HomeMy WebLinkAboutPermit Electrical 1991-10-28
SPIIINGFIELO
225 FIITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. (O~tN ~(f~ C; lo 11 ) ::
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~:~::!~i~ '''Pi''
if work is not started wl~na~~o days
of issuance or if work is suspended for,
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Heritaoe Elect
Address 855 West 24th Avenue
City
Euoene
Phone 344-1500
Supervisor License Number 9455
Expiration Date
10/1/
Constr Contr. Number 63137
Expiration Date
12/27/
Signature of Supervising Electrician
~v tU. ~ 715-5
Owners N~~()0 hn p Ji./1 ')
Address ,_, '.,
cityfl )QQ J'ULPhone(12XK.4J!:r3
OWER ~ALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------~. ----------
DATE:__ _ 10 .~, . A
RECEIPr 11: ~~ Ilcz...l{ (;;I--
RECEIVED BY: \/){ J.. ~U /
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or port ion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling ~ $ 40.00 BD
Service or Feeder
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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts 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 Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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4
. JOB NO. 9\1-z..r~
CITY OF4pPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: LoC.t-\A"~~\t-J.E:~
LOCATION: Co9, I "'?r-_c.,..'" GLk"-l1-l ~
Ilc",:>7.1"ZA - O~G,OCl
DEVELOPMENT TYPE: Lo ~ - GA-lZ-A&e
BUILDING SIZE: ~~ ~~
I. STORM DRAINAG~
IMPERVIOUS SQ. FT. SICo X $0.186 PER SQ. FT. S \0\ \Yo
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
LOT SIZE
SQ. Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S -- X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
s
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x
X $388.61
X $388.61
s --
X
s
X X $388.61 S
(See Attachment C To Determine Trip Rates)
SUBTOTAL (ADD ITEMS 1,2, & 3) S I bl \~
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
S ?~
TOTAL-CITY SDC S \\L.~
5. SANITARY SEWER-MWMC
NO. OF PFU'S
x SI3.25 PER PFU + SIO MWMC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
l~.-,~~
-(j Kip Burdick
SDC Coordinator
lo/'l..? /....,
, ,
S
TOTAL-MWMC SDC S
TOTAL SDC S I\~?~