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HomeMy WebLinkAboutPermit Electrical 2003-6-26 ~\'io~y l\\C ,- . SIl'O sgec . 'gc\&s ~\l.\te _ 'QtO~. :\,0 ."225 FIFTH STREET ", "-,,,\"\l.~esf?,:,' \!":: ,C" CTRlCAL PERJ\11T APPLICATION '" i,'.,. SPRINGFIELD, ORECl~~7.~~ ~~:,;~~,q (. l' ,,,.; ff ' 'fl&" (If\^ . .' f. ' INSP?C~]O~ REQUE5-~9<l2~':r~~:~' ~ ~.;': i~;;'I;y Joh N~~h~r~3':.C034( , ~~.;;.~~. t ;OFFICE:'726.3759')\'"\&~:-' >"~"1'iJ.~,.; \ ~""~ t.'~~r~ r:P J...~'.;...~:~.r. ,..:'.,l" .~'. :",':"'~'~~" . .. ,,";,, t'...~. ~':;;"'" .i':'~" i.;. ':". ;.'" I'";;''''' " COMPo LE FEESCHE ULEBELO\V' "C,' '. '~i" 5'1 ;..' .:;-.: ":~ I~: ,.\ '.;:);'~ ~'\... e-'''-~ 6'~ . (\aW'i;e-:if",. 3.,-; _.1 TE D" . :,', " ~ ,.,', '.'1'''.'1. r." .~. 1.-, ,. T - . -~, ';,-" 6l'Ng~'J l'_'.'-i.l.~' ~',.I"- ~'.f_..",~_"" ? ......,.:. '.." ,.': ........, ~, ~. i "',_;l.~:'" 'f, ]A~ I h, W':.t ,~,...t~~_';'ll'" rH"b'_t ,. i" ....... " \', "-~'. ',' '" . ,..... L:, . _, ~ -" . . >' ... ,..,. . .-....... " '~'_:"'.:'.',:.'";.,.;.;,",,..','r.' ~'~"l"': ~', ~'j . Ul':"~"'l:i"~~";,":";':"\'!> ,',J.....-.'..\~'.-,"'.,;;i,.,':.'-.~. ... , ..'. .... . ~ - .... A.' Ncn>Rcsidcntial-Singlc or' ~ ". ...'~}o.I.". Multi.Family pel' dwelling unit. Sen'icc Included: ." . '-'. '.',- ,.; .~ ~ ';: '. '. ..../~ '-~ ~ .,.' , '.i~',:,:, ~~; .~~: ~',~ 1000 sq.fl. or.less Each additional 500 , sq, ft or portion Permits arc lion ransferable and expire t,hereof if work is not'started within ]80 daleS Each Mannfd Home or ';:.. of issnance .of if work is snspended for Modular Dwelling r:, \ &<......^ . . ,00 180 days. ',f Service or Feeder ;"-,~ ',: . _ $ 50.00 ...i,;,J,j. ,: . ~:\"';': ' . i , 2. CONTRA~OR I~ST ALLA TION ONLY B. Sel'vices or Feeders "~,,,~?~.;,\\~I . ~ . , ':;:. . , ~, \\".... \",,1 ~l ).,.. , ,.t' " / ,,~.: :".~/.......... ~11~, Installat~'l.~"Alterati~jjs:'[I.\{'\\',' ';:.. " .- ElectricaIContractor:/~ G~ Reloe'ition;(\eO(~''''''~~""I\O...'...,''' ,]' ..;:, , .' ~"\"',. ,1\ ,....;c.;,.,. ",..,.o?J , >'. ." :"'f . ;-~ ~'. ..: ~v J"" \~v 6'OJ (uJ.',":Q./, t!-.1~+\J::- f1'('~ " t;'..... . ..'. : ~ . :>~....;~~rf;,. "":;,,, . OJ ,0" -iJ\e ~r,o. I- ;f"{~~' t":'\"(':~ .: i ,." ... i'" -.: Address .' '::.'/b'''n r::=..., ..:' '~'. :..,...:.,': \ S 'O'200~I.nps,or},;~~'i,l-;:t\(~'~ "lL:'...":;",$ G~.qo~;, >')~."~ ~;,.i": ':"(l.':: "';":r'~~ ..j{t~~e c60J"~l\'~~ tli'429.:~'!.\llpst~e~~'ilhp,,~...,t'I ." $. h99 _..:..:...:" '-':".' '. Clly ~:~PhoneEf':rt<>~~;'~:~'i;1\9,~ \~,ol'~mps\t.o:GO~.an\psb;;j,(,'<\\:r'''' ~.$1~5,O~---':"":: \.,,!......: .;5':',,:,'; ~""'':;: ~.,.~.,.. ~\'~_I"",~~.t~~'lc'GO)I~i'riprs\tc5\]'0'001aIllPs,.t,\~),: ..,. "-.$fG3:00 "', ....'("..~ ;..<"" ,.~ ,.' ,+ ,..I "'-~':::lt:Wh~~~' ~'\~) ~".~~ ....,,,,... ?:1..-Jf'f"1. -..' -\- '~';:1~'.; ; SllpervisSl+~ ,~1~e~:scj:N\~,n~~;r ..1..' ,:~~ ~ ~..~ ':' J ,"J~$':J'ri~\{y;t~~~~..9~~Sil 0~1~}HlPS/\~t~~2:~<:'~\ r.-:.~ ., . :_::;' $3 7 5.~0 ~:, . t. i l~: l~!.~t:.:?_~;; >j" }.i;;,.....'. .;" "~7"X(P~"" ~~",., ~:-up",'\,\,n,t\'Reconnect Onlv,~.."") ~-.. '.+.'~ .:'~ :,~. $ 50,00 \, J ~,',,,,,, ',' '~"""l<......;t-L""f1'A'ACL'''~'J~/j~ ..\...::."'\\-<I:v)oO!.,c.\t'1o.......;.\J:;'\.~.. .f~~'~""'" \.'v"-;--::-- -J' '~-. ~,~ ~\'t"; Expiration Date :.:r ,~. ':,:" .~\. <.1"'-'.~ .r.:..~:~!:J;~:'"... ~r."~~~'~ ..'t-o:~l",~~\::i;, ~",\~; '; '...,.....;,.,...;..~ 5,., . ;.:~. '.: ~ ~ ;'rl~;t; ."Or(, -,...; i,."" ~.". . ~:I;.\. .. ~Il" 'I.' '.. i:.. A ;(..~~,~lY' _^('l.~,.tJ ,..'..,..,., "" ~ l.";-.~.. :.',\:,', '.1'.. '. ... ",,,.' ,.; ~ ,;':.;,.' '~1 ~l '\ ,.L: ~..h~j'./ ~ ,,:-,"i: ~ ,t.. .... :G!} Temporal'\" Servlces'or Feeders '., " "::', ~"' '. .....i...~ '" :;i( :;'i, l. C~~~t; C~ntr" N~I;nbe;~:t~. .b.~ 1[.~~.. :l~/ " -., 'b:);.~ '~In~taihitio~; Altcj'~ition1 or.Relo~nti(ni'~ ~.~; l';+ ~:~,~ 'I"':;' ~~ .' /.'~ ;:-; ~",'_~'J- "-~~."'.r:":"'",-,"'... ~.'.~"r. y.~.)';.' '..--::".."....::...:.:..._.::.._j..,'.:,.~'':'.'J_~.:. "~,-l:;;'f">- :"\.' "..~ \. "J-~"1.;. -:.,L.t.....,/.~~'l..-;_...lr:y.~(,.""j<~<\-"',,'.:,'t'.c:.<t.~t...........''J''..f.'.' ~ '.\ J" l;X -..f~-"'...~.t'~~'~'...".:~l~.' ".' . ~, ;[;::/,:'{/;" '.. ,",,, ", .." . -. '"'' ,",. r"" .,,~'" .:~~ .::~: :~l~.:Expiration Date _.J'/'~j.\?:?p;; .l~: A, ':'~;' "':'~'~,,,~~ .:~. '~..;.'..20,~,a!~1~~ ~r !t:ss .:l<~"; ;.;, ~.~:- ~- .\". :::..:':::..hss'q.9Q' ~i ','~ ....t~.. ~. ""~-i."l;.~.5.J'''l: ' ':'" '201 amps to 400 amps'! , '", ~,."\1'..$6900' I,. '. ..' )'/";:-' ,:.,. .~~:, '_l:::.t~! ..! ,,,I ... ,< '" i.- . 1 ,,;'. p ,,:"'1. . ,--=-.:- . ) . . ~ ,,:l';.' .' '. .k:'.!; . Signature of SUJlcn'ising Elcctrician ~....l-:-:,O\'e{401 to 600 amps '.. ..~' 1'<:",'.. '. i'J, 1: $100.00 -:.. ;J . '....~~'..>:- , ',,'"'. ....." ... " ',,} '. "",,' . r,.., ......"') ----;" ~ ",~;1..~'\~t"i;:'r<,..,i::.,:::P'{"'''~S'r"'~, O\"er600ampsorlOOO~' 8l~e '~;';,<""~",~: '''';'')~ . \ 1.'~~ I ''''~'''T ~ -....,+I....~ ~ ~ ...... ,p, ..".~l;'~" .' ., '. ,,,,," _' \' .,. "", v )t7'~" ) "B" ~bo\'e ..ci.t: '(:..." .. .. ~!'P.. .., .' ;,; :~ ; :;,,>~.~,(, " r"":' \! ",<,;-. :- ..:'~', ';l " '. t,.....' . , , \t \'f' c.. ~\J\ '_ ',' .;:';;:" .'.n . ,t", ~ ._,....(' ;,:;~ ':;;\:~:;;}' "~I. . :." '.' , :;."'O\?'t. 0'''\\\'''0 .': ';;.:,t. "';.., .';'\~: ~"",::I.,;,,;,,'-~'''.,,' \: .,..::.::A,.~' ('",l/" ^ .n. Branfl~~ai/1'l",~,?'t.~\~' ~ijn < .'c'.~.', ,'. "", ;;~: '~:.~{~'.'?;~I-;;;~'~ N~~~{~~llr\ d)H ~:L~'\\C~' ~~ ~\)'i\lfiit1\;~~~slOn Per Pa~ne! "< ~':. <," ':.:" ~:'>"':::':>~i""":;\"~K'I'\\:A.t:u..'\'Ir..'0T'\~"?'t.'?\ ~~~~ ~,~'ON ;.: .' ',.:.,(.'. :; >. : AddrcSS~~I~'rT~)\.'Un~ Cl?\\'t.'lYfO~~~~. ..' '~$~2'00 '~', , ~,., (\ .... NY . . ';';'A' ~'t.~ ~ '?'t.'?\ " , . <'. ". . ". :'. . .:,'; , '. City .:"'-A. '!J ~ Phone '~r;:l . 1'1 \'Of;:j ~lch'Addition~1 Circllit or with Service,,' ~ '(b . "::. '., \' . ,.., :, .;': .N or Feeder Permit +$3.00.~ . ..' OWNER IN ALLATION,".:. ','., .' .' The 'installation is being made on-,. E. Miscellaneous (Scl'vicc/fccller not included) propel1)' 10\\'11 which is not intended ,Each inslJll~tion for s~le, ]e~se or rent.' ' Pump 'or irrig~tion 1-' "".',," , Sign/Outline Lighting Limited Energ)'lRes Limited Energ)'/Comm l~lf!)\1~~OJ ~1\)'l(L .J','~ . Items Cost SU1;n', .. ..;.... ,':J.. ~ .'. . "j.",::' $IOG.OO .. . <~:: '.,' $ 19.00 ';' . 'r'.. I ., " ". $50.00 $50.00 $25.00 $-15.00 , . Owners Signature: """ ". Minimum Electric Permit Inspection Fcc is S-I5.tlO + SUI'Ch"~CS -I. SUBTOTAL OF ABOVE ~.' a 70/0 State Surcharge S% Administrative Fcc lr>a.D/ TOTAL , .. . '.-- , ;, ,- ',,', . . DRAINAGE FIXTURE UNIT (DFU) CALCULA nON TABLE NUMBER OF NEW RXTURES x UNIT EQUIVALENT - DRAINAGE RXTURE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL RXTURES) NO. OF FIXTURES UNIT FIXTURE TYPE NEW OLD EQUIVALENT IBATHTUB 0 0 3 = IDRINKING FOUNTAIN 0 0 1 = IFLOOR DRAIN 0 0 3 = IINTERCEPTORS FOR GREASE / OIL! SOLIDS / ETC 0 0 3 = IINTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = ILAUNDRY TUB 0 0 2 = ICLOTHESW ASHER / MOP SINK 0 0 3 = ICLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = IMOBILE HOME PARK TRAP (! PER TRAILER) 0 0 '12 = IRECEPTOR FOR REFRIG / WATER STATION i ETC 0 0 1 = I RECEPTOR FOR COM, SINK / DISHWASHER / ETC 0 0 3 = ISHOWER. SINGLE STALL 0 0 2 = ISH OWER. GANG (NUMBER OF HEADSt 0 0 2 = ISINK: COMMERCIAURESIDENTIAL KITCHEN 0 0 3 = ISINK: COMMERCIAL BAR 0 0 2 = ISINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = IURINAL. STALL! WALL 0 0 5 = ITOILET. PUBLIC INSTALLATION 0 0 6 = ITOILET. PRIVATE INSTALLATION 0 0 3 = MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = TOTAL DRAINAGE FIXTURE UNITS "EDU (Equivalent Dwellin~ Unit) is a dischar~e equivalent to a sin,gle family dwellin,g unit (20 DFU's) set at 167 Wlllons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED CREDIT RA TE/$I ,0001 ASSESSED VALUE I $4.92 $4.92 54,83 $4.77 54,64 $4.47 $4,30 $4,09 53,78 53,41 52,98 $2.52 $2,06 $1.64 $1.45 $1.31 $1.I3 $0.97 $0.82 $0,63 $0.41 $0,22 $0,04 IS LAND ELGIBLE FOR ANNEXATION CREDIT! (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDm (Enter I for Yes, 2 for No) BASE YEAR BEFORE 1979 1979 1980 ' 198] 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT FOR LAND (IF APPLICABLE) VALUE/1000 CREDIT RATE $0.00 x $4.92 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $4.92 TOTAL MWMC CREDIT = ~ , DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o o o o o o o o o o I JI o o 1979 $0.00 o $0,00