HomeMy WebLinkAboutPermit Building 1995-02-17U
SIDEN IIAL
PEliMll i\l'PLlcAi loN
lrrsq:cctirrtt .l,' .l(i-3 I b'J
O[[rr;r.:72{i 1r, :)
\7b ! 70_!*
.lOtl NL,MUt:l(
225 l'itth Sltcal
$prirrg(ie(<(, Outt.lt>n 97'l / /
TAX t-O'fl
:)PBIN()-r:Ltf,
ga i tL\
SUI]DIVISI()N
Pl-toNE
rl
qbDW-t
0h,
LO()/'\l l(-)l l a,
AS:ll-i)l;Ol,:;
Lol
OWNER:
ADDFTESS:
CITY:,...----
,rnoI'o
IAP:.. -
Lxi
r l) W(rrtN
t1-oz-_3o _G3ft _Af tU.
t72P
4?e''u,gpGa-D
lll-O( )K: ,.-- ,
M rz-ute!+e__.
LJ. ZA-E
7L6 - 7ue9
zrp, _ 41_41 -7:
DEll(tnlilt: \*.* 1
)nK Bra.^t_9F^_ft6121!@
REM()D[.r_ _ADDITIC}N DEMOLIS}I -_-OTHEI]
$sell-e-@c*a€ a-:..err-,r.1--.
STATE:
ADDI-'IE:;S
LAND USE:
// OF [JNIT:;:
CONSTR. IYI,I
IIEAI SOURCT:
RANGE:
-
CON TRAC l()r
GENtsRAI.:
PLUfvtBlN(i:
MEC}{ANI(J,4 I
ELECTRICT\t
OtiAtl A[1{ /,,
/, Lrl Iil t)(,'
(-)(l(,r (;l:i( )l
/ ()l lll(),,1i
S NN Mt:
Z$eoat'- #**"tad t4( /fur4l-ti , -- - dbql7
CONST.
CONTRACTOR /
./_lgzjicwl1
[ba,6 frE-t& /Lzs-tn: *-- %_&o-
_ OFFICE USE -sk!\r-4\bD
l,o --:- LL
FLOOD PLAll.l: --
I
R3
\,,L
ZC)N|NC COI)r
, OF lilDRMS:
[;tCONDARY llt:AI:
S;QUARE FOOIAGE:
_ts{L
a--\-,
WAIt tl lll /,ir Il 11fyL
To retluesl:rr'j insl)ectit),r, you tliust call 72s'3769. Tlris is ir "4 lrrrLrr recording. All inspectiorrs i.e(luesled before 7..urJ tr.mInadc $le r,iirrre wotkirl0 (lay, in:;pections rr:cluested after 7:00 a.rn. will be made the following work rlay.
REQUIRED INSPECTIONS
will lrr:
l-- | Site trr..lrection - To be rrraclct-' alter r: ;tvati(,n, i,ut pIi(,r to
setttt)i: lr)t nts.
ll Rough Etcctrical - prior totJ cover.
Tenrl,r; .,ry Electti,;
Undrrr :, l.rb Plrrrnbirrg/ Electr ical /
MeClriil'rCill * Prr.)t tO (j()V(-,r.
Masortrt/ - Sleel locatio,rr, botrrll)calrr,i ltr.>ttttrtg.
Posl itrrrl Bearn -,. Prior ru flc.rorinstrl;itr,,n or (lcC,..lng.
Floor ltrsulation -.- Prior tr_r
dechm, t.
Rough Mectranical - prior to
cover.
Final Plunrbing - When allplunrbing wcrr li is ccrrrriilt_.te.
Final Electrical - Wlrr:n all
electrical worli is colrl,l(jle.
tl Final Mechanical - Wtt{ jn iill
rrrechanical work is r:orlplet,,
t_l Final Builcling - Wl rr:n rillrequired inspcctior-rs lr;rvo brr.rrapprovetl antl buil<lirrr.; r:;
cornpletcd.
[- -l othcrLI
Plurnbing Connecticlrrs -._ U,,ti,rrr
It<-rnrC ltaS l)(:.(in COnnr](;lr:(l lr.,w.itcr atrd :ruvrcr.
Final - Af ter all rcrltrirt;rlinspections irte apptL,v(_,(l an(1porchcs, skirtir-rg, de(:l\r.;, :ln(lventing flave t,een in.;t;illr:cl.
f lfioofin11 - Af ru,r lrenclre:; ijreLl exca'.r,,t,,r,
l_l
t__l
r_l
r_J
L]
r:l
[--l Stonn liewer - l'1or t(, trli'lg
-
lren,'l)
f-l Watcr Line - pri,rr to fiiling* tren(r lr.
Electrical Service - Must be
a1-rllroveil l(, olitarin perrr);lnent
elr-'ctrical l)()wcr.
Fircplacc. - [,rior to i:rcirrg
rlrirterlals ;rrttl llarrring lrrsp.
Fr:rnring --- [)ri,it to cc]vet
W;rll/Ceilirrrl lnsrrlation - prior to
cover.
Curbcul & Approach * After
fclrrnS ari. r.rt-.t;lutl l.lul J,rtclr lupl,;rcemeilt ()f (,oncretc.
| ]Eleclricat Connectiorr .- Wlr,,rr- - lrlo<:king, sol-u[), an(, l)lutnbin,Jrrrspectionl; Ir;rve l-rer.rr altJ:rr,v,:.1;rnd tl)e h(rrnU is c()nn(-,ctcd t(,the servicc 1t;rrrel.
l-rNfoutr<llrion - Atr,),. f()urrs a,e
-'Cre(:t(.,t l)ltt f)tiOI to 911111.1,_.1g
plitr:,;rr,.111.
fl UnO,,rUr.:rrnd Plur,rbing -- t)riorL-J tr.r l,rr'i, tren,.t l- I Drvwall - l'ric'r to tapino.
[--l unct.,rtt,,or Ptumbins/Mechanicat MOBILE HOME INSPECTIONSr'---r - t)rit r trr insulario-n.rr,r".Xi,i(J. [-l Wooa Slovo - After i,tstallafion.
t_l
f* I lnsert - r\tter (irepla<:r.l irpproval'- arrrl inst.rlliiti(lr of unit.
[I.]-nloct<ing arrct Set.Ulr - \Vhr.,, ,,1
-
bloCki,lg is r;,,rnl)lr-,1(:
L-l Sanilary Sewcr -ttc-n,;lr.
Prior t,r f illirr<1
Rotrlllr l,lumbing - Plior tr_>
COV(rf.i- I Street Trer;s * Wlren irll recltrired'- trC(.,S ar(-, l)l,illto(t.
,
a<.
[-l Sidewatk & Driveway - Af ter.- ex(;avatir>rr is coilrpletc, loflnsartrl sub-ltase nrirteriarl irr place.
l__l Ferrce - Wlrr:rr comPlcted.
IZ
EXPIRI,S Pl lofl l:S1r 4@-qzdz,
J'l%- c/'
- aee -tu"
Lot faces
Lot s(1. ltg.
Lot coverage
TopograPhY
Total height
Lot Tygrc
A tnterior
_=- Corner
--- Panl-randle
-
Cul-de'sac
Sctbachs;
PL,HSI:GNR ACC
'rls, lHt: IrllOPOtiED WORI( lN TllE
llll;ToHlcAL Dll;1 L1lcT, otl oN
I [-lE l-llsToRlcAL REGISTI--Fl'? -- --.'-- - -
It yes, this application mttrrt llc signed
;rncl ;t1;lrtovccl try ttrc l'l i:;torical
Coortlit'ral<-ir prior to permit issu;lncc'
API'ROVED
N
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
ranted on tlrc express cor-rditiorr lhal tlre said
in all resltects, cotrform lo tlre Ordinance
DatcPlans Rovie.'wed BY
This perrnit is g
corrstruction shall,prinqfield, inclutiing the
the construction arrd use ofed bY the CitY of Sadopt
plnent Cocle, re-qu lati n gDevelo
clecl or revokecl at any tilnebuildings, and ntaY be susPcn
s of saicl orclinances.on violation of anY Provisiot-tUp
r: __ -
Plan Check Fee
Date Paid:
ReceiPt Numbe
Received BY:
BUILDING PERMIT
VALUE
[\esud
statc surcha,g.+3%)
-[ot:rl Fee (A)
__5.Q I
rt
SO. FT. X $/SO. FT.
2-.
Total Value
Builcling Permit Fee
ba5l
ITEM
Main
Garage
Systems Developtncrrt Cllargc is <Juc on all trttclcveloped
properties withirr thc City lit'rrits whiclr are boirrt; irrtprovetl'GE (SDC)
4ltp ttP
A RTNHcMPEEEVLOSMDEYSTS
B)
ADDIT roNAL C OMMENTS
ITEM
Fixtures
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moltile Home
PLU MBING PERMIT
FEE
N0
+3o/o
FT.
FT.
FT.
(c)
t5 P
JD
Plumbing Permit
State Surcharge
Tcrtal Clratge
Furnace
Exlraust Hood
Vcnt Fan N1---.-
Woocl Stove/ lnsert/ Fireplace Unit
DrYr:r Vctrt
MECHANICAL PERMIT
d(D)
Meclt:rnical l-'ermit
I ssuance
State Surcharge
Total Permit
Lly signattlre, I slate ;rtrcl agter)' tlrat I harve carof ('tly r:xantined
the conrpletecl application and do lrereby cr:rtif y ttrat all
in{ormatirln hcrcon i:i trttc:rtltl cortcct' atrcl I f rrttllot <;etlify
tllat any arrrl all worl< pcrfottncd shall be dono itr;tt:<;ordattcu
with the Ordinan<;es of tlre City of Sprirrqfieltl';rrrcl llro ['aws
o( tltc [lliltc of ()[(](l()ll prltt;rirlinl; to llrc wotk rlr::;crilrcrl
lrcrein, ;rtrd tlrat NO OCCTJPANCY will bt: rtrarlt: of ittry
sttucture withr:ul pertnissiot.t of the []uilcling S;rIcty Division
I further certily that ollly corrtractors and etnl;loyees who
are in compliance with ORS 701'O55 will be r'rsed on tlris
proiect.
ensLrre that all required inspections are
r time, that each address is readable
Signature
Date
-,
/
g
I f urther agree to
requested at the Prope
rrnit carcl is locater.l at the f ront
f rom thc street, that tlre Pe
set of Plans will remainof the ProPertY, and tire aPProved
tructios durion the site at al
__1 ---
MISCELLANEOUS PERMITS
3?o
fr
CP
(E)Tota I Miscellaneous Permits
Curbcut
Mobile Home
State lssuance
Statc Surcharge
,.1
Denrolitiorr
Slatr: Sutr;lta11;c
OUNT DUE (excluding electrical)
ancl E Combined)TOT/\L AM
(A, t3, c, D,
VAl.IDAI ION:
RE,CEIPI'NUMBER
DATE PAID
AMOUNT BECEIVET)
BECEIVED BY.
/6?-/?-
2-/
(.@.6
CITY OF SPR'A'GFIEI-OREGOft,
225 ?TFTH SlREEf,
SPRINGFIELD, oREGoN 97 2-
INSPECIION REQUBST: 725-,3759"
orrrcst 726-3759 Aulhorrzeo
SPRINGFIELD
BIJCTRICAL PERI{IT
Job Nurnber
3. COHPI,BTE FEE SCffiDULE BELOS
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
$ 85.00
LDLZoni
I
Permits are non-transferable and expire
if york is not started vithin 180 days
of is6tiance or if vork is suspended for
1.80 days.
1 OF
2. COI{TRACTOR TION ONLY
Electrical Contrac
Address
Ci ty Phone
Supervisor L cense Number
Expiration Date
Constr Contr. Number \a3t 3r)
Exp iration Date
Signa ture of Supervising Electrician
L000 sq.ft. or less
Each additional 500
. sq. ft or portion
thereof
Each Manuf'd Home or
. Modular. DveIIing
, ,''' - ' Service or Feeder I $ 40.00 _40.qd
ON
Sum
$ 1s.00
B
D. Branch Circuits
i
Nev, Alteration or Bxtension Per Panel
One Circuit $ 35'00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2'00
E. Miscellaneous (Service/feeder not included)
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 L000 amps/volts
-
Reconnect 0n1Y
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40'00
over 4b1 to 6oo am-ps
-
$ 8o.oo
over 600 amps or rbOOETls see uBu aE6lif
-Each installation
Pump or irrigation $
sign/outline Lighting- q
Limited Energy/Res
-
S
$ s0.00
$ 60.00
s 100. 00
s130. 00
$300.00
$ 40.00
fi
c
Owners
Address
Ci ty Phone
/3
v61btr{t
The installation is'being made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
40.00
40.00
20.00
36.00
DATE:
DDAEiTITIiN R
2
5
ooI
SP;lItrlGFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBER
225 Fif th Street
Springf leld, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
3rd
TAX LOT:
BLOCK: SUBDIV|SIoN:
Z
PHONE:
ztPazSTATE:
OWNER:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS EXPI RES PHONE
-25-?f
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
CONST.
CONTRACTOR #
_ OFFICE USE _
LAND USE:
WATEB HEATEFI:
ZONING CODE:
RANGE:
QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS:
--
To request an lnspectlon, you must call 726'3769. Thls ls a24hour recordlng. All lnspections requestec1 before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
Rough Mechanlcal - Prlor to
cover.
Final Plumbing - When allplumblng worl< ls complete.
Slte lnspectlon - To be made
after excavatlon, but prior to
setting forms.
Rough Electrlcal - Prlor to Flnal Electrical - When all
electrical work is complete.cover,
Underslab Plumblng / Electrical /
Mechanlcat - Prlor to cover.Electrlcal Servlce - Must be
approved to obtain permanent
electrlcal power.
)!f finat Mechantcat - When ail
fiqecnanicat work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Final Buildlng - When ail
requlred lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
n Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to fllllng trench.[-l Drywall - Prlor to taptng.
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decking.
MOBILE HOME INSPECTIONS
Wood Slovo - After lnstallation
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approvsl
and lnstallatlon of unlt.
Blocking and Set.Up - When ail
blocking ls complete.
Floor lnsulalion 4 Prior to
decklng.Curbcut & Approach - After
forms are erected but prior toplacement of concrete.
P.lumbing Connections - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to fllllng
trench.Electrical Connection - When
blocklng, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Sidewalk & Drlveway - After
excavatlon is complete, forms
and sub-base materlal in place.
Water Llne - Prlor to filling
trench.
Fence - When completed.
Street Trees - When all requlred
trees are planted.
Final - After all required
inspections are approved andporches, sklrtlng, decks, and
venting have been installed.
Rough Plumblng - Prlor to
cover.
" 721e4
# OF BDRMS:
--
FLOOD PLAIN:
n Temporary Electrlc
E
E
tl
E
E
E
fl
Storm Sewer - Prlor to fllllng
trench.
il
r:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
- lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Lot Ty IS THE PROPOSED WORK TN THE -
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Hlstorlcal
Coordinator prior to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
VALUE
(A)
x $/so. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ, FT.
Main
Garage
Carport
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, includtng the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Receipt Number:-
Plans Reviewed By Date
Plan Check Fee:
Date Paid
Received By:
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fix t u res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
PLUMBING PERMIT
FT.
Plumbing Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
MECHANICAL PERMITFurnace /6tf /q/ry
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge ,7f try'f
Total Permit (D)
.rZ..a/
ZG LO
/o 6Q
/Lo
By slgnature, I state and agree, that I have carefully examlned
the completed appticatlon and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Bullding Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with ORS 701,055 wlll be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set ol plans will remaln
X^n"
Date
on the site at all times duri
MISCELLANEOUS PERMITS
Mobile,Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, Q and E Combined)
1t 2h-/-92#
L,6
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
FIECEIVED BY
SYSTEMS DEVELOPMENT CHARGE (SDC)
FT.
/<oo--.-
sP, _.'TGFTEL[)
h,
225 FIFTE STREET
SPRTNGFTELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFPICE: 726-3759
1. LOCATION OF
LEGAL DESCRTPTION/7oz- 3o 34 />9 zo2-
ELECTRICAL PERUIT APPLICATION
Ci ty Job Nurnber
COHPI^ETE FEE SCESDTILE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
$ Bs.oo
3
A
Sum-(
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COI{TRACTOR INSTALI.,ATION ONLY
Electrical contrac rcr bC- fu-T
Address 6 tfo* =-
Phone 4?d- q Z/d
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hanuf'd Home, or
Modular Dwelling
Service or Feeder
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
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_
0ver 1000 amps/volts
Reconnect OnIy
Pump or irrigation g 40
Sign/out1ine Lighting- $ aO
Limited Energy/Res
-
$ 20Limited Energy/Comm S 36
$ 1s.00
L g 40.00 W"
<?\60U-Szt-
B
Ci ty
s s0.00
s 60.00
s100.00
s130.00
s300.00
s 40.00
Supervisor License Number 3r'f z S
Exp iration Date ,za . Q{
constr contr. Number b67? 2
Expiration Date 6^ Z f
Signature of Supervising Electrician
,0
Ovners Name
Address
ci ty-Phone
OVNER INSTALI.^ATION
The installation is being made onproperty I ovn vhich is not intendedfor sale, Iease or rent.
0vners Signature:
DATE:
C. Temporary Services or FeedersInstallation, Alteration or ReLocation
200 amps"or less $ 40.00
201 amps to 400 amps
-
S 55.00
over 40L to 600 amps
-
$ 80.00
0ver 600 amps or 1000-vofts see rrBrr amE
D- Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each AdditionalCircuit or with Serviceor Feeder Permit S 2.00
Miscellaneous (Service/feeder not included)
-Each installation
E
00
00
00
00
oo
o2
RECETVED
5
/A/O <o
E j/4 iPd
ATT.ACHMENT 81
l0B N0.15o izr
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENI CI-IARGE
WORKSHEET
(COHHERCIAL & RESiDENIIAL)
r,1 t ct-t Lu-L tAbNA}4E OR COHPAI.IY:
13-LO +k'15',-,-fe TLOCATION:
OEVELOPMENT TYPE:L.D,E.RLTLAC€T,I rvr oF 5. €. (.
BUILDING SIZE
1. STORM NRAINAGF
IMPERVIOUS SQ. FT.
2. .O*rroRv sFwFR-cTTY
NO. OF PFU'S
(See Reverse)
5. ANHINISTATIVF FFFS
BASE CI.IARGE (SUBTOTAL ABOVE) X .05
{fo:x fi,r\LusfErz Dareffi'S8€=ftu+FHr*€F
OT SIZ
SQ. FT.
X 543.26 PER PFU
fe6. ,c\q5
\
D€5'voeur- (t'.e ?rcr fuAu)
X $0.209 PER
Ft
(
s
8z-
7Vs 130-
8l
1
I TRANSPORTA.TTON
NO OF UNITS X TRIP RATE X COST PTR TRIP
x _ x s436.i9
x
-
x $436.19
x
-
x $436.19
Hone
R€?IAL.-^EJJT
SUBTOTAL (ADD ITEMS 1,2. & 3)s 3oz
4. SANTTARY SFhIFR-I'IWMC
NO. OF PFU.S 1 X $17.i9 PER PFU + $iO Ml^It,lC ADMiN.FEE
(Use PFU Total From Item 2 Above)
Ml.lMC CREDiT IF APPLICABLE (SEE REVERSE)
TOTAL.MI^I}4C SNC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)$3AG3L
x"
82. SDC
TOTAI SDC
il.g lllo '-
FIXTURE UNIT CALCUL.-r'lON TABLE: Number of New Fixtiies X Unir Equivalenr = Fixrure Unirs
(NOTE: For remodels, calculate only the NET additional fixrures)
NUMBER OF
FIXTURE TYPE NEW FIXTUBES
Bathtub........
Drinking Fountain....
Floor Drain
lnterceptors For Grease/Oil/Solids/Etc.................
lnterceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More....
tr4obile Home Park Trap (1 Per Trailerl......
Receptor For Refrigeratorl/V ater gtation/Etc
Fleceptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stat|..........
Shower, Gang........
Sink: Bar, Commercial, Flesidential Kitchen
Urinal, Stalt/Watl.
Wash Basin/Lavatory, Single
Toilet, Public lnstallation.
Toilet , Private....
Miscellaneous:Jr+* mc3 .gat
TOTAL FIXTURE Ul'llTS 1
UNIT
EOUIVALENT
FIXTURE
Ul.llTS
Z
-_-+
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
2
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Bate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
o.61
o.44
o.15
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
{3q 10.6'{o 3b Bix$
(Rate X Assessed Valuelx $_
(Rate X Assessed Value)
CREDIT TOTAL $3L e\
?RL - \ qGc)
I