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Home My WebLink AboutPermit Electrical 2004-10-4 '>' " 225 ".,. n STREET - SPRINGFn~LD. OR 97477 _ PH:(S41)726-37S3 _ FAX: ~~1l1211.uo9 It,. . ,,"""W ELECTRICAL PERMIT APPLICATION. '",,( "0'0'0,0,% City Job NwnbeU::xn.Jcm4.-Q I0750ate /0/ Dq' /Q;;J:." <'0". "~":"~~v. . 1. L~~gt!ii't;H~~.f.!~~[;~ti:9~::i:.~::s;Y:( 0'-10 S uXLl/::?:1 AJn "1 c.:5! LEGAL DESCRIPTION A, / 7 0 ~ a:t-' ~ 0 (j () q 0 t.f Service Included I . JOB DESCRIPTION , 1000 sq, ft. or less $ 00 ./ A2 /J /1 k Eac~ additioual500 sq, ft. or '" 6 012i1 /Y){ ;, ( , ) y(/ , 11 .:::. Pllrl1OIljthcrcof . ,'___ ",,$ ~,oo P i... 'E",.vh'~ A~}r.i;M~0HN^OrAflli)~I,~'''IF~'t'N(J;jXI't~1 . erm Is are non-tran..erable and expire ifwOTk IS ,!-C MlllIUtal:t ' orne or"'^1 ~ n ",,-(&rn, I"' I d .thin 80 f' k' M<od"u'~bl;-""'LI'tl"nP< aL,l<l<,"ce"'€orl Y, LfJ~ N"I,lIJ0,"" ' ~:~~';;.;~;; ai~p; -:.aii.i:~~i~ ' : ' , " "., ...", :. -- ,'".." ,,,' vcaiii~g'theceniet(Nbte:tl)e',,,,er",,;,:":".m"'J..., Electncal Contractor flit. r.AJf:. t~/CL 2OO~tlM%?lor the Oregon Ut,lity Notlsf'cllW 201 Amps to 4~m.1?lj- is 1-800-332-2344).s 75.00 401 Amps to 600 Amps $125,00 601 Amps 101000 Amps $163,00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 07/29/03 Tl~ 09:27 FAX Address /.).0 mOil! RJJE... ::a-, City 6<.u..l~ ~f Ph')ne 3L{t1 - 3 6-/P / I . Supervisor License Number 5''ijt;'i. ( Expiration Date /& J 01 I ::Aoo7 El<piralion Date fjDJ. 0 (J --3/( ::;../ /J ~ Constr. Contr. Number Signat~f Supervising EleclriciO . ~ G/f~ #1dellc;.lcv.l ./ OwncrsName/YJ~dJ) &tLp Addrcs~073 06 /rr>"fY~- :SC- City ~.J Uo"" ' V- OWNER lNSTAJ.LATlON The installation is being made on property J own which js not intended for sale. Je.'1Se Or rent. Owners SignatUre: Inspection Rcque$l: 726-3769 CITY OF SPRINGFIELD ~002 C. [i:r~~'ffi~I~i\&~~~~rl~f~:;;i:j';;1\\j:2/1if:i;?;i:;:;;;':!i)(~;j~;2tT(::n:';;1: Installation, Alteration or Relocation 200 Amps or less 201 Amp' to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B"' above, D. ;~~~~.~6.~~:~~ji~ji~~~~H1E;~~~;~;i~:~~E~~~~~2~~~~Zi}~i~~~~~~~~i{~}1~i~~~{~~~~~'~.~\~4~~i~Z $ 50,00 $ 69,00 $100.0P Now Alteration or E:otcnsioD Per Panel One Circuit / F.ach Additional Circuil or wilh -... Service or Feeder Permit " $ 43,00 o-z> "'VL~ . , I c)l) <9- $ 3,00 E, ii::~~~~~~~~,~;j~,~i~~~f#~,~,~~~~iiil~~~:~~:i~it~;~1~;:, Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limiled EnergylResidential $ 25,00 Limited Energy/Commercial $ 45,00 Minimum Elcctric .l'erlllitln.pection Fee is $45.110 + Surcharge. 4, jf~~~~:i~~,R~{M~'!~~J!~if'9'~~~J~6?;' 7% State Surcharge 100/0 Administrative Fee uLr ,Db - 4 ''-1% cp-4CO 7.t.; ,~ TOTAL Shared Orivc(T:YBuilding Forro$!EI<<;~1 Pcnnit Application 1.o3.doc , GP-l'lllllOF.lELD. -Wirf.t,." ""~,'~,,- ..-..'.....' . .. "'", .'~ , .' .",_;1" Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/04/2004 APPLIED: 08/27/2004 EXPIRES: 04/04/2005 VALUE: $ 127,500.00 SITE ADDRESS: 3405 GATEWAY ST ASSESSOR'S PARCEL NO,: 1703222000904 Springfield TYPE OF WORK: Restaurant TYPE OF USE: PROJECT DESCRIPTION: Demo playland and update dining room and restrooms, Owner: MCDONALD'S CORP Address: 2073 OLYMPIC ST STE 211 SPRINGFIELD OR 97477 NOnCE: TUIQ PI=RMI1 SHALL t^r1nl.." "" .... .' I CONTRAC:rOR,INF:ORMAl1I0N IthlVtll I~"u I . OMMENCED DR IS AtlANUUI~tLJ rUK Contractor C .IV,1Arl nAY PERil;~,ense Expiration Date RICHARD O. FREIHEIT, ~RC:HITECT LEMAR & SON CONSTRUCTION INC" 32241 BUILDERS ELECTRIC INC 4296 Contractor Type Architect General Electrical # of Units: . Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Alteration Commercial 04/28/2006 12/10/2007 Phone 425-827-2100 541-747-0568 541-485-0922 BUILDING INFORMA nON I # of Stories: Lot Size: A-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd F:loor: VN Water Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Sq Ft Other: Sprinkled Building: nla uirPf~I!P,ant Load: _ _0.' ^~,,""nn IHW reQ I DEVELOPMENT iNiORMATI0NI , ,e ure\J~~~;'i~;th N tl ~ation Center. ,"VyJ ruleos Aak 952-lW!QUIRED PARKING o II~ 0010 through OVl\f!aYIDist:52-001- . opies of the rule[flJlllI: # Sttest~r~.slRqd:Y Obtatn(~ote: the telephOIHBndicapped: Paved e1i\r.~,~tld:' center. Utility NotilicatCl&npact: % of "'?M1!'X,~rjlgelhe, Oregoo..332.2344). Ceoter IS 1-800 I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspoutsmrains: Page I of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Fee Description Plan Review CommlInd/Public + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge Total Amount Paid Fire Department Review Initial Review Public Works Review . 09/07/2004 08/30/2004 09/08/2004 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 127,500.00 Total Value of Project l..Fpeo PiilLI Amount Paid Date Paid $441.61 $6.40 $4,48 $64,00 8/27/04 10/4/04 10/4/04 10/4/04 $516.49 I Plan Reviews I 09/20/2004 OK 08/30/2004 09/08/2004 APP SKG APP SB Pa!!e 2 of 4 . CITY OF ~rKll'lu1<1J!,LU Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/04/2004 APPLIED: 08/27/2004 EXPIRES: 04/04/2005 VALUE: $ '127,500.00 Value Date Calculated $127,500.00 $127,500,00 09/13/2004 Receipt Number 3200400000000000222 3200400000000000274 3200400000000000274 3200400000000000274 GRG Plan Review: interior remodel. Job #COM2004-01075, Occupancy classification: A-3. Construction type: V-No Maintain address numbers in contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (Oregon Structural Specialty Code 502 and Springfield Uniform Fire Code 901.4.4). Maintain fire extinguishers with a minimum rating of2-A:IO-B:C every 75 feet of travel distance, The top of the extinguisher(s) shall be between 3 and 5 feet above finished Ooor (Springfield Uniform Fire Code 1002,1), SDC'S FOR ONE FLOOR SINK ADDED. NO ADDITIONAL FLOOR SPACE, OR IMPERVIOUS SURFACE. . CITY OF ~rKll'1uFIELD Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/04/2004 APPLIED: 08/27/2004 EXPIRES: 04/04/2005 VALUE: $ 127,500.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 09/09/2004 09/09/2004 WE JMP Structural Review 09/13/2004 09/13/2004 WI JMP Structural Review 08/30/2004 09/08/2004 WE JMP Structural Review SUB Review 09/30/2004 09/0712004 09/30/2004 09/17/2004 APP WE JMP JF SUB Review 09/30/2004 09/30/2004 APP JF Talked to Terry from Lemar & Son; and Loy Taylor from McDonald's, No mechanical, Replacing some plumbing fixtures and adding a Ooor drain for a dipping well. Left message for Loy asking for clarification on the different values submitted, Talked with Dave Puent and Loy Taylor. Deduct $7,500 for painting from the $135,000 total for a net value ofSI27,500. Received 9n12004. Left voice mail message at Lemar & Son Constr. requesting information on mech" plumb" and bid value, Received last internal review. Requested clarification from architect and project manager regarding lighting system and building envelope, To Request an inspection call the 24 hour recording at 726-3769. All inspectipn requested befpre 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. I Rpn~ntT1i,P,lrt~ Framing Inspection: Prior to cover and after all rough in inspections have been approved, Wall Insulation: Prior to cover. Drywall: Prior to taping, Ceiling Grid: After drywall approval but prior to cover. Final Fire Department. After all requirements ofthe Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Rough Electric: Prior to Cover Final Electric: When all electrical work Is complete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection, SUB Final: After all required energy inspections have been requested and approved. SUB Ceiling Grid: Interior Lighting Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee30f4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~rKlr\jl"<l1i,LU Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/04/2004 APPLIED: 08/2712004 EXPIRES: 04/04/2005 VALUE: $ 127,500.00 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 Community Services Division, Building Safety, I further certify that only contractors and empl~yees who are in compliance with ORS 701.005 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 the site at all times during construction, ownerorc~~e ~ Paee40f4 1()/~/tJt{ Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-01075 COM2004-0 1 075 COM2004-01075 Payments: Type of Payment CreditCard 10/4/2004 . RECEIPT #: Description + 7% State Surcharge + 7% State Surcharge + 10% Administrative Fee Paid By RUSSELL ROBBINS GI!~AlI!!!!",,',~_"_"_ '., ~! "'.A50 I . ~ ' .~_.__.~ . .......' ! lfiii.ty of Springfield Official Receipt Whelopment Services Department Public Works Department 3200400000000000274 Date: 10/04/2004 Item Total: Check Numb~r Authorization Received By Batch Numher Numher How ReceIved njm 004587 Phone Payment Total: Page 1 of 1 lO:41:40AM Amount Due 64.00 4.48 6.40 $74,88 Amount Paid $74.88 $74,88 ) i~ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/05/2004 APPLIED: 08/27/2004 EXPIRES: 04/05/2005 VALUE: $ 127,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3405 GATEWAY ST ASSESSOR'S PARCEL NO,: 1703222000904 Springfield TYPE OF WORK: Restaurant TYPE OF USE: PROJECT DESCRIPTION: Demo playland and update dining room and restrooms. Alteration Commercial Owner: MCDONALD'S CORP Address: 2073 OLYMPIC ST STE 211 SPRINGFIELD OR 97477 , CONTRACTOR INFORMATION I Contractor Type Architect General Electrical Contractor RICHARD 0, FREIHEIT, ARCHITECT LEMAR & SON CONSTRUCTION INC BUILDERS ELECTRIC INC License Expiration Date Phone 425-827-2100 04/28/2006 541-747-0568 12/10/2007 541-485-0922 32241 4296 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of ~tories: Lot Size: Hejj:llt of Structure Sq Ft Ist Floor: &- -TY.'P,{'of Heat: Sq Ft 2nd Floor: VN ~ '\~ :\w.~S!" Type: , Sq Ft Basement: ~~ ~ ~~R",nge Type: Sq Ft Garage/Carport {f.~ ~<{; ~~ergy Path: Sq Ft Other: ~'v ~ '\~S sJ:S Sprinkled Building: nla 0'<> ',&~cupant Load: .,~.<>. -,,-,\~ , ,\ J~~ ,,^ ~~. #- ~~~\)-.: {o '<DEVELOPMENT INFORMATION.'t'~~~ 0'''0~1;)'' ~'\'\o~~0.-~\:)"\:)~~'V ~'- 0\0 '(}0\~?; fo'Q1u:QUlREDPARKlNG ~ S' ~ <(..'-' ~<{; ,1> i<:io0 0'" !(.. ,s.-0 ^0. Frontyard Setbacli:\~ ~V:o\S ~~\J ~ Overlay Dist: f:?,0~ 'Q~ "I \~ O'f i<:io0 ~ ~O' "'.l~I: Side 1 Setback: ~ ~~ 'O~ \:) # Street Trees ~qf:' ~l> ,<:<0",0 ,it d- "I e-.0<;ll\,(,iffimdicapped: Side 2 Setback: ~\S ~ '\ Paved Drh;e,~qd.i~o<;l \.-<\ ~o R,0'" -<s-0 "I~o~ Compact: Rearyard Setback: ~ % ofLo~J;;ov~!ago;;~0 !;:p,I;).,~ (,0 0,0' .~~ ~. Solar Setbacks: ~"\ ~ \V r;:. V s::," '$),'Ii' ~ r;:. \)"1 ~'"(; ,,0 _",0 ""SJ _\ 0 . ,,:\. ....0 n.~ I PUBLIC IMP.~()V::EMi~~'I',)\'~ 0\:'501;)" ~ s::, ,,\'S' ;),,,, ..s- s::,'ll . ~~Q, \ ,,0 ~0bidewalk Type: I::J (,1> '$)000 >>~ Downspoutsmrains: ~ A-3 Street Improvements: Storm Sewer A vailablc: Special Instrnction: Notes: Paee 1 of4 \' " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Tvpe of Construction Estimate Estimate Fee Descriptiop Plan Review CommlIndlPublic + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge + 100/0 Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fixture Minimum/Adjustment Plumhing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Total Amount Paid . I Valuatinn Oeserinlion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 127,500,00 Total Value of Project L.Fpp< p.,W Amount Paid Date Paid $441.61 $6,40 $4,48 $64,00 $75,36 $52,76 $43.00 $9.00 $656.65 $14,00 $31,00 $54.83 $72,13 $6,35 8/27/04 10/4/04 10/4/04 10/4/04 10(5/04 10/5/04 10/5/04 10/5/04 10/5/04 10/5/04 10/5/04 10/5/04 10/5/04 10/5/04 $1,531.57 I Plan Reviews I Pal!e 2 of 4 . Ul l' OF SPKll'llJFIELD Building/Combination Permit PERMIT NO: COM2004-01075 ISSUED: 10/05/2004 APPLIED: 08/27/2004 EXPIRES: 04/05/2005 VALUE: $ 127,500.00 Value Date Calculated $127,500.00 $127,500.00 09/13/2004 Receipt Number 3200400000000000222 3200400000000000274 3200400000000000274 3200400000000000274 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 2200400000000001240 Paee30f4 l..a ( . . CITY OF ~rKlI~l.-F1J<..LJJ Status Issued Building/Combination Permit PERMIT NO: COM2004-0I075 ISSUED: 10/05/2004 APPLIED: 08/27/2004 EXPIRES: 04/05/2005 VALUE: $ 127,500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. I ~lfrrllir~d Tnmeetinns I Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover, Drywall: Prior to taping. Ceiling Grid: After drywall approval but prior to cover. Final Fire Department, After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete, Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing Inspection, SUB Final: After all required energy inspections have been requested and approved. SUB Ceiling Grid: Interior Lighting Rougb Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Community Services Division, Building Safety, I further certify that only contractors and employees who are in compliance with ORS 701.005 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 the site at all times during construction, i/I1U/I./ h7A A _A./A4\- Owner or Contractors Signature Date II) -,j--/J 4 / Pal!e40f4 ~ ATfACHMENTA CITY GFIELD SYSTEMS DEVEWPMENT CHARG.HEET JOURNAL OR JOB NUMBER COM2 -01075 NAME OR COMPANY: MCDONALD'S LOCATION: 3405 GATEWAY MAP & TAX WT NUMBER: 1703222001400 DEVEWPMENT TYPE: DEMOLITION AND RE/.!ODEL NEW DEVEWPED AREA (S.F.): EXISTING DEVEWPED AREA (S.F.): TOTAL IMPERVlOUS SURFACE (S.F.): ,. .' ITE: ITE: WT SIZE (S.F): " ~,', .,"' ~4i"'" ',-" ~,. , .. G.I' :::.~, ~ ty; "'x';):>~':>" j~' ';? . !l j,,;; :'~"'l)';r:S"a"; . Tf':-g ~; ,.' 0 0 ~ '_ ='U I STORM DRAINAGE IMPERVlOUS SQ. FT. x 5 0.310 PER SF TOTAL STORM DRAJNAGE SDq $0,00 '.1070 2. SANITARY ~J'WI'R,nT'( A REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) 3 x 5 24.04 PER DFU i $72.131091 :':-"'<:1 TOTAL WCAL WASTEWATER SDC:' $ 126.96 I $ $54.83 1092 i: ._;~" , 126,96 - 3 x 5 18.28 PER DFU 3 TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A REIMBURSEMENT COST: 0.000 x 0 x 5 18.30 PER TRIP x 0 NTF 1$ B. IMPROVEMENT COST: 0,000 x 0 x 5 80.72 PER TRIP x 0 NTF 1$ EXISTING A REIMBURSEMENT COST: 0.000 x 0 x 5 18.30 PER TRIP x 0 NTF 1$ B. IMPROVEMENT COST: 0,000 x 0 x 5 80.72 PER TRIP x 0 NTF 1$ y ;.,': .<~. .,.", TOTAL TRANSPORTATION REIMBURSEMENT SDC:' $ TOTAL TRANSPORTATION IMPROVEMENT SDC:' $ TOTAL TRANSPORTATION SDq $ ~ $ ,.1093, , 1094 LSL\NTTARY SFWI'R - ~ NEW: A REIMBURSEMENT COST: NUMBER OF FEU's 0.000 x 50.00 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0.000 x 50.00 PER FEU 1$ EXISTING: A REIMBURSEMENT COST: NUMBER OF FEU's 0,000 x 50.00 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0,000 x 50.00 PER FEU 1$ MWMC CREDIT IF APPLICABLE (SEE REVERSE) i..'~ " I I $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMC SDC:' $ ~ $ /~: , '1054: j054 , lOSS' , lo;;~ " , $ 126.961 SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) 5 126.96 x 5% 5 6.35 TOTAL TRANSPORTATION ADMINISTRATION FEE:1 $ TOTAL SEWER ADMINISTRATION FEE: $ j' . ,10~8 , 6.35 '1079 steve"" w. Be."~rl:l B.rvetS 9/812004 C\5lli2~~NALDS, 3405 GATEWAY,x1s DATE TOTAL SDC CHARGES , $ 133,31 1 JULY 2004 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIX11JRE UNITS (N01E; FOR REMODELS. CALCULATE ONLY THE NET ADDmONAL FIX11JRES) MCDONALD'S FIXTURE TYPE BA TIITIJB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASEJOIlJSOLIDSIETC. INTERCEPTORS FOR SAND/AUTO WASHlETC. LAUNDRY TUB CWTIlES W ASHERlMOP SINK CWTIlES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIGERA TOR/W A TER ST A TIONIETC. RELu, u" FOR COMMERCIAL S1NKJ DlSHWASHERlETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIOOUBLE LA VA TORY SINK: SINGLE LAVATORYIRESIDENTIAL BAR URINAL, STALUWALL TOILET. PUBUC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S' UNIT EQUN ALENT 3 1 3 3 6 2 3 6 12 I 3 2 2 3 2 2 1 5 6 3 FIXTURES NEW OLD o I o o o o o o TOTAL DRAINAGE FIXTURE UNlTS~ .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 ~Jons per day 3 " . DRAINAGE FIXTURE UNITS o o 3 o o o o o o o o o o o o o o o o o 3 o o CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PER SI,OOO ASSESSED VALUE $5,29 $5.19 , $5.12, $4.98" $4.80' $4,63. $4.40 $4.07 $3.67 $3.22 $2.73,' $2,25: $1.80 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) COM2004-01075, MCDONALDS, 3405 GATEWAY.xls YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER SI,OOO ASSESSED VALUE $1.59 $1.45 $f25 $1.09,' $0.92 $0.72 . $P.48 " $0.28, '$0,09' ,$0.05.' ,'$0:00' $0.00, . $0.00' x X CREDIT TOTAL SO.OO SO.OO SO.OO 1 JULY 2004 . 225 Fifth Street Springfield, Oregon 97477 " 541-726-3759 Phone . ,,!,~"''''~'!!!,D,''I. 111:- " ' , I 1 , lIIIIIiiiity of Springfield Official Receipt .velopment Services Department Public Works Department " .';: , '0 Job/Journal Number COM2004-0 I 075 COM2004-01075 COM2004-01075 COM2004-0 1075 COM2004-01075 COM2004-01075 COM2004,O I 075 COM2004-0 I 075 COM2004-0 I 075 COM2004-0 I 075 RECEIPT #: 2200400000000001240 Date: 10/05/2004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Fixture Minimum/Adjustment Plumbing Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Check li~:-, I;, '~~ " "li." 10/5/2004 LEMAR & SON CONSTRUCTION, INC. 9659 In Person Jmp Payment Total: Page I of I 8:44:12AM Amount Due ,43.00 9.00 14.00 31.00 72.13 54.83 6.35 656.65 52,76 75.36 $1,015,08 Amount Paid $1,015,08 $1,015,08 , II! ~,,~. I t 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(54I)726-3753 . FA.X: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number Co~ 'Z.OO~. O\CY1S Date \0.5.cx\- 1. f'i6CATiON.OEiNsiAiiAl1(;Ni:T~~g~'J,. 3. :Ji6ftlPU:l'EJ.iifsCHEDULE Bt:'LOW"}'.'''", r, .,;,:,.~~~.,... r,\,," .',.,) ,'; ,....'('(-'"'..~.;. . \'~_"""';;";-;; 1.', ~ I~ , ..,.,_.".\.~:, ..'. ,\~I - ~ t,.;.'. '''~ . ',"I':,~,"", '."""4~> ", '_". .: ",: ., ,:.,," .' .' -.'.' ,,~, ,;~,,' ',~ ,.:, .~' ., '3<\-05 G.~\:E-We.- r LEGAL DESCRIPTION n 0-::' --z..:z.. 7...0 00 q 04;-: JOB DESCRIPTION E-l"-'\'iE.~~ 4- ~'2A.~c.~ CI:<-Cl.l\'\S Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1f('!::: -';!~.::"I~"'" :';:;'j.:' "-cl:~'-'. !~" ~ .:"'1 .;~ .~ ,0;' -! ..~ ,r-:"> '-,.;"; c,CONTRACTORINSTALflATION.ONLY,. 2. t:';'~':fll';';"ii~~r:...il':;;; ':~-fl~'~,-7':;,r:..'4'),':~'.o:'O;il.'tJ; ~. ~~~'.1 f. ;:' ~ it.-!!""l,' ..,!~'!-'~~ !.--\. Electrical Contractor ~t lI'ldf',{s 'flectrlt InC Address IClS Mack'ian Phone 4 ~5 ~ en~:z City t::1"Q("n( v Supervisor License Number 3:J.CJ 0 - S(, ~\)~~~. ~ ~l~\'(\~{:> Expiration Date I 0, I - -'CT'i' OJ '",w.. ~Q...~ ~\)~ \,1-' S,<';; ~.:<"v ~.:-v\.."\~ Sl~ Constr. Contr. Number. (), (,Q... ~ "-~ ~.~ 'W-S~v Expiration Date '\{t-~'X~tt),\.~a <IJ~ :.,\)\). rZ "\y..\~ y.,\:F' ~\;'(..v ~'(.." Si atur of SupervisingElec6:ma~~ r \)""" 'O\J __ A~~~~\ - Owners Name ~c-. ~~"""L:~S Co~'i:" Address "'LO l3 0 L ~'? \e 'Z.. \\ City g, e\Ll~G. Hg:.I...:t> Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~;. ",: '''-~--_,;.~<;','' .;" ,",,', -. - '",......,;.~. '," ." _ . .... '7" .- " . ... A. ;.New:Reside'nli"I..:"Sillgle'or lI-iulti-Farililv per d,,'elling 'unit.: . -:.';.t:'.,:"." ,~,~".,,;;o> "",' "." "'-.,'_ ... '-." ~~. ,. ;f.n. ~.:.' ~ Service Included 1000 sq, ft. or less Each additional 500 sq, ft. or portion thereof Each Manuf"ct'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ,,--~ . . ': ., -'" .. ~ ... B, ~!S~fvice~o~Feeders -,Install;tio~, Alterationsor R~locaiioit: ~:.:,:.' ," ":h. :::'~;"'-.,.. '. . ~~.. . ~' '.. "., '_, > ~':. . .,' ~;" -::.. . .~~. :', ~ . .:~ 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpslVolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 .~;.. T<?'~"" ,--',- -',~-:-t.. . "":;"' " y. ~"'''''Y' ~~'I"1.,..~ ~;;-':~;,.'<. '1"'~~'~~"f"/' ,~', .....>:.;J:.c;:~\-;~!l /;Te~po~a_ry.S~rvl~~~ or.F,e~ders . .it,.. "i ~~!s"1' ,:t~,~~~..-t;~:t~$\~:~ Installation, Alteration or Relocation 200 Amps or less ,0 $ 50.00 201 Amps to 400 Amps.,Ov .~~~ $ 69.00 ",'\ .,~ ~' 401 Amps to 600 A~ps ~'V ,0 .' $100.00 ~n'O e' ~\.i' ~,~er60~A~;,,~.srC'~~~f"e0~~~a~~~e. ~.r', "',,' '. ',..,.,'.~ D. 'Branc~~il.~itil,\~00~<?-~\~o<:o0 , .. ~;"';"....>,;.}. .';,:. ,oQ) ~'Q..e :('0 ~..:s' 0"0 \,# Ne'~~ft~~t~Q:or ~t~~sro~rli.~nel ~~'c;;jr'2u&. r::, # 0~,0. -:s-e ~O~..' $ 43.00 d.:- '3, ro ,t'~~~ tQflrt~@'iiI~~~' ~~~' ~ ~ oa ~, ~fu!jcef!P'Fe~r ee '~' n'1; $ 3,00 ' "~O of{! !l: ~ 10.0' Q) Y \0 ~q,-Cb'9 -~'I>"'e<:'~rl;"QS)~--,< .- '-. . .' -- '. -- " ' ~tEO~I~<6~".&,lItrc~/feeder not ~ncluded) -Each Ins.tall"tion ,<:-- ~r::,' ~<::o~ ,0'" .01- ~nW>~~~ $ 50.00 Sig~line Lighting $ 50,00 Limited Energy/Residential $ 25,00 Limited EnergylCommercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges . ~-';-\' "., ,.....~:".".7 ' . ....~. ~ .~ ,::n'::1<'~'.:,).f.'::. '''I\,'~...,:_~'o:".:; 4, cSl!~ro.TALpI;ABO,lJ':~i'>", 't, "'\ " . ' , .0 . l' .: ..-, , "'" .. ,. ~ '. .' S'Z..,cQ '3, f,~ S:Z.O f,O.e,(f,. 7% State Surcharge 10% Administrative Fee TOTAL Shnred Dlivl."(T:}/Building Fonns/Electricnl Pcnnit Applicnlion I-03.doc