HomeMy WebLinkAboutPermit Electrical 1994-12-9 (2)
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLA'J1I~_
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JOB DESCRIPTION \ l. _n -:J
~ L,/ S .e:-}~ 'TL I
Permits are non-transferable and ex~he
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
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.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~\~HJ IJ.,-c-kIC:.
Add ress I ~ ,<:'1.0 ~ ~ S--.L
Ci ty j'f\r\rl..eA'-
Phone l}1 S;....J1'?,g
Supervisor License Number I ('){)(o :'\
Expiration Date
10-I-q,:;-
Constr Contr. Number ~g7i..J~
Expiration Date q-4- q'S'
Signature of Supervising Electrician
t1/~~1-- ~~-----
Owners Name 11 ~ J li!..u'T: ~~.
r / / -
Address "897 .-<; -=:' .!:l...P ~
Ci ty 5;:J~L-,..., Phone 7AL/-tb9hC.,
. .
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
.'
DATE~--------------'\14=~~--~----
RECEIPT 11: . .,,2.-.1 - ) \<::""1/ ~
RE~EIVED BY: Q '\L~ J) Iv
ELECTRICAL PERMIT APPLICATION
City Job Number
q4Ig~)
.,
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling ~it.
Service Included:
Items Cost Sum
1000 sq.ft. or less ( $ 85.00 .85
Each additional 500
sq. ft or portion .sL 3D
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
~
$ 40.00 .
$ 55.00
$ 80.00
volts see "B" above
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 100u
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
~.~
----3. 9-~
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"
.6 NO. '1 f/i' 5' 0
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
-.
ATTACHMENT B1
.; ".
NAME OR COMPANY: . /~.-..A ~-
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LOCATION: $,/0 j)~L /,1 3"3
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DEVELOPMENT TYPF' '7;:= D
BUILDING SIZE:
1. STORM DRAINAGF
IMPERVIOUS SQ. FT.
I OT SIZE
SQ. Ft.
.23GIS
X $0.209 PER SQ. FT.
(;:77 1Z. ~ '7)
-~
2. ~ANTTARY SFWFR-rTTY
NO. OF PFU'S .
(See Reverse)
/'6
X $43.26 PER PFU
'~~:0
3. TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X /, tJ ( X $436. 19
$~. .>-~ )
-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. ~ANTTARY SFWFR-MW](
NO. OF PFU'S IF x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 7yj".~ 2
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 3-1:' 0
IQIAI-MWMr snc $c2.'34.V
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ /?9?-9~
5. AnMTNTSTATTVF FFFS
.-- ~
B~E.~ (SUBT~' ABO~E) X .05
~ AU Date: /.2-'?--?9
/Mary or i9, P.E
SDC Coo dinator
~1'?: c0
IQIAI snr;
$ 20 r "i. q/
B2 . SDC .
FIXTURE UNIT CALCULJaON TABLE: Number of New FixteX Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only iW'liEI additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub..................................................................... .
Drinking Fountain.... .................................................
Floor Drain................................................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher................... ........,.. ,.,..
Clotheswasher . 3 Or More............,........................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall............................................,.,..
Shower, Gang...................................................,......
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..::...................................................
Wash BasinlLavatory, Single..................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous: ,TANI ra.l'~ SoI/oIJc
'2
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
.).
<1-.
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'2...
'2.
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CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
I
/
2.
:2.
TOTAL FIXTURE UNITS
=
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985 .
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
Year
Annexed
Rate per $1,000
Assessed Value
l
1985
1986
1987
1988
1989
1990
1991
1993
=
~4. G tJ
J. ~~ X $ /CJ. trnj
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
.-
CREDIT TOTAL = $ ~~ 6 cl