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HomeMy WebLinkAboutPermit Electrical 1996-1-9 ". . ~n~;Jt..') ;(..;/1 ~IL~/,~ .'_ The following project as sUbmtttod, has Ih.. 10 0 \,,'Pi~, 6'\':, , and does not r~re~lhC land use '''''''~.~i-~;'' .~". ':;.1[:/ ~~~~~al~cni~J do<Jf?/"N"~"'", - 225 FIFTH STREET ", Date /.-:- '1 -1 ~ /"l.ll ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ..(\"h izoO Slgnalure. ~ / nt::::\OO I (J INSPECTION REQUEST: 726_3/69or 1 City Job Number X1~~, OFFICt{~-3~: If y V'7V ,. 3.. ~'?R. tJ~~~~~t't- ' ~ -lD3 i~ciSION 0\000 ~.~.~~~ ??-Jl\ Permits are non-transferable and expire if ~ork is not started ~ithin 180 days of issuance or if ~ork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor BOB FISHER Address 1 RO KTI\lr,SRfTRY l1YENlW Ci ty t;-TTr.!'R-:\Tl4' Phone fiR9- 7..9.,73 Supervisor License Number ~7~~ Expiration Date In_'_OQ COMPLETE FEE SCHEDULE BELOV Ne~ Residential-Single or Multi-Family per dvelling Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular 'Dvelling 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 It ems \ ""3 unit. Cost Sum <&S % S 85.00 S 15.00 S 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Constr Contr. Number 96275 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date '_7"'_01'; Signature of Supervisin~ Electrician Y-- ~P:J-.J~ Ovners Name ~ ~l l..<L.. ~ ~ Address ?->C;C\~ ~\\l.\ (" ~n\~ City l.t'Ot1\P- Phone <\~~.5\'\lO OVNER IN~TALLATION The installation is being made on E. property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: , ~~~E~-~----------~a~qC---"f~ 5. RECEIPT~: ~) ~ 200 amps' 'OT less V- S 40.00 ~.t). 00 201 amps to 400 amps S 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Each Addi t ional Circuit or vith Service or Feeder Permit S 35.00 S 2.00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee 40.00 40..00 20,00 36.00 S $ $ $ ~ ,--~ 1.4.;"" L........I!t..- /70.40 ~~ 7=,b /~ Lc!> '. . Job. No. q~\~~lP , SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME: ~'\llJO_ PJ ~f\; PHONE: L\t~.~\lLP ADDRESS:~~~ \{\\\~mo-, STATE: tW.:-ZIP: 4l4D'3 LOCATION OF PROPOSED BUILDING SITE: 8m €i~~ 5tceet Add''n~ ~ \CO.!J\l.-J. ~\ciot - \Jfc Plat Name: ~\\lW (;lOJf\ " Tax Lot Number: \1fl~'1.~ 1. DEVELPPMENT TYPJ::, (Check appropriate dwelling(s), SDC calculations and dwelling t ype definitions are on the back.) . A. ~inf)IA-F::Jmilv DAt::Jr.hAn \ Single Family home , NO, OF UNITS '( Manufactured home not in a park X $1,000 per unit = $ \ tim, CD B. SinQle-F"milv AtI::Jr.hAQ NO. OF UNITS X $924 per unit' = $ C, Multi-Familv ADartment NO. OF UNITS X $692 per unit = $ D. fv1::JnlJf::JctlJrAn HomA P::Jrk NO. OF UNITS WILLAMALANE SDC 2. SDC CREDIT (if applicable) SDC-payer must furnish proof of Willarnalane Credit approval. See SDC Credit Worksheet. $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) ~~~~~~~~~ment City of Springfield