HomeMy WebLinkAboutPermit Electrical 2000-1-14
~.
,
, b 'tled hes the following
The following prolec\ es su m~ specific land use
loning, and does not requlr
approval. l.. D lZ-
225 FIFTH STREET Zomng CO ELECTRICALPERHIT APPLICATION
SPRINGFIELD, OREGON 974Tbale (-Ill-" cK:J
INSPEcrION REQUEST~ 726-;'lh~?,zed SignelurE ' ei-ty Job Number
OFFICE: 726-3759 u
3. COMPLETE FEE SCHEDULE BELOV
LOCATION OF INSTALLATION
40lv 5<12t.o~ Pi.. J
LEGAL DESCRIPTION
{",-r 11
1.
Nev Residential-Single or
Hulti-Family per dvelling unit.
Service Included:
A.
Sum
Items Cost
/ $85.00 JS-
3> $ 15.00 lfS
1000, sq. ft. ,or less
Each,additional500
, sq. ft or portion
. thereof
Each Hanuf'd Home. or
Hodular'Dvelling
Service or Feeder
JOB DESCRIPTION
-s,.r,(2...
Permits are non-transferable and expIre
if vork is not started vithin 180 days
of issuance o~ if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
$ 40.00
Services'or Feeders
Installation, Alterations
or Relocation:
B.
Electrical Contractor /z/,f7Z:, fkcr,
Y07 ev<Q.
r--
h"l, ~ 'i?I,t..Z
Phone ~ Zi8 -S--/Cil
4135 :!:,
Expiration Date It> II J 01
Constr Contr. Number 22-1'S5"'c...
Expiratio Date /Dk~J
. . /.
tur of supe~vi~Electrician
~r. //rt,
'/
(~<>:>-<-' I- L"" he;!..
'32.. rfJ ;? r-I...., (?v.J
S 50,00
$ 60.00
$100.00
$130.00
$300.00
$"0.00
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
Address
t.1.I6W1.-
Ci ty
Supervisor License Number
Temporary Services or Feeders
Installation, Alteration or Relocation
X
C.
$ 40.00 drJ1
$ 55.00 -P4
$ 80.00 I
see "B" above I
200 amp~'oT less
201 amps to 400 amps
Over 40l to 600 amps
Over 600 amps or 1000
Si
voJ.ts
Branch Circuits
D.
.'
\./
Ovners Name
Nev, Alteration or Extension Per Panel
9;;:-:
'-?-1,...t-t:. q c., t<
Address
$ 35.00
One Circuit
Each Additional
Circuit or vith Servi~e
or Feeder Permit
Ci ty $;b.....6.....7oi.-14
Phone
'.
$ 2.00
OVNER INSTALLATION
.
E. Miscellaneous (Service/feeder not included
-Each ins tallation
Pump or irrigation $ "0.00
Sign/Outline Lighting $ "0.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE /7/J.~C)
5% State Surcharge . 'JI."'P
3% Administrative Fee <f/;IP
TOTAL' / e ..., h-
I' I
The installation is being made on
property I ovn vhich is not intended
for sale, lease o~ rent.
Ovners Signature:
---------------------~-----------------
DATE:
RECEIPT a:
RECEIVED 8Y:
.
.
.
.
~,... Willamalane
'"t'-""!' Park & Recreation District Job. No. '\ 't l (oS '(
,;,'" SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: U. \rl \ ~(\ \:l.ll ~~~
ADDRESS: 3~.c:::.~ ? \.>.A~~~ ~....~
LOCATION OF PROPOSED BUILDING SITE:
Street Address: LtDllo ~ ~~o('TJ ~.
PHONE: 1 L{L{-Co<t~(p
STATE: O'\ZIP: <tl't 78
Plat Name:, \ ~n~C'\('^ \ \
Tax Lot Number: (~Cro
1. DEVELOPMENT TYPI! (Check appropriate dwelling(s). SDC calculations and dwelfing t
ype definltlons are on the back.) .
A. Sinole-FAmilv DetA~hec1
!\) Single Family home
NO. OF UNITS \
. ,
Manufactured home not in a park
Ot.
X $1,000 per unit =$ I c:JtJo -
B. ,Sinole'.FRmilv AttR~herf
NO. OF UNITS
X $924 per unit = $
,..
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
,D. Manuf:lctlm~rf Home PArk.
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit = $
$
2. SDC CREDIT (If appficable) SDC-payer must (umlsh proo( of
Willamalane Credit approval. See SOO credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED
Qf SDC reduced (or Credit) , $
Ii\\?:'
~iopment Services Department
City of Springfield
I
I
Date