HomeMy WebLinkAboutPermit Electrical 1991-8-27
225 FIITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION Qll., INSTALLATION
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JOB ,ill:SQl.:(..PTION
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
'180 days.
$1-,IINGt:ltlLU
3. COMPLETE FEE SCnEDULE DELOV
A. Nev Residential-Single or
Multi-Family per dvelling uni to
Service Included:
Items Cost Sum
1000 sq.ft. or less , $ 85.00 -85
Each additional 500
sq. ft or portion ,~ ~
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
~~~r . {)~ Installation, Alterations or
Electrical Contractor' \ \V( Q 1\~Relocation:
Addres~ ~ \ \ l 200 amps or less
. 1.1'v..\\'\'-':. 'II ' (\A-r-'IAiV\rJ 201 amps to 400 amps
Ci ty\)J' '\.1.\L.Vn \ ~hone . f-\lO-"\U-'rO 401 amps to 600 amps
~l)~rr S 601 amps to 1000 amps
Supervisor License Number ,~'-\~ Over 1000 amps/volts
\r--. ,~\ . q f\ Reconnect Only
Expiration Date \ J n..
'Constr Contr. Number \ 0 c::{)ffi
Expiration Date
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Signi~re of Supervising Electr~cian
'fr~ O__'1.J_ ,- -
C._f.~~:....lJl(\ f) 1\ J ~\)'<II ~ \ d~
~~\ - \
Address
Phone \'\41 o,.qlo<(D
City
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
- -i.----.---~-. ----------
DATE:\ ~ 1(\1
RECEIPT 1\:.t9~ ~' .
RECEIVED BY: l_ IW~./
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
"V
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
$ BO.OO
see "B"
1Cl~
above
Nev, Alteration or Extension Per Panel
,
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 1 rJD.CO
5% S ta te Surcharge f'i), p...()
TOTAL \' \~ ,q(')
Metropolitan
Wastewater
Managernent
Commission
.
.
CDr.'.r,',ISSIW r,~p:t:tt:,S
R~~ Bf-~t~:l-(u;~n! Co:;r':i':~:~:;:)
S:l",{' D~::y-fu~eile Lal :;f';:lrfw::~:i.e
Seo:: E:l;$;::,.l1-S;....I;lieICllaj Repr(H~:,::;E
C:-orisli.mn:-S;lrin;:ieldCr''Jn:.:-f:!;':l.
Chl;~ :,:g;s,n-lar,( C{lU".~}' l~J' Rf:"f'~~A:a:;\'t
Je;;y Rust-LiI'lC CClm:;- C~r;.;';'t!S':1E'r
j.',a:~. \'.'estlin~-Eu'tne Lai' R~;.:e~u,:a:I;'e
FIi'TH AND A STREETS - SPRII,GFIELD CITY G,"LL - ~i'i',::':Gi':ELO, OF-EGON 9i"77 TELEPHO:,E (503) i.:i.':5:1
IWMC COliNECTION CHARGE
\';',
'.
Building Address: ru. J?, J?gC'?C:a.7T LJY.
Reference Number: ,\\ [)~2:Pr\~
O\'ner: .t\\~ \. \)0 [)'\. 'd Cnf"Q..
Address: A43 (\;QJl
Ci ty: C( A ~O X\Q.
State:
Tax Lot Number: If)~
N\r\. ~h~p&3.44tR
~ Q _~fJ7\- ziP:1J4DL
~Residential Fee ($222.00)
$ :JM ,cP
Commercial Fee (nev non-residential development/
remodel)
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $
Credit Due (see reverse of this form)
<$
3~,6f
>
TOTAL M~MC CHARGE
$ IEb. 'II
Date Received:
7-2v. -'J/
2C>;f;,/'7
Received By:
~~
Number:3lridJ ~
Receipt Number:
Building Job
.
.
Fixture Unit Calculation Table: Number of new fixtures multiplied by unit
equivalents. NOTE: For remodels, calculate only the NET additional fixt~res.
Fixture Type
3a t h tub. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Drinking foun tain. . . . . . . . . . . . . . . . . . . . . . . . .
Floor drain.......................... .'. . . .
Interceptors for grease/oil/solids/etc:...
Interceptors for sand/auto .ash/etc.... ...
,Laundry tub/clothes .asher......, .........
Clothes washer (3 or more)..... ...... .....
Mobile home park trap (1 per M.H.)... .....
Receptor for refrig/.ater station/etc.. ...
Receptor for Com",~r sink/dish.shr/etc.....
h . 1 '11'
S o,,'er, slng e sta ~......................
Shower, gang (per' head).... .. ............ .
Sink, bar, commercial........ ...... .......
Sink, commercial/industrial/etc...........
Urnial, stall/wall........................
Vash basin/lavatory, single... ............
Vater closet, publie installation.........
Vater closet, private........ ......... ....
Miscellaneous: ..........
...... ....
. ..... ....
Total fixture units
x $13.25 each
of
F xtures
Unit
Equivalents
Fixture
Units
"
2
1
2
3
6
.2
6
6
1
3
2
1
2
3
2
1
6
4
Total Units:
Total Charge: $
Credit Calculation Table: Based on total value of property at time of permit
appli ca t i on.
Year 'l..nne>:ed
to the City
- "'
I '?c:o s
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
Credit
q? ,h t:'
Rate
x S
1"34"2..0
,
Assessed Value
s
55--' 61'
Total Credit
Credit per $1,000
assessed value
$2.66
$2.64
$2.53
$2.41
$2.19
$2.04
$1.69
$1.35
$1.15
$0.92
$0.59
$0.23