HomeMy WebLinkAboutPermit Electrical 1997-6-26
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~oning_f21 0 ELECTRICAL PERMIT APPLICATION ",.--
9 7 4 77 DP'/(l& --.t& /11- ' q '7u CL t7 t.:..
726-3769 Ci ty Job Number 0 D .J
Au,horiz,~d Signature-I}1J4
3. COMPLEL~ FE% SCHEDULE BELO~
LOCATION OF INSTALLATION
3.Q ~ c 1!:j\.)~c.LN,v~-AL ~lJtO '
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LEGAL DESCRIPTION
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170~1.fb3LI(}&~,/Ji7\
JOB DESCRIPTION C/l)
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Permits are non-transferable and expire
ifIJork is notstarted....ithin 180 days
of issuance or if ....ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
Ci ty
Phone
Supervisor License Number 1673 PS
Expiration Date .I(),~
Constr Contr. Number
Expir(ition Date
Supervising Electrician
Name~R~f1~I'i\ ~~Th~'~ .
Address---, <~.5 M ff/Sf""
City <;fl'urrllJi)Ot/rPhone ?l1-c:'~?.s
OVNER, INSTALLATION
The installation is being made on.
property r o....n ....hichis not intended
for sale, lease or rent.
A.
Ne.... Residential-Single or
Multi-Family per d....elling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
ModularDlJelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cost
Sum
S 85.00
S 15.00
S 40.00
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration. or Relocation
'200 amps"oT less $ 40.00
201 amps to 400 amps $ 55.00
'Over 401' to 600 amps $ 80.00 ,
Over 600 amps or 1000 volts see "B" above
,"
" '
D. Branch Circuits
Ne...." Al tera t ion or Extension Per Panel,
One Circuit '/ $ 35.00
Each Additional
Circuit or IJith Service
or Feeder Permi t. --'- $ 2.00
not, included)
Miscellaneous (Service/feeder
'-Each installation
, Pump or irrigation
Sign/Outline Lighting
Limited Energy/R~s
Limited Energy/Comm
E.
~OW'l1ers Signbature: '" ....,:
p .J- _ ':" '. . , ':, ,. :", ", ,
___...: _/__'- Z------------------:-7.--:-:--~-: " 5.. '",.SUBTOTAL OF ABOVE'
AT : ( fJ?-:lh ...-Q7 ' .- . ';-, ' '. ",5% ,Sta te Surcharge
EIPT #:. ']t,.Q'If I -' '.;,,3% Administrative Fee
RECEIVED BY: I~'-v<;, /,. TOTAL' '
$ 40.00
S 40.00
$ 20.00
$36.00
3i.^ ~~
I " (I '
3Q" tt~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
(COMMERCIAL / INDUSTRIAL)
Name or Company: SPRINGFIELD SCHOOL ~
Location: 326 CENTENNIAL BLVD
Developement Type:' C Building Size:,
1. STORM DRAINAGE
Impervious Sq Ft 1.0 X
2. SANITARY SEWER - CITY
Number Of PFUs. 1.0 X 8
(see Page 2)
3. TRANSPORTATION
Number Of Units
X
Trip Rate
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
8
MWM~ CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) X
TOTAL SDC
Reviewed By: DENNIS ERNST
X
X
X
0.216
X
, 44.75
Job No.: 970885
Lot Size:
Per $q Ft
Per PFU
X
Cost Per Trip'
Per PFU +
20.690 +
0.50
MWMC Admin Fee
10.00
Date: 06/13/97
Page 1
Sq Ft
$0.00
$358.00
$0.00
$175.52
$0.00
$175.52
$533.52
$26.68
$560.20
Job Number: 970885
FIXTURE UNIT CALCULATION TABLE
Page 2
Fixture Type
Bathtub
E:::':'i:~~':'::3 ]j:~...E..::':"R f:YIr ""AS~
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/Water Station/Etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residential Kitchen
Urinal, Stall/Wall
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
TOTAL FIXTURE UNITS
~REDIT CALCULATION
Number of
New Fixture
Unit
Equivalent
Fixture
Units
o
1
o
o
o
o
o
o
o
o
o
o
o
1
1
o
o
2
1
2
3
6
2
6
1
3
2
o
1
o
o
o
o
o
o
o
o
o
o
o
1
6
o
o
2
2
1
6
4
8
TABLE: Based on assessed value,
after annexation date, credits
(calculations are by $1000)
Year Annexed:
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
If improvements occured
are calculated separately.
o
0.00
X
0.00
o
x
0.00 -
0.00
CREDIT ,TOTAL =
$0.00
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)