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HomeMy WebLinkAboutPermit Electrical 1992-6-24 ~ . . : IlIeio\\Q'llilI9. . ' , .' 225 FIFTH .....-. ., .'" i~ ~anlllJ&O ELECTRICAL PERHIT APPLICATION . SPRINCFIELD, OREGON 9~.M~f"jlla~fl~'\\cllllli6Peo\110 ' , q/()n/IJ .INSPEClION REQUEST: ~i :'6a .. City, Job Number' .. LL OFFICE: ' '726-3759 ~IO'le'.. ~ -. , .'. " , ,P ~'6~LII>~ 3. COMPLETE FEE SCDEDULE BELOV .'. TION . ,.. - e... .' _ t 618AA...- t.ew Residential-Single or A~~~ea~~~ ',Multi-Family per dwelling unit. ~u, Service Included: ,. '1. LOCATION OF 'INST , ,!i~1 LEGAL DESCRIP'ITON -r: j... , .:),,/fJV. JOB DESCRIP'ITO~. ? () ~ l?1o 19;).; )~ f.Jfd;Y'" 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. CONTRAClOR INSTALLATION ONLY. B. .,' Electrical contractor~;kJ/l;(hd~ Address 1s:J IJJ.aI 'dL/& . , , City ~t7 ,Phone ;'5 t./{/,-/ ')7X) Supervisor License Number (}c/c:; -,") Expiration. Date /Q Ie; I 'Constr Contr. Number ;:;0- ~?f() ('. Expiration Date . //J jql Signature.of Supervising. Electrician .~.,~ , OWl)ers Name, Addr~ss . City Phone OVNER INSTALLATION The.installation is being, made on propertY,I .own, which is ,not. intended 'for sale; lease or rent. Owners Signature: '~A:k'-~ ---) DATE: _. b-2 y, 9<- . 116..",uJ: I: ~ } RECEIVED BY: ,~~~ -/ 1500 sq;ft. or less Each addi tional 500'. sq. ft or portion thereof . Each Manuf'd Home or Modular Dwelling'. Service or Feeder Items Cost $ 85.00 '$ 15.00. . . ~. '$ 3S.00!J.l2 Services or Feeders (10 8ranch Circutts .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 C. $35.00 $ 60.00 $ 90.00 , $130.00 $300.00 $ 35.00 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 D. Branch circuits $ 35.00 $ 40.00 $ 80.00 see "8" above New, Alteration or Extension Per Panel One Circuit . ,Two, to ten Circuits Each Addt'l ten or portion thereof 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL E~ Miscellaneous (Service/feeder not inCluded) -Each installation Pump.or irrigation Sign/Outline Lighting Signal Circuit or. limited energy panel $ 35.00 $ 50.00 $ 15.00 . $ 36.00 $36.00 $ 36.00 11 DCO .~.SD f)?'> .::::L.J . Metropolitan Wastewater .. Managernent Commission . . (-:'.'; ',' : ~ -:.'. '::: :.:: C.:~ ~~'.'~::-r~,;:~:. C:".::"; .~:. ~,:r.i C'~:~..'-f L;i::' f :'! =.;:;f!tO ,"',f ~:~:: ::;!:':":".-~:' '.;'.t.: ~.. =t:'I::'~'.~ c',':; ~i'!:'.-~;':~;'!~': .~:~.: ::"::-. c~.':~ ','.:::.-:-l:-: :::.~..:} :'~l :,i:":~~.'i.:.: .:i:::'y :;:.:~!_~(.rl (..'~ -.:, (: - -.: ~ :. ,I !':':'. \';H::~:,; -:-~; i:'.~ Li " :.~: :: ~ i :.::: .:: Flr"'jH Ai'~D A SiF.EEiS - ~rt=,::"'GF:::LD CiTY !-::":.LL - ~FR::'~Gr:ELD. C;:,EGC~J ~7':'77 TELEr-:-:G:,;: i':C::) 7":;.':::i lWKC CO!(NECTION CHARGE Building Address: '?21 ~GlJUUJ&n.-A-u~ Refere(j.'umber: I 'To 3 21) 3 , Tax Lot Number: 0.2 400 O.ner:, ' D0JlCU )p {\ " i~ /\In .AJ-{).u...S 0 Address: \ \ C\ C\ \\ \~:{\l\ \L- Phone Number: l o~<6 - -\\[3 City: fA ')060 JL.L ,State: (()i~ J)cym.. Zip: q f\4r)'L 'i.. Residential Fee ($222.00) $r0Q~ ~ Commercial Fee (ne. non-residential development/ remodel) Total fixture unit charge (see reverse of this form) S Credit Due (see reverse of this form) SUBTOTAL $ <$ 1)f).45 > TOTAL K-KC CHARGE S 'lQ4,S5 Date Received: ,c;-2 V.-'?2 Received By: ~ ~~ 'r Building Job Number: q 10 '111 Receipt Number: ~ / . . . Fixture Uni t Calculalio:l Table: ::cc,~€~. cr r,e'" fi:,:tures r,ultiplied by tlni t equivalents. !iOTS: For re:r,odels, calcJ!3te e,nly the ::ET acdi tional fi:-:t,:res. Fix ture Type of Unit F xtures Equivalents Fixture L'ni IS 3a t h tub. . . . . . . . . . . . , , . . . , . . , . , . . . . . , , , . , . , Drinking fountain........,.,....",....". Floor drain.............,......".....,.., Interceptors for grease/oil/solies/ete,." Interceptors for sand/auto ~ash/e:c,....., Laundry tub/clothes vasher..., ..,.".,..,. Clothes ~asher (3 or rnore)....~.,.,....... Kobile home park trap (1 per M,~,).....". ?'eceptor for refrig/vater static~/etc...., Receptor for Co~~er sink/dist~s~::etc..... Sho.er, single stall..........,.,....".., Shover, gang (per head)., ......""..., '" Sink, bar, com~ercial., ...... ,..",.,..... Sink, commercial/industrial/etc"......". Urnial, stall/vall......................". Vash basin/lavatory, si~gle...,....,...,.. Vater closet, public installation........, 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 513;25 each _ Total Charge: $ Credit Calculation Table: 3ased on total ,alue of property at time of permit application. Year "J..nr;e:.:ed to the Citv Credit per $1,000 2.ssessed va.lue \~~ 1979 1980 1981 1982 1953 1ge4 1985 1966 1987 1968 1969 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 r:ate x S 1(0)31.-0 r.SSEssed Val-..:e = s Credit Total Credit 1