HomeMy WebLinkAboutPermit Electrical 1996-1-12
.
The fOllowing project as submitted has the loll
zCnlng, and does, no! require specific land uae
approval, . ' .J I) tJ
ZOnlng.:J..dLJ ~ _
225 FIFTH STREET'/.
SPRINGFIELD, OREGON 974Y?te 1-1 z.-~ ~
INSPECTION REQUEST: 72~ut1.6~ Signature
OFFICE: 726-3759 "
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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. CONTRACTOR INSTALLATION ONLY ,B.
Elec trical Contrac tor tea..lv S [' leel/tlc.
Address PD, ~o:t 1.;$1<;"
City fLt.']t!iVt 91'iD'l. Phone 9''3S''"- 5"301
Supervisor License Number 5~lq 5
Expiration Date 10-1-'1S'
Constr Contr. Number "l'l5"IQ
Expiration Date C -20 - 91:
Signature of Supervising Electrician
"\)- L h -
Owners Name ~^~^ f\ \~ ~\
Addre~~~~G lj.
City '- " 6 _ Ph~ne l' .~
o~ TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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ELECTRICAL PERMIT APP~~~<lN.tA
Ci ty Job Number G\~ \
A.
COHPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'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 Only
C.
Items' Cost
Sum
. \ $ 85.00
:~ $ 15.00
~~
45
$ 40.00
$ 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 1090 volts
..''!''-
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
.'
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
'- :'.:.{.~~-:..",
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36'dJ
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Job No. 95~9
ADDRESS:
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
l\f\5.0f!PP . ': PHONE:~
'- ~~~ :\)~STATE:~IP'lhtll
- - (\ .
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lq<:ATION OF PROPOSED ~U!LH!NG SIlfs.., ~^ 1 .
Street Address if Known: lJ) ~C::) U U.(\ V\ f\\" (\ ~
. . . ~ .
NAME:
'.
. '
Platt N
Tax lot Number:
JJt, .
If)O~&l~iJ{)~
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1. DEVELOPMENT TYPE (Chedc appropriate dwellirigCsl. SDC calculations and dwelling type
definitions are on the back.) , " '., " , ' ' '
A. SiOlde Familv - Detached
+ Single Fa~i1y home.
I
. NO OF UNITS
Manufactured home not in a park:. . (j)
X $400 PER UNIT.s:, "". $ 4-CO.
B. Sin~le Familv - 'Attached
.'
\ \
NO OF UNITS
X $370 PER UNIT =
. $
C, Multi-Familv ADartmen~, ,
!
"
NO OF UNITS
X $777 PER UNIT =
$
D. ManufactUred Home Park
NO OF UNITS
X $280 PER UNIT =
$
.'. $400 tV
':g
..
$
$1fDOO
WPRD SDC
2. SDC CREDIT (If applicable> SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. , .
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
~;\~)~tw~
\ , \2-,-10'
~ ,
.
.8 NO. 'JSo~3'J
CITY OF SPRINGFIELD,SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~ 5'fCAt-J f3:; u,R.P
LOCATION:Y~c; ~HOL-4S VfL
DEVELOPMENT TYPE: Lo~ - 1Jf?:..w SFR
1'7()-:,7.7-/1-- OI?O(,
BUILDING SIZE:
I.OT SIZE
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
?:>'2.4S
X $0.209 PER SQ. FT. (loIBZ0
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
\"'1
X $43.26 PER PFU
G9> 2. \ 9;:')
~
3, TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $436. 19
X $436.19
C 4-4-0 S~)
---- -----
$
$
/
X I. 0 1 X $436. 19
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S \4 x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ ??c.-~
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
$ Ai/A
~
'--... --
.$ 'Z2- "11 ~~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
~ 1<- ~rL-~
. ~ ~ Kip Burdick
SDC Coordinator
X .05
Date: s/~, /0,'5
, ,
TOTAL SDC
Cll?~~
-- ...--'
$ -Z~"l' \ 1
FIXTURE UI)nr;,9~LCULA TI~ TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels; calculate only the. additional fixturesl .
, NUMBER OF UNIT FIXTURE .'
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.,..,......". ,..,."".",..,."."......,..,.....,.......,.....,....
Orinking Fountain.....................................................
Floor Drain",..".., ,...,....',.'""..',." ,.,.',.'",',...,.. ,.",.,..,.
Interceptors For Grease/OiI/Solids/Etc,........,....,..
Interccptors 'For Sand/Auto Wash/Etc,..,..,..,.......,
Laundry Tub/Clotheswashcr,.." "". ,,",' ,"" """,.'"".
Clotheswasher - 3 OrMorc......"..,..,..,..,....,..,..,.......
Mobile Home Park Tr;p (1 Pcr Trailer):.:..,..,:,......,
Receptor For Refrigerator!Water Station/Etc..,....,
Receptor For Commercial Sink/Dishwashcr/Etc..
Shower, Single Stall..,........,..,..............,...................
Shower, Gang................, .......,..,..,.......... .........,:.,.....
Sink: Bar, Commercial, Residential Kitchen.........................
Urinal, Stall/Wall,......,..., ,.......",......,..,',..,....,.... ..;.....
Wash Basin/Lavatorv: Single..,..........,.., ......,..........
Toilet, Public Installation..,.............,......,........,..,....
Toilet, Private......,..,....,....,...,......................,...:....
Miscellaneous:
'2-
\,'
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7--
TOTAL FIXTUI1E UNITS
2
1
2
3
6
2
6
',6'
1
3
2
11Head
2
2
1
6
4
4-
1.-
'2-
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'6
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CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table,
calculate credits separates,
r
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rale per $1,000
Assessed Value
1979 or before
1980
1981
1982
1'9,83, . .
1984
1985
$3.46
3,38
3,32
3.21
3,06
2.92
2,73
1985
1986
1987
1988
1989
1990
1991
1993
Credit ior Parcel or Land Only If Applicable
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Impro;'e~~t (if ,after annexation date)
CREDIT TOTAL
.,r
=
$2.46
2,14
1.77
1.37
0,97
0.61
0.44
0,15
_-I
= $
NIA
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LOCATION OF PROPOSED WORK: &3...S \. f\ \(' .n()/(11\ ~ -' ,
ASSESSORS MAP: l')n~.2.W TAX LOT: - n/~...I?-
LOT: ~ BLO~K' SUBDIVISIOt-L~ \ \(,\\'\l~)
-- ,
PHONE:\~o.f'f(\/\
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
.
SPRINGFIELD
.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
OWNER:,'-.'l 1(\[\ f\ \.-~ (\f)(f)
^OO::"''A~ 2i\l;'>'S t 1m ~ [\ 11 \)\ 1lL." II AD /) I'n"I
CITY: fiQ.~ () STATE: (.......~~".
DESCRIBE WORK:~ J;('l/r'({..L~\()ffil Q LA \~\[\ 0 f\t".9....-
NEW . --REMODEL ADDITION DE~ISH OTHER
ZIP:
qCtI.l
CONTRACTOR'S NAME t ~ADDRESS
GENERAL: 0..hnlln1\ o.r' a..f:)_
PLUMBING~'?\ tJC{ \.. \roD
MECHANICAl, Q:\(\').l ') ~~
ELECTRICA~ f\~
CONST,
CONTRACTOR N ,?:PIRES PHONE
~~ I c9 .e.~b ~cs.l3l&L
1{)1I0~ 8'I~q~ 2A:~'rn1S
<~'/cJ..og2 ,!;) . 'd.\o_ C\1 tJb "ltQ]}
9Pi12C\ ~. n.~ to \oy:,~ l?DlQ
- OFFICE USE -
QUAD AREA: \~ ~)\O LAND USE: \\ , \ FLOOD PLAIN:
\ l~~
. OF BLDGS: N OF UNIT'" ZONING CODE:
OCCY GROUP: ~~ \J\. CONSTR. TYPE:---1L1\J . OF BDRMS: .!J,
-l N OF STORIES' , HEAT SOURCE: ~L SECONDARY HEAT:
U G SQUARE FOOTAGE: ~
WATER HEATER' RANGE:
To request an Inspection, you must call 726,3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 8.m. will be made the following work day.
.I6J Temporary Electric
o Site Inspection - To be made
after excavatlon, but prior to
setting forms.
O Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
r\tt Footing - After trenches are
~ excavated.
o Masonry - Steel locallon, bond
beams, grouting.
rc1 Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
rlI Underlloor Plumbing/Mechanical
t-pt - Prior to Insulation or decking.
rv:1 Post and Beam - Prior to floor
L...p:aJ Insulation or decking.
m Floor Insulation - Prior to
Lf>I decking.
rY1 Sanitary Sewer - Prior to filling
Lp.J trench.
rn ~tor!'1 Sewer - Prior to filling
trench. .
r\7l Water Line - Prior to filling
l...-p:J trench.
rVl Rough Plumbing - PrIor to
LPJ cover.
REQUIRED INSPECTIONS
, f'\i\I Rough Mechanical - Prior to
~ cover. .
rV1 Rough Electrical - Prior to
/ l..,[::J cover.
f)rl Electrical ServIce - Must be
I approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
n Wall/C~lIIng Insulallon - Prior to
L\-l' cover.
~ Drywall - Prior to taping.
o Wood Stove.- After l~stallat'lon. .
o Insert - After fireplace approval
and installallon of unit,
r\r1 Curbcut & Approach - After
l....fJ forms are erected but p.rlor ,to
placement of concrete.
rYl Sidewalk & Driveway - After
L-f'" excavatIon Is complete, forms
and sub-base material In place.
D Fence - When completed.
o Street Trees - When 'all required
trees are' planted.
IVl Final Plumbing - When,all
l+-' plumbing work Is complet,e.
IVl Final Electrical - When all
~ electrical. work Is complete.
r"\71 Final Mechanical - When all
Lp mechanical work Is complete.
r'Y1 Final Building - When all
~ required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME'lNSPEcrlONS
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
Inspe-ctlons are approved and
porches, sklrtln'g, decks, and
venting have been. Installed.
Lol 'aces
1L
Lot Type
~terlor
Lot sq, flg.
Lot coverage
Corner
Topography _
Total height ~_:~.
BUILDING PERMIT'
::1: \\~DO
4 <DL\
Panhandle
Cul,de.sac
Garage
X $/SO. FT. =
6IQ.W
\4 10
Carport
Total Val ue
Building Permit Fee
Sta.'e Surqharge . ~\.8-.0 'H~.7~:
. " .
." (A)'
Total, Fee - "
.
I P.L.
IN
Is
Iw
IE
VALUE
8C\ a.{Jj
l()~
9.lal1t\1
.L\rl} 4. !.Q
3..3" 11
4.~l,q~
SYSTEMS DEVELOPMENT CHARGE (SDC)
, ' . (B) -i ~~ll.:!. ff?
PLUMBING PERMIT
ITEM
Fixtures
Re~ldentlal Bath(s)
Sanitary Sewer
Water
N'
~
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge 8.~-+l...\,.t.O
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
~
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge l.C;~ -+ .'1.5
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
'&S
~
,fl
It
Curbcut
Demolition
State, Surcharge
,
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, end E Combined)
FEE
\<'0.<82.
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Clio
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Setbacks
HSE GAR Accl
l..ttHE 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.
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 construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: ~'7'5 .Iq0
Date Paid: l'5L3Q.L{ ~
Receipt Number.l~ S44- -
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Received 'By:
Pla~l;Sed By
L 0.(.,1..,
1" Dat'e
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
A~D1Y~~MENTS
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By signature, I state and agree, that I have carefully 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 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 ensur~ that all required Inspections arB
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 appro d set of plans will remain
on the SI~t1meS+ln onstructlon.
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VALIDATION: /'f\t\c::::_r /
RECEIPT NUMBER ~ 1\) 0'-b
DATE PAID \. (?,cq (1
AMOUNT REC~': ,0 ~ ~1S .<17
RECEIVED BY T \~ )
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