HomeMy WebLinkAboutPermit Electrical 1992-6-24
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1. LOCATIgN OF INSTALLATION, !.5fILJ'''I',fll./)
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LEGAL DESCRIPTIQN '_'_
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JOB'DESCRIPTION '
9u+6LJl. Fr>.-/l'U1' Q~'d26ih2'
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REOUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
q\~
772
City Job Number
"unrwa.. ..... SCHEDULE BELOII
Ney Residential-Single or
Multi-Family per dyelling
Service Included: .
uni t.
Items
Cost
Sum
I
~
~5.
1500 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each ~anuf'd Home or
Modular Dyelling
Service or Feeder'
$ 85.00
3D
Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical contractodilurn 1o-ru It1tt.,
e..J
Address wCl6 ,~T'"1 alii.
Ci ty tityA71' _ Phone (/J[flj/u:Jdfl
Supervisor License Number 50/ 7 S
Expiration Date JO-/-t12-
_ - 4..? <"SO
Constr Contr. Number .an ' --:J"'k. t'..
Expiration Date +0, /- ~ t;//0z.
Signature of superv~lectrician
~.~/..
ok --;NSTALLATION 0 , _
Nam~ ~oo~~ f\ , tif)~,
Address \~l1>\o< o4.DlD .
City CoqPIlO _ Phone fo€:'b-CftJ
The installaQion is being made on
property I own which is no~ intended
for sale, lease or rent.
$ 15.00
$ 35.00
B. Services or Feeders (10 Branch Circui.ts
included)., Installation, Alterations
or Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
$ 60.00
$ 80.00
$130.00
$300.00
$ 35.00
-,-
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less I
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 35.00 "3),00
$ 40.00
$ 80.00
see "B" above
D.
Branch Circui ts
Ney, Alteration or Extension Per Panel
One Circuit
Tyo to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00
$ 50.00
$ 15.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00
Sign/Outline Lighting $ 36.00
Signal Circuit or
limited energy panel $ 36.00
Owners Signature:
15Q CO _
J0;€-il
S. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
---------------------------------------
DATE: t:; -:;;,>~.92..
RECEIPT #: 5""2:'>2
RECEIVED BY: ~k-~
'/
Metropolitan
Wastewater
Management
Commission
.....
.
.
co~",r:,ISSI0:: :.'ti.~f[:;,S~ , .
t;~~ g~>ltl! :1- ['J~er,,: CO~:;:I!;,e:~ ~ ; .'
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S:~:i :::;5::: 11-S;/';;:;eia lC'i Rep'fHr.tc:,~
C~,'lS l~:s'Jn-S;:irin;:ield CO:.l'C;l~tl~,""
Ch'is '.~t.:S=,...-LHI~ C{'U:".:y L",' ~t':\'esf-"':t.:i'''l
J:i)' R.:,:sl-Li:~,{ eN!:''l1,' Co'n;':'l!~si:':1tl
1.::::-. \"'!s:1in;-~t:;t,'e Lei' ;::'f~-:l'Hr,~':I~'e
FIFTH AND A STREETS - SFRII'iGFIELD CITY HALL - 'SPR!i,GFIELD, OF,EGOI'J 9i477 ELEP;,OI,E (503) i4i-"5:1
I1'JMC CONNECTION CHARGE
Building Address: .f? 1.~.Ji~T+
:::::~"'~b;';~~ r8fy~~ To< Lo' '"'b,,/)5200
Address: "'~ l 0 \ 0 ...0 - 4(~ '\'--l Phone Number: l.ei ~ . Cf1.3/
City: .81.2JlJU - State: (1JA 0 .~AJI\.. ZiP:_Qf)4()S
~~sidential Fee ($222.00) $ ()f){J ,CX)
Commercial Fee (new non-residential development/
remodel)
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $
Credit Due (see reverse of this form) <$ '>cf.}( >
TOTAL MVMC CHARGE
$ (';7. 6"9
Receipt Number:
Building Job
4~~
// .::r-' ~ . ~ ......
Number:' I Ulf:.//\ l /
Date Received:
h -;2I./-C?z...
tt;""2~2...
Received By:
1/ 0772-
"
.
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Fixture Unit Calculation Table: Number of nev fixtures multiplied by unit
equivalents. NOTE: For remodels, calculate only the NET additional fixtures.
Fi?:ture Type
Ba t h tub. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Drinking fountain............. ... .........
Floor drain..............................\
Interceptors for grease/oil/solids/etc....
interceptors for sand/auto vash/etc.......
Laundry tub/clothes '!asher......,.........
Clothes vasher (3 or more)...... ..........
Mobile home park trap (1 per M.B,)........
Receptor for refrig/vater station/etc.....
Receptor for Commer sink/dishvshr/etc.....
Shover, single stall.. ............ ... .....
Shover, gang (per head)........... .... ....
Sink, bar, commercial.....................
Sink, commercial/industrial/etc...........
Urnial, stall/.'all........................
~ash'basin/lavatory, single...............
~ater closet, public installation.........
~ater closet, private..... ... ............,
Miscellaneous: ..........
..........
Total fixture units
"
# of
Fixtures
Unit
EQuinlents
Fixture
Uni ts
'-
2
1
2
3
6
2
6
6
1
3
2
1
2
3
2
1
6
4
'--'
Total Units:
x $13.25 each e Total Charge: $
Credit Calculation Table: Based on total value of property at time of permit
application.
Year J~nnexed
to the Cit~
1~11o
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
Credit
:<. . 06
Rate
x S \2)90lJ
Assessed Value
s
:> 'j<(. "5/
Total eredi t
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