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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 - /7~-;U-/~_6?:S/&:sC> JOB DESCRIPTION tt:xreH'"!? 2 L;~cv,rS- 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 ~ .:;.,- II -D? -Lk- 14 - o?lbO 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, ~