HomeMy WebLinkAboutPermit Electrical 2005-3-8
I ..
225 FIFTH STREET. SPRINGFIELD, OR ')7477 . PH:(54I)726-3753 · FAX: (541iS~
ELECTRICAL PERMIT APPUCATION . 0 0,.,,/ ""0'''.9.0"
~ __ " 0'0 '3-~
City Job Number L-'> -CCDC-,<.f. Date . t~ ~ ,,~"/
'- o^. "'"
Vfi<., ....... -'//') 0, ",$',
3. lr!eoMi>1iETEiEEE' '-'-"'rEE~<?f
~,^"..,.........~. "~",,,,~_.' '"'' "_"'" _ J'lSi
(9, .s'.o -1...
~q~" &~~Q
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
2 ~€Oi\TTMCTORi1NST~;:ifT!!4.?fioN1om.~~ B. iSi1f~~~ififtiiIititJ1i,wAit~6~~tiRei~tigfli.);i
. ifii.!!.._!~.....~....,.t'-ov..~,tr.~:'::~"'I.tJJIiII!ol.""';""clI."':N' .,l-_~,'..,.~""",,r:;!.?:J 1!*':'r.~~"'''';;<h-T"o;._...,-....~,,~.~~-&;,l;;.''''''''_if,~'tJ,.;;.t;.,~<....!..;I'....,.~
ElectricalContractor ~(\t{YY\(LI'\ 8eCmL, 200Ampsorless $63.00
~ I l Y\C, 201 Amps to 400 Amps $75.00
Address ~1L\ \ ~ i Ill. y- n 'oC:\,,~ \....e~ 'f\..L, 401 Amps to 600 Amps $125.00
. C W 601 Amps to 1000 Amps $163.00
City! h('(J'\D'I iJhone C\q(<,- 'lt~l Or\'(9,y~J9PP~~bU to $375.00
, 1\ ,. ",I"" OdOltLRe~ect'Ori\y';;'''' U" $50,00
" .'." .' " vU uy "'" Cflegon tllity
I) \~,. f~ltl()" Center. "j;) l.:..c"f~ .et.~t:n" >e-i""""~ ~4.: ,,~.." f<'~~'''.Y. ~~ll~
Supervisor License Number - ,--x( Ai;!,\nA-QJj'i::>-001-06r~tt~lY~~w'ir;fjIerstt"i!'.;J~,~,,~~~~Jf~.i:;.":1l
Expiration Date i lJ _ \ _ l) ~~ii~~~h~ay o~ta.i';l~i\Pjll~n~wnA-&"\ml~lkeloeation
.. cen er. 8 ~ thme telephone I $ 000 <::'0,00
Constr. Contr. Number .ii \ "::> \~re~~~~~elso; n UII~ s~. $ ~9:00
t r. -'7/ C' q 401 Amps 0 ~mps $100.00
. 0 1,'1-, - }
ExpIration ate ....
Over 600 Amps or 1000 Volts see ''B'' above.
D !.I'i"''''''''''Ii"~'''''''"'''''''''''_~_~~'~,,~Ilil1!;!'i1\\li'~'''''l'i1\J
. . d,rn.nS,,_~~~.~~~~~~~~.2tIr~~
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Pennit
r2/!F
Owners Name !Io~ ~MkJ
Address ,. 7 7 I ",- _- . .1"'lICE' E.~Mi~~IUilieo.""J~f(s~!1>-'W.-Ie<\cl>.)""""M''''>ihir~1ifd~..",)c;'tE1'cJ:i,'f~~o~~
;..). _ LM I<-~ <..:!IITI RM\T~"'t'XP\Wlffi:.L'I'/uA%-"';~"'~'-"'~''N=''"-~'~".il
City t-:"UJ::st:7l/t:.. Phone h 'b 3 - l~ERIZE~WJm!~[*,~ PERMIT IS NOT $ 50.00
/-IU Iii MENC ~?fI~nl\BillM\!1@NED FOR $ 50.00
OWNER INSTALLATION COM 60 0 . ~u~y/Residential $ 25.00
ANY 1 t. dE IC . I
The installation is being made on property I own which Imlte nergy ommerCla $ 45.00
is not intended for sale, lease or rent.
I. !lJEoCiiTiON:Oit.iNST,4\rii;4.TI:ON:~~ilt~j
!Z:i'- .._. ...,............1-,~.~'.w'._...:..~,UUili~~..."~.......... - ~,ritt.....
1'-14 /N~ !Ln.r t..~ ur-
LEGAL DESCRIPTION
1'1-o-r, 21-H G>11.oo
JOB DESCRIPTION
!!.es\/b"U", LJLI' c,.,v DWl.III"5
Permits are non-transferable and expire If work IS
Dot started wlthiD 180 days of Issuanee or if work Is
Suspended for 180 days.
Signature of Supervising Electrician
/~h~-?~..L-
/
Owners Signature:
Inspection Request: 726-3769
~
$50.00
$ 43.00
$ 3.00
MIDlmum Electric Permit Inspection Fee Is $45.00 + Surcharges
i)."~ '- >~ .;~'>4.~:;:-.:...l"~~ii{'~~"~j".'i:;..".. ""'mt,~"",~;.~. '- ;Ji'I>t~.'i! -""-t.iN.~.'~.'~
4. "SlJB'n)TAI.-OF'A:BOVE.~,;;h , ' .'.~",,_.ti.\' '"
~I~ -i;~i'l::i"~_.,~.(.:::;.~,"iJ-:~"""'t-f':.;f:4~,~'''r~~!''_, :,,,~~t-~--, _ ......;t
S Do ..x:>
2.-1 ,00
,e>. 00
11 ~,oo
7% State Surcharge
10% Administrative Fee
TOTAL
~
CITY OF sAG FIELD sys!EMs DEVELOPMEN"RKsHEET
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
. COM2005-00064
Duane Kni~t
144 146 Kaylee Ct
1703271103300
SINGLE FAMILY RESIDENCE
2 BUILDING SIZE (SF;
2340
LOT SIZE (SF):
5331 .4
1. STORM DRAINAGE
'"
~
Cl
o
I~
'"
G
~
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I
I 2960.00 I $0.3 10 I = , $917.60
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
1 0.00 . I $0.310 I 50% I = I
ITEM I TOTAL - STORM DRAINAGE SDC '$917.60 I
DISCOUNT
$0.00
$917.60
1070
I.
2 SANITARY SEWER. CITY
A. REIMBURSEMENT COST:
I NUMBE~40F DFU's I x COST PER DFU
$24.04 $817.36 11091
B. IMPROVEMENT COST: I
I NUMBE~~F DFU's I x
$18.28 $621.52 . 11092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1.438.88 I
3. TRANSPORTATION
A. REIMBURSEMENT COST:
1 ADT TRlP RATE 1 x I NUMBER OF UNITS I x 1 COST PER TRIP x INEWTRlPFACTORI
I 9.57 I I 2 I $18.30 I 1.00 I $350.26 11093
B. IMPROVEMENT COST: I
I ADT TRIP RATE I x I NUMBE\OF UNITS I x I COST PER TRlP x I NEW TRlP FACTORI
9.57 I I $80.72 I 1.00 I $1,544.98 1094
ITEM 3 TOTAL - TRANSPORTATION SDC = I $1,895.24
4. SANITARY SEWER - MWM(
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 2 I $82.03 = $164.06 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's 1 x ICOST PER FEU
I 2 1 $865.31 = $1,730.62 11055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054
MWMC ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $1,904.68
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I $6,156.40 _I
5. ADMINISTIl A riVE FEE:
I SUBTOTAL x I ADM. FEE RATE 1= CHARGE I
I $6.156.40 1 5% I $307.82 1
TOTAL SANITARY ADMINISTRATION FEE: 170.61 11079
TOTAL TRANSPORTATION ADMINISTRA nON FEE: $137.21 11078
Cheryl Slaymaker 1/21/2005 TOTAL SDC CHARGES = , $6,464.22
PREPARED BY DATE
-.--...........-..-
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTIJRES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONLY THE NET fuJUJ J IV1~AL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 2 0 3 6
DRINKING FOUNTAIN 0 0 1 = 0
iFLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC 0 0 3 = 0
I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER I MOP SINK 2 0 3 = 6
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG I WATER STATION I ETC 0 0 1 - 0
RECEPTOR FOR COM. SINK I DISHWASHER I ETC 0 0 3 = 0 I
SHOWER, SINGLE STALL 0 0 2 = 0 I
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 :1
I SINK: COMMERCiALiRESIDENTIAL KITCHEN 2 0 3 = 6
I SINK: COMMERCIAL BAR 0 0 2 = 0 I
SINK: WASH BASINIDOU8LE LAVATORY 0 0 2 = 0 I
SINK: SINGLE LAVATORYIRESIDENTlAL BAR 4 0 1 = 4 I
URINAL. STALL I WALL 0 0 5 = 0 I
TOILET. PUBLIC INSTALLATION 0 0 6 = 0 I
ITOILET. PRIVATE INSTALLATION 4 0 3 = 12 I
MISCELLANEOUS DFU TYPE NUMBER OF EOU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 34
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
i-:YEAR CREDIT RATE/$I.OOO ~ LAND ELGlBLE FOR ANNEXATION C~DlT?
ANNEXED ASSESSED VALUE 2
I BEFORE 1979 $5.29 (Enter I for Yes, 2 for No)
I 1979 $5.29 IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? 2
I 1980 $5.19 (Enter] for Yes, 2 for No)
1981 $5.12 BASE YEAR 1979
1982 $4.98
1983 $4.80 CREDIT FOR LAND (IF APPLlCABLE)-
1984 $4.63 VALUE I 1000 CREDIT RATE
I 1985 $4.40 $0.00 x $5.29 ~ I $0.00
I 1986 $4.07
I 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
I 1988 $3.22 VALUE I 1000 CREDIT RATE
I 1989 $2.73 $0.00 x $5.29 ~, 0
1990 $2.25
1991 $1.80
1992 $1.59 TOTAL MWMC CREDIT = $0.00
1993 $1.45
1994 $1.25
1995 $1.09
1996 $0.92
1997 $0.72
1998 $0.48
1999 $0,28
2000 $O.Og
2001 $0.05