HomeMy WebLinkAboutPermit Electrical 1997-11-21
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~~~~:LD~iicoN 97477 D&te-/k'kI-i1~- ELECTRICAL PERMIT APPLICATION
INSPECfION REQUEST: 726-37li'90rlzedSlgn~lura-b.L::::!, City Job Numb,:r ,q7/~
OFFICE: 726-3759
3. COMPLETE FEr;"" SCHEDULE BELOV
1. LOCATION OF INSTALLATION
///~ . ~~/A? "1>'- .
LEGAL DESCRIPTION
. />.?~-"3<;;:v.z.. ~.....~
JOB DESCIQ;.rrION '
.M~F~~ Lu~~/!~"~~.
p;tmits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACfOR INSTALLATION ONLY
Address
BUILDErs EUCrIIC
19511ADlSUft, .
~::,
Phone 4~ -c<1L'l- .
Electrical Contractor
City
Supervisor License Numb~r ~~-~
Expiration Date~
Constr Contr. Number lO-('L\;
Expiration Date ftJ-r.-q9\
Signature of Supe~ing Electrician
f-f4 ~~~
Ovners Name }3~~< ~.z:>
Address ///'!r ,M~/# ~ '
Ci ty ~~,~. Phone :7y;i'7.v~
. 9~7>
OVNER INSTALLATION'
The installation is .being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovner~signature:
-,
". .
DATE: //'<V-"7'?
<.r.\..t.J.PT 1I: -::<' ~/
RECEIVED BY: ~ ~/;~- __
,. p- -
. A.
Nev Residential-Single or !f
Hulti-Family per dvelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home,or
, Hodular, 'Ovelling'
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
,B.
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 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amp~'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
D.
Branch Circuits
.'
Nev, Alteration or Extension Per Panel
One Circuit / $ 35.00 ~
Each Additional
Circuit or vith Service
or' Feeder Permit ~ $ 2.00 ~,~
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightinv $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. /j/.'.
SUBTOTAL OF ABOVE ~~.
5% State Surcharge :?_~
3% Administrative Fee /_~
TOTAL Q ~,Ag
.
.
'.
CO M M ERCIALlI N DUSTRIAL
PERMIT APPLICATION
~
JOB NUMBER q.'7/,"",~
INSPECTION LINE: 726,3769
OFFICE: 726,3759
225 Fifth Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: ,/~S- ~~~
ASSESSORS MAP' J 7-0~ -~'5'.~Z
. <,OWNER: -- ~<<d( S/"-dNd
ADDRESS" ';;; s fit,..:...
CITY: 5p~/-i
~.
"
TAX LOT: --P 7~C::::>
STATF'
cO,
),
PHON" 7t17- - 'y.e';ly
~ r If'l- ;2t::J3/
ZIP: fflt/J'l-
DESCRIPTION OF WORK:
1:,.1.'//
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
VALUE: /ZO!Jt1~.~
NAME
ADDRESS
PHONE
ARCHITECT:
CONTRACTOR'S NAME
GENERAl' (7!N A.J.<..r
ADDRESS
CONST.
ro'''~*''''''
.'
PHONE
PLUMBIN'"
!J.., c
MECHANICA' '
ELECTRICA' .
:f<J" ,.' ;;/, d
fr j...",L ,
PLUMBING I MECHANICAl I
I FEE :....,~~ Nn """ rUll.Rr.:c I
-'f' Furnace/ burner & vent I
Single Fixture ~ y~,~ < 100,000 BTUs
Reloealed Bldg. I Furnace/burner & vent I
(new fix, addtl) >100.000 BTUs
Water Service I I Floor furnace and vent I
It.
Sanitary Sewer ~<5- I :25:'" I Suspended wall or floor I
It. mounted unit heater
Storm Sewer ;. I I Appliance Vent I
It. separate
I I Stationary evap. 1
Backflow Device cooler
[ I '9 Vent Fan/Single I
duct
[ I Vent System apart I
from AC or hlg,
I [. Mechanical exhaust I I
hood and duct
I I [ [
I [ [ Permit Issuance [ $10,00 [
TOTAL PERMIT [~- I TOTAL PERMIT $/~ ,[ /;:?: I
- OFFICE USE -
HANDICAP ACCESS:
FLOOD PLAIN'
QUAD AREA'
LAND USE:
, OF STORIES:
"'5-/
/
, OF UNITS'
CONSTR. TYPE: ~ IV
HEAT SOURCE:
ZONING:
..........L
, OF BLDG~'
OCCY GROUP'
LIGHTING POWER BUDGET:
WATER HEATER'
sa FT,
$/SQ. FT.
VALUE
SQ. FTG MAIN
X
SQ, FTG ACCESS
SQ. FTG OTH ER
x
x
TOTAL VALUE OF ,PROJECT
PLAN CHECK FE!:
~.I?
RCPT' _ 2S&>S/
DATE
//- =</~,)
BY
~.-,,-- -
",.. /(;; ~ ... f#.-~-
[ BUILDING PERMIT J ~2.Sc::::> PLUMBING ,'d,~' DEMOLITION
15% State ~.6' 5% State ~ ~.:A'2
Surcha~Qe "?Ifi: SurcharQe / . ?'!"
I MECH~~;": [ /.P', -c:> FENCE I
/~,-- VALUE $_
15%Slate' ~ ~~ SIDEWALK SUBTOTAL I /?~ ~/
Surcharae FT. PERM ITS
I PAVING I CURBCUT SYSTEMS [ ~~Y<.
FT. DEVELOPMENT
. I &~.B~
TOTAL PERMIT FEES ,
EXCLUDING ELECTRICAl ~(Eq. w: <8-
/47"411/ 'lIP""'''' /17
..
It Is the responsibility of the permit holder to see that all Inspections are made at the proper time. To request an Inspection, call
726,3769 (recorder), state your City designated job number, job address,type of Inspection requested and when you will be ready
for Inspection. Requests receIved before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION: To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel In place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all Inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment Items are
In place but before any
concrete Is placed.
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor Insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to Installation of floor
Insulation, decking or floor
sheathing.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals In accordance with
UBC 2415.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
)-
FINAL PLUMBING
/
FINAL ELECTRICAL
Y FINAL MECHANICAL
)I FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS'
.
REQUIRED INSPECTIONS.
-.
y
PAVING: After gravel Is In
place but prior to placing
asphalt or concrete.
ROUGH PLUMBING,
ELECTRICAL &
MECHANICAL: No work Is to
be covered until these
Inspections have been made
and approved.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Ownerl Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
ATTIC DRAFT STOPS &
CURTAIN WALLS
y
FIREPLACE: Prior to placing
facing materials and before
framing Inspection.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are In
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanIcal are approved.
HIGH STRENGTH BOLTING:
During all bolt Installation and
tightening operations. (306
,a,6)
SPRAYED ON
FIREPROOFING: UB.G.
Standards 43,S,
STRUCTURAL CONCRETE: In
excess of 2500 P.S.1. (306 a,1)
STRUCTURAL WELDS:
Performed on the job, (2722 f)
INSULATION & VAPOR
BARRIER: To be made after all
Insulation and required vapor
barriers are In place but
before any lath or gypsum
board Interior wall covering Is
applied,
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
.Y
GLU'LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed, (2501 U.B.G.
STDS, 25-10,11).
LATH AND/OR GYPSUM
BOARD: To be made after all
lathIng and gypsum board,
Interior and exterior, Is In
place but before any
plastering Is applied or before
gypsum board Joints and
fasteners are taped and
finished.
STRUCTURAL MASONRY: (306
a,7)
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material In
place.
'In addition to the Inspec.
tlons specified, the Building
Official may make or require
other Inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
SITE PLAN REVIEW BOARD: Must be requested 2 days In advance
of the date you wish Inspection. All project conditions such as
landscaping, parking lot striping, etc. must be completed before
requesting this Inspection.
X FINAL BUILDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate 01 Occupancy has been Issued by the Building Division
and posted on the premises.
PLANS REVIEWED BY
//~ '7 DATE //'2&-97
//'" /'
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify th~t all Information
herein Is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances
of the Clty,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 re inspections are requested at the proper time, that project address Is readable from the
te at the front C?f the property, and the approved set of plans will remain on the site at all
street,~e~permlt card Is 10
times ~:constructlo ~
Slgnature~Y~1 ' _
V'
VALIDATION:
Date...f/j-Zi/f17
RECEIPT N'
AMOUNT RECEIVED: ~Y1i'
'2Ac,Si?/
DATE PAID:
RECEIVED BY:
/C/
,
//-2.('...9:>
/:7,~ ~
// '
'-
JUD I~U, ' / //&','0
. ATTACHt1ENT A .
CITY OF SPRINGFIELD SYSTEMS DEVEL~MENT CHARGE
WORKSHEET
Ku55:bJ/7tr;.r.".,.J
NftME OR COI1PMIY:
LOCATION // /..C:;- Uu'n_'5Y-
oE'/EL.OPi1Ei-IT T'lPE kc;;..l-mro. "; C'I/; "" f!,:~,-/~,,/ /;'" Jl:...,j, !-5/.-.jP
BUILDIi>IG SIZE
IQT SIZE
<:::0. Ft.
1 . S TnRi.! OK.;: f :\!;l:~ ~
IMPER'/ICUS SO. FT,
-&
:< SO. 226 PE2 SQ, FT, $ ,g
2. SANfT.;:,R';' Sr~,'fFR -C 11':'
NO, OF FFU'S ~
(See Reverse SiceJ
x S~6.86 PEK PFU
, a~
"'., .~
$ < 1.",:p.
3. TRt,NSPORT.u.TTON
'1'10 OF UNITS X TRIP ~~TE X COST PER TRIP
x
X $472.49
$ t;+ ,
X
X $47249
$
x
X $472.<19
$
4, SANiTARY SF'.~n~-r1\-jMC
1'10:- OF FEU'S
x
PER FEU + -$10 MWMC/AoM FEE $ <f9-
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $
TOTAl -MWMC SOC $ ~
0;:'
SUBTOTAL (ADO ITEMS 1.2,3 & 4) ,$ B2f}-
5. ADM!N!STRATlVF FEFS'
BASE CHARGE (SUBTOTAL ABOVE) X ,05
7'''''
$ , /{.--
/V.4- /h.-..r'
// SOC (0'orlf}{ na tor
Date: /1~97
TOTAL SOC:
. '2 L'; 4t.;iL
$ -7'7".1/-
, FIXTURE UNIT CALCULA TJON TABLE: Number of New .res X Unit Equivalent = Fixture Units,
(NOTE: For remodels, calCUlate. the NET additional fixtures! ' ' '.
NUMBER OF UNIT FIXTU~
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub..... ......,. ......,...,.,.".,..".,. ........,.......".,......,.....
Drinking. Fountain.......,.....",.."..".... ....,..,.. ,....,.,.......
Fioor Drain.. ....,... ....,.......",..",.".,.., ....,.......,..............
Interceptors For GreaseiOII/Sollds/Erc........,....,..,
Interceptors For Sand/Auto WashiErc..........,..,....
Laundry TubiC!otheswasher.,. .'" .,., ..,............,..,....,
C!otheswasher. 3 Or More..,..,......,..,........,............
Mobile Home Park Trap {1 Per Traded..................
Receptor For Refrigerator/\Nale; Station/Etc....:...
Receptor For Commercial Sink/Dish'NasheriEtc..
Shower, Single Stall..... ... .......... ...............................
Shovver, Gang.... _....... '.............................................
Sink; Bar, Commercial. Resjce~~tiaJ Kitc:-,en........................
Urinal. Stall/Wall.,..........,.. ,...."...... ........,....,...... .......
Wash Basin/Lavatory, Single......., ..................... .....
Toiiet. Public Installation....................... _................
Toilet, Private.......... ............ ....... ..........................
Miscellaneous:
2
1
2
3
6
2
'0
0
1
3
2
jlf-:ead
I 2 ,.,<'
2
I /
6
I J. 7"
TOTAL FIXTURE UNITS
=
7
CREDIT CALCULATION TABLE: Basad on assessed value, If improvements occurred after annexation date in table,
calculate credits separates.
.I
I
!'
.I
Credit for Parcel or Land Only If Applicable
X $
IRate X Assessed Value!
X $
, (Rate X Assessed Value)
=
Improvement (If after annexation date)
=
CREDIT TOTAL = $
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Residential...:...........,.......;...0.4
Commerical.............,........... ,0.9
. Industrial............................ 0'5
Governmental....,......,.......... b,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF.COEFFICIENT