HomeMy WebLinkAboutPermit Electrical 1994-11-2
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SPRINttELD
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The following project as c"bmmcd,has the follow
zoning, and dees not requiia epe~ific land uso
225 FIFTH STREET approval, ELECTRICAL PERKIT APP4\~ON
SPRINGFIELD, OREGON 97477 ZOnin\l!.-De.-- q \ \
INSPECTION REQUEST: 726-r:il.7.69 11_ 2--4,0 City Job Number _ _ '
OFFICE: 726-37 9 ". .1
IJro-. COMPLETE FEE SCHEDULE BELOV
1.
LOCATION OF
'?Alf'h ~
l~GAL DESCRIPTION
't')()'U)~
f(,ln ~cO
,J9~ DESCRIPTION
,.MI?~ 5~~
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
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Phone l..\l S-J..I?' 9
l !lD{o ."
Electrical Contractor
Address \;:), >,tD <.,(;;.
Ci ty ~eA(
Supervisor License Number
Expiration Date
\ 1,- I -q~
Constr Contc Number ~.,^lLj.S-
Expiration Date '1-'-J - ~~
Signature of Supervising Electrician
~-4__~-''''''''- ~ D.
Owners Name ;.,L~", ~) %:1~Y, ~
, I- ' " ,
Address "ri 9 'T - ~_ _ 3~ J~
City~~~L0' a Phone 7LJtI-&.?:66
O~ INS;(LLATI~N
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Owners Signature:
"
~~~~~-:~---7~7~;-~----------
RECEIVED BY: , /Y'=-- _
. ""{-.-;:-
,
A. Nev Residential-Single or
Multi-Family per dvelling ~nit.
Service Included:
Items Cost Sum
1000 sq.ft. or less \ $ 85.00 Ef2
Each additional 500
sq. ft or portion "L ~
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
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 100U volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Circuits
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 Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE \\S~
5% State Surcharge ~.~~
3% Administrative Fee ~-{."'c-~
TOTAL 1;..\4.?.!L-
,.,;~.........._._.
- ..
ATTACHMENT Bl ~.
WOB NO. q~/6//
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
N/>J'1E OR COMPANY: J! aA-oh ~
'i '
LOCATION: ~ 4-1C. j)~-t/1
DEVELOPMENT TYPE' 'SP /)
BUILDING SIZE:
1- STORM DRATNAGE
IMPERVIOUS SQ. FT. 23~~
2. ~ARY SFWFR-CTTY
NO, OF PFU'S /7
(See Reverse)
3, TRANSPORTATTON
lOT 5171= SQ, Ft.
X $0.209 PER SQ. FT, C?-9~~
X $43,26 PER PFUC T ?:!)
NO OF UNITS X TRIP RATE X COST PER TRIP
/
X 1,0/ X $436. 19
X X $436.19
~o'0
$ --
X
X $436,19
$
SUBTOTAL (ADD ITEMS 1.2. & 3) i/ '1/f,/f2
4. ~ANTTARY SFWFR-MWMC
NO, OF PFU'S /i' x $17.19 PER PFU + $10 MWMC ADMIN,FEE $ 3/9,"/.2
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ "3-1. Co 0
, TOTAl -MWMC Sac. $(2l1"4.y~
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $/q'J?9~
5. p,nMTNTSTAT1VF FFFS.
r~OORG~~B ABOVEl X .05
~ /1'-' Date:
/' KilrY\Hornig. P E. '
SD6=-toordinato
0??S)
/0-.2 7-~~
TOTAl snr
$ ~ 09 e>. 9/
B2,SDC '
. .
FIXTURE UNIT CALCU.ION TABLE: Number of New FiaS X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the l'!fI additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
Bathtub"".,"'."."."""'.".""..,.,.,..""'."."'..,..,."."'..,. .
Drinking Fountain."."".,."".,."""",.,...",..,."""""""
Floor Drain,.. ..,.............................,....,.. ....................,
Interceptors For Grease/OiI/Solids/Etc......,....:.....
Interceptors For Sand/Auto Wash/Etc...............,..
Laundry Tub/Clotheswasher".......................,...."".
Clotheswasher. 3 Or More................,....,..,......,.....
Mobile Home Park Trap 11 Per Trailer).................,
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall......,................,.....................,...
Shower, Gang. ..........,....'..... ....... ,'.,... '..... ......", ". .,..
Sink: Bar, Commercial, Residential Kitchen........,..,...........,
Urinalo Stall/Wall:.:.".,.,."..,...,.,.".".,.,..,.,...,...,.,.,..,...
Wash Basin/Lavatory, Single...,......,............,..,..,...,
Toilet, Public installation........................................
Toilet, Private..................,.....................,..............
Miscellaneous: ,ToIoNI TrlP:S $.INK'
z
/
I
2
2.
TOTAL FIXTUClE UNITS
UNIT
EOUIVALENT
2
1
2
3
6
2
6
6
1
3
2
llHead
2
2
1
6
4
..1.
=
FIXTURE
UNITS
+-
2.
z.
2.
l?
/P
CREDIT CALCULATIDN TABLE: Based on assessed value. if improvements occurred after annexation date in tableo
calculate credits separates,
Year
Annexed
Ra:e per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2,92
2,73
Year
Ar.nexed
1985
1986
1987
1988
j9S9
1990
1991
1993
Credit for parcel or Land Only If Applicable
'> ,4-(, X $ /0, o-tro
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Improvement (if after annexation date)
."-. "-
Ra:e per $1,000
Assessed Value
II
$2.46
2,14
1,77
1,37
0,97
0,61
0.44
0.15
II
=
31f.C, 0
=
--
CREDIT TOTAL = $ 5 fl. 60
SPRINGFIELD
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LOCATION OF PROP'AE~ WORI<' 3'\ '\ \ D '\"'nl X\ \ C\ 1\
ASSESSORS~N'~ h::::o'd-O\.oC'1:) " " ' \ ,TAX LOT:\llD ry-p,rx:)
LOT: aJ\V " BLOCI<" , SUBDIVISIO~~~l~f\~
OW~EP: cr\\\.iD 0)\ r !\>:lJ '(\\~ \ L\Q1) 'l~(\(' <'HONE: t \0/\ . \d4 Lr:lo
ADDREP~:~~(;:J ~~:JNi \"lJtl\OO]-1
CITY:U\\ 1\ t ri I ~; (j (V - , STATE:!ll.9 rzpf\ ZIP: Ol~ --, ?)
DESCRIBE WORK: ~ f\'r\^ Q, ~() N\.lV, { \ ~O t\\O Qf\C'L
NEW ~ REMODEL ,tADDITION' DEM~ISH OTHER
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
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JOB NUMB~R full 0 I \
225 Fifth Street
Sprlnglleldo Oregon 97477
CONTRACT~o~ NAM~E J ADDRESS'
GENERA"l...)'l'u..lOQ{\ 1\\,\., "
PLUMBIN; ~JrC\Q.(\ \. "pj,llo~ \
MECHANICM.' ~ ct 0 J\ Y -N-).
ELECTRICA;\o~\ \ 0 fA f 1~)\l' ~ )
CON ST.
CONTRACTOR'
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5 \'\?tr")
B\.'\C\~
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To request an Inspectlono you must call 726-3769, This Is a 24 hour recording. All Inspections requested before 7:00 a,m, will be
made the same working day, Inspections requested after 7:00 a,m, will be made the following work day,
, , ,
REQUIRED INSPECTIONS
r\7\ R~ugh Mechanical ...; Prior to
LAJ.. cover.
QUAD AREA: ~ ~Q "
. OF BLDGS' \
OCCY GROUP', ~?, -\ tv\
\
r ~
. OF STORIES'
WATER HEATER:
--
o Temporary Electric
o Sfte Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
f'VI Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
.beams, grouting.
~Fou"datlon - After forms are
erected but prior to .concrete
placement.
o Underground Plumbing - Prior
to filling trench,
rc7I Underlloor Plumbing/Mechanical
~ -,Prior to Insulation or decking.
I'D Post and Beam - PrIor to floor
~ Insulation or decking,
C8:l Floor Insula~tion, - Prior to
dacklng.
IVl Sanitary Sewer - Prior to filling
L..O.I.. trench.
~ Storm Sewer - Prior to filling
trench.
~ Water Line - Prior to filling
~trench.
~ Rough PlumbIng - Prior to
~ cover.
- OFFICE USE -
LAND USE: ,\ \ \
· OF UNITS' \, \
CONSTR. TYPE: 'IV TV
HEAT SOURCE: \ l IT\
RANGE: r:.....-
f'ViI Roug'tiElectrlcal - Prior to
I..AJ. cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
rzlDryWall - Prior to taping,
o Wood Slove - After I~stallatlon,
o Insert - After fireplace approvzal
and Installation of unit.
~ Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
excavation is completo, forms
and'sub-base material In place.
o Fence - When completed.
o Stroet Trees - When all requIred
trees are planted.
EXPIRES
~.\';\,
q. \.l\.
fl:\Q..
Q4
FLOOD PLAIN'
ZONING CODE:.ID1C...,
· OF BDRMS: . .3
SECONDARY HEAT:
SQUARE FOOTAGE: ~
~ Final Plumbing - When all
- plumbing w9rk Is complete,
~ Final Electrical - When all
~ electrical work Is complete.
@Flnal Mechanical - When all
mechanical work Is complete.
r=tl Final Building - When all
L..Z:t'-requlred Inspections have been
approved and building Is
completed,
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical ConneclIon - When
blocking, set-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot faces
,_r.
L~t ~pe.
K Interior
Lot sq. Itg.
Lot coverage
Topography
Total height
Corner
Panhandle
~
Cul.de,sac
BUILDING PERMIT
\~T,
J~lcO
ITEM
x s/SQi)
&.
14,/0
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
:~~,( \'.~::f: , "'t':'~: ~r.j ~.;,"~:e-i:,(,r.;..
';." . " Setbacks, '.. '
P.L HSE GAR ACC'
N'
Is
Iw
IE
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 1.2091'.91
~5'IO
1 jr dJ
1-. ""I.
/0:41+ ~~
(A) ~'J-!
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
FEE
lLoO.CO
Plumbing Permit
State Surcharge
Total Charge
0/\ I (ouro
4.ctJ ~ B.a;
(C) 172,~U
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
N' ~
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
. '5Of
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Su rcharge
Sidewalk ~ It
Curbcut 2J.J1 It
Demollllon
Sft Surch'R~ \)_
\ }<~ k\ V\~ t\. u.u
4.m
q.CO
'(~.oo
f(o.5U
10.00
.A~
~
?>r:s.7D
~.C\O '
~9J.
Total MIscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) Ol'J{O~
(Ao B, C. Do and E Combined)
'_S THE PROPOSED WORK,tN THE.. '
'''HISTOJ;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPRov"n. '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condlllon that the said
construcllon shall, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, Including the
Development Codeo regulating the construcllon arid use of
bulldlngso and may be suspended or revoked at any lime
, upon violation of any provIsions of saId ordinances,
Plan Check Fee: 'L\f-\ J ./
Date Paid: oJ ~
Receipt Numberu Y
Received By: ~
~S!\~ltti
'/, \'2:> ~
- ~
Date
Systems Developmenl Charge Is due on all undeveloped
properlles within the City limits which are being Improved.
ADDITIONAL COMMENTS
~Q tt-o. ~d Q h 'Yl \i~
,
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\ _~~: \ VI. 00
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By signature, I atate and agree, that I have carefully examined
the completed appllcallon and do hereby cerllfy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Sprlngfleldo and the Laws
of the State of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
J further agree to ensure that all required Inspections are
requeated at the proper time; that each address Is readai?le
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during const~UCtl
'>( a ,/') /2- ..
, Signature ,,4?A:td/'--{, l:/V3A S:::>
, Date' 11- t -c?d
r _ I
VALIDATION:
RECEIPT NUMBER
DATE PAir,
AMOUNT RECEIVED
RECEIVED BY
IS:J, :2;?
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