HomeMy WebLinkAboutPermit Electrical 1993-5-19
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1. ~yATION :iSTALLATIO!'l-IJ /}/',/\
C\ ') J z:){) _ ().J..1.d/l J"f7 o'U-J
110?'~~() ION 04400
l~~S on-transf~b~~e::
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
2. CONTRACTOR INST~I.L~,ION ONLY
Electrical contract~rn-\o ~
Address Rh.1:::\ \.A.) .c0:\"". cA~i2~_
Cityicao.no, Phone 1~q-l~
supe~iCen?e Nu~ber ~
\().\.ClS ..
Expiration Date
Cons t r Con tr. Number ~ '2\ \::P{7
\~ .~iJ,q?\
ELECTRICAL PERMIT AP9f%\IONJI
City Job Number L1~1. )l(Jtlo
~u~PLETE FEE SCHEDULE BELOV
New Residential-Single or *
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling ^
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
$ 85.00
$ 15.00
$ 40.00?b
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Expiration Date
I
I'
Signatur~~~pervising Electrician
. ~~
Owners ~ame J ~~1 tt b'Y.:::+-
Address~<:::[) '1 /l fl ~
Ci ty ~J} fj) _ Phone j3jffi3J
OVNER lJSTALLATION
The installation is being made on
property 'I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: ,.
RECEI'PTlI :
RECEIVED BY: \..
~--. - ----
, l~tI. ~
_ . 11lC:;:Y\'
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. . Branch Circui ts
$ 40.00
$ 55.00
$ 80.00
see "B"
,
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited. Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit (
E.
5.
SUBTOTAL. OF ABOVE
5% State Surcharge
TOTAL .
$ 35.00
$ 2.00 /1
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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CITY OF tRIUGF[ELD SYSTE!-IS OEVELoAtrn
WORKSHEET
(C011/1[RCIAL t, RESIO[ftTl^L)
CII/\I1GE
q~04Bt
r~Ai'IE'OI( COHI'ANY: J~Lo.~JJ:..._kQ}J'-0~_~..&L'=..I"'.. ~oW\1::. .Pr-.~ J..ISo 'f.Cvvv1.C0
LOCATlOil:....5DC -r;;\:7~'-e..'rJ.JL\0JI-1v..~ i.J,O~'1 I.-P-- W-brvlS \":> tv\o\JtG~\ k.\ . d ;)../";;'
DEVELOPl'lEllT TYPE:
[JUIlDING SIZE:
LOT SIZE'
.SQ. Ft.
I. STOR/,I DRAIrlAG~
1I-1P[RVIOUS SQ. FT. . X SO.18G rER SQ. Fr.
(See Reverse For Runoff Coefficients If Actual I~perv. Area
Is 0-
Is UnknO\m)
2_ SANITARY SEWER-CITY
110. Or: pru's I t.j. . X S3!3.55 rER PeU
(See Reverse To Octennine Total prU'S)
Is ?"?q I~ I
3. l!Sf~T?.?Oi~TJrrr.Q;l.
r:o Or: U11ITS X TE~(l RJ\TE X COST PER TRIP
\
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~: S3S::'.GI
Is 1~"'2.":;'o,::,,!
:~ ~3SS.G1
:;
.,
"!. 5328.61
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(See Attachment C To Odemine Trip Rate:;)
SUBTOTAL '(ADD
ITE ) S -, I " 1~
11S 1,2, & 3 I "" '"
4. A01l11HSTRATIVE FEES
'[JASE. CHARGE (SUBTOTAL fillOVE) X' ;05 Is "7'OIj. I
TOTi\L-CliY S0C 'S Eeo ~
5. SANITARY SEWER-HW/1C
:.~.t~l>:!!~'.,'OF .p~U'S ,,:, ,.f- ." x Sl~.~5 PER PFU .+ $10 1-1WI1C A!):'HN. FEE s l"l t; ~
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. ~ -.. . '. ': .. ..-. ,. ':, .'. .. ~- ' . .:: '
.- ' .... ..':.;"':-.i(Use PFU Total From Item 2 Above) ", . "". .. ,..... .
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...... . ........_ ___,../,_, :"::_ ._...:',,~':::;:.:~::.-<'c .,..,- ,...... C',',_. .~ '. ',., :.". ...f ....
,,:..:.. ~lWHC CREDIT IF ArPLICABLE(Sf:E REVERSE) ." -. ..,... '.' .,. S
":::;;::';- V,'.. ..~...~'~''':'<... ~ /~'1 /&f~ . TOTAL-~W~1(: -~DC Is I'1S~ 1
, .,.,;;":,,.: ~ K1p BurdkK I I TOTAL SDCS qq &, e
SOC Coordinator
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