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HomeMy WebLinkAboutPermit Electrical 1995-5-12 Tne, following project as submitted has \hD lollowlnQ 2'.onlng, and does not require specific land use approval. Zonin< L-D2-- 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 ~..~ ~. .4, \(L ~.~ . .' 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