HomeMy WebLinkAboutPermit Electrical 1997-4-30
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225 FIFTll STREET Zoning LOlL-
SPRINGFIELD, OREGON 97,477 4-?^
INSPECTION REQUE'ST: 726:3'769- -')(T,n Ci ty Job Number
OFFICE: 726-3759 Authorized Signature. AJIVl
.:I. L:ur{1>hE'ffi- FEE SCHEDULE BELOII
1., ,~~~~t-
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~f~~mAO"~
Permits are~~-~sferab\: and'~Pire
if york is not started 'vithin 180 days
of issuance or if,vork is suspenaed for
180 days.
2..' CONTRACTOR INSTAL~TION ONLY. B.
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Elec t ri cal Con t rac tor / _ O){\\.(\~'\U
Address\\M _ \\\'N\\ ~N
City r10l.IT\Q-. Phonel15t.\~
OCJ- ,
Supervisor ~cense~~er ct~~
Expiration Date \fJ. \ .u'<i<'
Constr Contr. Number \ 6:), \?f)
Expiration Date \'d, ~,'C\1
The installation is being made on
property I oyn vhich is not intended
for sale, lease or rent.
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Ovners Signature:
~~TE~----Lf:~I5-=~='-----------------~-
RECEIPT II: 'lq::;l-/ Z.
RECEIVED BY: fA{
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 85.00
$ 15.00
i $ 40.00
grn
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 100u volts
$ 40.00.
$ 55.00' .-
$ 80.00
see "B" above
D.
Branch Circui ts
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tional ,
Circuit or vith Service ,~
or Feeder Permit ---l- $ 2.00 (+-
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/Outline Lighting $
Limited Energy/Res $
Limited Energy/Comm $
5. SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
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Job. No.. C\'\{)~"1~
NAME:
ADDRESS: .ffi"\
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
_ PHONE:t44.~
r~ #-\44 STATE: OIL ZIP: q"f\17
LOCATION OF PROPOSED BUILDING SITE:
Street Address: 'Ol44 ~'t~(\_~t D(
Plat Name: Qjc\i\L 0ll.QLJ-t- Tax Lot Number: li02..011:f n(~
1. DEVELOPMENT ~PE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. f;innIA-FAmilv DAtAChAd
Single Family home
I Manufactured home not in a park
X $1,000 per unit = $ ~ ,CD
. NO. OF UNITS
B. BinolA-FAmilv Attacheej
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv ADartment
NO. OF UNITS
X $692 per unit = $
D. ,Manufactured HomA PArk
$
$
(fYt).CO
if
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit =
2. SDC CREDIT (if applicable) SDC-payer must furnish proof of
Willamalane Credit approval. See SOC Credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
ltID J~ ~~ L(
Development ?~;~s\ ifelpartment Date
City of Springfield
$ IfYO.cO
15010,7
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