HomeMy WebLinkAboutPermit Electrical 1992-3-27
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SPRINGFIELD
::t.'
225 FIFTH, STREET ' . ELECTRICAL PERMIT APPLICATION'
SPRINGFIELD, OREGON 97 4 7~h.a,lc!1owinll projee! 9Hubmltled hM the follow' ' ' , ,
io.lInJ)~ ond QOOO nol require. r I "'II /'1 "'\ -, I
INSPECTION REQUEST:' 726~6J.l1.' . peOlle on</ ~~i ty Job Number ~I ~O ::> 0
OFFICE: 726-3759 Z' ~() -;)
onl09 I L..-:;" , "OHPLETE FEE SCHEDULE BELOV,
1. LOCATION OF INSTALI..@iI41N 0,2-7. 'i..- .
4434 Jessica Street A,........')(! 'ii1fr::'..'-J.tf A.
LEGAL DESCRIPTION,
18 0.2 0.5 2 4 TL 210.0.
, Nev Residential-Single or
;~'~~:' "'Illily per dvelling
Service Included: '
JOB DESCRIPTION
5 F Residence
1000 sQ.ft. or less
Each additional 500
SQ. ft or portion
thereof
Each Hanuf'd Home or
Modular Dwelling
Service or Feeder
Permits are non-transferable and expire
if york is not started vi thin 180 daY$
of issuance or if york is ~uspended for
180 days.
2, 'CONTRACTOR INSTALLATION ONLY
'.1'
~
"''';o,~ '
$ 85,00 as
$ 15,00 3D
,
,I
Items
$ 35.00
Electrical Contractor Rose Corp.
B. Services or Feeders .<10 Branch Circui,ts
included). Installation, Alterations
or Relocation: '
Address 89976 Day Lane
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts'
Reconnect Only ,
Ci ty Eugene
Phone 686-0.90.5
Supervisor License Number 15685
Expiration Date 10.-1-92
$ 35.00
$ 60.00
$ 80.00
$130.00
$300.00
$ 35.00
Constr Contr. Number 54431
C. Temporary' Services ,or Feeders
Installation, Alteration or Relocation
Expiration Date
9-30.-92
or less
to 400 amps
to 600 amps
amps or 1000
-200 amps
201 amps
Over 401
Over 600
Signatu:~u~ervis~Electrician
(////IA / /~ -
D. Branch Circuits
OWER INSTALLATION
t.--
$~OO
$ 40.00
$ 80.00
see "B" above
volts
Nev, Alteration or Extension Per ,Panel
Name Capstone Homes, Inc, of Oregon.
One Circuit $ 35.00
Tvo to ten Ci rcu'i ts $ 50.00
Each Addt'l, ten or
portion' thereof $ 15.00
Address P,O, Box 22636
'Ci tyEugene, OR 9740.2 Phone 689-5567
'E. Miscellaneous (Service/feeder not included)
-Each installation
Pump 'or irrigation ",' $ 36.00
Sign/Outline Lighting $ 36,00
Signal, Circuit or
limited energy panel $ 36,00
The installation is being made on
property I o"n "hich is not intended
for sale, lease or rent.
Owners Signature:
~~~~~---~---~'=S-~l}-:~~---~-:---
RECEI PT I: r II _ ~ < :""'>'\
RECEIVED BY: (~11 '\\A../
5. SUBTOTAL OF ABOVE
5% S ta te Surcharge'
TOTAL
/-6"<:'_"-C '
7.75-
/~-;::>- ?<""".
Jutj N'U. -1t.-U?Ul
t
CITY OF SP~GFIELO SYSTEMS OEVELOPMEN1..CHARGE
. WORKSHEEf I .
. (COMMERCIAL & RESIDENTIAL)
NM1E OR COMPANY: (~P'7"\9N1:::. ~~S. }'J-.!C-. of' oREbON
LOCATION:' 4'-1-'2;,'-/ :5'€c4'?\CA S1'.
DEVELOPMENT TYPE: LD r:< - l<l€cW <7f-K
\ e, 0'2. o<.?'2. '-I-
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ, FT. 2.."1'1-9 X SO.186 PER SQ. FT. ~ <;0'1 s"i
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
LOT SIZE
SQ; Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S l~ X 538.55 PER PFU
(See Reverse To Determine Total PFU'S)
3, TRANSPORTATION
$c.q?/ ~ ,
NO OF UNITS X TRIP RATE X COST PER TRIP
X \,nne, X ,$388.61
~~,--?!:>
$' -TI()'''''''''
,,'
$ -
x' X $388.61
'..'''''' '... >'0' f- ,,~=, X S388.61 . ,
(Se~ Attachment ~ To Determine Trip Rates)
'. . SUBTOTAL '(ADD ITEMS 1.2.
". "~
'"
" ..._.-.-..
$' -
&. 3)' s:1 5'1.'- ..4~'.--'
4. ADMINISTRATIVE FEE~
'BASE CHARGE' (SU~TOTAl ABOVE) X ~05
$ 7'1 ~
TOTAL-CITY SDC S {(P, I ,..'-1-
5, SANITARY SEWER-MWMC
.-
NO. OF PFU'S
t8
x 513,25 PER PFU .+ S10 MWMC ADlHN. FEE $ ZL\-e,~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
~'_.~..L-
'-J' . Kip Burdick
sac Coordinator
~/? /'17-
, I
. s ?, \ '-I:]
TOTAL-MWMC sac s -z..n o~
TOTAL SDC S (~ee,"'7.
,.'
r,'
FIXTURE UNIT CALCULATION TABLE: t'uinber of New Fi,1ures X Unit Equivalent = Fix1ure Units (I--JOTE
For remodels. calculate only the NET WiliOll2l fix1ures) .
NUMBEfl OF . UNIT FIXTURE
.FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub...........................................,....................--,...
Drinking Fountain..:...:..............................................
Aoor 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 Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc.:
Shower, Single StalL.............................................,
Shower, Gang...................:,....................,_..............
Sink, Bar, COmmerciaL......................_.__............
Urinal. StaUfWall.....,...................................._............ '
Wash BasinfLavatory, Single..,.............._......_.......
Water Oose!, Public Installation.............._.............
Water Oose!, Privata..........................,......--.........
Miscellaneous:,
'2-
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
\
'2-
7_
TOTAL FIXTURE UNITS
=
'-f
'2
2-
2-
B
~~
r'
CREDIT CALCULATION TABLE:
calculate credits separates.
I
Based on assessed value. If.lmprovements ClCCUrred after annexation date in ,table.
"
Rate per $1.000
~Value
, Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
52.66
2.64
2.53
2.41
2.19
2.04
Year' ..
Annexed
1985
1986
1987
1988
1989
1990
Year
AnneXed
Credit for Parcel or Land Only If Applicable
'2-. Go 10 XS\I~
(Rale X Assessed Value)
X S
(Rate X Assessed Value)
CREDIT TOTAL
::, \ 'iJ
=
Improvement (If after annexation date)
=
= s ~\ 'n
$1.69
1.35
U5
0.92
0.59
0.23
J
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL............................ ...........i............. 0.4
COmmerciGl..................--................................- 0.9
IndustriaL__.., __.......__ .....______......,__ __ .....____......... 0,45
GovernmentaL....____...______....,.......................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
JOB NUMBER
225 Fiflh Street
Springfield, Oregon 97477
ASSESSORS MAP:
65A
LOCATION OF PROPOSED WORK: 4434 Jessica Street
18 02 05 2 4
Springfie'ld" OR 97478
2100
Lucerne Meadows
LOT:
BLOCK'
ADDRI=~C:::'
P.O, Box 22636
OWNER: Capstone Homes, Inc, of Oregon
CiTY:
I?ugene,
STAT'"
OR
NEW
XX REMODEL
Single Fami1~ Residence
OTHER
DESCRiBE WORi<'
ADDITION
DEMOLISH
TAX LOT:
SUBDIVISION'
PHONF'
689-5567'
ZIP'
97402
CONTRACTOR'S NAME ADDRESS
GENERAl capstone Homes, Inc, of OR P,O,B, 22636
CONST.
'CONTRACTOR #
Eug.,OR 97402 62018
EXPIRES
10-18-92
PLUMBING: Frid111nd PIl1mbina 'R562R ni11eyLane Eug. :OR '<171105
MECHANiCAl' Garibau Heatina 4207 W. 5th Ave'. Rl1a. .()R 97402'
ELECTRICA" Rose Corp, 89976 Day Lane Eugene, OR 97402
QUAD AREA: ~ qQ~ j
# OF BLDGS: :)\ - ~
OCCY GROUP~"'\.'c)---\- ~
I
# OF STORIES:
~
WATER HEATER'
~:NFD u~~~~OF\\\, YE )
CONSTR. TYPE: $/\
HEAT SOURCE:_ ~V
E.J
RANGF'
51 R1S
1?-14-92
12-21-92
9-30-92
#SP37
Cj dC'J3C)
PHONE
689-5567
746-9433
344-2481
686-0905
FLOODPLAIN: - ,,-.1
ZONING CODE: U ) ~
.:~
\q~~
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.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Temporary Electric
[E] Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
(X] Foundation - After forms are
erected but prior to concrete
placement.
[K] Underground Plumbing - Prior
to tilling trench.
[]
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
[ZJ
Post and Beam - Prior to floor
insulation or decking,
r:l1 Floor Insulation - Prior to
~ decking.
[Xl Sanitary Sewer - Prior to filling
trench.
rt7I Storm Sewer _- Prior to tilling
LAJ trench. ..
~ Water Line - Prior to filling
t...,.L::j trench.
rI7'1 Rough' Plumbing, "':"')Prior t,o
LAJ cover.
REQUIRED INSPECTIONS
I""i1 Rough Mechanical - Prior to
L,OJ cover.
[Xl Rough Electrical - Prior to
cover.
r\7l Electrical Service - Must be
t...t:U approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
[RJ Framing - Prior to cover,
[K] Wall/Ceiling Insulation": Prior to
cover.
ell Drywall - Prior to ~a'pjng..
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit:
C8J Curbcut & Approach - After
" forms are erected but 'prior to
placement of conc~ete.
I7l Sidewalk & Driveway - After
~- excavation Is complete, forms
and ~~b.base material in place.
o Fence - When completed.
l71 Street Trees - When all req"~ired
L..!.\) trees are planted. .". '.
7054S
54431
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
r;;tl Final Plumbing - When all
l.,.L.J plumbing work is complete.
171 Final Electrical - When alt
l...f--J electrical work ,i:S complete.
[l]
Final Mechanical - When all
mechanical work is complete.
[ZJ
Final Building - When all
required inspections have been
approved and building is
completed.
OOth.,
,
- "
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. .'.
o
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 ~ Lot Type. Setbacks . THE PROPOSED WORK IN THE
Lot sq, fig, Interior I P.L HSE GAR ACC I HISTORICAL DISTRICT, OR ON
~O IN o/',t:>~ '- I THE HISTORICAL RErtSTER?
Lot coverage Corner Is I If yes, this application must be signed
~~- -:20 and approved by lhe Historical
Topography Panhandle
J2' lw' (f:,' I Coordinator prior to permit issuance.
Tolal heighl L Cul.de.sac
IE ~:5' 1 I APPROVED: .
BUILDING PERMIT
SQ, F~T' X $/SQ, FT.
,,\45<. ' "'59,/C?
l\-4r /w./t!?
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
'State Surcharge
- Total Fee
(A)
VALUE
~"?,~?3
,
~;?OO/
~~'2?'?
,
~/--
/6.5'5"
?? 4'7, s-s-
'SYSTEMS DEVELOPMENT CHARGE (SDC)
, ,.. (6) :Ii (e,e>f> ~ $
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N" ?
Sanitary Sewer FT,
Water FT.
Storm Sewer FT.
Mobile Home
.
Plumbing Permit
,
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
" .......
Exhaust Hood
N"
?
Vent Fan
Wood Stove/lnseri~ace U'2Jl::>
Dryer Vent
&#"!> h~~
'j
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk.
~6 fI
-,z.q fI
Curbcut
Demolition
~
State, S, urch~_
1U-~ ,/7CW~7&:G
Total Miscellaneous Permits (E)
FEE
/.60
/;:;0
<;;)
/h~_ .-
,t; _ t:>e>
$/.,5"c::>
4.#6
/5:. .-.
7. -e:>
2,~
:<'9. 50
..
/0.-
/.~
"3'"/, L/Ej
j~'IO
I? bIP
t/a --"
fi<9'.-
TOTAL AMOUNT DUE (excluding eleclrical) -:z.-5":<~.?cO
(A, B, C, D, and E Combined)
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 lhe
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: . .,fO -
Date Paid:
Receipt Number:
~ec' By: c.. ~
, '~- ,//~ -~
s Reviewed By" , ~
'?-S- J7"2-...
Date
.SystemsDevelopment Charge Is due 'on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
\' cA-+-\ \'W~ I \R"rJf-)
2CA.K\\OJ[ .1 n~ y! \qt,n
,
(\ ~ q X f) <Xt rt 0
~~~.OQfQ}()P
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 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 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
-{1\the property, and the approved set of plans will remain
" m the site at II times during construction.
) ~lure. /;~ q
1 ~te
VALIDATION: .It ( ....., r-
RECEIPT NUMBEFl T"-.) ')
DATE PAID r...... ~ .r!l'} J.f f) ~
--../
AMOUNT RECfJ::!.5.~ ~ ~x. </-s;-
RECEIVED B..['-1)( .-J
~. -