: such work has been inspected and approved. Separate permits are required for electric, plumbing, hei
ventdiation and air conditioning. This permit t;ecomes null and void if work or construction authorized is not commenced within 180 days, or if t
construction is suspended or abandoned for a per;od of 180 days at any time after work has commenced I hereby certify that 1 have read
mined this application and know the same to be true and correct. Ail provisions of laws and ordinances covering this type of work will be com
h whether specified herein or not. Grantinpt of a permit does not presume to give authority to violate or cancel the provisions of any state or local
5/23/25
Signature - Please sign here Issue Date
Electrical Permit No. E25-259
J L I I
Required Inspections
24 Hour Notice Required
(406) 758-7730
Inspection Type:
Commercial Temp
Construction Power to Meter
Main
Electric Rough In
Final Electrical Inspection
Inspector: Date:
City of Kalispell
201 1st Avenue East, Kalispell, MT 59901
Phone: (406) 758-7730 Fax: (406) 758-7739
bldgdeptia)kalispell.com
JOB ADDRESS
605 STILLWATER RD
Affinity -temp electrical