HomeMy WebLinkAboutPermit Electrical 1995-5-12
Tne, following project as submitted has \hD lollowlnQ
2'.onlng, and does not require specific land use
approval.
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9J!+7A I 7. ~
nt:nt9 N I. ^
.1.\U1ndrized Signaturo IV \
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. g.Wt ~'dH~LA~&
\~~N () t:>flD
pe~~ :~jt;a: ~~~it
if york is not started yithin 180 days -
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor UAVGK /HA....~~r EI~T.
,
Address 35'"3 .s c,..,f<..
Ci ty SPfi} Phone 7<(<( -" (,5"
Supervisor License Number ~ Sf7 - S
Expiration Date /0 _~S
Cons tr Con t r. Number f"'~ 7.. 3
Expiration Date
3-S-"f1c
Signature of Supervising Electrician
- ~
~ O~.A
Oyners Name ~t:f ~
Address1QD~ ~ 51~~
Ci ty~.~tlphone
O~ ~INST~LATION
The installation is being made on
property I oYn yhich is not intended
for sale, lease or rent.
Ovners Signature:
~A~E~--------~-~~~~-----------
RECEIPT 1I: ' / /77'77F
RECEIVED BY: ~ _
I _
ELECTRICAL PERMIT APPLICATION
City Job Number q~\?A \
3. COMPLETE FEE SCHEDULE BELOll
A.
Ney Residential-Single or
Multi-Family per dye1ling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or'
Modular'Dyelling l\
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
unit.
Cost Sum
$ 85.00
$ 15.00
$ 40.00 m
$ 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 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see ttBtI above
Ney, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or yith Service
or Feeder Permit 1
E.
M~scellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
S 35.00
$ 2.00 4-
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
~..~
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.
.' SYSTEM DEVELOPMENT CHARGE
. WORKSHEET
NAME: ,\~ _ 9i\N'\f) ,
ADDRESS:. \O~~ ~ -~l1t\~'tr
.
q 5lZf\-\
PHONE:
.STATE:~ZIP:-Wi
LOCATION OF PROPOSED BUILDING SITE:
Street Address: nl~ R\dno - 0AoM-) \JlliI.Q~
Plat Name:~ ~MOC- Ta~'~ot-~umber: \R(yLD,\4-{)\~CO
1. DEVELPPty1ENT TYPE, (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. SinoIA-F::Jmilv DAt::JchAQ.
.'
Single Family home
NO. OF UNITS \
\ Manufactured home not in a park
X $1,000 per unit = $ jJff) If) .
B. ,SinC)IA-F::Jmilv Att::JcheQ
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $ _
D. Manufactured HnmA P::Jrk
WILLAMALANE SDC
$
$
\XJ()() ,W
f3
NO. OF UNITS
X $699 peruilit =
2. SDC CREDIT (if applicable) SDC-payer must fumish proof of
Willamalane Credit approval. See SDC Credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC -ASSESSED
~~:D:~:;) 9
Developmen~,~_~' Department Date
City of Springfield
$ ttro fO
I /2- I j'J