HomeMy WebLinkAboutPermit Electrical 1993-3-8
. 1;-he following project as submitted ha", the following
:Zoning, and does not require specific land usa
epproval. 7)
225 FIFTH STREET '. L ~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 200lng_
INSPECTION REQUEST: 726:.,,3769:) - <J -tt3
OFFICE: 726-3759 Authorized Signeture 5' C
7- 3.
1. LOCATION OF INSTAIWATION
:::l1~1) ".;)()2., '/K()A.A/laJ
- .
. LEGAL DESCRIPTION
n ()2.,';).iltJ
04L./(YJ
JOB DEScrq:P'i'I~
~ II.uv-<-. cL - :JDO AMP
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
I.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor.1..12A,; J;n dQ/~c{"
Address_JD4:) ~/V1} 1!..()~L-
Ci ty C(.) 1~/'Y\P Phone &:''ifi<.1 ldJo
Supervisor Licen~e Number t1LJ~,~
Expiration Date 1'::1 Ja2.,
Constr Contr. Number :J.():f:JS?OC,
Expiration Date l;:).jCj2.,
.
Signature~is~n~ D.
Owners Name~",)^"p, ()/Vl/JiA'-;' {I >
()/V\~
/55l
Ci ty ~rf. Phone /44 .{)L/5t,
01lNER INSTALLATION
Address
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------~~Tq-~
KJ><;t;.LPT. I: II_QQ
RECEIVED BY: OP.
City Job Number q 30 19-1
COI,rJ..t.." r"" SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items
Sum
1000 sq.ft. or less $ 85.00
Each addi tional 500 .
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
~ or Feeder --L-- $ 40.00 ~
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
$ 50.00
$ 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 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
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 J...JQ D()
5% State Surcharge d D()
TOTAL ..!:::[;) _t'Yl
. \
CITY
OF.'IIIIlCFIELD SYSTCt-1S OEVELO.Jn
WORKSHEET ·
(COllI1ERCIAL t, RESIDENTIAL)
CIlAIIGE .;l/SO L~t\.
NAlIE Olt COIWANY: J0_o.t::lJ"J\_,b.Q.r0.0~.<?& l'==-\;-- ~ow\ I::. p,.,,~
LOCATIOU: c,ljc. -ro\7E:. S:\:tJ2.~~!:lV.~ iv\0"-,11.-lC. t-l-brvlS I":> Mo\JtG~\~.
DEVELOPMENT TYPE:
[JUILDING SIZE:
1. STORM DRAIHAG(
Il,tPERVIOUS SQ. rT. X SD.IBG rER SQ. Fr.
(See Revcirse For Runoff Coefficients If Actual I~perv. Arc a
LOT SIZe
SQ. Ft.
Is 0-
Is Unknwn)
2_ SANITARY SEWER-CITY
r:o. or rru's 1+ . x 538.55 rCR pru
(See Reverse To Octenninc Total rrU'S)
Is ?"?q I~ I
_"J. le!1! L~J~Q.Bll\~iJ.Q; 1.
no 0;' UU I T~ X Tf~ I I' !U\TE X CCST PER TR I P
,t::,jl_t
';' ~~C0 r:l
., - ............. -.....-
ls 1/1..";-0.::..!
x
v ...~~~ r.l
,', J-'".... ~.
~,
-_.--_..- ------..
......
v
X S383.Gl
Odcmine Trip Rates)
SU[JTOTAL '(ADD
v
(See Attacl;:nc~t C To
ITEKS 1,2, & 3) S
- ,
-; fv~ ..;;,.
4. AOI'!WISTRATIVE rEES_
'U,'\SE CHARGE' (SUBTOTAL ABO\'E) X ~05
Is "7'OIj. I
TOT/~.L-CII'{
,-"",'""
.y,..:\..
90
.~ €co -
5. SANITARY SEWER-I11-iI'\C
'. 1l0. OF PFU'S
.' I"+-
x 513.25 PER PFU ,+ 510 l1\1HC ADMIN. FEE S /4 c; ~.
.......-
,-" .......<..
.,~:':'~;~~'(iJse PFU Tot~.l From lte~2.Above)
.."" - ..... '.' .-.....,....,.'-,..,...-. -.....
NWI1~ 'CREDIT' IF' APPL-liislE .'(SEE' REVERSE)
': ..' '..' ,,:'~. .
- -~. .~. .":"
.~ .., K~-~Burdick
SDC Coordinator
: 0.{- /']-";;1 'V
" . S
TOTAL -MW~!C - SDC Is I ~ c; ~ J
TOTAL SOCS qq {,. t/;!!..
. . .~."..' . . ,"
--:-. ....;-~ .~,. . ,......
. ~.~.. , ,-
. :;.:.:-......-;1' :,.
.' ..:./.: ~'''':;.;s. .
. ... ;..'
CITY OF.HIrlGF[ELD SYSTEl-1S OEVELOilliifNT CllAHGC OJ d \S"!I
WORKSHEET · ,;lIS ~ '")'""'\
. (COll/1cncIAL t, RESIDENTIAL) 0 ~~ 0<-.:>1.:;1
rW1EOfZ COl'lI'AUY: J':JQ~T':'__hQ-'0.0~.~.&~f,:. ~oW\I::.PI\~
LOCATlOll :_c,Ij( i;;nr:- V'""J.JL\0]!:lY-;N MOP">".-t==:. U.~Mf..: I ":> M~lG"\ kl .
DEVELOpr,\EHT TYPE:
[JUILDING SIZE:
LOT SIZE,
.SQ. Ft.
I. STORr.! DRAINAGE
mrERVIOUS SQ. FT. X SD.IBG rER SQ. Fr.
(See Reverse For Runoff Coefficients If Actual I~perv. Arca
Is e-
Is UnknO\.m)
2. SANITAlZY SniEfZ-CfTY
NO. a:: rFV'S IL~ . X S38.55 PER PeU
(See Reverse 1'0 Octeluine Total prU'S)
Is ??"1"~ I
~.. JJ?r\rL~CD.:nJ3JJ.Q;I.
rm 0:' UUITS X T~\IlI !V'\TE X COST PER TRIP
t-,-rL:
____________4
~ S:2S~CI
I 1"- 0'. I
)' /~';'-I
\
v
X ~3SS.Gl
_____4'___.4
..--'
v
X S3S3.Gl
LJ~tCrr.Ilne Trip R.:.tc.::)
SUBTOTAL' (ADD ITEl-\S
1,2, r, 3) S
4.f"",-;0
flv:'" -
(See Attacl;:nc:1t C To
4. ADIHlHSTRATIVE FEES
'[lASE CHARGE '(SUBTOTAL fillOVE) X ;05'
I~ "7'OIj. I
TOTt.L-CI1Y 50::,
90
-- €.C0 -
S. SANITARY SEWER-H'..!IK
~ ,,'.110. OF PFU'S
. ,., I
... Lf"
. I ~o
x S13.25 PER rFU .+ S!!ll-lWHC ADMIN. FEE S 4 c:; ;..--
.""." . . ~
. -....... -'-' ..,'-. .."'~ .
~lWHC CREDIT, IF APPLICABLE (SEE REVERSE)
'. . '. '. '. :.;~.' :-.
. - '. ~...__. - c.f /~'1 /f'V
..,,::.,...: ; .~:. . ..... (j Kip Burdick
"'_ SDC Coordinator
';,.
. S
TOTAL-MW~lC SDC Is 1"7c)~ I
TOTAL SDCS qq ~ e
t. .:
"'~:" .. -. - - - .,.
..; ~ \\~\ <6, ~q J,~!ortti.p
'; :'~;j~:~{:~~.:}:',~-' - ...
CITY OF.'IUtlGF[[LD SYSTG1S OEVELO~NT
WORKSHEET ·
(COHI1ERC I AL t, RES IOENTlAL)
CIIAIIGE 01 d- I SS-q
~\SO ""CUif\&\....
-t=I~O~
. NAll[Olt CO/WAN),: J:1,q~::L.;.._,lQ}'J1/.:~,~,~.&L'.:::.f,"- ~OW\I::.P",~
LOCATlOIl: SDC -ro1?~_e..'r-,.JL\0J!:lV~ M()f-';>II.-t2. U-orvlS I":> M.:>\JtG~\k.\.
DEVELOpr.IEllT TYPE:
[]UI~DING SIZE:
I . STOR/.j ORA IliAC C
Il'\PERVIOUS SQ. FT. X SO.IBG PER SQ. Fr.
(See Reverse FOI' Runoff Coefficients If Actual Imperv. t,rea
LOT SIZE'
.SQ. Ft.
Is e-
Is UnknO\;n)
I '
Z, SANITARY SEWER-CITY
1:0. a:: rrv's 1+ . x $38.55 r[R PeU
(See Reverse To Octeluinc Total prU'S)
Is ??q I~ I
3. IBf~:r2'!.~.Q.l~TC\]J.Q;1.
r:o 0:- UUITS X Tf~~;l !t!,TE X COST PErl TRIP
i. __.~_'_~~~_.__
~: SZES.Cl
Is 1/'2-";,0'::"\
v
'f. $3~S.GI
i,
"'/'
'I
-'---~-------
-~~.
v
. y. S28S.Gl
To Odcmine Trip Rate:)
SUGTOTAL '(ADD
ITmS 1,2,& 3) S
- ,
10'2 I;'
(See Attach:nc",t C
4. ADllIIHSTRATIVE FEES
'[]l\SE CHARGE' (SUBTOTAL ABOVE) X ;05
1$ "7'OIj. I
TOT{:.L-CliY ::~0C.
90
r See ~
5. SANITARY SEWER-H'..!I'\C.
',.' lID. OF PFU'S ",...f-
x 513.25 PER rFU .+ S!!l1-lWHC ADMIN. FEE S 1"1 C, ~
,": ......:..
, "
"." '__A
"" ........:,...
,', ;":,,:'(u:e rFU ,To~al_:ro~__.-!,~:,~2 .Ab,~,ve)
." ....< .._. ""0" .
,,''';:. .
. c.f /~1 /1'2/
. s
TOTAL-MlmC SDc,Is l"l c, ~ 1
TOTAL SDC ~ ~ e_
~jWI1C CREDIT IF ArPLICABLE (SEE REVERSE)
~ n K:PBurdicK
soc Coo'rdinator
..;:......:. ;","
.,
t -:-.~..:--'.#..". .....
.~. ".,-:-, "~':.,
. ~:- :'~'~~:~~";~') . :': ,..
'. ...--:..:..... -. ..-....."
. \.;
i.J;1sB (1/13/l7
..........,...' " ..,
CITY
OF.n I nGFI [LO SYST[t-1S OEVELOf1W<7NT
WORKSHEET
(cO/mERC I AL t, RES IOENTlAL)
CIlI\HGE
!
NM1[' or~ COI.lI'ANY: J:~to.~::r..;.__lQH\0~_9J? L~f"_ . ~o WI I::. . PA~
LOCATlOll:--'spC. -ro17~_e..\-J.JL\0J!:lv~ M.r')p"I.-12- t-\-iJrvlt'-- I":> Mo';lI2.DII--1.
DEVELOPl'lENT TYPE:
[]UILDING SIZE:
.LOT SIZE'
SQ. Ft.
1. STaRt.! ORA WAGE
mrERVIOUS SQ. FT. . X SO.18G PER SQ. Fr.
(See Reverse For Runoff Coefficients If Actual. Imperv. t,rea
Is 0-
Is UnknO\m)
7., SANIT^RY SEHf](-C!TY
NO. OF rFU'S IL~ X $38.55 rER PFU
(Sec Reverse To Octeminc Total prU'S)
Is ??"1"~ I
~"i . ]J~LlL~J~Q.B.I!~IJ.rr 1.
f10 Or: ur: ITS X TE I I' ;~)\TE X COST PER. TR I P
;, ___~_'.J~~____
;: S32:.C1
[, .., '7 - 0'- I
"' l--,,_';'-I
v
X $2SS.Gl
i.
.-.'
v
x S2S:S_Gl
O~te~ine Trip Rates)
SU[]TOTAL '(ADD
ITEl-IS 1,2, i,3) S
- ,
/(;;'7.. ,~
(See Attach~c[1t C To
4. ^1)IHHISTRATIVE FEES
. . '
[]1\SE CHARGE (SUBTOTAL fillOVE) X ;05
Is "7'OIj. I
C,D
TOT/~.L-CI1" 5::C, .r SCD ~
5. SANITARY SEWER-MWI'\C
-.," - .;. . :.' . '. .: .:, ~':'.':.
,._:>:,.<,i-(use PFU Total From Ite~2',A.bo~e)
..' . .~.' -: . N~I1C CRED-'IT- IF - ^~~~i"~~~E(SE~ REVERSE)'
110. OF PFU'S
, ,...f-
x S13.25 PER PFU .+ S!!) 1-I1-1HC mXIN. FEE s 1"1 t; ~
h'-"'"
,,'.' .
.' ....,-.. ~~. """.'~. -
. S
.;:v .
. "'..
..". ""
,~ hK~-~~urdick
'. SOC Coordinator
- ..[- /1---111'2----
TOTAL -MWMC SOC. Is I q t3 ~ I
TOTAL SDCS qq toe
""",,,,
....:.....
--. . --.#
~ .:- ..~.,: .
.-" ..' ..''''":''
.-' '~~"':..'" "
.'
. ... ''':,:_,< .:-., .'C.,
,',.-"-,,..