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HomeMy WebLinkAboutPermit Electrical 1994-10-24 " . .. 225 FIFTH STREET ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 City Job Number "9Y/7..c-", OFFICE: 726-3759 1. LOCATION OF INSTALLATION /.h// 7>r"-A'"'~~7- r of - - -... . 3. COMPLETE FEE SCHEDULE BELOIl A. New Residential-Single or Multi~Family per dwelling unit. Service Included: LEGAL DESCRIPTION /~9-~ Y'/~:;- ,'~ / JOB DESCRIPTION Permits are' non-transferable and expire if work is not started'within 180 days .of issuance or if work is suspended for 180 days. 2. CONTRAClOR INSTALLATION ONLY Electrical Contractor Philip~ Fl~rtr;r Inc. Address 3170 M~~nn~ r~n~ Ci ty F",:':l:'~ Phoneg740? , Supervisor License Number ?71 ac:: Expiration Date 10/95 Constr Contr. Number 20-179C Expiration Date 10/95 Signature of Supervising Electrician .. . .r ~ -6' D.. owners Na,me r7r~e~Cf~,on-r I. Address ~, ~ , CitY,Z;Z:>..A..z:,/ 'Phone,?~/~?/~ 01lNER INSTALLATION The. installation is being made on property I own which, is not intended for sale, 'lease or rent. Ovn~rs Signature: DATE: RECEIPT I: ' RECEIVED BY: M ~Z '(--3lf /~6?.;. .....:2:' ip:---- ~ , Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 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 $ 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 amp?or 1000 volts Branch Circuits New, Alteration or $ 40.00 $ 55.00 $ 80.00 see "B" above Extension Per Panel -S 35.00 ~- One Circuit' Each Additional Circui.for' with Service, or 'Feeder.Peimi t '--L' $ Miscellaneous (Service/feeder -Each installation Pump or, irr;gation~ Sign~Outline Lighting ,~imited Energy/Res .Limited' Energy/Com~ E. 5,. SUBTOTAL OF' ABOVE 5% State surcharge . ", ,,' .,T()TAL, ' ,.; .,'. ,.r ~ .. '. 2.00. 7,--' not included) $ 40.00 $ 40.00 $20.00 $.36.60 ~./. ~ /. ,l9S>-'" 1.lf '39.9& . NO. '14\ ?Z-l CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) .-. AlTACHMENT B1 NAME OR COMPANY: MI'<R.Y E: LLt:::tJ 'f:>IZA.Y LOCATION' \ OIl ?Le.""c:.A.r-.1-r " I ,o'?"2..(.,'-H - 07000 DEVELOPMENT TYPE: l-D~ - ('.,.A-ItP,c,E:. BUILDING SIZE: '2"",1-Z- ... / ejl,\Ie..!:> LOT SI7F SQ. Ft. 1. STORM ORA TillAGE IMPERVIOUS SQ. FT. t77Z- 2. S8MlIARY SFWFR-rTTY NO. OF PFU'S (See Reverse) X $0.209 PER SQ. FT. $ t \ '" "'3. X $43.26 PER PFU $ 3. IEl\NSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x X X X $436.19 X $436.19 X $436.19 $ $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 4. S8MlIARY SFWFR-MWMC NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ IQIAI -MWMC SOC $ SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ t\'\ ~ 5. AOMTNTSTATTVF FFFS BASE CHARGE (SUBTOTAL ABOVE) X .05 $ S~ o ,,~L..t... ~ary Hornig, P.E. sac Coordinator Date: I 0 . IS - "I '-\- IQIAI snc $ lZ?~ B2.sac '