HomeMy WebLinkAboutPermit Electrical 1995-8-9
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The, following project .s submitted has lh. folloY/in
z~n1no; an.::l does not roquite specrtic land use 9
approval, II " J
Zonir;,:j ,-,<:-I
97~f7~'~ V
7 ~3f1bll Signature
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION P~~I
;J /( tJt:Cfl74 fru..7V r / ,,,,-U
::? <{DO M/t-llv ~7"'>'<{t7-
LEGAL DESCRIP~ION
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PAOB DESCRIPTION S'~
o 1-1 u: =f LJ /'rf<.~u. "
ELECTRICAL PERMIT APPLICATION
~
Ci ty Job Number
<9?~::2.
A. Ne~ Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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 J5l'? \.fttV 1)A\" Il..c
Address t.f27 K:ODftl(, D;;:::
Ci tyf'/'t(,.Lcg 7flt'Z Phone 770-/112-
Supervisor License Number -3 '7/'/S
Expiration Date /0/0 t/c;r
Constr Contr. Number Sf o'r' /
Expiration Date C) 31/9/97
s~u~ng Electrician
Owners Name u..J ^c.P.r (<(',ot-cHi
Address :1 'f 0 (J /?1/I-7/l./ )r
Ci tyS"~ (IC'1..j) Phone
OYNER INSTAL~ION
"
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: ~. ~~'>
RECEIPT 11: 781?s /
RECEIVED BY: '--:YT_
-
.
3. COMPLETE FEE SCHEDULE BELOY
Items Cost
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
SQ. ft or portion
thereof $ 15.00
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less 1
201 amps to 400 amps
401 amps to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00 ~~.~
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' '01: less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100u volts see "B" above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit ft $ 2.00 /It?-
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
/'Y. -e>
, I../YP
-, .~e>
/qt:P.VO
40.00
40.00
20.00
36.00
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.
.B NO. Q'5002-'2-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: WAL-LY k.1JISGHI
LOCATION: '?:l4oo tv\A<IN. S-r.
\ ( 0 '?_? I'=> \ - -z. ")..00 7-?-,()O '7A-oI)
, / - .'
DEVELOPMENT TYPE: c..c:.: l-.h:,\!\l WA-ltEl-I-ot)S~, k ()F~\c.t
,
BUILDING SIZE:
LOT SIZE
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
SQ. Ft.
-? '2-q CoD
X $0.209 PER SQ. FT. ~
C~I-Co\~
..........., -
X $436. 19Cot>l: ll().GEI-i.ofC~IC.E: $ ?i,<o~
X $436.19 IOT'AL TMI-lS, 0L4,?e,ov
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'2.1...
X $43.26 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
1"'1.0"1
Z;A,
X $436.19 c.opf. \c?o - W4'rtll2-140USl:.
X
0.74
X Z ."7.4
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S to.!.A. x $17 .19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBTOTAL (ADO ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
8ASE CHARGE (SUBTOTAL ABOVE) X .05
V.,"0S" _D~c.k Date: "?A'2-/<j<;;
\j Kip Burdick f f TOTAL SDC
SDC Coordinator
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'-- -----
$
$
~
---- ----
1.D11"-,f>:,~
C BS'}~
---- -----
$ 1~047~
FIXTURE U,NITG~lCUlA T~ T ~.BlE: Number of New Fixtures....nit Equivalent = Fixture Units
(NOTE: For remodels, calculate only th_ additional fixtures) .
, NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub..........,.............,..,......................................... .
Drinking Fountain........... ..........................................
Floor Drain..........,....."..,..., ,...,..."..",..,...."...,...........
Interceptors For Grease/Oil/Solids/Etc,...,............
Interceptors 'For Sand/Auto Wash/Etc.....,...,........
Laundry Tub/Clotheswasher,...".....,."......",..........,
Clotheswasher,. 30r,More..",....,...,.."..""........,....
Mobile Home Park Trap (1 Per Trailer)......:...........
Receptor For Refrigeratortwater Station/Etc,.......
Receptor For Commercial Sink/Dishwasher/Etc.:
Shower, Single Stall.................................................
Shower, Gang...................... ..... ....................... ';',' ....
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stallf\Yall................. ....... ......'..... ............ ..'.....
Wash Basin/LilVatory, Single....:.....,.,.....................
Toilet, Public Installa'tion..................,.....................
Toilet, Private..... .........",...."...,..,...,....,....,......:,...
Miscellaneous:
I
1-
?
TOTAL FIXTURE UNITS
2
1
2
3
6
',2
6
6
1
3
2
lIHead
2
2
1
6
4
"2-
"2-
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'2.'2.
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates,
Year
Annexed
'Rate per$1,OOO
Assessed Value,
Year
Annexed
L
, ,1979 or before
1980
1981
1982
1983
1984
1985
$3.46
:3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
Credit for Parcel or Land Only If Applicable
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
tmp'rovement,(if after annexation date)
=
CREDIT TOTAL = $ N. ,A
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