HomeMy WebLinkAboutPermit Electrical 1992-5-5
'7]-,d lOllo'io';nQ pro'O<;t " tI~
::::min(J. end du!;:"I.- as S~bmit'od has the...toUo . . ~
225 FIFTII STREET i)ppr,..",i." not reqUIre epecific 'end~~CAL PERIlIT APPLICATION
SPRINGFIELD, OREGON 97477 z' r1 I) r----,r::...'D\
INSPECTION REQUEST: 726-3769 SI;J:-:l ~ Ci ty Job Number~~I~( Fe )
OFFICE: 726-3759 Dale '
Authorized ~gnlll iG"'" 3 . ('\ COMPLETE FEE SCHEDULE BELOV
1 LOCATION OF -+~STALLATION Ure ,-1:0 2!;\lI_~~,
( 0 n..e::; ,X\ . c:.vN,e 14 Ol7J..l. A. New Residential-Single or
L-) Mult~-Family per dwelling unit.
J::l(l~N n'lcrco SerVlce Included: Items Cost Sum
~B DESCRIPTI~" rP )
\ I. 0 m f'\ ~\ A'J.. ')E' 't--
Permits are n~n-transferableand expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
Ci ty
Phone
Supervisor License Number
Expiration Date
1000 sq.ft. or less'
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
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
$ 85.00
$ 15,00
$ 40.00
S 50.00
S 60.00
$100.00
$130.00
$300.00
S 40.00
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electrician
Owners Nallie \\\ ~ ~\ y-\ \N\O. nJ D.
Address~o()\ e~~< ~.Q.Q.))
City ~~Ph:e~Io-3137
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
~rs/Z~~
1~~~;~-~--~~:~C)~~~~~-----7-~-~--~
_,RECEIPT It: ~ ~}.-:..., ,
RECEIVED BY: GU~7'0- ~}
200 amps or less \
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Ci rcui ts
$ 40.00
$ 55.00
$ 80.00
see linn
10
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightinr
Limited 'Energy/Res
Limited Energy/Comm
One Ci.rcuit
Each Additional
Circuit or with Service
or Feeder Permit
E,
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
S 35,00
$ 2.00
not included)
$ 40,00
S 40.00
S 20.00
S 36,00
4D,'~
Li-CZ .UQ
I
JOB NO. q7,..()So/
CITY OF S.INGFIELD SYSTEMS DEVELOPMa CHARGE
WORKSHEET J
, (COMMERCIAL & RESIDENTIAL)
NM1EOR COHPANY: Jv1'C-H~f;.L I-/UDN'A/'o..'
LOCATION: CooS L-u>vE-12LE.AF'
17~3-Z-7.-<-f7-- - 07'1()O
DEVELOP~lENT TYPE: MlJ/i!.. - ApUl-T CA-iLE:. t:-A-t-/UTY
BUILDING SIZE:
LOT SIZE
. SQ. Ft.
I. ~TORH DRAINAGF.
IMPERVIOUS SQ. FT. t.f?'-f~ X $0.186 PER SQ. FT. I~ ~<I(,!.!..
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S I-M X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
3, TRANSPORTATION
Is /t.."I(, ~ I
NO OF UNITS X TRIP RATE X COST PER TRIP
UP!::. ~c;,-z....
./1 X, 17? X $388.61
Is ,?;,q ~2:j
X
X $388.61
s
X X $388.61 i
(Se~ Attachmen~ C To Determine Trip Rates)
.' . ' SUBTOTAL (ADO ITEl1S 1.2. & 3)' $ ';2-515,2.
4. ADHINISTRATIVE FEES
BASE, CHARGE (SUBTOTAl ABOVE) X ,05
Is 1"'</ ~
TOTAL-CITY SDCS-;o../'f'? if;;
5. SANITARY SEWER-MWMC
NO. OF PFU'S ' <./-</
t::.a....~
X S13.25 PER PFU + SlOMWl1C ADMIN. FEE S -:;> 1/
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
s 2-'?!:..
TOTAL-MWMC SDC Is 51..('~ I
, /~
TOTAL SDC L'-I-o/'2.-
K:- ~.L. J.....' ?I/~' /"'I'l--
~ Kip Burdick
SDC Coordinator
(
(
FIXTURE UNIT CALCULA~N TABLE: Number of New Fi>.1uresX Unit Equivalent = Fi>.1ure Units (r~OTE:
For remodels, calculate only the NET.itional fi>.1ures) , .
NUMBEfl OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
oJ.
2
1
2
3
6
2'
6
6
1
3
2
l/Head
2
2
1
6
4
'J-.
I
Bathtub..............................................................,......,
Drinking Fountain.......:........................ ......................
Floor Drain....... ....:........:.......................,................,..
Interceptors For Grease/Oil/Solids/Etc.........,:......
Interceptors For'Sand/Auto Wash/Etc..........:,......
Laundry Tub /Ootheswasher......,.......... ......,....,......
Ootheswasher - 3' Or More...............................,.....
Mobile Home Park Trap (1 Per Trailer}.....,............
Receptor For Refrigerator fWater Stalion/Etc........
Receptor For Commercial Sink/DishwasherfEtc.:
Shower, Single Stall.........................,......................,
Shower, Gang.................,.:........................_....,.... '
Sink, Bar, COmmerclaL_.........-..........__......-....
Urinal, StallfWalL......:...........:......................_..........
Wash BasinjLavatory, Single ....-.......
Water Ooset, Public Installation.............._.........
Water Ooset. Private_..___......__..
MiscellaneouS:.
J
'2-
'~
1-
L/
~
(",
,<I
/'-f
It.
TOTAL AXTURE UNITS
=
4-4
CREDIT CALCULAllON TABLE: Based on assessed value. If.lmprovements occurred after annexation date in.table
calculate credits separates.
I
1985
1986
1987
1988
1989
1990
. Rate per $1,000
Assessed Value
$1.69
1.35
1.15
0.92
0.59
0.23
'I
\
1979 or before
1980
1981
1982
1983
1984 '
Rate per $1,000
AssesSed Value
52.66
2.64
2.53
2.41
2.19
2.04
Year '
A...,~..loi.j
Year
AnneXed
"
Credit for Parcel or land Only If Applicable '2 . (" " X S If:>. 0 (., '2-G. 7.=.
(Rate X AssesSed Value)
Improvement (If after annexation date) . X $ =
(Rate X AsseSsed Value)
CREDIT TOTAL = 5, '2" 7~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL.........................................,..........., 0.4
CommerciaL..............................,.....,....,......... 0.9
I ndustrial................:............................. ............. 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
~ JOB NUMBER
..~ 225 Filth Street
~!' ,Springfield, Oregon 97477
LOCATION OF PROP~SED WgB,K' l QD~ (\ ~ 0\ \ Q x1..Qr\ ,...... _
ASSESSOf3S MAP' C1D.,\)~N4~, '.. TAX L9"~ ,L..mq(~ ')
LOT- ' ~'1 BLOCi<' SUBDIVISION: (-W\...'\)'\t\ r\ fL.1l-
o V ~t:\\)d...ffi(\ \r\ PHoNE:_:IRJo.=..en 'Ft.)
, \ 0 f'" K \ Q Q fl \-.).f\\ L '. - - ~ ..
'-'-, STATF' ~ 'ZIP:~
l'[) \Q ~Jrt ,
ADDITION 'DEM;)~S~ OTHER ,j
CONST.
CONTRACTOR'
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
OWNEUJ\i -"
ADDRESS: ,CoO.
CITY:
)
DESCRIBE WORK( r:A(\t t O'{-
NEW
REMODEL
.
SPRINGFIELD
CONTRACT~~ NAME (\ & L ~DRES~
GENERA" U \ \. ~~)L ~. -~ . O-,-f:,)
PLUMBING' ' '
MECHANICAl'
. ELEGr~ICA' . '- ~\f\ f\J... )
QUAD AREA:' ~.'{\ 1 [')
. OF BLDGS: . )\' .
:;;s U._ I '\
OCCY ~ROUP: ~ ~
'<4 '
?....
. OF STORIES:
WATER HEATER:
- OFFICE USE -
. tAN 0 USE~
'. 'OF UNITS' ~
CONSTR. TYPE: ~
HEAT SOURCE: - ~ f=l
TJ'
RANG~'
q (Yy~jj l
EXPIRES
PHONE '!
FLOOD PLAIN:
ZONING CODE: ,"~\;:' . p )
. OF BDRMS' . \ 4'
SECONDARY HEAT:
SQUARE FOOTAG E: ~:O4-\
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, Inspectlons requested after 7:00 a.m. will be r:nade the following work day.
REQUIRED INSPECTIONS
lKl Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
rvl Footing - After trenches are
L..AJ excavated. .
o Masonry '- Steel rocation, bond
, . beams, grouting.
rVl Foundation - After forms are
..14-J erected but prior to concrete
placement.
(Kl Underground Plumbing - Prior
to filling trench.
[Xl
Underfloor Plumblng/Machanical
- Prior to insulation or decking.
l4J
Post and Beam - Prior to floor
Insulation' or decking.
lZl Floor Insulation - Prior to
decking.
fVl Sanitary Sewer - Prior to filling
~ trench.
~ Storm Sewer - Prior to flll1ng
l,.LLJ trench.
IVl Water Line - Prior to 1IIIIng
L4-J trench.
rV'l 'ROUgh Plumbing - Prior to
JL!-J cover.
r7l Rough Mechanical - Prior to
~ cover. .
rI.Yl Rough Electrical ....; Prl~r. to.
~ cover.
n7l Electrical Service - Must be
~ approved to obtain permanent
electrical power. .
D Fireplace - Prior to facIng
materials and framing Insp.
[l] Framing - Prior to cover.
rx1 Wall/Ceiling Insulation - Prior to
L,LJ cover.
[XI Drywall - Prior t.o taping.
D Wood S'tove - Ait~r Installation.
D Insert - After fireplace approval
and Installation of unit.
[Xl Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
r\7l Sidewalk & Driveway - After
I,.A.J excavation Is complete, forms
~nd sub-base material In place.
I2J Fence - When completed.
1lJ. Street Trees -..When all r'equl red
trees are planted. . , .
~
Final Plumbing - When all
plumbing work Is complete.
[2] Final Electrical - When all.
electrical work Is, complete.
r\7l Final Mechanical - When all
LAJ mechanical work Is complete.
n7l Final Building - When all
~ required Inspections have been
approved and building is
completed.
gJ Other.;:;~f'L-:5~
.0{;~L ~5
MOBILE HOME INSPECTIONS
D Blocking and Set,Up ~ When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Co~nection - When
blockIng, set-up, and plumbing
inspections have been approved
and the home Is connected to
the se~l.ce panel.
D Final - Alter all required
Inspections are approved and
, porches, skirting, decks, and
venting have been Installed.
Lot faces
lot Type.
Interior
I PL.
IN
E-
L
_ Lot coverage ~ ~ Corner
Topography ~ ~ Panhandle I S
-L'/!/#O ..' ,..., , ,I W
Total height ~'Y:>.' ~ Cui.de.sac" . _'I'
"lg~f:Y~'M'?#-~~?;~. E
~
. THE PROPOSED ~ORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to perm'it issuance.
Setbacks ~
I HSE "GAR I ACC I
I
I
I
1
/
II
I
~AW.
4:S~~.I;' ,
/9/'
Lot sq. Itg.
BUILDING PERMIT, '
SQ, FT, X $/SQ, FT.
VALUE
/'177/3.22
.$2P95: Y'6
ITEM
Main/aC
::2"C>~
<f:r?~
-,?392.23
721 6G.
41'2, ~
~Z~
Carport
Total Value
, /79:~.6'8
CD/~ 7S-
""5".0.09
6~/. ~~
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)~
(B) IJ <lol'J. '.!;..
PLUMBING PERMIT
ITEM FEE
Fixtures ':::(~ ~//d ~.
Residential Bath(s) N'
Sanitary Sewer FT. -::<57
Water FT. A>
Storm Sewer FT. ::2S
Mobile Home
~FLL:x::'-> .bkwCG /C>
Plumbing Permit 5~ -~-?. ~
State Surcharge I/.. 7~ ,!-7' 75
Total Charge, (C) '551.7$ q ~:::'.7?
MECHANICAL PERMIT
Furnace
h.~
9.-=-
9.-
Exhaust Hood
--;;;> ~''/.~
N' -q)\ -:?
Vent Fan
Wood Stove/ Insert/Fireplace Unit
Dryer Vent
~-- R~,,;-
_.. v' ,. "
~e>-
"'2, -=
'::7G:.""'::> .... 7, -'-
I.,/>. Ot:>
G/.. -'J'
---... ',~ "
/."?II!!> /'t'~,
'OIC......-::2~ ,I" ",-=
lD)....'. _ ->J..:'"'' ~
MechanIcal PermIt
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk /7"3 It
Curbcut /'1 It
~ 5",95"
/2./.0
Demolition
State Surcharge
tzl:/k"'~ 1f M5:......
c:;: ~
Ii? P-:5"
Total Miscellaneous PermIts
(E)
""-z. '""'? b ---,.-.
TOTAL AMOUNT DUE (excluding electrical) ~~_ ..t.....'....c.-..J
(A, B, C, D, and E Combined) 1i'2'1~.1t!>
APPROVED'
, .
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:
~Ai'~ ....
/~ =-0
. J
Date Paid:
Receipt Number'
Received By:
4~z,- ~~-'7
, p('..,fs Reviewed lBy ,
~-/6-"9~
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are bein.g improved.
~ITIONAL COMMENTS
r,,-1-7#=-/ _
~1Cl~ OD. Yn'/~
c<1\\\\\ Q >(l ll-h,,: \J(\O~
\ :A-T'C \ \t)\l )\OC )
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that alt
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 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 witt 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
-:-tn_the sit~rin co ruction.
. \~natur""v
Date
VALIDATION: A r--',.... Q
RECEIPT NUMBER '"l ~"'--)
t:::.. L.:::::;:~jf~
OATE PAIr' ,r -----J'
AMOUNT RECEI~ ' _ _:3 (3 , I
RECEIVED BY lL.X 1:. )
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