HomeMy WebLinkAboutPermit Electrical 1996-1-12
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 Authorized SIgnature
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. .~~:w O~\\~~f.\ f\ \Y
\ ~f~~nI~\ ?1).Ln
~OB~8J~InION \.t-\ln\?J
Permi are non-transferable and expire
if wor is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY .B.
Electrical Contractor beo..lv ~ fleS,ol:.
Address P. D. \So;!: '1 <;9 ~
Ci ty (/.l'V",t 91,/01 Phone '1''3 S" - <';"503
Supervisor License Number ~gl~ 5
Expiration Date }O -I - ~lf
Cons tr Con tr. Number 9'1 S"IQ
Expiration Date C -20 - <Il;
Signature of Supervising Electrician
't.-L
Owners Name'\. ~l !'/)
Addres. s~. ~~
City ~ Phone
O~:\NS LATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------~~~c:r~~-~-:--------
RECEIPT 1I: -} ':\;,; ~"~
RECEIVED BY: n17.J(j ~JV--
vI"'
7::;';:':.-
.;.
0f ELECTRICAL PERHIT~PUCATION
Ci ty Job Number L.I\ <:)mo. 10
3. COHPLETE FEE SCHEDULE BELOII
A. New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
Items
1000 sq.ft. or less ,
Each additional 500
sq. ft or portion ~
thereof L-
Each Hanuf'd Home. or
Hodular. 'Dwelling
Service or Feeder
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 OnIy
C.
Cost Sum
$ 85.00 ~S
$ 15.00 ?J)
$ 40.00
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00;
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to'400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
.-''1'- -
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
.'
One Circuit
Each Addi tional
Circuit or wlth Service
or Feeder Permit
E.
Hiscel1aneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
..:::.f.1.,.....
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36cO
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SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM~ ~l ~R ~ 1) ep r---
LqCATION OF PROPOSED B'IIL~~SITE:n r it 1-,. I ^ - ")
. Street Address if Known: LA j;..J { {lj' ( O{!) .f) .f..)f.L)
PHONE:
STATE: f1E:,ZIP~'
'J4h.R11L
PI,. N=,(l i ~ it rlMJ T~ W. Nom"'" i.?D3f1[J/!l.})'f/J/P
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.l
A. Sinl!le Familv - Detached
-+- Single Family home
NO OF UNITS I
B. $inl!le Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home 'Park
NO OF UNITS
Manufactured home not in a park (J[) .
$1lfJ. . .
X $400 PER UNIT _="
.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$1Qn rfJ
:4~
WPRD SDC
I
2. SDC CREDIT (If applicablel SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET 5DC ASSESSED (If SDC reduced for CreditJ
~
\ I~ ~\Q
n:'tfflo
r
.
.B NO. Cf5()7"1"
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: SYC-AN 'B (!o/2..f'.
LOCATION: (o~z- M,O!-OL.4S 1)f?JV~_
DEVELOPMENT TYPE: LD~ - ~E:W SFfl..
/7037-7..-1'1- - 0130(, pit>
BUILDING SIZE:
LOT SIZE
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
z.~o'?
X $0.209 PER SQ. FT. ~~O~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
IS
X $43.26 PER PFU
0n~0
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X \ . 0 1 X $436. 19
X X $436.19
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S \~ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
X $436.19
C~~0
$
$
$ ?\~+'Z.
TOTAL-MWMC SDC
$
~
...... ~
Ioq,
$ "20'6'2- -
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
~,;:p . .,C ,_~,
'J Kip Burdick
SOC Coordinator
X .05
Date: <;'/-"'0 /'1~
, I
'TOTAL SDC
GIO'\-~
'--- ,../
$ '21~1oq,~
'.' .
FIXTU HE U~IJ;'C.A,t..CULA TIa(\I T ~BLE: Number of New Rxtures ~nit Equivalent = RXMe U~its. "
(NOTE: For remodels. calculate only theWi: additIonal f,xtures) . '.
. NUMBER OF UNIT FIXTURE --
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub......................."".......................................... .
Drinking Fountain................................ nO....... ...........
Floor Drain, ...",...'.'",'..'",.'"..',.. ....".',..,.,.........'... ....
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc.......,..........
Laundry T ub/Clotheswasher."",."",.".,."",.,.,........
Clotheswasher - 3 Or More,..'...:,..'.................'..'.......
Mobile Home Park Trap (1 Per Trailed........:......... '
Receptor For RefrigeratorlWater Station/Etc........
Receptor for Commercial Sink/Dishwasher/Etc..
Shower, Single Stall..........,......................................
Shower, Gang... ............,. .......... ..... .... ....... ........ :,.....
Sink: Bar. Commercial. Residential Kitchen.........................
Urinal, StalllWall..,..............,...,................... ...............
Wash Basin/LavatorY ".Single,.., c......,........,.............
Toilet, Public Installation."..,.."...,. .,.,..,..,...............
Toilet, Private..................................................:....
Miscellaneous:
2
1
2
3
6
2
6
6 ..
1
':3'
2
l/Head
2
2
z.. 1
6
-z.. 4
'l..
1..
1..
'Z-
'2
'6
TOTAL FIXTUnr: UNITS
\~
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
nate per $1,000
Assessed Value
Year
Annexed
nate per $1,000
Assessed Value
.\
L
1979 or before
1980
1981
1982
1983.. '
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2,14
1.77
1.37
0,97
0.61
0.44
0.15
Improvement (if after annexation datel
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
Credit for "Parcel or Land Only If Applicable
=
CREDIT TOTAL = $ /.l.A,
'1/
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
ASSESSOR-, MAP:
LOT: \ 'r\.
.
BLOCI<"
.
C\~'D\C\\()
JOB NUMBER
~:Jjl 1? f? ' PHONE: l4ln.A111
ADDRESS'- ~ ~ l ~ UtQ11) I/)
CITY: 'Yu f1L(-.-/ _ 0 STATE:_llJJIJ 1f/rLJ ZIP: 47477
DESCRIBE WORK: (':). - \!~ Iw1 0 IVQQ.~
V" .
NEW REMODEL ADDITION DEMOLISH OTHER
CON ST.
qlfSIRACTOR 'cf)d~~h 'g(573trR
lo:rrf~ Q . (5'-1$ ~
55~ AdbCf7 ~
.8173{ (.), ./7. - ~.,?(J1::)
QUAD AREA:
\ QJ\)U )
\
. OF BLDGS:
OCCY GROUP: -!X ,~ M
I
. OF STORIES:
WATER HEATER:
r..J
- OFFICE USE -
LAND USE: _, (( (
. OF UNITS: (
CONSTR. TYPE:..JJ.))
HEAT SOURCE: _.f:" U
o
RANGF'
FLOOD PLAIN:
ZONING CODE: --LJ}V' )
. OF BDRMS: ........ tJ...,
SECONDARY HEAT:
SQUARE FOOTAGE:
fHlfCL
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecttons 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.
CKJ Temporary Electric
o Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electricalf
Mechanical - Prior to cover.
r"\l1 Footing - After trenches are
l.-...f'l excavated.
o Masonry - Steel location, bond
beams, grouting,
m Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - PrIor
to f1l1lnQ trench.
f\Tl Underlloor Plumblngl Mechanical
~ - Prior to Insulation or decking.
ill Post and 6e8fT1t' - Prior to floor
I Insulation or decking.
fVl Floor Insulation - Prior to
L..f'" decking.
r)tJ Sanitary Sewer - PrIor to filling
J trench.
rVl Storm Sewor - Prior 10 tilling
I trench.
rV\ Water Line - Prior to filling
~ trench,
fVl Rough Plumbing - Prior to
L.pJ cover.
REQUIRED INSPECTIONS
W, Rough Mechanical _ Prior to
~ cover.
Lso Rough Electrical - PrIor to
cover. .
00 ElectrIcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
CKl Wail/Ceiling Insuletlon - Prior to
cover.
C$J Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
r'tl Curbcut & Approach - After
I forms are erected but prior to
placement of concrete.
!'Vi Sidewalk & Driveway - After
~ excavation Is complete. forms
and sub.base material In place.
o Fence - When completed.
rVl Street Treos - When all required
T trees are planted.
r\71 Final Plumbing - When all
~ plumbing work Is complel,e,
~ Final Electrical - When all
/ electrical work Is complete.
r1l Final Mechanical - When all
r mechanical work Is complete.
o/Flnal Building - When all
required Inspections have been
approved and building Is
completed.
~Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
InspectIons are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot faces ~ lot Type .
lot sq. Itg. ~nterlor p.L.
Lot coverage Corner N
Is
Topography Panhandle
-,. Iw
Total height lli Cul.de.sac
(~\') IE
Is
BUILDING PERMIT
so. FT. X $/SO. FT. = XA~l
\~'2lo ~.7..Q -ri J~
l\C\O \4.10 " -LtA(
ITEM
Main
Garage
Carport
Total Value
6\J4?< -;
311. <&
30U
l\ DG, ~
Building Permit Fee
State Surcharge \ 8.<1.5 + I \.1>1
Total Fee (A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~ "Z-l~("g;.-$
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ~
'......
Sanitary Sewer FT.
Water FT.
~ FT.
Storm Sewer
Mobile Home
FEE
---U. (\ '<!loa
Plumbing Permit
State Surcharge ~,c.o~~,e,c.)
l (,0 (,JQ.
\.!L~
\(~-~
Total Charge
(C)
MECHANICAL PERMIT
\" <a2
1.\. f;Q.
'1.:~'
Furnace
Exhaust Hood
Vent Fan
N'
'3.
.
Wood StovellnsertlFlieplace Unit
Dryer Vent
~':b
Mechanical Permit
6\.~
ttJ.. ~
~U-
.l.\.I...\.O~
Issuance
Stale Surcharge \ .S\:?' -\- .c,,!;
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
:1\~
\ ""\ &:.9.
Sidewalk
l'-\~
30
It
It
Curbcut
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
.Ll.s, ~
J..~S~:?"
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,
. "JI
(
~
",'
::
ia THE PROPOSED WORK IN THE,
"'HISTORICAl DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR ACC
\'2
II
APPROVED:
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, Including the
Development Code, regulating the cOr)struction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: _'~~\;~S
Date Paid; __ ~
Receipt Number:--.:1'.f\ -=;L ~
Received By: ~ m )
~~~evlewed By - ~r
Systems Development Charge is due on all undoveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
H" flJ. >(;: IS1Y.S '/
':dJ-.-: 4-4nt) , O;()f rm.lu)
'- - (\
~ ..!l~,..k..~~
KJ> r.vLI'~ \l!;l.
if" ~.. ,~
, -- -"-- . 'C----
By signature, I state and agree, that I have carofully 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 Ihe Laws
of the State of Oregon pertainIng to tho 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 thai all required Inspoctions aro
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 (Urln construction.
,,~tur~- V
L:tp
VALIDATION: r\ c:::...
RECEIPT NUMBER .1.~L)
DATE PAID \. \l /ctlo
AMOUNT RECEIVE~ , 6.!l. S ~ .7.b
RECEIVED BY ~.D(\.. )
lilt
!-ax
.
JUrr-"L5 :<1: =>i
THE COUNTRY GARDENER
87284 Territorial Rd.
Veneta, Oregon 97487
(503) 935-9524
<
~l <{,II-
PROPOSAL AND CONTRACT
The following constitutes a contract by and between Bruce
~~aham/Character Homes and The Country Gardener Landscape
~~rvices for the landscape services herein described.
T&e contractor ~grees to furnish all the labor and materials
11('C!?S,-;a r" to do' and perform in a good, workmanlike manner
(he foll;wing landscape services at 632 Nicholas St.,
s",'ingfield:
_ To spread 6 yards of loam over an area of 1,000 sq. ft.
of proposed lawn area.
To lay 1,000 sq. ft. af sod.
_ To spread 1 unit of Bark-a-Mulch in the frorit garden ~rea
not committed to lawn.
_ To plant 'tJj street trees .in the place indicated 'by the
client.
The r:ontractor agrees'to perform the work, in a timelY'manner,
:.)mpletlng the project wi thin two days of commencement, ,,,eather.
.'ltld' material availabll'i ty permitting.
The customer and contractor agree that any changes not
,'lr.eady agreed to may alter the cost of the project. The
c~stomer recognizes that su~h changes will probably result
in ~dditional charges. The ,contractor agrees not to make
cd',/ such changes without the customer's consent.
In connection with the preceeding, the customer agrees
~o pay the contractor the sum of $880.00. payment shall be
due and payable upon completion of the project and must be
paid in full no later than the tenth of the month following
completion of the project. A late fee of l~% per month (18%
per. annum) shall be charged if payment is not received by
the tenth of the month following completion of the project.
PROPOSAl.
For: T~/f?ntrft/f3aI,rdener '
By: /f/.j..~~
Date: .c; .:f.lJh
AGREEMENT
For: Character Homes
By,:
Date:
Landscape Business License #6305
issued by
Orego~ State' Landscape Contractors Board
Salem, Oregon 97310
,( 503).378-46'-1