HomeMy WebLinkAboutPermit Electrical 1992-1-6
225 FIFTH STREET ~,<,,";~,~;~~~;;~:J;:~,;'i'-'P
SPRINGFIELD, OREGON 9747,7."-:-':,,,,;;'
INSPECTION REOUEST:'\'.r:7'~'6.;376Q9 '
OFFICE: 726-3759 \c:'";,':{,),
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1. .r\-9G,gION OF INSTALI+TI ,
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ity Job Number ~~~
COMPLETE FEE SCHEDULE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
, LEbAL ~~ON
-17 ~ (j":::J(.J{)
t _ {\ ~~i f~CRIawl r fL)
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical contracto~~~
AddressJ11l9() rOOf)fI.(=/QfO./
City fluf7J2-- Phone~t -277 J
Supervisor License Number ~C)
/ (), I CjiJ
Expiration Date
Gonstr Contr. Number (oQ W/Jq
Expiration Date /c!) , /4 .CJ....:{'
Signature of SUP~lectrician
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O'Jners Name
Address _~~~~
Ci ty ~ c:; ...&.--<"" ~/-'2--?7 /
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01lNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
~~~;~------'--~:C1T~~~-=-~--~------
RECEIPT II: "--'- / ,",>-,": '~.-::'6/..J
RECEIVED BY:(~~~/
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Ci rcuits
It ems Cos t
Sum
$ 85.00
$ 15.00
$ 40.00
volts
$ 40.00
$ 55.00
$ 80.00
see "BII
above
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5t State Surcharge
TOTAL
S 35.00
$ 2.00
not included ~
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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CITY OF
JOB r1O, "12-0/0"2.-
. ..
SPRINGFIELD SYSTEMS DEVELOPM~' CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NM1E OR COl-1PANY: L;' '7 ~oN), \~IL..~~
, I
LOCATION: ?oS "5, A 6.,
\ ., D ~ ? c; 0 C - b6 2- 0 C
DEVELOP~IENT TYPE: C C : AD1:>-l'lo N
BUILDING SIZE:
-z.L\- -I- ?o
LOT SIZF
SQ. Ft.
1. STORM DRAINAG~
IMPERVIOUS SQ. FT. _ "/7.-0 X SO.186 PER SQ. FT, Is \~'"'-?~l
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO, OF PFU'S X S38.55 PER PFU
(See Reverse To Determine Total PFU'S)
Is
-
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $388.61
X $388.61
Is
.--
s
X X $388.61 $
(See Attachment C To Determine Trip Rates)
SUBTOTAL '(ADD ITEMS 1,2, & 3) s 1~?91:.
4. ADMINISTRATIVE FEES
BAsE CHARGE (SUBTOTAL ABOVE) X ;05
Is G:, lE-1
\,10"__....
TOTAL-CITY SDC S I
5. SANITARY SEWER-MWMC
NO. OF PFU'S
x S13.25 PER PFU ,+ S!OMWMC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
V'~~Lt.L_
~ Kip Burdick
SDC Coordinator
? /, c, /'1 Z-
II
S
TOTAL-MWMC SDC Is ---
TOT AL SDC S ''-J-o "':='"
MWMC CREDIT IF APPLICABLE (SEE REVERSE)