HomeMy WebLinkAboutPermit Electrical 1992-6-2
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225 FIITH STREET ,'I'p(;\'a!. ELECTRICAL P'ERHIT APPLICATION
SPRINGFIELD, OREGON 97477 1l2JOnin n 1'1'\1 T"YJ.
INSPECTION REQUEST: 726-37,69 .U~ City Job Number "-"\ \l) \l ^)
OFFICE: 726-3759 .Js!e ~ / /
I ",U'OIimd Slgilmuro L Ii/o.,
1. LOCATI~N Of l.NST.tJ4.Ap:O~ \ ~
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Permits are non-transfer~e 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
HeritaQe Elect
Address 855 West 24th Avenue
City
EUQene
Phone 344-1500
Supervisor License Number 9455
Expiration Date
10/1/
Constr Contr. Number 63137
Expiration Date
12/27/
Signature of Supervising Electrician
A4t1/ tJ. ~ qr?~-S
City F.!X1,Ul,J{ _~Phone b '/nfoCfj'
u...J:.l\ I~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: 1/7 ~~~~-------------
RECEIPTf; ~^ 4C L{)
RECEIVED BY , _ fA _ r
COMPLETE FE~ SCBEDULE'BELOV
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 A 40
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Add it i onal
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
$
Pf)~
~ (YJ
~rn
40.00
40.00
20.00
36.00
Metropolitan .
Wastewater
Management
Commission
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Jr.'MC COKNECTION CHARGE
I.
'.
Building Address: 5~ 4- S~ 4('Vlvn ]),-\vt.
0.
Refere~jUmber: 1103 2..1/ 3 Tax Lot Number: 05 (p 00
O.'ner: D0DCtt) ,r {\ " i /\In AjXlRf-~') (1
Address: \\C\C\ \\ \~,'0f\\" PhoneNumber:lo~<6- ,\\23
City: fA ')(l-{ 0 fLL State: CQ-W 1'>0 BY\. Zip: q f'\4i)'L--
(J . 0
~ Residential Fee ($222.00)
$r0~~ ~
___ Commercial Fee (new non-residential development/
remodel)
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $
Credit Due (see reverse of this form)
<$
r\)f)4~
>
Date Received: t 0 .c0 .q n
Receipt Number:~-
Received By:
$ /Cl4 ,f)~
~/J:PJ
TOTAL MVY.C CHARGE
Building Job Number: C'llo 103
I
Fi:nure Uni t
equivalents.
.
Calculatioil Table: ::uc,~~r d r,e..' u:.:tures r,ultiplied by Il:lit
NOTE: For remodels, (al(~l!te only the ~ET additional fixt~res.
Fh:ture Type
3a t h tub. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Drinking fountain.........................
Floor drain...............................
Interceptors for grease/oil/solies/etc....
Interceptors for sand/auto .ash/e:c.......
Laundry tub/clothes vasher.... ............
Clothes ~asher (3 or more). ... ............
Mobile home park tiap (1 per K.3.).......,
Receptor for refrig/.ater statio~/etc.....
Receptor for Co~~er sink/dish~s~::stc.....
Sho1.'er, single stall......................
Sho~er, gang (per head). ....... ...........
Sink, bar, com~ercial...... '0. ............
Sink, cOmmercial/industrial/etc...........
Urnial, stall/~al1........................
Vash basin/lavatory, si~gle...............
Vater closet, public installation.........
Vater closet, private......... ............
Miscellaneous: ..........
..........
..........
Total fixture units
" &
-;:- 0.1,.
Fixtures
Unit
Equi \lale:n t s
2
1
2
3
6
..2
6
6
1
,
J
2
1
2
3
2
1
6-
4
Total Units:
h 513.25 each = Total Charge: $
Fi:\ture
L'n its
Credit Calculation Table: 3a.ed on total value of property at time of permit
application.
Year 'l."nrle>:ed
to th2 city
Credit per $1,000
~sse55~d value
\<?~
1979
1980
1981
1982
1983
19C4
1985
19C6
1987
1988
1929
1990
Credit
:< S \ 0 /-:;'2..0
r.ssessed Val".;e
Rate
$2.66
$2.64'
$2.53
$2.41
$2.19
$2.04
$1.69
$1. 35
$1.15
$0.92
$0.59
$0.23
= S
Total Credit