HomeMy WebLinkAboutPermit Electrical 1991-10-18
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1 ~ LOCATION OF INSTALLATION
~~~~r
LEGAL DESCRIPTION
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JOB DESCRIPTION
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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
. :'
Electrical Contractor
Address
Ci ty .
Phone
Supervisor License,Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
.Owners Name-1/4-~t>rH~q#~
/: '- ,
Address ::? ~~ 2:J;;; .-:)7-..
., .
Ci ty 4'/'J1'.~/:)' Phone - 7~:> -fEY'Y<1'
,
OVNER INSTALLATION
The installation is being made on .
property I own which is not intended
for sale, lease or rent.
Owners Signature:
X /1 -' .
jJ//~~j '71-1, ~~: oft
-------~~-------------~-j--~---------
'DATE: - /0-/8 -PI
RECEIPT #: 7-i~:J 2-
RECEIVED, BY: ~~~
SP.lINGFII'::LD
City Job Number ~;I~/~~
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
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
New, Alteration or Extension Per Panel.
One Circuit
Each Additional
Circuit 9r with Service
or Feeder Permit
$ 35.00
$ 2 . 00' .
not included)
Miscellaneous '(Service/feeder
-Each installation
Pump or irrigation
Sign/Qutlin~ Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
"3?-~
I. B~
---:j> $. .~
1/
JOB NO. 91\l6~
CITY O~ SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: Po~H:Y ~\Gr
\
LOCATION:, I'Z-SQ ~ .:;.,-
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DEVELOPMENT TYPE: LDg.. - ADD\\\ONl
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. lCo<6 X $0.186 PER SQ. FT. $ ~e"..?-.
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
\"2- -t- \ <<-\--
LOT SIZE
SQ. Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
$
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $388.61
X $388.61
$
$
X X $388.61 $
(See Attachment C To Determine Trip Rates)
. SUBTOTAL (ADD ITEMS 1,2, & 3) $ ~l z?
, 4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
s \ s~
TOTAL-CITY SDC $ ~'2..~
5. SANITARY SEWER-MWM~
NO. OF PFU'S
x S13.25 PER PFU + $10 MWMC ADMIN. FEE S
(Use PFU Total From Item 2 Above) .
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAL-MWMC SDC $
-
~~Lt.k...- 10-3-41
o Kip Burdick
SDC Coordinator
TOTAL SDC S ~1, ~