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HomeMy WebLinkAboutPermit Electrical 1995-8-9 c~~ 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 ...,s e IZ r tV (. 1-1 f'1-J\ --i'. ~ -;,,' 'J/ ,..t:I1:Z ~.4IC 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 ~ . .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 ~ G"'ISI'?) '-- ----- $ $ ~ ---- ---- 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- \~ '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 ~