HomeMy WebLinkAboutPermit Electrical 1995-2-23
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i-f5225/r...~ Ul STREET
',li-tS'p~!>FIJ;:LD, OREGON 97477 , j 'D /? (\'~r-.r-n4
';iI!.l:S',6,"uON REQUEST: '726-3769 Zoning \../ r~ Ci ty Job Numbe; '-'\~J.. y\
',;[[OFFICE: 726-3759 . . 'J L""> r.. --- '
:"';'?i;",.,'.;.": . Dale~:/ 9-Vt) 3. COMPLETE FEE SCHEDULE BELOY
..',~;"(i~;'!iQ<(ATIW' OF INST~TIOlJI.ut..borized Signature (J ~ '
':'~~~;;L\A~\ ') '\=hK\\t'D \( R '7 A. Ne~ Residential-Single or
't~~~ '. ~ Multi-Family per d~elling unit.
~,.';fi;..'i.'~.~..Jl~~ClW'AION Service Included:
".(::,,\'0 )H\ )'f'l'~ - 0040], Items
(;,~:',:)2 ~~) -
/~:.. '"":'..:.!OB DE~PT~~ _ '
.e- :'\,>;::.~-O ~ \.10 J::\ruD~ \or::s::\
't~:~~~i~~_\~~> ~,,' _~'~'" . -
'i';S~Permi ts are non-transferable and expire
t;:;~{f.work is not started ~ithin 180 days
.~~~~~{ofilssuance or if ~ork is suspended for
,f,::J;~:.:.I'180"days .
~~.,~,:,:.,......,.,-",lo,
:,"';7'''~'~ ~~~''''.~'- ,';
':'\t~i:;,i ,2'; '" CONTRACTOR INSTALLATION ONLY
.. :'-~~.,<;*':~-.' .., - " .'
.?~;f~~'igi~ctrical Contractor R,r)se. C.orp.
~?~~~t:;{~~~i~~S~{b ))~ ~~ '
,~~~~ttc~\~~~ )~J- OR Phone fn8&,- 0Cta.&)
"/"^:f~4~t~;i~isor License Number 15'&"
'V~~i~~tion Date JO/' /'15
_~}f~'!;\~:T-;' c.
1t~f?~~,t,~ Contr. Number ~ ~O~J5.3 ~
"~;:E~;iration Date Q/30/ '15'
1_J:;'),:,_'~ ....L':~- . .
"":.t ,';ii~4si~~ture of ervising Electrician
Ij~:"t';i~';'P' ,,;::'.,' /J' ~
"i_"i;:-.'~'~",:,,\~~'~..~"-'~-" . . '" ?/ ~~
j:'-;,;"'::1~?':"/.' s', r,/-'....'A< - - D. Branch Circuits
).,~'j~!lZ~:o~rie.rs Name M1'\..D:l.On \\W,O ~
'..'.''','.;',~$.;:';'.. ".. _'V;;, _f'\Q r. hI OJD ^....... Ne~, Alteration or Extension Per Panel
}S;;::p,~il'Addre.ss~ \ l1f' 1'1\ I \A1! . ~ IVL,..
1A:';~~".~~1't:t;~-IA~ PhOn~()~q'l ~~~hC~~~~~~onal $ 35.00
,;:"~'" ~L) LI../"'\Il Q" Circui t or ~i th Service
};;'~<i1lNER I TALLATION lU L.Z...) or Feeder Permi t $ 2.00
, . "..,... .' ~" ."" ~ 1
:i~l~h~~;nstallation is being made on
"..{iti~1ipro~e:rty I ololn ~hich is not intended
........,. '~"'ti.~,"f" 1__ - _.'-- 1 1
''''f'~.~~.~. "}" or~,sa e, ease or reo t.
~~~:~~:t<t?~;f':".~~;;:~ ..;
Hh;\";~""~"'Ovn'-" . S' t
~<<;:~,;,";'-, . ers Igna ure:
[~.j,:'~.:r~'~-': <. .' .
~" .::'.~~~~~-:23~~-'~:;-~~~~-=~;--' 5.
. . "" 'RECEIVED BY: ~.I'V'---/u - ' J
~;.... :~: :'_.' Iv -
.
. .
..
,0
Temporary Services or Feeders
Installation, Alteration or Relocation
4D
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular ~elling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000,
"":: ;;,t(~.":qi~i~~~f~
. ':",' d, ""r ,.,v,r"I'
, :'_. ,J,"," .~,~/.. '."'. " <." S. .
~I },,:..;"*,.~~..,'r-l~~~~~~.~"'i .
, ,,' "'-lL
~hl1
~.'." ~;::.':"'~l~~.,,:"'i!"; t .:~;;:<:'" !
"
Cost
Sum
$ 85.00
B;
cQ
$ 15.00
dtL
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
\
$ 40.00
$ 55.00
$ 80.00
see "B'" above
volts
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation '
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
~15,CO '\{)oQ
,"'):~...... ;)JlJc/J.
.;-'1 ~'::.. -\,
~4 .;.IT) ')
40.00
40.00
20.00
36.00
r
. ATTACHMENT Bl
, .OB NO. '75"007''1
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMpANy: ~ ,i).-UJ.
LOCATION: 1/ 5'0 F~'
,.
DEVELOPMENT TYPE: S/ I)
BUILDING SIZE: /951f.u..;u.) LOT SIZ(
SQ. Ft.
1. ~mRM nRATN~
'~IMPERVIOUS SQ. FT. ..t. 2f /
X $0.209 PER SQ. FT. $ 1'1?i2
,2. SAtilIARY SFWFR-CTTY
, NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
If'
X $43.26 PER PFU
, " s7!;r 'i. C. 6
, I
X 1,0 I X $436.19
$ 4--10. S" :>
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) Vb.9~.of
4. SANITARY SFWFR-M'..JMr.
NO. OF PFU'S l'i x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ ']/"1","/z
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~J.~o
, IQIAI -MWMC snr. ~~ S.8Z.~
SUBTOTAL (ADD ITEMS 1. 2 . 3 & 4) $ / f ~~. '11'7
5. ADMTNISTATTVF FFFS
BASE-QtARGE (:'TOT~OVE) X .05
~ #V~ Date: ;;L-/3-?5~
/ Harry Hornig, P.E~
SDMordinator
$ '1 '1./ r
IQIAI snr.
,
$ ;;'0 4'$. 0"
B2.SDC .
, , 4It .
F!XTURE UNIT CALCUIrION TABLE: Number of New Fixtures X Unit Equivalent ~ Fixture Units
(NOTE: For remodels. calculate only the tiEl additional fixtures) ,
. NUMBER OF
NEW FIXTUI1ES
:~~ '?i~;~l;O::-C:~'::::<'::;;~ _::".<:.~-.,~, ki _. . '
FIXTUI1E TYPE
Bathtub............,.,......,..,.".....,.,.,........".......,............. .
Drinking Fountain............ '.... ....... ..... .............:..........
Floor Drain.............................. ......... ................ ..... ....
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher...................................
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailerl.................. "
Receptor For Aefrigerator/Water Stillion/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang..... ,.... .................................................
Sink: Bar, Commeicial, Residential Kitchen........................
Urinal, Stall/VVall. .:.................. ..................................
Wash BasinlLavatory, Single..................................
Toilet, Public Installation.............:..........................
Toilet , Private:.................................................. .....
Miscellaneous: ',TANI TOJ?'.s S/;/J::'
~
I,
z
2.
TOTAL FIXTURE UNITS
VNIT
EOUIVALENT
2
1
2
3
6
2
,6
6
,1
3
2
1/Head
2
2
1
6
4
~
~
1
FIXTURE
UNITS
4
z
2.
2..
~
/r
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
'I
Rate per $1,000
Assessed Value
Year
Anne,xed
, .1979 or before
1980
1981
1982
1933
L'1984"
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Credit for Parcel or Land Only If Applicable .
Improvement (if after annexation date)
3..f~ x $ r. "7/0
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
=
Rate per $1 ,000~1
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
J ). ,,()
~
CREDIT TOTAL = $ 3$..~o
--
.
~
o !!!il\i!"!!,~~!!~
Job No. q~4
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
N~~M, ~Q~ PHONE:MlDGHf)4f)J8
ADDRESS: ~ l-pfl\b\.Q. \Jt ~)~ - STATE: WAzlP qR2.,~\a'
LqCATION OF "'ROPOSED BUILDING SI~: - t)~ '
, Street Address if Known: 4 \~) tfJ~ ~ \ r\ )
Platt Name: --U-LX""In , Tax Lot Number: JPI::lci.\Jf:, f\ (\ ,
\~ ~
1. DEVELOPMENT TYPE (Check appropriate dwellingCs). SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Familv - Detached
Single Family home
NO OF UNITS I
B. Sinl!le Familv - Attache<!
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
Manufactured home not in a park
$4If)~
X $400 PER UNIT .="
.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
WPRD SDC
$ 4f1)fD
$r:Y
$4fx.)cxJ
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~~~~ ~ ,,9,?-J,Gt"i
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
NEW
.
SPRINGFIELD
BLOCK'
OTHER
.
q 5Dr:Pv1
JOB NUMBER
225 Fifth Street
Springfield, O'egon 97477
TAX LOT: CD'\D';')
SUBDIVISION:
ZIP:
C{2\. ~L\; LP
CONST,
CONTRACTOR' EXPIRES
~() \. ~.~.qs
CONTRACTOR'S NAME \\. .~. ADDRESS
GENERAL:\,\t).ill M .J\.JLU'_., '
PLUMBIN(>' ~~b ~ ~ 4 f'i\I)~
MECHANICAl' Ul\ M r\ Y\ ~ ~
ELECTRICAL:\ ~r)~ (~~
QUAD AREA: ';:;''V...S0--.
. OF BLDGS: l
OCCY GROUP: ~3 1- ~
c9,
B
. OF STORIES:
WATER HEATER'
?SCl52.Jo
. 'l)L\4,~ \
- OFFICE USE -
IU I
. OF UNITS: l
CONSTR. TYPE: J~
HEAT SOURCE: 1-'>= ,~
9~
LAND USE:
RANG~'
PHONE
cOil) .1nS
~.~s.qs ~ql).1f)2Pl
q . &J.q:; 1o~~y{'~l'5
FLOOD PLAIN'
ZONING CODE: ~
. OF BDRMS: 3
SECONDARY HEAT: -.ff
SQUARE FOOTAGE: 19CB-
TO request an Inspection, you must call 72~.3769. This !s 8,'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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
~nder$18tiPiumblnh"1h=lectrical J
~ ~echanl~~ cover.
r:-:::y"'Footlng - After trenches are
L:J ~xcavated.
D Masonry - Steel locatlon, bond
.beams, grouting.
0~oundatlon - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
.0' Underfloor Plumbing/Mechanical
. '.- Prior to Insulation or decking,
[3 Post and Boam - Prior to tloor
Insulation or decking,
rr::rF!oor Insulation -\ Prior to', \
~ decking, : ., ,-
o Sanitary Sewer :.- P;tor' to filling'
tr-ench.
@Storm Sewer - Prior to filling
trench.
......;, "
.....,( Water Llna ..:. Prior-to' filling
~ trench. '..' ~..
m .,)
. , .I, .
Rough Plumblng'-'Prlor to
cover. .
,
REQUIRED INSPECTIONS
~OU9h Mechanical -.Prlor to
cover.
~ough Electrical - PrIor to
cover.
W":lectrlcal Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framlng - PrIor to cover.
~all/C'elllng Insulation - Prior to
cover.
[LJ15ryWall - Prior to taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approv~1
and Installation of unit,
, ..
~ ~Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
~dewalk & Driveway - After
excavation Is compiete, forms
and sub.base material In place.
D Fence - When completed.
D' Street Trees - When all required
trees are planted. .' .
ill Hnal Plumbing - When all
plumbing work Is complete.
~Inal Electrical - When all
electrical work Is complete.
W'!lnal Mechanical - When all
mechanical work Is complete,
~nal Building - When all
required InspectIons have been
approved and building is
completed.
DOthar
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up. and plumbIng
InspectIons have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
L?t sq, Itg.
Lot coverage
Topography
Total helghl( GS.Er _
r9$~ ~".~J'
'. I
BUILDING, PERMIT
ITEM 'SQ, FT,
, J LPCf1
~~
Main
Garage
Carport
Total Value
Building Permit Fee
I
Stale Surcharge: 1- -oo;D,
" I '
Tolal Fee
Lot TY.
_ Interior
~ Corner
Panhandle
Cul.de.sac
Setbacks
I P.L I HSE GAR
I N I
S I
W I I I I
~I
&PD =q~~
It.IO-', 'lnrBi
(A)
- i
/ ...
/1l94L\j
15C\ .'l:)
, ~~C::) .13
, "::LILt .CG
I .
SYSTEMS DEVELOPMENT CHA,RFE (SDG)
, . I' . (B):? !O ,/[3. 0<;'
PLUMBING RERMIT
,
ITEM I FEE
Fixtures
, ,I
Resldenllal Bath(s)
l
Sanitary Sewe, 'I
I
I
,
,
I
!
,
I
I
Water
Storm Sewer I
Mobile Home
Plumbing Permll
State Surcharge :-+ 3%
I ,
Total Charge I (C)
1
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
!
Wood Stovellnserl/Flreplace Unit
Dryer Vent
I
,
Mechanical PermW
Issuance
State Surcharge
Total Permll
N'
--Q
FT.
FT,
FT.
N'
(D)
I
MISCELLANE9US PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk \ rz\?~ 'ft
Cu,bcut :El'>
It
Demolition
)/.;O,dJ
1LolJ.cO
(rG.~
/7ri.'tP
to.CO
4-.~
C\cD
,3.00
r--~ .~
JD .m
1 g(
34,~1
~.M
'\4.S)
r\ate sUrCharge. I \ A ) .Ui)
\A'lX\ 1\ (\ r ) ,:. no > U\.
Tolal MlscellaneoJjmlls (E)
TOTAL AMOUNT DjE (excluding eleclrlcal6B1? ~
(A, B, C, D, and' E' C?mblned) _'_n~_~nn ___
I
/
, "
\'"."
.
I, IS THE PROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Accl
I
I
,APPROVED: ,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permllls granted on the express condition that lhe said
construction shalJ. In all respects, c()nform to the Ordinance
adopted 'by the City ,of. Springfield, Including the
Development Code, regulating the construction and use 01
buildings, and may be. suspended or'revoked at any time
upon vlolatlon of any provisions of said ordInances.
",~
Date Paid: .
Receipt Number: ~
Received By: ~ .
Plan Check Fee'
/
Plans Reviewed 8y
Date
,
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
~ T: <--\' r"J \ f)
\,~f\f\g '}L lO:/ rf')
~1\D~r'? :~k\o.~
\ j)()bh \
By signature, I stote 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 certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of lhe Slate of Oregon pertaining to the work described
herein, and thot 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 properly, and the approved set of plans will remain
on the site a all times during construction.
Slgnat ~Cio /y)b^ ./
Date Feb ;)d: ) q 96
VALIDATION: 1\ /'\ '2.0Ci
RECEIPT NUMB~ r'V s...X ( \
DATE PAID 0) A\~ 'L1... '\
AMOUNT R';;Jr..~l a.loO
RECEIVED U)~