HomeMy WebLinkAboutPermit Electrical 1991-12-12
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,
225 FIFTH STREET , ,
SPRINGFIELD, OREGON 97477
,INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. , LOCATION OF INSTALLATIr '
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J?~<;AL \~crc=~~~1 ~\
rDJOB DESCRIP'tION
t.....I,()C';Qi(''-'\
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work, is, suspended for
'lBO days. '
.',,1, .', ';
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor,
." - . ""';'
Address
...",
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Nanie_&ttr~<'T~.4"1lf~""'''''' )
Address ;.23 L{, ;;;.t~A-Cr
Ci ty ...~L:> pI) Phone 7<=//-,;L.S?-9'2
OVNER INSTALLATION
The installation is being,made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~A~~~~~~-----------
RECEIPT II: CY T:'\:"t\~
:RECEIVED BY:,O~~) -
'~~
3.
., .,... .', .. ,-
COMPLETE FEE SCHEDULE BELOV, .,
' - , , .
A.
New, Re~idential~Single or
l1uld-Family per dwelling uni,t.
Service Included:
.".,
Ite;ms I ,Cost ,
Sum
1000 sq.ft. or less
,Each' additional 500
,sq. 'ft or ,portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ '15.00
$ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation: . I
200 amps or le'ss. \
201 amps to' 4~q amps
401 amps'to 600:amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00 2h:2.-
$ 60.00
$100.00
$130.00
$300.00
$ 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 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
LiinitedEnergy/Comm
One Circui t \
Each Addi tional
Circuit or with Servic~
or Feeder Permit \ \
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00 ?-JS
$ 2. 00 ?..~
not included)
$ 40.00
$ 40.00
$ 20.00
$ ,36.00
/ \("') ., ----
- f)~1:l
\ \ ~ , ~b
.
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
JOBNUMBER <7/L?.5<2C>
Inspections: 726-3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
E ,i'?.>>?,4 C7
LOCATION OF PROPOSED WORt<' --:2 "5Zc:.
ASSESSORS MAP' /7-ttP:l<'!,?-:<./'
TAX LOT' 0/<=6
SUBDIVISION'
BLOCK'
LOT:
"'BBuCtfF :5T-~#'#~<;/'5/><'
:252L ~ /7?{'7- ~ .
57P~C-~
DESCRIBE WORK:k'E,b='/;>?"? ,)(/r-f0-/L/r~/~n ,/!)~ l' c?'":"';''CC
NEW REMODEL;< ADDITION Y DEMOliSH OTHER
PHON'" /<//-28'7'2
W ~gt?-7'2""1/-$RVC~.
OWNER'
ADDRESS:
.c:>~
CITY"
STAT'"
ZIP-
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
ADDRESS
EXPIRES
PHONE
"
GENERAl - /?~~:z:?'
PLUMBING:
MECHANICA' '
ELECTRICA"
-' OFFICE USE -
LAND USE: \\ \ \
. OF UNITS:_I
CONSTR, TYPE: V Ai
HEAT SOURCE:
QUAD ARE~Q (\')(;)
\
OCCY GROUP: (2-3
FLOOD PLAIN- ~
ZONING CODE: ~ 1. ) !C-J
. OF BLDGS:
. OF BDRMS'
. OF STORIES:
SECONDARY HEAT:
RANG'"
WATER HEATER:
SQUARE FOOTAGE:
To request an Inspection, 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
gRou9h Mechanical - Prl?r to
cover.
~Flnal Plumbing - When all
plumbing work Is. complete,
~inal Electrical - When all
electrical work is complete.
o Temporary Electric
~Rough Electrical - prior-to'
~ ~over.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
~inal Mechanical - When all
mechanical work Is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
~Inal Building - When all
required Inspections have been
approved and building Is
completed.
~ Footing - After trenches are
excavated.
D. Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting,
~raming - Prior to cover.
o Other
F:::/rFoundatlon - After forms are
~ erected but prior to concrete
placement.
~all/ceiling Insulation':"" Prior to
cover. .
o Underground Plumbing - Prior
to filling trench,
~rYWall - Prior to .~a~ln9'~
........" "
MOBILE HOME INSPECTIONS
g Underfloor Plumbing/Mechanical
, -:- Prior to !nsulatlon or decking.
o Wood Stove - After installatlo~,
o Blocking and Set-Up - When all
blocking Is complete. .
~ Post and Beam - Prior to floor
~ Insulation or decking.
o Insert :.... After fireplace approval
and Installation of unit.
~Floor Insulation - Prior to
~ decking,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panei.
o Sidewalk & Oriveway - After
excavation is complete, forms
and sub.base material In place,
o Storm Sewer - Prior to filling
. trench.
o Fence - When completed.
o Waler Line - Prior to filling
trench, '
o Final - After all required
. Inspections are approved and
.. porches, skirting, decks, and
venting have been Installed,
I'Q'f Rough Plumbing - Prior to
~ cover,
o Street Trees -'.W~en all,requlred
trees are planted. ~.~. . < '
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
;11c~-=c.. i ;9z>Pt:T/~
Total Value
Building Permit Fee
State Surcharge
Total Fee
(Al
VALUE
/2 ,,---=-,,,,-
r
J il. J)&J
I
q;,>,u
<<,e~
1'7./3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~O'1. ~ ~
PLUMBING PERMIT
ITEM
Fixtures
.d
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT,
FT,
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
I
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
(/4 I/O.)
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~c7t)
-.,
~.CJO
-:;../90
~.~
00'0
1-. >CJ
>. &cJ
"3, t9 0
/ tP. $"&>
t'tf),tfJO
~.~$
~r.M
4~:l/. 6>.3.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said, ordinances.
Plan Check Fee: _~, r=t
Date Paid:
7- /:;> -"7/'
Receipt Number' 2~.::6'9 .....
R ~d /"7. ,~
4 y:~~ '~;<vh/
F'fa/(( eviewed By 1 U ~te ,
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further certlfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining 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.
I further agree to ensure that all required inspections are
requested at the proper time; that each address is readable
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 construction.
Signature ~UL ~all'\4f7i\ ./
Datp 1AzJ q \
VALIDATION:
RECEIPT NUMBER -::z tP<7 &5 Y
DATE PAl n ;;::; ---7"2 '''3 {"
AMOUNT RECEIVED-S(6'9, ~ ==3' '
RECEIVED BY ,~~~~~~
CITY O.RINGFlELD SYSTEMS DEVElO_NT CHARGE -:tf~\Oe,....o
WORKSHEET
NAME OR COMPANY: 13~uc-t SltSP HAt.1.Sc;t.l
LOCATION: '2-'?-z.<.. E:.lzt.llA: C'.-,. i:'1-b'?-L-,-'2-1 01"'2-00
DEVELOPMENT TYPE: LO g, - At>Ol"-WN
, I
BUILDING SIZE: Gj '0( It ::: q'i <;Q. t="t LOT SIZE SQ. Ft.
1. STORM 'DRAINAGE
IMPERVIOUS SQ. n: ,,,\'" X $0.186 PER SQ. FT. ~ \'3'i!-'
(See Reverse For'Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S ~ X $38.55 PER PFU
, (See Reverse To Determine Total PFU'S)
3. TRANSPORTATION
s z.Co"1 ~
, ,
NO OF UNITS X TRIP RATE X COST PER TRIP
N fAX ' X $388.61
,
s ~
X'
X $388.61
s
X X $388.61 , S -
(See Attachment C To Determine Trip Rates)
", -0'", ., -- , SUBTOTAL,(ADD ITEMS 1,2, & 3) S '2-eB~
. ...'.
4. ADHINISTRATIVE'FEES
,
BASE,CHARGE (SUBTOTAL ABOVE) X .05
s It..!- 'i.!.
TOTAL-CITY SDC ~ ~o2- "'2
5. CREDITS
IF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL: , . II.
, TOTAL-CITY SDC X (50%)= ~DJUSTED CITY SDC Ll:1.t.'A
6. SANITARY SEWER-HWMC
NO. OF PFU'S
N/A-
x $13.25 PER PFU + S10 MWMC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
HWHC CREDIT IF APPLICABLE (SEE REVERSE)
S N IA-
,
-0 -.~L~ '7 /~'L /'1 I
'~ Kip Burdick ' I
SDC Coordinator
TOTAl-MWMC SDC S ~
TOTAL SDC ,$ ~o1.. b2.
~iXTURE UNIT CALCuuloN TABLE: Nu~ber of New FixtUre_nit Equivalent = Fixture Units (NOTE:
, ' ,
Fpr remodels, calculate only the NET additional fixtures)
1 '
I
FIXTURE TYPE
!
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
FIXTURE
UNITS
i'
Bathtub.............'............................,............................
Drinking Fountain................,....,......,.........,:.............
Floor Drain..................."....,........,............,...............,
Interceptors For Grease/OiIjSolids/Etc,................
Interceptors For Sand/Auto Wash/Etc,.......,.........
Laundry Tub/Ootheswasher..,.,..,...........................
Ootheswasher. 3 Or More............,.......:................
Mobile Home Park Trap (1 Per Trailer)..................
~eceptor For RefrigeratorjWater Station/Etc.:......
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall..........,.........,.,.,........................
Shower, Gang..........................................................
Sink, Bar, Commercia!........,.........,.......,..................
Urinal, StalljWall..............,...................,.,.......,..........
Wash Basin/Lavatory, Single..............................:..:
Water Closet, Public Installation.............................
Water Closet, Private......,..".,.,..............,..............,..
Miscellaneous:
\
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
2
\
\
I
4-
TOTAL FIXTURE UNITS
1
CREDIT CALCULATION TABLE:
calculate credits separates.
~" '
: Year
! Annexed
, ' .
Based on assessed value' If Improvements occurred after annexation date in table,
~.~:':~..: ~,.~ t.;.:' , ::. '.. -. .', -:', ~~. '"
!:
"
",
1 &:9 cr bef.:)ra
Rate per $1,000 Year Rate per $1,000
Assessed Value Annexed Assessed Value
" ~- ii
52,66 1925 51.'39
, "
2.64 .. 1986,.. 1.35
2.53 1987 1.15
2.41 1988 0.92
2.19 1989 0.59
2.04 1990 0.23
I' 1980
L' , 1981
I ..~;~-~:
1954
Credit f?r Parcel or Land Only If AppliCable
Improvement (if after annexation date)
X $
(Rate X Assessed Value)
X $.
(Rate X Assessed Value)
CREDIT TOTAL'
=
=
'= s
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential,."..".."".".,..""""....,."""""",.,."", 0,';
Commercial",.., .."".',."" ,'," """,., """"..', """" 0,9
IndustriaL..,..."".....,.."".,..,.,.,..,.,...,.........,.,..,.. 0.45
GovernmentaL,..,.",.""...."".,.,.,.,....,......,.".,... 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT