HomeMy WebLinkAboutPermit Electrical 1996-5-13
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97477 Oal. ? Ii.3/!i ....:::; /2 ELECTRICAL PERMIT APPLICATION
72~_3Af19,--:::.:r;,19nkure- 1 Ci ty Job Number tq6lJ7?t..
3. COHPLETE FEE SCHEDULE BELOY
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REOUEST:
OFFICE: 726-3759
1. LOCATION OF INS~LATION 1';-.....
7,~(,,[) t;/l1I'I"1ol- ~t.J~ 1,.),......
LEGA,L DESCIU;r,POJ,l I),
/.;o"r'i4- I r:, tn- 6 (0 l::r dY a b
JOB DESCRIPTION
/1/~ FK
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
4Lb.UJ .ZfU4d/,CD
3~ :>,,-;
Address / .2 ~ vU
Ci ty ~A-'bJ24<;
Supervisor License
Phone /,/7\- -;).) } 7
Number /G) e>L ~
Expiration Date /0 - / '- 7,<;-
Constr Contr. Number t1::>"l? 7#S-
Expiration Date '7 ~ 4 -9 ,-
Signature of Supervising Electrician
~&~~~-<~~1 D.
Owners Name ~~,'T>~A..l Fd ,~C",
~1-1 5,3;J.-ds>/.
Address
City -<;o?l."
I -
., .tJ iJ -.;/,. 9<4::
Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
~;~;::~H~i~;el
RECEIVED BY:
A. Nev Residential-Single or
Multi-Family per dvelling uni t.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00 0:? .07)
Each additional 500
sq. ft or portion ~- ~.07J
thereof $ 15.00
Each Manuf'd Home, or
Modular, 'Dvelling
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
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
Branch Circuits
.-
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
40.00
40.00
20.00
36.00
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
/I ~ (J1J
I-J. -'T-;)
?] . LjC,
11J.,tf.~
.
'.B NO~j50Z'b~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: I-IAYOEN E/J-rE:..ef'1Z6E:..~ INC.
LOCATION: ?'5 (",0 ":5, ~~W()()D DIL
/15 0 2- 0 (.. rz. - () '2-fD 0"
DEVELOPMENT TYPE:' '-De.. - Nl':.W SFR
BUILDING SIZE:
I,.OT SIZE
$Q. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
A.J. A,
X $0.209 PER SQ. FT. ~ -8- )
2, SANITARY SEWER-CITY
NO. OF PFU'S
(See Revet'se)
1<6
X $43.26 PER PFU
078~)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I X 1.01 X $436.19 cC ~50
X X $436.19 $
X X $436.19 $
4. SANITARY SEWFR-MWMC
NO. OF PFU'S I){ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ :? /9 4-.!-
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
$ 2(" 2. !!>
~
--- .,./
1..1212. 4-Z-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
k::~ ~ L.~ Date: 5/;" 1<15
V Kip Burdick I I 'TOTAL SDC
SDC Coordinator
C 75';:-;
-- ,../
04-
$ /see -
FIXTURE UNIT. G~~CULA TI_ TABLE: Number of New Rxturcs ~it Equivaient = Rxturc Units
(NOTE: For remodels,'calculate only the ~ additional fixtures) ·
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Z-
2
1
2
3
6
2
6
,6
1
,3
2
l/Head
2
2
1
6
4
4-
1-
Bathtub..........".....,.".",.."",.............,.....,................. .
Drinking Fountain.....................u.....-........................
Floor Drain.,..."""""""" ,..",.""., ,...,..,.".,..,..,.,.,.."..,
Interceptors For Grease/Oil/Solids/Etc,....... --......,
Interceptors 'For Sand/Auto Wash/Etc....,.,......,.....
Laundry Tub/Clotheswasher...................,...........,... '
Clotheswasher. 3 Or More.....................,.,.......,....,
Mobile Home Park Trap (1 Per Trailer)..............,;..
Receptor For Refrigeratortwater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL...",,"........,..............................
Shower, Gang ........ ........'" ............,..... ..... .... ..... ;',' ....
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stalltwall...., .......,." ...",.."....,..,.,..,. .....,.' .......
Wash Basin/LavatorY, Single.........,..,.....................
Toilet, Public Instzllation........"....,.........................
Toilet, Private..........."........"..."..,.,..........,......:....
Miscellaneous:
,
2
z.
z..
....
B
TOTAL m:TURE UNITS
\B
CREDIT CALCULATION TABLE:
calcul3tc credits separates.
I
Based on assessed value. If improvements occurred after annexation date in table,
..- -_.,,~_._----
-" -, - -
Rate per $1 .OO~ 'I
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1:9.83
1984
1985
$3.46
3,38
3.32
3.21
3,06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2,14
1.77
1.37
0.97
0.61
0.44
0.15
j
L
Improvement (if after annexation datel
?4"- X $ ,.",,8
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
'l-"Z2.
Credit {oi Parcel or Land Only If Applicable
=
CREDIT TOTAL = $ 2.,,-2.]: