HomeMy WebLinkAboutPermit Electrical 1995-8-1
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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>
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7 f "':2 ::> f_~ ~
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