HomeMy WebLinkAboutPermit Electrical 1994-12-20
\,
.
e
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST:: 726-3769
OFFICE: 726-3759
1. ;!jj~I~ ~aJJJ1l:,0~
1~~;17IrION 04400
L
Permits are non-tra and expire
if work is not started within 180 days
of issuance or if work is suspended for
180' days.
2. CONTRACTOR INSTAL~TION ONLY
Electrical Contrac\.od'\Q..1(\ ~
Address \\f\l) _l ~ I ~~
CityZk -00 If\CL Phone '\~ '. \qD
. ~' 19'(;8 jIQCo
SuperVlsor Llcense Number _ CI. 4~",
\n.\.Q5
Expiration Date
Constr Contr. Number~~\~'1
\~.g,~.q.q
Expiration Date
"
Signature of Supervising Electric~an
..~~
Owners Name oflO.n:h U loNQ AIf'...,::>
Address W)~ N\l\ ~. ~
City~~ Ii / phoneJijn211l
OIlNER I~TALLATION
The ins talla t ion is 'being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
--------------------Zl-- ---------------
DATE: 12/2<) 1~
RECEIPT U:. :I<~ 1/
nUf"L'Tut'n RY. -. -;('/~
ELECTRICAL PERMIT APPLICATION
City Job Number Cf4IQ\Q
3.
COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
B.
Services or Feeders
Installation, Alterations
or Relocation:
.:.1
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
..
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
, ". Modular'Dwelling ~ Ph
.- .'" ,,' Service or Feeder $ 40,00
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
C.
Temporary Services or' Feeders,
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
, Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
$ 35.00
$ 2.00 :J
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ....P::1 ~ _
5% State Surcharge ~O .
3% Administrative Fee ~OI . Z\: to-
TOTAL e5.slt:>
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ,
.
~
o y!iRi!!!!~!~!!t;
Job No. q4\q R
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: r;rlOtU- Ull\\\UT\. \'\\ ~\2:>
ADDRESS: ~\f)4. ~ &1- I ~
PHONE: J.9 J Q Q.. \11
STATE: oo...ZIP Gl71Jg'
LOCATION OF IiROPOSED ~I~G S1TE~ .. =IJ IIn I _. .,
Street Address if Known: n \ _ ) IJ.J1/1f1 ~ Q/r.!..{ .p
Platt Name: ~(diL ~ lot Number: -.J!1h5$f) ~
1. .DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl1le Familv - Detached
Single Family home _ Manufactured home not in a park
NO OF UNITS X $400 PER UNIT _= $
Sinl1le Familv - Attached .
B.
NO OF UNITS X $370 PER UNIT = . $
C. Multi-Familv Aoartment
NO OF UNITS X $277 PER UNIT = $
D. Manufactured Home Park
NO OF UNITS X $280 PER UNIT = $~gO.Cf)
WPRD SDC $~RO.(j)
2. SDC CREDIT (II applicable) SDC-payer must furnish proof of WPRD Credit g'
approval. See SDC Credit Worksheet. $
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) $cQgD,cO
~~~~
.I').. I ~ I~
Date
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
FAX (503) 726-3689
MOBILE HOME AND MANUFACTURED HOME AGREEMENT
UNITS TO BE PLACED IN A PARK
As required by the City of Springfield Development Code and/or the State of
Oregon, I understand and agree, as shown by my signature on this form, that with
~a p~o~~ of .}~e a~~ached permits for a home to be located at
~~~lo , Springfield, Oregon, City Job Number
I~~ I wifl meet or exceed the below listed minimum setbacks.
Home Setbacks
10 feet from a park building
20 feet from any public street
5 feet from any rear space line or in terior space line
5 feet from the edge of a park street
2 feet from the interior edge of a park sidewalk
Accessory Structure Setbacks
10 feet from a park building
20 feet from any public street
5 feet from the edge 0 f a park street
2 feet from the interior edge of a park sidewalk
3 feet from an interior space line or rear space line
I further state, by my signature below, that I have been provided with the
following information:
Manufactured Home Blocking Requirements
Minimum Requirements for Permanent Steps
- Electrical Connection
_ L/ /""~{
l>~ure
/2-20 '9Q
Date '