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HomeMy WebLinkAboutPermit Electrical 1995-1-10 "- ,I ,1 ' ..-. . .. SPRINGFIELD The following project as submitted has the folio zoning, and does not require specific land use 225 FIFTH STREET epprove!, /J ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ,L.. Ole.-- INSPEctION REQUEST: 726-3769 zO/Onlon..... 'City Job Number 9t:;//$~ OFFICB: 726-3759 DMe I~ -~~ . ~~ COHPLETE FEE SCHEDULE BELOV 1. .-LOCATION ~~LAT:dltV:'oriZad Signature ' ' ~S~0' ~~./fP>. A. Nev Residential-Single or , .' Hulti-Family per dvelling unit. , LEGAL DESCRIPTION ~ _ ~ Service Included: 17-1!>2-/9~o.- ,~dr/~ Items Cost: Sum J~~ DESCRIPT~ 1000 sq.ft. or less --- $ 85.00 ~ -4/f{_'/1;:'?:?/"f"~.f~ ~...?'~-:'> . Each additional 500 t': sq. ft or portion Permits are non-transferable and expire thereof ~ $ 15.00 ~ if york is not started vithin 180 days Each Hanuf'd Home or of issuance or if york is suspended for Modular Dvelling 180 days. Service or Feeder $ 40.00 ! 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations or Relocation: , Electrical Contractor ROSE CORP Address 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnec t Only 89976 DAY LANE City Phone n8n-nqn~ ~11r::~r~~ Supervisor License Number -15fiBS Expiration Date 10/1/95 .. C. Temporary Services or'Feeders Installation, Alteration or Relocation Constr Contr. Number .. 5443i~'" Expiration Date 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 q.L3!l/ q S Signatu~ervising Electrician " / /?..I!/ ~ v Ovners Name D. Branch Circuits $ 50.00 $ 60.00 $100,00 '$130,00 $300.00 $ 40,00 --s 40.00 $ 55.00 $ 80.00 volts see "B" '7&> above Address Nev, Alteration or Extension Per Panel $ 35,00 City Phone One Circuit Each Additional Circuit or vith Service or Feeder Permit OWER INSTALLATION The, installation is being made on property I ovn vhich is not intended for sale, lease or rent. $ 2.00 Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. Ovners Signature: 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL DATE:_ I-/~-,??_ RECEIPT, t: t~.,.., RECEIVED BY: ~~ - not included) tf- $ $ $ $ /BS' - " ::<> ~~ ~~ /.,-, .SJt::;, 40.00 40,00 20,00 36,00 ~" - o !!y}!I!o~~!~!!~ - Job No. Cf4\Bf)S SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: ~ @is-\- ~~ ~ ~ ~rrJ_ ADDmS, ,q:J.. 7,,1'1 ,Ql.o 'SLt'\ ~ "_~'~~'~ Tax Lot Number: 11D1-\l\(Y) ?illPrO LOCATION OF filROPOSED BUILDING SITE: , Street Address if Known: (~'\- Platt Name: \ 1\ \C\ ) , PHONE: 141. \ c:s 2>4 STATE: .Q{Z..zIP ~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back.! A. Sinqle Familv - Detached -.L Single Family home NO OF UNITS J B. Sin€,le Familv - Attached NO OF UNITS C. Multi.Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS WPRD SDC Manufactured home not in a park c(J $ .1f(). ., X $400 PER UNIT _= X $370 PER UNIT = , $ X $277 PER UNIT = $ X $280 PER UNIT = $ $~ $ft $ 400 pO 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl I I Date