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HomeMy WebLinkAboutPermit Electrical 1995-8-1 ~"'~ ~I The following project as submitted hac th;:l kBp.E'cnUCAL PERMIT APPLICATION 9747toning, and does not requim s,pedfic iand use 726~'l~'6ge~Oing~ oIL- Ci ty Job Number 95() 1 ~c:; Date~"""1 -&j ') 3. COMPLETE FEE SCHEDULE BELOV 1. LOCATION OF IN~ALLA~~N ^ I ~ 5 ~"" r-. -5~lq }. orizoci Signature 1\1'. I" 1'" . J l' 1 S' 1 au':'") ~ 0 -Rrt 'cw .[\\::"'... 1::1. la - Ing e or Multi-Family per dwelling unit. Service Included: B. Services or Feeders Installation, Alterations or Electrical Contracto~o~-<-t N( Relocation: Address &....It) -, N\.-0 "I <2Jbi-~,..., 200 amps or less \ J .~ /' . 201 amps tp 400 amps Ci ty VAN~LJ A- ~e '!hoie_l~ )~J--I3ft,~40f amps to 600 amps _~ 601 amps to 1000 amps Supervisor License Number ~~~ Over 1000 amps/volts / I Reconnect Only Expiration Date 1 tJ I ~c. \' . " ~ I C. Temporary Services or Feeders ,:s, ~33Ll ~ Installation~ Alteration or Relocation )D~~ . . \ Signature of Supervising Electrician ~ IJI ;6~ 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759. LEGAL DESCRIPTION '7-0-;" . ?;'3-~~J d(Jf()3 17-0").. ~~ I ~~. oo[ (J;l JOB DESCRIPTION 11) ((~.tii~ (8) ~ 0~ l~~. 002,01 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. CONTRACTOR INSTALLATION ONLY Constr Contr. Number Expiration Date Owners Name '<~:> ~ITR. . . I . . Address,. 1~7q "S.\J...Y\V\...J "b t.3 1\'; CitYC""f M:' rfon~"8a~"1q5 O\lNER INSTALLATION. u . The installation is being made on property I own ~hich is not intended for sale; lease or rent. Owners Signature: DATE: _ g-r-"7->-- RECEIPT tt: /G~ 'D ' RECEIVED BY: ./' ~~ " ,/' . Items 1000 sq,ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder 3;< .200 amps 201 amps Over 401 Over 600 or less. to 400 amps to 600 amps amps or 1000 D.Bra.n~h' Circui ts . Cost Sum $ 85.00 ;t7.20 ;< $ 15.00 ~6 $ 40.00 $ 50,00 $ 60.00 $100,00 $130.00 $300,00 $ 40.00 volts $ 40.00 $ 55.00 $ 80.00 see "B" above New, Alteration or Extension Per Panel One Circuit Each Addi tional:. .Circuit or with Service .or F~eder Permit $ 35.00 $ 2.00 E. Mis~ellane6~s (Service/fe~der not included) ~E~ch'installation P~m~or irr~gation $ ~O.OO Sign/Outline Lighting $ 46.00 Limi t.ed Energy/Res$ 20.00 'L1mit~d Eneigy/Comm .$ 36.00 5. 'SUBTOTAL OF ABOVE 5.: S ta te ~qi~h~. rge . . ~.%. ~AAl1IlV\~\~~11l::: .. .t>ce '.. ~L ~ 1 SO 0<1> \-:;"7.':>0 82' SO ~q7o ~ 't I .~~ '1 ~"l, Willamalane '(,.'\ij Pa,k & Rec'eat;o~ Oiwict Job NO.q~I){oS SYSTEMS DEVElOPMENT CHARGE WORKSHEET NAMk: ~ ~ C',. . ... PHONE:r::\-la:Dla:s1 STATE: e-e. ZIP C\11Dl . '. lOCATION OF PROPOSED BUILDING SITE: f\, \. t n1'.b ~ -StreetAddressifKnown:-5ROS"~\C\ "r\m.(~). ~-fr-f) Tax lot Number:J!JD.1 ~014 (JD tO~ - - '2.01 .. Platt Name: 1. DEVELOPMENT TYPE (Check appropriate dwellingCs). SDC Calculations and dwelling type definitions are on the back.) . . .... . A Sin{!le Familv - Detached . Single Fa~ily home NO OF UNITS Manufactured home not in a park X $400 PER UNIT _=" $" - B. Sin{!le Familv - Attached .. NO OF UNITS X $370 PER UNIT = .$ C. Multi-Familv Aoartment . . NO OF UNITS 2> ~ X $~77 PER UNIT = $ rel61 ,ttJ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ . PPicfr 00 ... $ ~ '$' tJ $MltA ~ WPRD SDC 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. " 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced (or Credit> \~~{~ 7 f "':2 ::> f_~ ~ n;ltp