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HomeMy WebLinkAboutPermit Electrical 1996-4-26 ,,,,,", 1- i t \I . \ect as Qubmllte.d ~ t~ .@..€! I'M iollOWin9 prO'j . ulre spEJ\l11\l; l3.f\g \.11M! lt~pi"'c'. and d<.\6S not loq , , . ~PP;~~a~'~,. -ifF ELEcrRICAL 97477 D<:;te :<~ 7..........,. ../7 726-3769 . . Sl natJre ~r../, r;'ty._,loo Number ~uthonz 9 - f I 3. COMPLETE FEE SCHEDULE BELOTJ 1. ~o}]\~~ \!:\~{D C1}\()'"<, ~~~~ro, .- \tC\LoB 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 Permits ~re 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 Eles I BILL'S ELECTRIC Addi 3170 W 11TH AVE ' ,- EUGENE OR 97402 Citi L ( . I SUpE I Expi, Con~ ~ SUPERVISOR L1C. #980S' EXP. . DATE 1_0/3.0/9.'1 CCB #21.35~ EXP~' DATE4i28/9fi,. ;-- I ',- I I -_......._---~ -- ----. ----_.- - -~---- Expiration Date c St},:J:/"::5!:-Ele1Jan Owners Na"'-.~:,\, 1'\\~ --- D. Address \J}~ <.\. ~ 1 City~_ Pho:~~8~1!} o~ ~:;ALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: DATE: l/ -<C"~b RECEIPT #-: 'Z I~? RECEIVED BY: /'Z~" '/' PERMIT APPLICATION C.lo.al-~ A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular.'Dwelling 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 C. Items ~ Cost Sum $ 85.00 En $ 15.00 15 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation t./b 200 amps' 'or less ...-- $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" Branch Circuits above ,. New, Alteration or Extension Per Panel $ 35.00 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 3% Administrative Fee TOTAL $ 2.00 " not included) $ $ $ $ \ bD...QO I yo ....m. J .v-'\. 7-"" ~ .a.OiJ- '(.2(7 -.-\.()-t-.6V- (S -{ .2,:: 40.00 40.00 20.00 36.00 . . I I ~~'Willama:lane ..t~ Park & Recreation District Job. No. '. SY,STEM DEVELOPMENT CHARGE WORKSHEET NA~E:~\~: t'{\\S ~ ADDRESS: \OQC\. Cl, ~ LOCATION OF PROPOSED BUILDING SITE: Street Address: ~~~1- t C\l~ qtQ~ PHONE: \\.~'~K\cll' STATE: 92-Z,P: %1-1 Tax Lot Number: tll )L~~~)[{}lQ3 \ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations ~md dwelling t ype definitions are on the back.) Plat Name: A. Sinale-Familv Detached. \.. Single Family home . NO. OF UNITS Manufactured home not in a park l X $1,000 per unit = $' \ rtf) ri) 8. .Sinale-Familv Attached NO. OF UNITS X $924 per unit = $ C. Multi-Familv Aoartment NO. OF UNITS X $692 per unit = $ D. Manufactl,Jred Home Park NO. OF UNITS X $699 per unit = $ I $ _ \000.00 if $ tro pU $ WILLAMALANE SDC 2. SDC CREDIT (if applicable) SDC-payer must furnish proof of Willamalane Credit approval. See SDC Credit Worksheet. 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) ~ Development S City of Springfield 7" I ?G I '7G' Date , , .- .. ,_..".. ..~ ..- -- I