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HomeMy WebLinkAboutPermit Electrical 1991-9-27 ~ , ELECTRICAL PERMIT APPLICATION City Job Number ,'G\ \ Dl07 225 ~~~.u STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: ,726-3759 3. COMPLETE FEE SCDEDULE BELOV A. New Residential~Single or , Multi-Family per dwelling unit. Service Included: '1. LOCATION OF INSTALLATION , ...... ~U' Ln,. f,A IP,u LEGAL DESCRIPTION '"/. L J 5ZJi) 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 70 Service or Feeder "); $35.00 JOB D,RS,qp:mON, ..p () ...4- YVI.(7hJi.l 'kfJvwJ ~~.- . .. , Permits are non. transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 da!s. 2. CONTRACTOR INSTALLATION ONLY B. , , Electrical contractor~A/~d -t kfu6 " 0. ' ,Address >?,~() If J 0/ ::Jdl&.- ' , CitY~d/r/, ,Phone :Jt/tJ/S7Jn Supervisor License Number ~<Ii~~ - ~ Expiration Date, ' . /0/9/ Constr Contr. Number dlJ-,;(f(() (7, Services or Feeders (10 Branch Circuits included). Installation, Alterations or,Relocation: $35.00 $ 60.00 $ 90.00 $130.00 $300.00 $ 35.00 100 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. Temporary Services or Feeders Installation, Alteration or Relocation j() 19/ ,Expi~ation Date 200 amps or less $ 35.00 201 amps to 400 amps, $ 40.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits Signature 'of Supervising Electrician ~"~ 'Owners Name ' New, Alteration or Extension Per Panel Address' One Circuit , ,Two, to ten Circui ts Each Addt'l ten or portion thereof $ 35.00 $ 50.00 $ 15.00, , City Phone ,OWER INSTALLATION , The installation is being, made on property, I ,own 'which is not intended · for' sale, lease or rent. E~ Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation, Sign/Outline Lighting , Signal Circuit or limi ted energy panel $ 36.00 $36.00 OWners Signature: $ 36.00 l (\CX) ,..,.~) .:-~,~) 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL DATE: , RECEIPT I: RECEIVED BY: Metropolitan . Wastewater Managernent Commission ~ (~".~::':.: -: '. ',':,' :: ~ c..~ =__. -,.._r,,-,., "', ..:. .,_. ...... .., ............ .. ~.:t'f V.'\'-fL;t:.f ~i! :,i::t!i" t';,;. s:::: ::;::':"':".-S;'"";"f.:t;;, :r:'t::.;..! ~.:,: ~i.'~: ~.- ~ ;':~; ';t:: .: ~ ~ . :::':: -, (:.'.! ':f;; ~.-:;~~~::t ~:.'~"2~.~:~:1). ~~:~!~.~: .~. ~~ ~ ~ l.~i::;. \,."[$:;::-,;-::.:; cO,t ~;,- =.~: 'f!! :.:::.: Fi:=iH A!'~D A SiF.EEiS - ~;:r:.;:<GF:~LD CliY r,":'.LL - ~FR::\Gr:ELD. C;:,EGC!J ';;7:.77 lEU:r';-.:C:,E (:C:;) j':i.':::i l1ilMC CO!~NECTION CHARGE Building Address: 5so ko~bYv,4ul/rVAL Refere;~j.'umber: 1'7032/1',:;,. . T:;' Lot Number: 01500 O.'ner: D0AJO 1) r {\ . i /~r1.A+~-,,__~ ~ Add",,, \\ C\ C\ \\ '\~~'01\ \: _ Pho.. ""b." l o? IS" - q \23 City: f'J...')060 niL. State: (()JlY .D~BY\ Zip: 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 $ <$ d f) ,4:3 > Credit Due (see reverse of this form) TOTAL KV~C CHARGE $ \C\4 .55 - Date Received: q.21J'l/ a\4~ Received By: ~1~ Building Job Number: Q/o1(Jrr Receipt Number: ~ . Fi:<ture Unit Calculatioa Table: ::cc,~€r cr r,e',' fi:-:tllres r,ultiplied by t1!1it equivalents. NOYS: For remodels, cllc~!3Ie Dnl~ the ~ST additional fixt~res, Fixture Type of Unit F xtures Equivalents Fi:-:ture L'l1i IS 3athtub..................,.....,..".,... . Drinking fountain.,.....,......,...,.,.,.. Floor crain...............,..".,..,..,... Interceptors for grease/oil/solies/etc".. Interceptors for sand/auto .ash/e~c,...... Laundry tub/clothes vasher.." ,.,..,.,.,.. Clothes ~asher (3 or more).......,.....", Hobile home park trap (1 per ~.~.)..,.",. ?eceptor for refrig/vater static~i~tc".., Receptor for COc.rr.er sink/dish~s~=/:tc..... Sho.er, single stall........., ,.,.,..,.". Shover, gang (per head).., .....,.,..,.".. Sink, bar, com~erclal..., .... ,.,....,.",. Sink, commercial/industrial/etc.......,... Urnial, stall/~all......................., Vash basin/lavatory, single.....""...... Vater closet, public installatio~.,....," Vater closet, private.... ........."...." Kiscellaneous: ,'..,...,. 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 .l-.rljje:.:ad to t~~ citv Credit per $1,000 e.ssessed value > 1979 1980 1981 1952 1953 1ge4 1985 1926 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 \ 9'4.. Rate "S I O,'3>z..o ;'.ssessed Val \.:e = S Credit Total Credit