HomeMy WebLinkAboutPermit Electrical 1994-10-13
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SPRINcttLD
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Th. following project.. .ubmItGd.has th. fo , . .
225 FIFTH STREET zoning, and does not require epecmc mhl!I1'rRICAL PERMIT APPLICATION
SPRINGFIELD. OREGON 97477 approval. ('14 \~\ Lo
INSPEctION REQUEST: 726-3769 Zonino L-D(2/ . Ci ty Job Number '-1. U
OPPlCS: 726-3759 .
0eI.r.);\~A'-'-3. COHPLETE FEE SCHEDULE BELOV *'
1. I.OCA.TIOlf--PP \I~ST~tION .~ . I yT'i'-'
0' ) \..Q'f., ~h \ f'i\ ~ F\ """,rtllld $19"" yr'I\.. \".., l\eS10en tla~-Single or
Hulti-Family per dvelling unit. .
. LEGAL DESCRI",ION 02""" N'\ Service Included: .
\ <f(())J-..;\ \'\ vLJJ....) Items Cost Sum
::1~ ~~k~~::'~~l~
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
!
2. CONTRACTOR INSTALLATION ONLY
,
Electrical Contractor ARC ELECTRIC
Addres85783 HWY 99 SOUTH
Ci ty FIIGENE
Phone 741-0494
Supervisor License Number
20985
Expiration Date
..
Constr Contr. Number
--
~ :..:.-
00603
Expira tion Da te
Sign~e~f Supervising Electrician
t7,{, hJ.-U~Crr.~
ovn~rs Name....... ~ f\ 0.11 t"6 m
Address :~\)~, ~~\\\\)\
Ci ty 5;;~ ~ no-,- ;hon~ lo~ ' \
OVNER M-rALLATION
The. installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE:
RECEIPT I:
RECEIVED BY:
In',I'~q4
'-f - . \c2: 4"V\ I
C')(LY--.~'J' J l\.C.I
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd.Home or
Modular Dvelling ~. IDc:D
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 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Branch Ci rcui ts
Nev, Alteration or Extension Per Panel
E.
One Circuit $ 35.00
Each Additional
Circui t or vi th Service Il ,CD
or Feeder Permit ~ $ 2.00 ~
not included)
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
81.cj)
- ~ \()
c-<J ,<1 (/)
58. S kJ
SUBTOTAL OP ABOVE
5% State Surcharge
Tlli'AI, 3 '1'c) ,
.
.
D !!!i!I$!!!!~!~!!!;
Job No. *1511 (J
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:-&(\ ~1
ADDRESS:
- I Y .
d \-
lOCATION OF "'ROPOSED BUILDING SITE: .K.I\\' ...... \
Street Address if Known: ~ r') lo ~ \) 1) tV\ If) I
Platt Name: 'G~V1f. TaxlotNumber: \~N2J~\~ o36DJ
PHONE: le-~C1.. 14115
STATE: ~IP ~
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), SDC Calculations and dwelling type
definitions are on the back.!
A. Sinl!le Familv - Detache1
Single Family home
NO OF UNITS (
B. SimIle Familv - Attached
NO OF UNITS
C. Multi-Familv ADartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
I Manufactured home not in a park
X $400 PER UNIT .=
$ 4tO.ro
.
X $370 PER UNIT =
.$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$1[1) ,ro
$#
$ 400 po
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 Creditl
~~~~LV Din I \~ I
_~"-_ _L r__:_~:~I.J
q1
I
. ,
. AlTACHMENT Bl .OB NO. 9.41'::>\<0
CITY OF SPRINGFIELD SYSTEMS' DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ",:::>,Po.N C.~""I"-1It-..lC3I-\AM
LOCATION' ?'0?-:> 1C"A.l--,,^'A. l'i,Oz.oy\'-\: -"2;0"';>06
DEVELOPMENT TYPE: \....Dl2- - t\)\A,t-..!u w'oM.e ~ C;,.,.~p,c"c
H-oMe . .aop,w. G.-A(2..
BUILDING SIZE:'1.1i-o.l-'b.:!!.<>.<= 21-'(2~ tOT SIZ>
SQ, Ft.
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1,0 I X $436,19
X X $436,19
X X $436.19
$ 4-40 o::.So
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $
4. SANTTARY S>WFR-MWMr,
NO, OF PFU'S I~ x $17.19 PER PFU + $10 HWHC ADMIN,FEE $?I"I'4.1-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ?? ~
. IQIAI -MWMC SDC $ 2k.'4 ~
SUBTOTAl (ADD ITEMS 1.2.3 & 4) $ \9?~E'ti.
5. AQMTNTSTATTVF F>>S
BASE CHARGE (SUBTOTAl ABOVE) X ,05
$ 9(..,9'-1
r r ~J...:.tk
~~ ~ry Hornig, P.E.
$Dc Coordinator
Date:
IQIAI SOC.
$ 'Z6 '?? '7:!-
B2,SDC .
_..--:.:....:.:-_~t..~,___.
FIXTURE UNIT CALCULelON TABLE: Number 01 New FiXI:'x Unit Equivalent = Fixture Units
lNOTE: For remodels, calculate only the tiE[ additional fixtures).
, NUMBER OF
NEW FIXTURES
FiXTURE 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 Trailer)..,......,........
Receptor For.Relrigerator/Water Station/Etc..,;....
Receptor For Commercial Sink/Dishwa~her/Etc..
Shower, Single StalL.,.....,.,.......,..:...........,..,..,.,....,...
Shower, Gang........,...,.,.,. ,.......,...............,.............,.
Sink: Bar, Commercial, Residential Kitchen,.........,.............
Urinal, Stall/Wall..:."".,...,.,............,.."......,.,....".."".
Wash BasinlLavatory, Single..,...............,...............
Toilet, Public Installation...""...".",."....."..,..,....,...
Toilet, Private......,.................................,....,.........
Miscellaneous: ,TANI TDP'$ $.INk
'Z..
,.
-z.
'Z-
TOTAL FIXTURE UNiTS
UNIT
EOUiVALENT
2
1
2
3
.6
2
6
6
1
3'
2
1/Head
2
2
1
6
4
~
=
FIXTURE
UNITS
't
'Z-
'Z-
'Z-
S?
IB
Based on assessed value. if improvements occurred alter annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates.
I
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
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
s <;;, 7.,2:
Credit for Parcel or Land Only If Applicable _?, '-1-'" X $ I? 9 '"
(Rate X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
=
=
Rate per $1,000 l
Assessed Value
$2.46
2,14
1.77
1.37
0.97
0.61
0.44
0,15
CREDIT TOTAL = $ ??'2..!::
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726'3769
OUlce: 726,3759
LOCATION OF PROPOSED WORK:
/~O'L
ASSESSORS MAP'
/4.
LOT:
.
"'..., (., It"
~
~l....
/4-
/
BLOCK:
OWNER'
ADORES'"
CITY'
:5T~ G...A30.3.N b- ~
''3~ k:'..,u(,,-!>'3u~'1'
fu,~
~\""A.)
DESCRIBE WORK:
NEW + REMODEL
STATF' . 6llR..
14:;" l>.EO"-lTI....'--
blll..l ~u..I"" \.r
ADDITION
DEMOLISH
OTHER
1'. I rr.
.
9~1 J/ (.'
JOB NUMBER
225 Flflh Street
Springfield, Oregon 97477
r;;>3?!'D
TAX LOT:
SUBDIVISION: c:;'",;7~(I&) ~A'7'"-~
I <''''4<11
PHONE:
t-,ffl-/4-"IS
ZIP'
0.",/:.::.,-\
M..bBlLEo
k.l
~ ~ 9nnorp ~
CONTRACTOR'S N~ME ADDRESS.
GENERAL: (,J'l>l'O"'- f.:~/..A.u""TI~ ~"_- .~ ~
CONST.
.CONTRACTOR .
qSI'Z~
PHONE
~-S7ZS-
PLUMBING'
MECHANICAl'
ELECTRICAl . .A-~I'_
t:-"t=, c:-nu '-
~~
B;t"
,.
EXPIRES
" II)H.../qlf-
\ I,
l
QUAD AREA: ~R~ I - OFFICE USE -
LAND USE: \ \SlJ FLOOD PLAIN'
. OF BLDGS:_~ . OF UNITS' \~,A) ZONING CODE: ~
OCCY GROUP: R, + fV\ CONSTR. TYPE: . OF BDRMS: ~
. OF STORIES: \ HEAT SOURCE: FS SECONDARY HEAT:
y.-/ " U \8.r) ~
WATER HEATER' RANG'" SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Afllnspecllons requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a,m. ~1I1 be made the following work day,
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior 0
setting ~~CU-d .
Underslab Plumbing lectrlcall
. echanlcal - Prior r.nvpr
o Rough Mechanical - Prior to
cover.
Waugh Electrical - Prior to
r cover. q~
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Plumbing - When all
plumbing work Is complete.
. .
~Inal Electrical - V\.I.hen alt
r electrical work is ~mLtlj),Q....-
o Final Mechanical ~ ~hen a~l- ~
mechanical work Is complete.
~nal Building - When all
O FI~e~l,ac,_e :- :,r~o_r _to_ facln_9 required Inspections have been
r:;i;de:r,a,., ai'la ..a,,;I"9 Ins.... D.ppio'..ed and bU~'1 t~ ~s,
Masonry - ~teel location, bond .. completed. . wliJl1 () ___
.beams,9rou ng, [S2t1ramlng _ Prior to cOvrI'llrl----' ' y---~~
~OUndatlOn - After forms are {~ qdA~~ D Other
erected.but prior to cOan~ WalllCelllng Insulation _ Prior to
placement. q~ =- -p~r ~ cover.
o Underground Plumbing - prO Drywall - Prior to taping.
to filling trench.
F otlng - After trenches are
cavated.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng, .
o Floor Insulation - Prior to
decking.
I
r1'i'2anltary Sewer - Prior 10:f11l1ng
~rench.
~Storm Sewer - Prior to filling
CP trench.
~ater Line - Prior to filling
~ trench,
D Rough Plumbing - Prior to
cover.
D Wood Stovo - After I~sta"atlon.
o Insert - After fireplace approvlll
and Installation of unit.
~rbcut & Approach - After
rms are erected but prIor to
placemont of concrete,
~idewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fen~e - When completed.
~treet Trees - Wh~n all required
~trees are planted.
MOBILE HOME INSPECTIONS
rtl6),klng and Sel'Up - When. all
,lOCkIng Is complete,
r!lumbing Connections - When
home has been connected to
water and sewer.
74Jectrlca, Connection - When
blocking, set.up, and plulQbing
Inspections have been approved
and the home Is connected to
the service panel.
~I - After all required
Inspectlons are approved and
porches, skirting, decks, and
ventIng have been Installed.
Lot faces
. : -i .:' 'J' . ,.... ': ~ ::,l;: ~~'~\f.;:~;' .
Setbacks,
I' P.L. HSE GAR ACe' I
IN
Is
Iw
IE
Lot sq. Itg.
Lot ~yp.
.)(Interlor
Lot coverage
Corner
Topography
Totaf ~elght
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. VALUE
r>.1aln ,/#H ~,~
,
~') /1'-/0 '. ~(PFO
Ga~age
Carport
J=bJJ (~~ 2 '2...S"c,
Total Value '79.'7",,-
Building Permit Fee ~9':, S" 0
State Surcharge ..7~ /tiM"'~ ).~::r
.ss.
Total Fee <A) ~-:;-.q<:=\
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
.... '9
(B) ."..20'!><;. -
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
Residential Bath(s)
N'
L\{\CD
"\-{) .W
4,-0 pU
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge t :Ph
Total Charge (C)
laDPJ
q , Gll.
laq .lLD
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
_f?{
\DsCO
~l}CO
,.~.~
\ ~.\5
13.\5
--3., \ ~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ::J \ ft
Curbcut ~ I ft
9. .. 80lo
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) C:J~L10 ,0]
(A. B, C. D. and E Combined)
_S 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.
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.
*4. ~.3
7'/-1' o/5'd.
/4' tl ("
~~
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
"clTT~..\~\ CA.\Q(J
,i:A\'\\\UU.JTI ~: \ ~ 'lq
01l \ 'f\N III (L
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
of the property, and the approved set of plans will remain
on he site at all times durIng construction,
h
'"
VALIDATION:
.. RECEIPT .NUMBER ~ (~n4( /J
DATE PAID-L~) '1'"=5~
AMOUNT REC~El" d ~ 'i; 'l.t &.~
RECEIVED Bye '/\/M )
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