HomeMy WebLinkAboutPermit Electrical 1991-6-24
.'
'fi,H IOllowiM p'rojeci. b.'
, -..: a~ su mittod has tho following
~on~n~, and does not re<;uire specific land use' . I
225 FIFTD STRBRT pp oval..: ELECTRICAL PERMIT APPLICATION.
. SPRINGFIELD, OREGON 97477 Zon!ng...:Jd)i2 rJ I ",--v'l I ~.
. .INSPECTION REQUEST: .1.:tA-3769"'1:::.ulev" Ci ty Job Number - \ \ ( ) II VJ .
OFFICE: . '726-3759 -
Au~horL~ed Signetur$~
1. I.OCATION OF INSTALLATI.ON)
...5;7S::- J-o"...hAu tM/.
LEGAL DESCRIPTION
-r:~.. ~::::'DU
110~;;713
D-;;;t:;aJ
..' JOBLDESCRIPTION
. n74J D I'L -i::-Irnu...
('.fur
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~# .~~
Address 2',S:c:;it LA) 6lL/1:&..... .
.. City~tJ' .Phone~11/~/SZJo
Supervisor License Number C}~')-< c:;
j() /9/
Expiration Date
'Coilstr Contr. Number ~()- dXO (!
Expiration Date' ull?~/
Signature'of Supervising. Electrician
...~.~
I
. Owners Na.me.
Address.
C~ty
Phone
. OVNER INSTALLATION
The installation is being. made on
property. I.own which is .not.intended
: . .'for' sale.. lease or. ren t .
Owners Signature:'
(h~ ,~~~:;>
-~
tt: - Q 'I- "72-
~6
/:" ~/-
iVV'
DATE:
. "".u,r-l" I:
RECEIVED BY:
3. COHPLETE FEE SCDEDULE BELOV ...
A. New Residential-Single or.
Hulti-Family per dwelling .unit..
Service Included:..
Items Cost Sum
1500 sq.ft. or less $ 85.00
Each additional 500'
sq. ft or portion
thereof $ 15.00.
Each Manuf'd Home or
Modular Dwelling ~ .-2CJ
Service or Feeder $35.00
Services or Feeders (10 Branch Circu.its.
included). Installation, Alterations
or. Relocation:
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps.
Over 600 amps or 1000
$ 35.00
$ 40.00
$ 80.00
volts see "B"
above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
. . Two. to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00 .'
$ 50.00
$ 15.00
E; Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation. $ 36.00
Sign/Outline Lighting '.$ 36.00
. Signal Circuit or
limited energy panel $ 36.00
5. SUBTOTAL OF ABOVE ~!)CO
5% State Surcharge .~.~
TOTAL rJ~_ SO
.'
Metropolitan
.Wastewater .
Management'
Commission
.
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ri~TH Ai'~D A SiP-EElS
S~~.::.;GF:oLD CiTY c;;U - S~;:':';Gi':ELD. Ci'.EGC'J ,,7"77 ELE,':-;G:,o (::(:0) :"7."::::,
l'.Vl-\C CO!,NECTION CHARGE
Building Address: 'oJ~ ~(!hl)~
"''''g'Ob''' ) I D i"){;y'7 17"1 . T" Lo, N,.b." ()QSL()
O.'ner: D0AJCH) P (\ . i_ /\Jr1 /tin) f~~')
Add,.,,, \ \C\ C\" ',\, '--'01\ \, _ Pho.oN,.b", l 0 ~ 'i'/l \ 23
City: fA ')(160 J1L State: (\)i~ 1)~BY\ Zip: q '\4()"L
~ Residential Fee ($222.00)
$r0Q~ ~
Commercial Fee (new non-residential development/
remodel)
Total fixture unit charge (see reverse of this form) S
Credit Due (see reverse of this form)
SUBTOTAL $
<$
/.)f):1,r-'1 >
TOTAL KV~C CHARGE
S
\C\4 .~ ~
. Da te Received: L::- 2 '1-&92.
Receipt Number: ~~~~
Received By: 4.r.; /?~
~/"tr .
Building Job Number:~
.
.
Fi:<ture Unit Calculatioil Table: ::CC'~H d r,e'.' u!-:tures r.ulliplied by t!nil
equivalents. NOTE: For remodels, calc~!3te only the ~ET additional fixt~res.
Fixture Type
of Unit
F xtures Equivalents
Fixture
L'ni IS
3a t h t II b. . . . . . . . . . . . . . . , . . . , , , , . . . , . . , . , . . .
Drinking fountain............,.,....:.: ..,. ".
Floor drain......... .,'... ,. ,..., , ,.-,...,... \."
. . ,
Interceptors for grease/oil/solies/etc.,,:,
..'Interceptors for sand/auto ~a~h/E:c..:,.,..
Laundry tub/clothes vasher.." ,.....,.....
Clothes 0asher (3 or.more)....~......,....
Mobile home park trap (1 par ~,~,)"...,.,
?ecepto~ for refrig/~ater static~/etc.....
Receptor for COLLer si~k/dish.sh~!etc...,.
Sho"'er, single stalL.........,.....,.,...
Shover, gang (per head).......,.....,.,..,
Sink, bar, com~ercial....,....,.......,',.
Sink, commercial/industrial/etc.,..,.,....
Urnial, stall/~all........................
Vash basin/lavatory, si~gle, ....""......
Vater closet, public installatio~"..,.".
Vater closet, private......., ,....,."...,
Miscellaneous: .....,....
2
1
2
3
6
. .2
6
6
1
3
2
1
2
3
2
1
6.
4
..........
..........
Total Units:
Total fixture units
x 513.25 each _ Total Charge: $
Credit Calculation Table: 3ased on total .alue of property at time of permit
application.
Year -]..nl"le:-:s.d
to th~ City
Credit per $1,000
2:ssessed value
[9104-
1979
1980
1981
1982
1953
1924
1985
1926
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
.
,
Rate
x S 10)3'--0
r.SSEssed Value
= $
Credit
TOlal Credit