Engineering Services | 925 S Main Street, Lebanon, Oregon 97355 | 541.258.4906 | cdc@ci.lebanon.or.us
APPLICANT INFORMATION
Name (Owner): Phone:
Address: Email:
Company Name:
ENGINEERING INFORMATION
Engineering Firm: Phone:
Address: Email:
Designated Contact Person:
Location of Work:
Description of Work:
DRAWING REVIEW FEES
Estimated Cost of Construction (attach copy of itemized estimate) $
Under $1million: 2% of estimated construction cost $
Between $1 million & $4 million: 1% of estimated construction cost $
Over $4 million: .5% of estimated construction cost $
Plus Fixed fee $ 250.00
Total Fee $
APPROVAL CHECKLIST
Five copies of Drawings and Specifications submitted
Itemized estimate approved
Private engineer has City of Lebanon Standard Construction Specifications
Private engineer has City of Lebanon Public Improvement Standards
Payment of drawing review fees
Design calculations submitted
Other
AGREEMENT – The undersigned applicant agrees to comply with all city ordinances
Applicant: Signature:
Drawing and Specifications Approved By: Effective Date:
ADDITIONAL INFORMATION
1. Drawing & Specification approval expires one year from effective date unless renewed.
2. A separate permit for private construction of public improvements is required prior to start of construction.
OFFICE USE ONLY
Date Received: Received By: Receipt No.:
APPLICATION FOR PUBLIC IMPROVEMENT
DRAWING & SPECIFICATION REVIEW
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signature
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