HomeMy WebLinkAboutPermit Electrical 1995-4-19
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....VI,'nO and d' 'om tted h
tlpprov~J. OSs not require sPGcff' as the fol101
Ie land use
Zoning , .....-
225 FIFTH STREET ...-r- ./.-
SPRINGFIELD OREGON 97479':. q-/ 'i -&h /" -
, -
INSPECTION REQUEST: 72~~9od S' J '....A
OFFICE: 726-3759 - Ignature~ .-
3.
1. LOCATION OF INSTALLATION
,~4m t)l.;1fYl1>\C STRl"tFI"
LEGAL DES
ONh
JOB DESCRIPTION
A/~wf 7$iuUdf
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~ JAf~~
Address ~'O ( .1!-olC 2.lrD ~ / 1/71)2... vi. 6rH...
/
Ci ty ~fWtjCt~td.. Phone( ~1)bt;Io-~3Gi)
Supervisor License Number ~7 P,7..-<;
Expiration Date It! - I - 'is
Constr Contr. Number 2O-/J/r;L
Expiration Date
/t) -/ - 9 '5
Owners Name p.^.~
Address~ 'r')
Ci ty ~_~ P one~{t)
~ALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:_ 1..J-/~-"75>
RECEIPT j!: 1?L>2...?
RECEIVED BY: ~f-~:?~- A
ELECTRICAL PERKIT APPLICATION
City Job Number "Y 50'3 5" D
LOlll'ldlT" ~EE SCHEDULE BELOY
A. New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
It ems Cos t
1000 sq.ft. or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Reloca t ion:
200 amps or less ~
201 amps to 400 amps
401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00 J.4D.~
$ 60.00 -r--=
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation. Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B'I above
New, Alteration or Extension Per Panel
"
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit .J..5. $ . 2.00 3D. 0.0
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
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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.
.OB NO~ q5o~'5o
ATTACHMENT B2
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INOUSTRIAL)
NN1E OR COMPANY: INlPfZov€:'D Pf?.oDUG-rS, L..IC.
"
LOCATION: '?4tJD OLYMPIC- ST.
/707-~ooo - 6/12./
DEVELOPMENT TYPE: 'IAlnll<,-rIl-.1ITL - uJA-R.lE:-HouSE
BUILDING SIZE:
~(~-,(qo
tOT SUF
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. x 0.5 x ~~~~4-
X $0,209 PER SQ. FTC;-Z 1 '2. to 9i>
....... ---
2. S8NlIARY SFWFR-CITY
NO. OF PFU'S x 0.5 X
(See Reverse)
3. ~SPORTATION 0
NO OF UNITS X TRIP RATE X COST PER TRIP
t-.l.A.
X $43.26 PER PFU
~--B-'")
'---- ../
0.5 X
0.5 X
X
X
X
X $436.19
X $436,19
~'2.:z, 9 ~
'---- ../
$
0.5 X
?'2A
0.,4- X $436.19 6>pE:. 1"'0 ~""\2-E:-t-to\J!./::
$
4. S8NlIARY SFI,!FR-H~!MC
NO. OF PFU'S ~.A. x $17,19 PER PFU + $10 MWMC ADMIN. FEE $
(Use PFU Total From Item 2 Above)
IQIAI -MWMC SOr.
$
r;:--&)
~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
. ~~
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 2-"'4-"1 -
5, 80MTNTSTRATTVF FFFS
BASE CHARGE (SUBTOTAL ABOVE) X .05
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_oM,/'" . :0-
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SDC Coordinator
~1~2.~)
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Date: :, /24-/"1<; OM
TOTAl SDC $ "Z..., B'Z...-
B2,SDC