HomeMy WebLinkAboutPermit Electrical 1994-4-19
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225 FIFTH STREET approval. ELECTRICAL PERMIT APPLICATION
SPRINur..."..o, OREGON 97477 Zon1ntL!::,I;2&. n.-1 ~Iq
INSPECTION REQUEST: 726-3769 bMo A;~.',c..,~_ .C(_. _f,. I. Ci ty Job Number -Ill N
OFFICE: 726-3759 ~~ -:r *,'
~, : ~O,,!}.j:,. rnJ^Jr'JZONtJ;Qn7ign&iUr::~'~~~::d:::i:~::~:eB:~OV
~ /) Multi-Family per dvelling unit.
Ilf~~CJUjm D~4nO Service Included:
ffiJOB DESCR'l:PTJPN_ ~ ^ r-l (\?\ '\\ ~n
\. (1(\ u .i ~ )'{Y \ 0 1...-\ \.. UU \~\
~ermits are n~transferable and eKpire
if york is not started within 180 days
of issuance or if york is suspended for
180 days.
'2." CONTRACTOR INSTALLATION ONLY
Electrical ~iW;:: !t~~IIAf)F _E:u:a:
Address ~~ \.\2E.r'-,; 2-' ,,-\4- .-\oJ.F_
Ci ty \='-I^ (, i?.--I\.\ F_ Phone
Supervisor Licen~e Number
ll-q - ltJDO
Cjl\~l<; 65'6-1'''''1.
Expiration Date
lO..\-9"")
Consti Contr. Number (O3\~1
Expiration Date \ 2--2,-Cj.3
Signature of Supervising Electrician
~tJ.~
.. , I
. Ovners Name \'\\ \ ~ ('\ 0 ~
AddressR~ () \\l~t-JL..f\.-t
. City ~RS\Q --,phone..2A3--813J
. OVNER I~ALLATION
The, installation is being made on
property I ovn 'vhich is not intended
for sale, lease or rent.
Owners Signature:
.'
:;:- i,;~~;~)~t::~-'
RECEIVED B . ~ .. ~ A
. - - .
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd !Iome or
Modular Dvelling
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
d
Cost
Sum
$ 05.00
$ 15.00
$ 40.00
Rr)
S 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00
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 100u
D.' Branch Ci rcui ts
$ 40.00
$ 55.00
$ 80.00
volts see "0"
auove
Nev, Alteration or EKtenslon rer Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit I
$ 35.00
$
ra
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 nq ,cJ:)
5% State Surcharge .,.. l.r)
TOTAL _ C3(Q.,()
2.00
.
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SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM,,~QAfY\-+ \\1 k'f XL~~\Y\Q!:HON8 ,~?, ,'-<,,'737
ADDRESS, ffi 0 \Jl f\:0\) l'yt, ) tD% STAll', f1Lz" ~I
LOCATION OF Ii'ROPOSED BUILD~~IV 4/;:/11'\7
Street Address if Known: 0.1) \0 K J'{1J1/2fJ..J qu
fllc0 TaKLotNumber:Dffi~r;jn m4c0
I
Platt Name:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back,)
A. Sinl!le Familv - Detached
Single Family home
NO OF UNITS
B, Sinl!le Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS r
WPRD SDC
Manufactured home not in a park
X $400 PER UNIT _=
$
.
X $370 PER UNIT =
"$
X $277 PER UNIT =
$
$ J ~()JcD
$ ~~or.D
$ flY .....\
~_'lO,(L)
~ I \q/i[1
X $280 PER UNIT =
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~\~~Q(LP
Community Services Divisi~ \
City of Springfield
Date
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