HomeMy WebLinkAboutPermit Building 2008-11-25
CITY OF ~rl(JNGFIELD.
Building/Combination Permit
PERMIT NO:'COM2008-01708
ISSUED: 11/2512008
APPLIED: 11/25/2008
EXPIRES: 05125/2009
VALUE: $ 228,032.00
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i
Status
Issued
225 Fifth Street, Springfield, OR
541-726,3753 Phone
541-726,3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1151 S 41ST PL
ASSESSOR'S PARCEL NO.: 1802064108900
Springlield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single Family Residence, Same as 1262 S 40th Place, Lot 18, Filbert Meadows
..... " '-."" . '. "t-l, ,-., ..,.,., IT'''') ":''T'~ '."'" {:)
I DEVELOPM~NT IN(ORMATlON<h;;~:_.. '".,,;' ,"";i";':''''
Notificaticn Center. Ti,., 5',. ~I,.:' ,1~!HJ,ml},~l? PARKING
O I D' in OA8 952-00HJOlO iiHOU,;;; Olf'o't'acl..',OOI, 2
ver ay ISt:onqn y . ..' , ,
# Street Trees RQd: ou may obtam C;i'ples ot tHlloilicappJ\d:
P d D. R c.1l1ll1g the center IUnte' the t91Mh~ot'
aye rive Ra: - . Yes '.. t'QlJlpae:
% of Lot Cover~~~per for the, Or39m Utility Notification
Center'ls l-oUO-332-2344).
.. -'I
NO I IlJ!::'MIT S\1A.LL EXPIRE \1' -lbJ~LI:i~MPROVEMENTS I
Street ImW~%~~~.'rS:D UNDER T~1S 1~!\~'cnQ
f.U \ IIU"'~~_ A.Bk\~t>V' O\'eU' ,
Storm Se'0~,%~N1il\l\6tep OR IS D Yes . '
Special InA%'\"~'O'D DAY PE.RIO . ,
Owner:
Address:
BRUCE WIECHERT CUSTOM HOMES INC
3073 SKYVIEW LN
EUGENE OR 97405
,I CONTRACTOR INFORMATION, I
COl)tractor Type
General
Electrical
Mechanical
Plumbing
Contractor
BRUCE WIECHERT CUSTOM HOMES INC
L & E ELECTRIC INC
COMFORT FLOW
STEVEN R JOHNSON
License
101717
105475
460
65065
. BUILDING INFORMATION'
# of Vnits:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: 1
Height of Structure
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Gas
Energy Path:
Sprinkled Building: n/a
1
R-3
U
VB
3
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
14,00
5,00
7.48
25.00
3.74
Residential
Expiration Date
09/16/2010
03/30/2010
06/27/2009
03/1212010
Phone
54 I -686,9458
54 I ,933-2653
54 I -726-0 I 00
541-342,3765
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Fi Other:
Occupant Load:
6,614
2,000
644
Sidewalk Type:
Curbside 7'
Curb and Gutter
DownspoutslDrains':
Notes: Storm water to cnrb via weep hole
Pa!!e I of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Description
, Tvpe of Construction
V Wood Frame
Garaee
Dwellines
Garaee
Fee Description
-Mech Iss 2+ Appliances-
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
2 Baths One or Two Family
Addressing Assignment
Air Handling Unit Up to 10,000
Building Permit
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Furnace - up to 100,000 btu
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As .
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddU 500
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
SDC Transportation Admin
Sidewalk Permit
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family,.
Total Amount Paid
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2008-01708
ISSUED: 11/2512008
APPLIED: 11/25/2008
EXPIRES: 05/25/2009
VALUE: $ 228,032.00
I Valuation Description I
$ Per Sq Ft
or multiplier
$105.00
$28,00
Square Footage
or Bid Amount
2,000.00
644,00
Value
Date Calculated
$210,000,00
$18,032,00
$228,032.00
11/25/2008
11/25/2008
Total Value of Project
!<pp< Pli.IU
Amount Paid
$42.00
$190.00
$212,14
$107.74
$289.00
$37.00
$10.00
$1,120.83
$88.00 ,
$8.00
$11.00
$132.20
$18,00
$15.00
$6,00
$211.00
$227,00
$121.00
$88.00
$546.95
$719.29
$10,00
$1,009.17
$97.90
$93.32
$888.98
$201.54
$80.37
$88.00
$57.00
$24.00
$2,513,00
$9,263.43
Date Paid
Receipt Number
11/25/08
11/25/08
11/25/08
1,1/25/08
11/25/08
11/25/08
11/25/08
] 1/25/08
11/25/08
11 /2 5/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
11/25/08
] 1/25/08
11/25/08
11/25/08
11/25/08
11/25/08
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
220080000000000]680
2200800000000001680
2200800000000001680
220080000000000]680
220080000000000]680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
220080000000000]680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
220080000000000]680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
2200800000000001680
Paee 2 of 4
Status
Iss u ed
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01708
ISSUED: 11/25/2008
APPLIED: 11/25/2008
EXPIRES: OS/25/2009
VALUE: $ 228,032.00
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726:3769Inspection Line
Initial Review
Plannine: Review
11/25/2008
11/25/2008
Plan Reviews I
11/25/2008 APP
11/25/2008 APP
LLH
DDK
Required street trees as shown on
street tree plan attached to permit:
Species as shown. 2' Caliper, leave
name tag on until approved.
Storm water to curb via weep hole
Public Works Review
Structural Review
11/25/2008
11/25/2008
11/25/2008 APP
11/25/2008 APP
LKW
CJC
To Request an inspection call the 24 hour recording at 726-3769. 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.
IRpm~
Ufer Electrical Ground: Install ground rod at fo'oting and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundatio!': After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with tinish materials,
Framing Inspection: Prior 'to cover and after all rough in inspections have been approved.
Wall Insulation:. Prior to cover.
Ceiling Insulation: Prior to cover.
Final Building: After all required inspections have been requested and approved and the building is complete.
Underground Plumbing: Prior to tilling the trench and including required testing.
Underfloor Plumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to tilling trench and including required testing.
Sanitary Sewer Line: Prior to tilling trench and including required testing,
Storm Sewer Line: Prior to tilling trench.
Final Plumbing: When all plumbing work is complete.
Underl100r Mechanical. Prior to insulation or decking and including required testing.
Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance,
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Paee 3 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO: COM2008-01708
ISSUED: I II25/2008
APPLIED: ' 11/25/2008 .
EXPIRES: OS/25/2009
VALUE: $ 228,032.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Gas Service: After line is installed and line has been connected to,a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete,
, Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rongh Electric: Prior to Cover
Electric Service: Approval required prior to utility companY,energizing service,
Final Electric: When all electrical work is complete.
By signatnre, I state and agree, that I have carefully examined the completed application and do, hereby certify that all
information hereon is trne and correct, and I fnrther certify that any and all work performed shall be done in accordance with
the Ordinances ofthe 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 ihe front of the property, and the approved set of plans will remain on the site at all
"tilt;." .!) Iz ;/0 J
Owner or Con ractors Signature le"'"
Paee 4 of 4
.~--
"';." ,i ,.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: Com2008,01708
NAME OR COMPANY: Bruce Wiechert
LOCATION: 1151 S. 41st Place
TAX LOT NUMBER: '1802064108900
DEVELOPMENT TYPE: Single Family Residence
NEW DWELLING UNITS I BUILDING SIZE (SF: 2644 LOT SIZE (SF):
6534
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S,F, x I COST PER S,F, CHARGE I
I 0.00 I $0.357 I = I $0,00
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
I . 0,00 I I $0.357 I I 50% ~ I
ITEM I TOTAL, STORM DRAINAGE SDC '$0.00
2. SANITARY SEWER, CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I .26 I
1. ~T()RMnRArNA(tF,
, DISCOUNT
$0,00
$0.00
COST PER DFU
$27,67
B. IMPROVEMENT COST:,
I NUMBER OF DFU's I x
I 26 I
I COST PER DFU
I $21.04
ITEM 2 TOTAL" CITY SANITARY SEWER SDC = ,
3, TRANSPORTATION
,A. REIMBURSEMENT COST:
I ADTTRIPRATE I x
I 9.57 I
I NUMBER OF UNITS I x I
I I I I
B. IMPROVEMENT COST:
I ADT TRJP RATE I x
I 9,57 1
I NUMBER OF UNITS I x I
I I I
ITEM 3 TOTAL - TRANSPORTATION SDC = I
4 SANIT AR Y SEWER, MWMC .
A, REIMBURSEMENT COST:
INUMBER OF FEU's I x
, I I
B. IMPROVEMENT COST:
INUMBER OF FEU's I x
I I I
ICOST PER FEU
, I $97,90
ICOST PER-FEU
I $1,009,17
. I
I
MWMC CREDIT IF APPLICABLE (SEE REVERSE) ,
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL,MWMC SANITARY SEWERSDC = ,
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I
" ADMINISTRATIVE FEE:
I SUBTOTAL x I ADM, FEE RATE I~
I $3.473,84 1 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
Kaye Wilson
PREPARED BY
11/25/2008
DATE
$719.29
$546,95
$1,266,25
COST PER TRIP
21.06
x !NEW TRIP FACTORI
I 1.00
$201.54
COST PER TRJP
$92,89
$1,090,52
I x INEW TRJP FACTORI
J I 1.00 I
I
$888,98
=
$97.90
= $1,009.17 I 1055
$0.00 111054
$10.00 11056
$1,117.07 I
,
$3,473.84 II
CHARGE I
$173,69 I
93.32 11079
$80,37 1078
"
TOTAL SDC CHARGES =, $3,647.53
...-
-r-
1[0
10
18
lor:
,I '"
,f-<
I~
11070
1091
1092
I
I
I
I 1093
11094
I
"
1054
~ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIY ALENT = DRAINAGE F~RE UNITS [,
(NOTE: FOR REMODELS, CALCULATE ONt Y TIlE NET ADDITIONAL FIXTIJRES)
NO, OF FIXTURES DRAINAGE I
UNIT FIXTURE
FIXTIJRE TYPE 'NEW OLD EQUIVALENT UNITS
IBATHTUB 2 0 I 3 = 6
IDRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL/ SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER / MOP SINK 1 0 3 = 3
ICLOTIfESWASHER,3 OR MORE lEA) 0 0 6 = 0 I
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I
,RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0 I
RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 1 0 3 = 3 I
SHOWER. SINGLE STALL 1 0 2 = ,2 I
I SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 I
I SINK: COMMERCIALIRESIDENTIAL KITCHEN 1 0 3 = 3 I
I SINK: COMMERCIAL BAR 0 0 2 = 0 I
I SINK: WASH BASIN/DOUBLE LAVATORY 1 I 0 2 = 2 I
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 I 0 1 = 1 I
IURlNAL. STALL/WALL .0 I 0 5 = 0 I
TOILET. PUBLIC INSTALLATION 0 L 0 6 = 0 I
ITOILET. PRIVATE INSTALLATION 2 I 0 3 = 6 I
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 26 I
.*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single familv dwellinl!: unit (20 DFlJs) Set at 167 gallons ~r day I
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
I BEFORE 1979 (Enter I for Yes, 2 for No)
I 1979 IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? 2
I 1980 (Enter I for Yes, 2 for No)
I .1981 . I BASE YEAR . 2006
I 1982
I 1983 CREDIT FOR LAND (IF APPLICABLE)
I 1984 VALUE / 1000' CREDIT RATE
I 1985 $0,00 x $0.00 ~ ,I $0,00
I 1986
I 1987 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
I 1988 VALUE / 1000 CREDIT RATE
I ., 1989 $0,00 x $0,00 0 I
I 1990 II
I . 1991
I -1992 TOT~L MWMC CREDIT = $0,00 I
I J993 I
,I ]994
I 1995
I 1996
I 1997
I 1998
I 1999
I 2000
I 2001
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
.JOURNAL OR JOB NUMBER: Com2008,Ol708
NAME OR COMPANY: Bruce Wiechert
LOCATION: 1151 S,41stPlace
TAX LOT NUMBER: 1802064108900
DEVELOPMENT TYPE: Single Family Residence
NEW DWELLING UNITS I BUILDING SIZE (SF' 2644 LOT SIZE (SF):
L STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F, x I COST PER SF I I CHARGE
I 3737,50 . I $0,357 I . = $1,333,34 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUSS,F, I x I COST PER S,F, I x I DISCOUNTRATE I, I
I 0,00 I I $0.357 I I 50% ,~ I
ITEM 1 TOTAL, STORM DRAINAGESDC I $1,333.34' . I
DISCOUNT
$0.00
6534
$1,333,34
r-
I if]
10
18
I~
I~
f-<
'I ~
, 0
gj
11070
I
. '
2, SANITARY SEWER ,CITY
A. REIMBURSEMENT COST:
I NUMBER OFDFU's I x
I 26 I
COST PER DFU
, $27,67
B. IMPROVEMENT COST:
. I NUMBE~6,OF DFU's I' x .I' COST PER DFU
, I .$21.04
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3, TRANSPORTATION
A, REIMBURSEMENT COST:
1 . ADT TRIP RATE I x
I 9.57 I
B. IMPROVEMENT COST:
I ADTTRlP RATE I x
I 9.57 1
I NUMBER OF UNITS I x I
I I' I I
I NUMBER OF UNITS 1
I I I
ITEM 3 TOTAL, TRANSPORTATION SDC
~ ,
$1,266,25
COST PER TRIP
21.06
x I'
I
~I
COST PER TRIP
$92,89.
$1,090.52
4, SANITARY SEWER, MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
1 I 1
ICOSTPER FEU
I $97,90
B. IMPROVEMENT COST:
"NUMBEROE FEU's ,
I I I
x
ICOST PER FEU
I $1,009,17
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRA TlVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5, ADMINISTRATIVE FEE:
I SUBTOTAL x 'I ADM,FEERATE I~
$4,807. I 8 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
= ,
~ ,
$1,117,07 I
$4,807.18 I
CHARGE
$240.36
~,
$719.29
$546.95
TOTAL SDC CHARGES
x INEW TRIP FACTORI
I 1.00 I
x INEW TRIP F ACTORI
I 1.00 1
,. $201.54
$888.98
11091
I,
11092
I
i 1093
, .
11094
I
I
=
$97.90
=
$1,009.17
$0,00
$10.00
, 169,33
.L $71.03
~, $5,047,54
Kaye Wilson
11/25/2008
PREPARED BY
DATE
1054
I
11055
1054
J1056
l
I
1079
11078
,
DRAINAGE FIXTURE UNIT'(DFU) CALCULATION TABLE
r;ruMBER OF NEW FIXTURES x UNIT EQl!IV ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQU[V ALENT UN[TS
rBATHTUB 2 0 3 = I" 6
IDRlNKlNG FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 '0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER / MOP SINK 1 0 I 3 = 3
ICLOTHESWASHER,3 OR MORE (EAl I " 0 0 I 6 = 0
I MOBlLE HOME PARK TRAP (1 PER TRAlLER) 0 0 I 12 = 0
I RECEPTOR FOR REFRJG / WATER STAT[ON / ETC. 0 0 1 = 0
IRECEPTOR FOR COM, SINK / DISHWASHER / ETC, 1 0 i 3 = 3
!SHOWER. SINGLE STALL 1 0 I 2 = 2
SHOWER. GANG'<),V~!lER OF HEADS) 0 0 I 2 = 0
SINK: COMMERCIALlRESIDENTIAL KITCHEN 1 0 I 3 = 3
SINK: COMMERCIAL BAR 0 0 2 = 0
. I SINK: WASH BASIN/DOUBLE LAVATORY 1 0 i 2 = 2
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 I 1.. - 1 .
URINAL, STALL / WALL I 0 Ii 0 I 5 = 0
TOILET, PUBLIC INSTALLATION I 0 II 0 I 6. = 0
TOILET, PRJV ATE INST ALLA TlON I 2 1\ 0 I 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS L 26
~U (EQuivalent Dwellin,g Unit) is a dischar,ge equivalent to a single family dwelling unit (20 DFU's) 5eht 167 gallons per day
~I YEAR
ANNEXED
r---
I
I
I
I
!
';
,MWMC CREDIT CALCULATION TABLE: BASED,ON COUNTY ASSESSED VALUE
.
-CREDITRATE/$I:ooiJlr ,-: I, .
ASSESSED V AL~ [S LAND ELGlBLE FOR ANNEXATION CREDIT?
- 5' . . (Ente~[forYcs,2torNo)
[; [S IMPROVEMENT ELGlBLE FOR ANNEX, CREDIT?
. I
(Enter I for Yes, 2 for, No) ,
IBASE YEAR
,
I
I
I
I
I
I
I
I
I
I
I
I
BEFORE 1979
1979
1980
\981
1982
1983
t984
1985
1986
1987
1988
1989
1990
1991
1992
. 1993
1994
1995
1996
1997
1998
1999
2000
2001
20.0.6
CREDIT FOR LAND (IF APPLICABLE)
VALUE/IODD CREDlTRATE
$0..0.0. x $0.,0.0.
~ ,
$0.,0.0.
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA T[ON)
VALUE/IODD CREDIT RATE
$0,00 x $0,00 . 0.
TOTAL MWMCCREDIT
$0.,0.0.
=
l
I
I
I
I
I
I
I
I
~
2
II
I
I
I
I
2
125 nFI1I STREET . SPRINGFIELD, OR!I7417 . PH:(s41)7l6-3753 .. FAX: (S41)721>-J1il19 .
ELECTRICAL PERMIT APPJJl(ATION
City Job Number ~~.. \\ Ur") ,
2~ Amps or less $ 70.00
201 Amps to 400 Amps $ 83.00
401 Amps to 600 Amps S138.oo
601 Amps tolOcio Amos 0 n lr'" 'M";r$J8fuQPtn
Over 1000AUEsWJ~'.Ja:: dOrpetgeod' I~~'ih; ore$41iltoO',ity
f~rUIEis " ~,
Reconn~ofii(c r on Center. ThMP rilles ,$tSs!OOortn
C.
installatiollluWeea&i1t8ialUlOf8tihJ.ltility Notllicatlon ~')
Center is 1-800-332r2344L....::-' 54 IT
2ooAmpsor1ess I $~ 1\.
Constr. Coutr. Number I 0 S- LJ 7 S- 201 Amps to 400 Amps $ 76.00
3)10 401 Amps to 600 Amps S110.00
, ' Over 600 Amps or 1000 Volts see "B" above.
st:' ofS~ingElectrician D.,~~
(\ 0 . ~ . 0 New A1teratiolll6"flm~iqn Per Panel
~_' O'l~' lA-~ One Circuit ' CE.. $48.00
- Each AdditioI1lD.ldJltdilf~
ServiceorFeed.!J~ HALL EXPlllE,jJiirHE WnRI<
DJ<;.-IQM i+o;-~ I' ('(In' - lZED UNGcl'l I HI::> PERM- .,~
~"'''"''''',;.-'''i:-'., "^".~""''-'':.'''..'''''1''''''.,
I~.'~r" 'h'~-.t"'_"""~"'" ,.~-,-_.,,_. ...
1."'....'" ,-, -, "rJ!:f~~:"" ..W;,,'-'. .
, . ;, '~"=GI . ,'_.
115 I 5 LJ t st- tV I
!1frffft~r:OMOO
~~~\ . ro
...-. ~..~._~
not started within 180 days of issuauce or if work is '
Suspended for 180 days. ,
~~1i.."._~rn:~~""1mr-"'"~';I/I
2. ,~~Jt;'~~
Electrica1 Contractor L +/;; ,
Address 9 2 ~ s's "'J 0 k.c S Ac,,~ 5,
Ci1y~+'\~
Phone 57./- L/17 Zl
supervisor License Number 4 J 7 'i ~ S
/D/ol/oq.
Expiration Date
E..,.:'''::on Date
Owners Name ~vv~ LJ; (~"",.j..
Address "},,, -, L, S k:..., IIi e. u.)
I
city r"J c.-,-<- Phone ~o(,4 V)"8
OWNER INSTALLATION
The installation is being made on t"'~t'...j I own which
is uot intended for sale, lease or rent
Owners Sigoalure:
.~
IDspedion Request: 726-37691\ ... ~ ~\~
~ <b~O\
__~~--J~~
A. .. ."' '. r~ ~-!!!!!!y}J!e'~~
\'UJf> \ () I Of}
sH7:Oo ~\.
s)K.60 tIb ,a:;
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manulilct'd Home or
Modular Dwelling Service or
Feeder
_.,,~.
B . . - ,,""'..>>'.....~ ~." ,",. ,',' ..." ,," ;<1'." ,
. . .." -'''iII II ..... ",1111
<..- . ~ . -..... . - -",cy!:';(M. 1/;'0''''"",,.''-
\
~
S55.00
Pump or irrigation $ 55.00
Sign/Outline Lighting S 55.00
Limited EnergylResidential $ 28.00
Limited Energy/Commercial $ 50.00
MInimum E1eetric Permit Inspection Fee is $SO.OO + Snrcharges
4.~~~ 9__IQln9D
12% Stale Surcharge . ~ \ -: L{ , J-
10"10 Administrative Fee =?'J. lo.l /2()
5% Technology Fee b; . 'Plr;-
TOTAL SbaRxlllrive(T:)lBuilding FonnsIEIcotriaII Permit ~1~~~
Willamalane
Park & Recreation' District
Job. No. ~ \1r::Jn
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008
NAME: "P111tfLl0\e,~nort- ~1J PHONE:_ \Q~\o-q4ffi
ADDRESS~:m ~ ~'lt~ WqfJ\e.sTATJttIP: CfH.{p
LOCATION OF PROPOSED BUILDIN~~~' .
Street Address: ' \ \ D \ s.. \\ \J \
Plat Name: ~ \ u.rr- ~x Lot Numb~r: \ ~ (JU)\t1c \ ffiCf.W
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the
back,)
A. Sinale-Familv Detached
NO. OF UNITS (
X $2,513 per unit =
B. Sinale-Familv Attached
NO. OF UNITS
X $2,726 per unit =
C. Multi-Familv Acartment
NO.OF,UNITS ,
X $2,323 per unit =
D. Sinale Room Occucancv ,
NO. OF UNITS
X $1,162 per unit =
E. Accessorv Dwellina Unit
NO. OF UNITS
X $1,257 per unit =
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer ~ust fumish proof of
Willamalane Credit approval.) ,
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit) ,
~:~~~
City of Springfield
Date.
i~~\S ,cO
$'
$
$'
$
. CX)
$~tJ(3. '
$ 't/
$ 8Dt3.ex)
I
I
5