HomeMy WebLinkAboutPermit Electrical 1992-6-2
225 FIFTH. STREET
'SPRINGFIELD, OREGON 97477
. .INSPECTION REQUEST: .726-3769".
OFFICE: .726-3759
.
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1.
. Oat~ ..
LOCATION OF INST~TI .
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LEGAL DESCRIPTION
"{':L; /d.OV
JOB DESguPTION11 A _ "" /J ..4.._
/noh I 1.0 't:17rvuL' r fta.
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is. suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
'. Electrical contractor~J" (/~
Address l1'"S- I;) /..#/ -/q~ ..
. City~tJPh~ne3dc/- 1m/')
. SUpe~vis~ense Number. (}t/.:s- - ,<)
J 0/ q /
Expiration' Date
'Constr Contr. Number r2()-;)'i?O t
.Expi~ation Date
/ /) /9;
. Signature of Supervising. Electrician
'. . /)A AL..._.
. . ~;,,YGC'CA-1. . . .
. ./
.. Owners Na.me.
Address.
City
Phone
. OVNER INSTALLATION
The'installation is being. made on
property. I .own which is .not intended
. . for' sale; lease. or rent.
OWners Signature:'
.~ j(,r7h~~
. . ~ -
DATE:._ _ ((J r() ;C{'}-h." .
. RECEIn I: ....:./" ~:x--
RECEIVED BY: ( /)/.1 QA..., -
,
OHPLETE FEE SCUEDULE BELOV
New Residential-Single or
- amily per dwelling unit..
Serv ce nc1uded: .
Items Cost
Sum
1500 sq;ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof . $ 15.00.
Each Hanuf'd Home or
Hodular Dwelling ~. n T\
Service or Feeder ~. $.35.00'.-!J,..)
Services or Feeders (10 Branch Circuits
.included). Installation, Alterations
or. Relocation:
D.
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$35.00
$ 60.00
$ 90.00 .
$130.00
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 35.00
$ 40.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
One Circuit
. . Two. to ten Circui ts
Each Addt'l ten or
portion. thereof
$ 35.00
$ 50.00
$ 15.00
E~ Miscellaneous (Service/feeder
-Each installation
Pump or irrigation.
Sign/Outline Lighting
. Signal Circui t or
limited energy panel
not included)
. $ 36.00
.$ 36.00
$ 36.00
1/0.00
~ ,'::p '\
<t)3.~
Metropolitan
Wastewater ..
Management
Commission
,
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ri~7H AND A SiP-EElS - ~rr:,::':GF:::!...D C:TY :-:;'-~L - ~;:F;;;~Gr:ELD. Ci=.EGC!-J '::7.:.77 1ELEr';-.:C:....E (:(.::) 7.;:.':::'l
!r,'~c CO!<NECTION CHARGE
Building Address:
,';- j 'I
L~C.~l Qu..eJtJ /l U'ff
Reference INumber: 1703 '2.'7 /,3 . Tax Lot Number: ('11 '7 ('~'("'1
o.ner:dD0JlOJ) r 1\. i /~() A+~~pf~S
Address: \ \ C\ C\ .\\ '\~;m \: Phone Number:
""y' f'_U06Q 1lL ",," (~i~.Ar\ZiP'
lo~<6-q\23
q f\ 4()'L-
~ Residential Fee ($222.00)
$r0Q~ ~
Commercial Fee (new non-residential development/
remodel)
..
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $
Credit Due (see reverse of this form)
<$
:lflAS>
~.
Date Received:
Received By:
$ \<1-4,55
~~)
TOTAL KV~C CHARGE
Receipt Number:
Building Job Number: CJ /07 If fiY
,
.
Fixture Unit Calculatio;l Table: ::'"c.~€r d r,e'.' u:':t\lres r.ultiplied by tmil
equivalents. riOTS: For re;r,odels, calCJ!?te c.nl; the !:ET acdi tional fi:-:t~:res.
?b:ture Type
of Unit
F xtures Equi~alents
Fixture
L'ni Is
3a t h t \\ b. . . . . . . . . . , . , . . . . , . . , . . . . . , . . , , . . , .
Drinking fountain...,....,.....,..,..,.."
Floor drain..............,..,."........"
Interceptors for grease/oil/solies/etc",.
Interceptors for sand/auto vash/e:c..",..
Laundry tub/clothes vasher...., .,...,.....
Clo thes ~asher (3 or more)................
Kobile home park trap. (1 per-M,~.)...,....
?eceptor for refrigj-.,:at€r st2.tic::;~tc:.....
Receptor for Com~er sink/dish~s~::e!c.....
Sho.er, single stall............"..".."
Sho~er, gang (per head)...................
Sink, bar, com:r,erdal........".......,...
Sink, commercial/industrial/etc......",..
Urnial, stall/....all..............,........,
Vash basin/lavatory, si~gle. ..............
Vater closet, public installatic~",....,'
Vater closet, private.... ..., .,..."...",
Miscellaneous: ......,.,.
2
1
2
3
6
2
6
6
1
o
-'
2
1
2
3
2
1
6-
4
..........
..........
Total Units:
Total fixture units
x S13.25 each _ Total Charge: $
Credit Calculation Table: 3ased on total .alue of property at time of permit
applica tion.
Year "J..nr,e,:ed
to the city
Credit per $1,000
essessed value
I~~
1979
1980
1981
1982
1953
1ge4
1985
19Z6
1987
1988
1989
1990
$2.55
$2.64'
$2.53
$2.41
$2.19
$2.04
$1.69
$1. 35
$1.15
$0.92
$0.59
$0.23
.-
Credit
., S
to)3'Z-O
= s
Rate
;'.ss~ssed Val~e
TOlal Credit