HomeMy WebLinkAboutPermit Electrical 2003-6-24
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CITY OF S_ .,JNGFIELD, OREGON : /';, ':
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submitted has the following
quire specific land use
225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (54lJJ~;Z:1: IlIL
ELECTRICAL PERMIT APPLICATION 0: .~ [,ate' 'f
City Job Number Date Z if 0 '3 . ~/
. . _ I ' ."":mzed Signature -I$~
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LEGAL DESCRIPTION ~.
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JOB DESCRIPTION
p::'t;:~on~d~~J~iS
not started within 180 days of issuance or if work is
Suspended for 180 days.
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A. ~Af~R~~iaeilti~r~; si~gi~1~~.J\1~iti~Eai~iI
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Service Included
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1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B.
.
City
~
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only ....'O~'"
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l\U,\t~~~\1 ~~~~~' ~t.\)i'iiU"i
\~\~ ?t:t\\1t.Oi..\.~~~i~,~~9ation or Relocation
~'J\ t\Q x.~Ct.~O~~~ less \
CQ~~e\)\)~?~~~400Amps .
~~"{ 401 Amps to 600 Amps
$ 63,00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Expiration Date
$ 50.00
$ 69.00
$100.00
5D.oO
re of Supervising Electrician
Over 600 Amps or 1000 Volts see "B" above.
D.
Owners Name G.. \11 )...00 ~
Address ~ A..!J4-
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each AdditionatCircuit,oLwith;v\.:j~;,;., "...,
I,~~ryic~iorf~ed~r. ~~Qnjtii t,:;, \ ~:,.': :",,: ~:.. ,~.3.00
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City
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Phone ~l.Q.~
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Pump orifrigation,,, ';.' ',.',~ "....^..~~,$ 50.00
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. Sign/Outline Lighting,,_,,", . ..i',....,.,..:" ,.,,~$.50.00
Limited EnergylResidential. -: ,:.., < .' \ $ 25.00
Limited Energy/Commercial $ 45.00
MiJ1.imum Electric Permit Inspection Fee is $45.00 + Surcharges
OWNER INSTALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
I
7% State Surcharge
10% Administrative Fee
SJpo
3.50
5 .00
~~ c;1)
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./ tf'
4.
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)lBuilding FormslElectrical Permit Application l-03.doc
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW AXTURES x UNIT EQUIVAlENT = DRAINAGE AXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL AXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIV ALENT UNITS
BATHTUB 2 0 3 = 6
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER I MOP SINK 2 0 3 = 6
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG I WATER STATION I ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK I DISHWASHER I ETC, I 0 0 3 = 0
SHOWER, SINGLE STALL 0 0 2 = 0
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERClAURESIDENTIAL KITCHEN 2 0 3 = 6
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLELAVATORY 0 0 2 = 0
SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 2 0 1 = 2
URINAL, STALL I WALL 0 0 5 = 0
TOILET, PUBLIC INST ALLA TION 0 0 6 = 0
TOILET, PRIVATE INST ALLA TION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS ~ 26
"EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DRJ's) set at 167 gallons oer day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
CREDIT RA TF1$ I ,000 I"
ASSESSED VALUE
$4.92
$4.92
$4.83
$4.77
$4.64
$4.47
$4,30
$4,09
$3,78
$3.41
$2.98
$2.52
$2.06
$1.64
$1.45
$1.31
$1.13
$0.97
$0.82
$0,63
$0.41
$0,22
$0.04
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
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1979
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CREDIT FOR LAND (IF APPLICABLE)
V ALUE I 1000 CREDIT RATE
$0,00 x $4.92
= ~
$0.00
CREDIT FOR IMPROVEMENT (IF AFfER ANNEXATION)
V ALUE I 1000 CREDIT RATE
$0.00 x $4.92 = ~
o
TOTAL MWMC CREDIT
= I
$0.00
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.,r .Willamalane
Job. No. ~2JiY3.d)\~
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: (~_. Q~-
ADo'RESS: 2,1)....114
. PHONE: -10~\ .C\~Dg
STATE: ~ ZIP: ~,q"\D\
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.LOCA TIQN OF PROPOSED BUILDING SITE:
Street Address: ..,,\:1.~o of- A,fJ..~'A ~~~.9Oi- .. . .
Pial Name: . f\_\ ~ . . Tax Lot Number: \f1C1l.:O'L":13 <X:h:O'
1~ 'DEVELOPMENT TYPE: (Checkappropriale dwelling(s). SOC calculations and dwemrig l
~e definitions are on l~e back.) .
A. Bin9IA-Farni~hed,
Single Family home
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Manufactured home not in a park
NO. OF UNITS
X $1,000 per unit = $'
B. .$inale-Family Attached,'
NO. OF UNITS
'L
.X$924 per unit . =. $ \ t-4t.oO
C. Multj:-Fami1v Aoartment
. NO. OF UNITS
X .$692 per unit
.- $
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D. MantJfacfl!m9 HomA Pans
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NO. OF UNITS
WILLAMALANE SOC
X $699 ,par unite
$
.$
\ YA~.d?
(I
2. SDC CREDIT (if appftcable) SOc-payer must furnish proof of
Willamalane Credit approval. See SDC Credit Worksheet. $
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3~ TOTAL WILLAMALANE NET SOC ASSESSED
(If soe reduced for Credit)
1roJl.~ .
Development Services
City of Springfield
b
I
$t ~pU
2 Y I 6.3
Date