HomeMy WebLinkAboutPermit Electrical 1999-1-1
225 FrITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number C'Gf (J C(P--,;
'~.
3.
COMPLETE FEE SCHEDULE BELaV
L L?CATION OF INSTALLA').'ION _
'R. , "" c, -<- C = ~ .a T - ..s, 1-" A. New Residential-Single or
, Multi-Family per dwelling unit,
, LEGAL DESCRIPTION ,;",\, 1 1-' Service Included:
\ \..- u, 0(< ..,,' 1- -J...J \-i, '-l ,,"<, 1. ''-' ,~:;;;':',:." ,_, I terns Cos t Sum
JOB DESCRIPTION
J 00 C\.~ P .s;~'.R ,)~<:.:." ,""'..,'-:; I')
Permits are non-transferable and expire
if york is not started vi thin 180,days
of issuance or if work is suspended for
180 days. '
1000,sq.ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular, 'Dwelling
Service or 'Feeder
J, S 85,00 ~(', -
$ 15,00 ,.5:.-
. $ 40.00
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
') I _ Installati~n, Alterations
Electrical Contractor rtl-" "'" (\..f C --1'12.' or Re10catlon:
Address2~<) 8~ ~ .....-5-r:--c. 1.-.......""
City F/O~_N~-<
Phone S ~I)- "\<') 1-36~\
Supervisor License Number ;3? 3 J - _ '\
Expiration Date
\0-'>-<:::>';:'
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr, Number :J 0-3'/(,. ,-c:
Expiration Date
\ Co - \ -u i:)
Signature of Superv1sing ~ctrician
~ti--r-~.57#~
Owners Name ~ ,'l.... ~ J3 {,~, .-> ~ ".j
Address
1':1.. ).Jw.~
11 NO
{,.H-'g6'j7
Ci ty E..., 'I ,..~--<-
Phone
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
ovner~ure:
'- ~
-----------------------------~---------
DATE:
RECEIPT ~:
RECEIVED BY:
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation, _____' $ 40.00 _____
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
.:ft I()D. -
'1. -
"3. ---
.:ff-L' n , -
One Circuit
Each Addi tional
Circuit or vith Service
or Feeder Permit
E.
5,
SUBTOTAL OF ABOVE
'l'loState Surcharge
37. Administrative Fee
TOTAL
$ 50.00
$ 60.00
$100,00
$130.00
$300,00
$ 40,00
$ 40.00
$ 55.00
$ 80.00
see ItB" above
.'
$ 2.00
. .
f\', -
'~t,"~'Y)!I!t~m~!~~~ JOb.\~O. C\C\ffi~~
,(v SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME:~{\ ~'(\~' PHONE:~'~%kL
ADDRESS: C\.c\t) \~O\'r (}.CX \.') , STATE:~ZIP:~
LOCATION OF P~;POSED 8 ~LDlNR SITE: '
Street Address: ,~ru5 r< i~ 0 au At::
Plat Name:~-\{)n ~('huax Lot Number:.l~l}H\ \'OO11W
1. DEVELOPMENT TYPI; (Check aplPriate dwelling(s), SDC calculations and dwelling t
, ype definitions are on the back.)
A. .siw1p;.F~,:"i1v I).e.tached
Single Family home
NO. OF UNITS
~
\ Manufactured home not in a park
X $1,000 per unit = $ j(Y)n . D~
8, .0inale'.FAmilv AttAched
NO, OF UNITS
X $924 per unit = $
C. ,Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. ,MAnl/fActl/rAd Home Park
$
$
I D{i) .00
g
$ lOO{) pD
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit -=
2. SDC CREDIT (If appRcable) SDC-payefmust fu'11ish proof of
Willamalane Credit approval. See SOO Oredit Worksheet. $ .
3. TOTAL WILLAMALAN NET SDC ASSESSED
~:D~~I"C_'
Developmcmt Sel (ic.rs
City of Springfield
I
I
Date