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Home My WebLink AboutPermit Electrical 2005-11-15 "., \{I, 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAx: (5,4}~?irl8B9 0 "('(\..: 9 a,:' ELECI'RlCALPERMITAPPl/CATION 12)rV1j iGC>o.'" .C>9...... City Job Number (\ Yi). \~ I Date I~ 260::l' 1..oc>\ _.,e t. I LOCATlONOF.INSTALLATION J 3. I COMPLETEFEES€HEDUl$--liifiow 11\00 ~Q$\-'<C\.ffi~ LEGAL DESCRIPTION \"\.D?~ O~ JOB DESCRIPTION ,\S'\1 ~~.~\l.VID- Permits are non-transferable and eXPi::'Owork is not started within 180 days of issuance or if work is Suspended for 180 days. Signature 01S PervJ, 'sing Electrician A- 5 New Alteration or. Extension Per Panei ~;vt .t: __ /T One Circuit - Q Each Additional Circuit or with ~,..__ rl~_ _ Service or Feeder Pennit $ 3.00 Owners Name 51 ~ Address ~ q E. I Miscellaneous (Service/feeder not included) -Each Installation I City _~ uh , Phone ~ .e2flI5 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidentiaI $ 25.00 Limited Energy/Commercial $ 45.00 2. I CONi"RAcrORINSTALLATIONONLY I Electrical Contractor c,.tJm !/(l/,{'IIJ/tZtrfj Address ::J9.Jb? O///.htI Lu. sfR 6 City ~~ Phone -YtJ;H3~/ Supervisor License Number 'Y7'/~5 Expiration Date If) - /-07 /</9R3<1 l,;t - /3- a<" Constr. Contr. Number Expiration Date 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 1-"''':\'1.)''. A. I New Residentiai - Single or Multi-Family per dwelling unit. I \CXo~ /ILj Service Inclnded 1000 sq. ft. or less' ~. OreC]on law requtes y~tlJgoo Each.~dditiOna1500 sqUtlorJ by tIlt: v '/;: V , , UlIIIlY portidn thereof n Cenler. Those rulee;j-re s~tl~gf. r ,~ ~"1.()n10 througn U/'\n ,,52-UU - EaclrManufact-d Home or . . s of the rules by M d I D"II'-S"..ht~'flcople o !J .ar . .we mg ervJce or I Feeder I" the center. (Notp. the teleo $50.00 ca ,ln9. I ~___M llt;my Notification B.l SenH~~to~'~e!d,~f~,~'IlS~!~tt~tA1tera)ions or Relocation: 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $ I 63.00 Over 100~ts $375.00 ReconnelHis peRMIY SHAll ~IR~ !~f~ WOI1i\ C. I Tem\>oNml~IJJiWie~ IHI~ t'tKMU I~ NUl {ggI\ilM~N"\lIW Uf1IS Al;tAl\lYYI\l1;Y ~Yn Installatl~~0@j\.~n 200 Amps or less t15 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 AmI'S or 1000 Volts see "B" above. D. I Branch Circuits $ 50.00 ttit\.'Nl'\ ll-\"f. $ 69.00 $100.00 $ 43.00 Minimum Eiectrlc Permit Inspection Fee is $45.00 + Surcharges 4.1 SlJDH.IlAL OF ABOVE 2- Z- 0 7% State Surcharge I ~ ~ ...,.., -- 10% Administrative Fee "L- Z.'5:7 I.{O TOTAL Shared Drive(T:YBuilding FonnsIElectrical Pennit Application 1.03.doc . . CI~ OF SINGFIELD SYSTEMS DEVELOPMEAoRKSHEET ~ I~ II ~ I~ ItlJ .f- I~ 0:: JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS COM2005-0 1591 R~al Custom Homes 360 MountainGate Dr 1702343401400 SINGLE F AMIL Y RESIDENCE I BUILDING SIZE (SF: 4577 LOT SIZE (SF): 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I 5915.00 I $0.323 I = $1.910.55 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 0.00 I I $0.323 I 50% = I ITEM I TOTAL - STORM DRAINAGE SDC $1,910.55 I 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 29 I DISCOUNT $0.00 15637 $1.910.55 1070 COST PER DFU $25.07 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 29 I $19.07 ITEM 2 TOTAL- CITY SANITARY SEWERSDC = , $1,280.06 ,1 TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I I , I 9.57 I I $19.09 I 1.00 I B. IMPROVEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 9.57 I I I $84.19 I 1.00 I ITEM 3 TOTAL- TRANSPORTATION SDC = I $988.39 $727.03 $553.03 1091 I 11092 I 4 SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x I I I ICOST PER FEU I $82.03 B. IMPROVEMENT COST: INUMBER OF FEU's I x I I I ICOST PER FEU I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2.3, & 4) = , 5. ADMINISTRAT'VE FEE: I SUBTOTAL x ADM. FEE RATE 1= $5.136.34 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: $957.34 $182.69 11093 I $805.70 11094 = $82.03 $5,136.34 = $865.3 I $0.00 $ 10.00 CHARGE $256.82 196.08 $60.74 I 1054 I I 1055 1054 . 1056 1079 111078 Cheryl Slaymaker TOTAL SDC CHARGES 11/16/2005 PREPARED BY DATE =, $5,393.16 " 225 Fifth Street , , Springfield, Oregon 97477 541-726-3759 Phone JohlJournal Number COM200S-01S91 COM200S-01S91 GpM200S-01S91 COM200S-01S91 COM200S-01S91 COM200S-0 IS91 COM200S-01S91 COM200S-01S91 COM200S-01S91 COM200S-01S91 CDM200S-0 IS91 ~bM200S-0IS91 COM200S-0159I COM2005-01591 COM2005-0IS91 COM200S-0 1591 COM200S-0IS91 COM2005-01S91 COM200S-01S91 CbM2005-01591 CbM200S-01S91 COM200S-01591 COM2005-01591 COM200S-01S91 CbM2005-0 IS91 CbM200S-01S91 CbM2005-0 1591 ;C " Payments: Type of Payment Check :, :j ~r :f :1. r ~. 12127/200S :1 . ~ RECEIPT #: , ~ty of Springfield Official Receipt .evelopment Services Department Public Works Department 2200500000000001751 Date: 12/27/2005 Description Curbcut Permit Mountaingate Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Plan Review Major - Planning Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Boiler/Comp Up To 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee- Residence Wiring 1000 Sq Ft Residence Wiring Ea AddtI SOO + 7% State Surcharge + 10% Administrative Fee Paid By Received By REGAL CUSTOM HOMES INC. njm Page 1 of I Item Totai: Check Number Authorization Batch Number Number How Received 7268 In Person Payment Total: 12:48:35PM Amount Due 80.00 1,910.SS 727.03 SS3.03 182.69 80S.70 82.03 86S.31 10.00 196.08 60.74 150.00 1,248.IS 306.00 12.00 12.00 18.00 6.00 9.00 6.00 4.00 15.00 10.00 106.00 . 114.00 129.93 18S.62 $7,804.86 Amount Paid $7,804.86 $7,804.86 LDe.. 'he following projec! a~f~WI.~~"TJ>l(Owing I lrm and does not r~irv\Pec'fTtt:1'a.tfltfUS9 I" I I' I .~1l..4a4- NGFlELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)17260,3689 mnl ~^-:::i;;: ,,) CAr~: /'1 "I Lf-o-S- hu..."r".o Slg '0'.'. - - .. I Signature of Supervising Electrician J ~ ~; New Alteration or Extension Per Panel r~ One Circuit ~~~ -:A- E hAddi' IC" 'h ~ ac bona ITCUlt or Wlt O ) . - ~ k/\ L", - - - . Service or Feeder Permit Ownersl':"f J CUJ...Y r I PQ"'ltt}.) Addresrrn _\ N LJ-g'q E.I Miscellaneous (Service/feeder not included) -Each Installation I Ci~m, Pht?tH -C,3S- Q,u37 'f;rs 25 OWNER INSTALLAtION ~ 225 FIFTH STREET. SP ELECTRICAL PE City Job NumberC.S -() /.. I. I LOCATION OF INSTALLATION ?l en \lVim --- \" LEGAL DESCRIPTION \10-:1 Yt ?,~) ~i.f 1;~~Jl~a) Permits are non-transferable and expire If work Is not started within 180 days of Issuance or if work is Suspended for 180 days. 2. f CONTRACTOR INSTALLATION ONLY I Electrical Contractor CUJI.I) (jill.!, rCl.JLtJtU Address ~ Odhnl Lvi SUe, City ~p ~ Phone r _-Jit.fU': -:&7 Supervisor License Number A/7//025 Expiration Date //V 1-6; 1 ~9 %3</ Constr. Contr. Number Expiration Date /"Q -(7,- ().~ The installation is being made on propcrty [ own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. I COMPLETE FEE SCHEDULE BELOW A. I New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less $106.00 Each additional 500 sq. ft. or portion th~\1or:-:r.!TION: Oregon law requrre~ Y9:~~t~ E h M . t1 d 'd H'.". ?r:opted by the Oregon U I' Y Macd I anDwu aCltI. . som;'~~'^r Those rules are set forth o u ar . e mg eJV1ce or . S ' 001 Feeder . . '. , 52-001-001 0 Ih,~. ,~h n.l\l s.o.oo - l~ (>, . \ ~ h I bv '"^_'_ _.......;~<':' ......ft p rll P.!; B. I Services or Feedf~s ..,:'~~~!la~ip~.i~w;~@tIQIis ..hRillbcation: n~ '~h~r for the Oregon Utility Nolilicatloll 200 Amps or'less C t 's 1-B()n ",,?_?o$l~1,00 en er, . - . "'7 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 60 I Amps to 1000 Amps $163.00 Over 1000 AmpsIVolts $375.00 Reconnect Only $ 50.00 c. I Temporary Services or Feeders I Ins<<~atL~,~Iteration or Relocation L. c'f() 200~W~~~\1MIT SHAll EXPJREJF TH3Mml( c"J 0 ' 20 YI') 'i~!~61A.~DER THIS PERMIT'SiW. r . 40 A "I\' ~fj(j:~ IS ABANOONfO s:mo.oo Over ~~01RgpY~YI~~Rs see "B" above. D. I Branch Circuits $ 43.00 $ 3.00 Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric PermIt Inspection Fee is $45.00 + Surcharges uo 4.1 SUBTOTAL OF ABOVE I..~ (CjJ , . 7% State Surcharge l'? . S 0 10% Administrative Fee ... c::;;. U 0 d 3't. SO TOTAL Shlll'ed Drive(T:YBuilding FonnsIElectrical Permit Application I-03.doc