HomeMy WebLinkAboutPermit Electrical 1995-2-1
rJ
1'~~Vr~~
..
,
-
The following project as submitted has the followi
zonIng, and does not require specific land use
approval.
225 FIFTH STREET L\)~
SPRINGFIELD, OREGON 97477 Zoning _
INSPECTION REQuEsT: 72~il69? '1-'1)
OFFICE: 726-3759
Authorized Signatura f'lYT.
1. LOCATION OF INSTALLATION id
J:2! SO L~ I.( rl4 ~L)' /<24-
LEGAL DESCRIPTION
1?-a3-:2'-"'/o. ~ VY.sO
,
Jon DESCRIPTION /
/-t." +1- b,-,- '^" Il (' ~:t. .
. f
Permits are non-transferable and expire
if vork is not started 'vithin 180' days
of issuance or if.vork is suspenaed for
180' days.
2.-' CONTRACTOR INSTALLATION ONLY
Electrical Contra~tor./f;z~f,L!rn-". (
Address i?~') .%uJ 3~":,J..<
City Afbfrt'L... -O~. Phone.1Ie...l- q-=<..Q!i..
,
Supervisor License Number _~G. if") - <-
Expiration Date /;") -01- Cf's-'
Cons t r Con tr. Number 70,<; tJ '?
d - / ~ - C('{"
Expiration Date
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
.
Ovncrs Signature:
DATE:
RECEII'T /I:
RECEIVED BY:
?~/,9$"""
~9~___ .
ELECTRICAL PERMIT APPLICATION
City Job Number
~~MPbRTR FEE SCHEDULE BELOY
A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
<3'.~/~
uni t.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Malluf'd Home or
Modular Dvelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or- Relocation:
Items
Cost
Sum
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
60'1 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
C.
$ 85.00
$ 15.00
$ 40.0'0
$ 50.00
$ 60.00
$100.00
$130'.0'0
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
$ 40.0'0.
$ 55.0'0- .'
S 80.00
see IIB" above
Signature of Supervising Electrician
'/),~~Q ~
. U - - D. Branch Circui ts
Ovners Name~/'~'~~~~'~~Nev, Alteration or Extension Per Panel
Address >,,411 .-.
, ; One Circui t J S 35.00
Ci ty "'5~ Phone, :::> V.?- Y'~ Each Addi tional
, . - .' Circuit or vith Service
OVNER INSTALLATION or Feeder Permit
S
2.0'0
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.0'0'
Sign/Outline Lighting $ 40'.00
Limited Energy/Res $ 20'.00
Limited Energy/Comm $ 36,0'0
". _",;>.,.-00
J SUBTOTAL OF ABOVE ~~
57. State Surcharge /. 75'
37. Administrative Fee 1.<1~
TOTAL :?? i/o
!
CITY OF jJlr;GrI[~~~~~(Ti~~~~~V[LO:).:ki;1 L:::"\UL n4r \n
(CO"'''ReI^, , RESIOE/lTIAl) -. .'-\ #
NN1EOit COiWN1Y: J:J_o.r:.l::U:,.._.bQ..0.f\, r-^.9.l'?L':::.f-- ~Olv'\~ .p"e.:r.. .
lOCATIOil: SDL --;-;l:7:::. P,.-...\\).'I\IJ-lvN ivI,oP...>\L-e 1-krvlS t'? 1>./\0\1;2..':> '\;--\..
DEVELOPMENT TyrE:
[JUIlDWG SIZE:
.LOT SIZE"
SQ. Ft.
I. STom.l ORA I:lAG~
I!.:rERVIOUS SQ. FT. . X SO.ISG PER SQ.. FT.
(See Re\'er~e for Rt:r1nff Coefficients If {,ctu;!1 Ir.:;Jen. (,re:!.
Is &
I~ Unknmm)
2. Sr\nTTl\r~'{ Sr:~jF.!~-(rTY
1:0. 0:: rfU'S I Lj. , X S3S.55 r,,;( P::U
(See Rc\'er~e To O,~t<~1T.lir.e Tot;!] rfU'S)
b '7"';>"1 '..s I
." 1:~!:.~~~:J_'.:~T;~\l_:.:r:.
t~r; c:: I~::!T~ ~ 1::::' :U\T1: ~ (CST PC::' TRU)
4'" . """': l...~
--.- .-- _.-
~. <:;,...... ,. ~
" - ..............
!~ .., ~ - cO', I
I.':" (_~;.. .;' -I
" ...~~~ r,1
J.... ,.~. - .
" ____ ./ ~:::3_G~
(See I\..'c:.-"I..... l.' "1"'" U,...,.-;...."I -lro~'" I~...~f\...'
1"...... ............ v ...~~. ... I h\,,; l Ii-" ....:...........j
SUBTOTAL'(ADD ITEi'lS 1,2, &. 3) S i(,;. ~~
4. AOIHlHSrr.f,T!VE FE',5
.[J,\SE CHARGE (SUSTOTJ\L ASO\'E) X ;05
h ?CSI~ I
T~;7....~.-~I"7':' :::~:.~.
CO,.,
r c.....,.. ,'"
..........- -
'.
5. SMlI'r71'1F{.. .SE\-IER-M'ril\C
"'>"
""
,NO. OF PFU'S')~..f-
x 513.25 PER PFU .+ S!() 1-I1-!1-!C ADYaIN. FEE S 14 '? ~
. . . . .'
". .',...~.: ,.,. .-- ~ .-~- . ~~...._. .
; '.:: ::"',",:'c'(Use PFU Total From Item' 2 .Above)
.. '. "'>1~;1~ C'~~~ iT- iF - ^PPci~~iE (S~~ REVERSE)
'- . ~ ..
..' .....
.' '. .
'00
. ....... - .'-.
: . . . ".'h' ..::.:. . ~ ,..
,~."'....
..() Kip [JurdicK
SOC coordinator
: '-f /")-1/1'1/
,S
:rOTAL-M\-IMC so~,ls f""S~ j
TOTAL SDCS qq L, 'I:!:..
. .:;..~: '.'
.'" '."
..'- .
.. .-
,-:--'-'.-::_' .......
'. ~ .:.~.
" . ~:. ~. .;.:<.i...~..\, ,;~:. ~ -..
,:,",. ":~~:" ,:'::~-: ....
. ..-:..:. ....
.. ...~--,.... "
. - ..."
.. , ' ~
~~40ify~
'-'.'. :.~
.:'.' .'.