HomeMy WebLinkAboutPermit Electrical 1996-1-12
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SPRINGFIELD
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Tha following projocl89 .u'::~if1C \and use "Q
zoning, and does not :erJ __
225 FIFTH STREET approval. z/.j..j ~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonin\L:,. - 9W1loLo
~~~~~r:IO;2~~~~T: 726-~~~9 1 r ~ -?il; bJ.A) Ci ty Job Number
Authorizad Signalura .--:if:-.:.u........... tllll SCHEDULE BELOV
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.IjD!lJftJ';YTIO~ 130/1 ()()
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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
Electrical Contractor Dpo.lIv'~ flecIR;c..
Address 14cD GUi~\e.L~k\ \)~ '*11\
City [lAl "lIIi e. Phone b 9'6' 30 10
Supervisor Licen.se Number 'is? Iq 5
Expiration Date ID'I - 95
Constr Contr. Number 5i''1'l'\tf'
Expiration Date ~ - 11 . ~6:7
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Signature of Supervising Electrician
b~~
Owners Na~e~(\-t\
Address ~ _
Ci ty_~~ Phone
O~ ~N\JALLATION
I')
o~~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~----------~-\:-~-r~o-----------
RECEIFT I: . JP.. ~~61
RECEIVED BY: TJ~-
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
~01 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cost
Sum
~
30
$ 85.00
cQ
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 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 Lightinv
Limited Energy/Res
Limited Energy/Comm
One Ci rcuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
. XllT-AL ~%.
$ 35.0Q
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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Job No. q~ llo(o
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SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: ~~t\C\ ~ '. PHONE:'1\\~q4
ADDR~ ~ \ ~~:~~_'0 &.- STAle ~pct7'h1.
lq<:ATION OF PROPOSED BUILDI4.~rrs.... , \ ").' f"'..._,
Street Address jf Known: , 0 _ \ \ \ ~ \l \ f\ \J\\ \ "Ie.
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Platt ~ame: ~ \. ~() \.t\A.J
Tax lot Number. \ t\6_~~_o'l ~ r
1. DEVELOPMENT TYPE (Check appropriate dwellirig(sl. SDC calculations and dwelling type
definitions are on the back.l ' ' , ,
A. Sinl!le Family - Detached
\ 'Single Family home
I
, NO OF UNITS
Manufactured home not in a park" cfJ
X $400 PER UNIT .;:, $ ~ . ,
"~
B. Sini!le Family - Attached
.'
\
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Family Aoartment ' ,
NO OF UNITS
, '
X $777 PER UNIT =
$
D. ManufactUred Home Park
NO OF UNITS
X $280 PER UNIT =
$
4-rf)clJ
,$ .
.,'If
$ -
$ AJ:J1P
WPRD SDC
2. SDC CREDIT (I( applicable) SDC-payer must furnish proof ofWPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
'u.~)
r""...............;.:h'~,..n':,..t'\..
inn
\ I \ 1..~>q \0
n~tp
.
. NO. Q5D7t.l.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: $ -( C-A-1-.l 'B
LOCATION: NIO..I,oLA-<.> Of)., ~44
DEVELOPMENT TYPE: L-O(L',J e.W ~'*
BUILDING SIZE:
17 D 7:J --i-7--1 ']... - tJ /30 {, pit>
I"OT SIZE
SQ, Ft.
1, STORM DRAINAGE
IMPERVIOUS SQ, FT.
-z..t:;-z.",
X $0,209 PER SQ, FT. ~~
2, SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
\"6
X $43,26 PER PFU
Gl"B~
'- -----
3, TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $436.19
cc 44n ~
$
$
I
X I , ~ / X $436,19
X X $436.19
4, SANITARY SEWER-MWMC
NO, OF PFU'S l~ x $17,19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ ?\9~
JOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
$ MIA
~'~
~'
$ -z.O 61 'Z~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5, ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
~ 13 L.JL
\J Kip Burdick
SDC Coordinator
X ,05
Date: S/t-t:j/qej
- r I
TOTAL SDC
~O~~~
$ '2-110 '=>,2
FIXTURE UNIT, ~,~~CULA TI~ T ~.BLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels; calculate only the. additIOnal fixtures) -
, NUMBER OF ~NIT FIXTURE "
FlXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub. ,......,.......",."""".,.".,',."..,.,.,.,' ,..............,....
Drinking Fountain.......................-....... ............. ..-- ....-
Floor Drain.....".."""""""""""""..,..,.."..,',.". ,....",.'
Interceptors For Grease/Oil/Solids/Etc",,""""",.,
Interceptors'For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher,..", ,"," "..',,'" "" "," ,."
Clothes washer . 3 0r More,:....'..............................
Mobile Home Park Trap (1 Per Trailerl..........:......,
Receptor For Refrigerator/Water Station/Etc..,.....
Receptor For Commercial Sink/Dishwasher/Etc..
Shower. Single StalL,..",.....,......,........"."...,............
Shower, Gang.,..,....,......, ..,..... .... ,.,.....,... ,. ,. ,.. ,. ,: ,... ,.
Sink: Bar, Commercial. Residential Kitchen........,..,.....,......
Urinal. Stall/Wall,..,.... ,.....'",.."... ...........,......."...;..,.,
Wash Basin/LavatorY: Si'ngle..................................
Toilet. Public Installation........................................
Toilet. Private................................,......,...."..,,:..:,
Miscellaneous:
'Z.
'2-
TOTAL FIXTURE UNITS
2
1
2
3
6
'2
6
.'6
1
.3
2
l/Head
2
2
1
6
4
2.
'2..
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'Z.
'2.
't..
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CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits,separates,
'-~~t~>cr ~1~oo--1
Assessed Value I
$2.46
2,14 :'
1,77
1.37
0,97
0,61
0.44
0,15
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
19B1
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
Credit fai-Parcel or Land Only If Applicable
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Improvement (if alter annexation date)
~
=
CREDIT TOTAL = $ i-J /A
ASSESSORS MAP:
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OWNER' ",\ ~~t'~ 'C1 .
ADDRESS:~~ ~t \'}IJ)UJ
CITY: ,~<<\ ~O ~ STATE: -1\k~ ~ '\
~. t; .~(L~\(\Of\~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Ottice: 726,3759
LOT:
DESCR~ORi<'
NEW REMODEL
.
SPRINGFIELD
BLOCK'
ADDITION
DEMOLISH
.
q ~\J1Lol()
JOB NUMBER
PHONE:
\~\oB\"A
ZIP: U-r\-il
OTHER
CONTRACTOR'S NAME ADDRESS
GENERAL:~G'Wr~f\ '
PLUMBING: ,,~,\.!'\\t')-
MECHANI~.4'W"l;\ "\.li~ ~} ~~
ELECTRICAU \: M'l1\<; ~ OClM
CONST.
cflN-l;AC\OR' l. EXPIRES '3~s?fj!o~
\(,)\ioii_<Al\~~ 4';)'1- \:\2()
~ \0 V:;,L S .Ab!--\ r\~'l}j-Q
, ~f:rr~Y r~ .\l, C{\p \G~~';i?)O
QUAD AREA: \ \:.\\)lO
. OF BLDGS: ~'>
OCCY GROUP: ~N tJ..
\ .
U
. OF STORIES:
WATER HEATER'
LAND US~: OF\\\ ,\SE -
. OF UNITS' \ \)' ~
CONSTR. TYPE: ]oJ
HEAT SOURCE: ~ L
Lr
RANGF'
FLOOD PLAIN:--.T\i-
ZONING CODE: ~k
. OF BDRMS' .3
SECONDARY HEAT: ~ _
SQUARE FOOTAGE: '.~1
To raquest an Inspection, you must call 726,3769, This Is a 24 hour recording, Alllnspecllons 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,
o Temporary Electric
o Sito Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumblngl Electrlcall
Mechanical - Prior to cover.
r-l. Footing - After trenches are
lV' excavated.
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D Masonry - Steel location, bond
beams, grouting.
~OUndatlOn - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
10 filllnQ trench,
c::r Undarlloor Plumbing/Mechanical
- Prior to Insulation or decking.
gpost and Bea"", - Prior to floor
Insulation or deckIng.
[9'Floor Insulation - Prior to
deckIng.
~anjtary Sewer - Prior to fllllng
trench.
ffStorm Sewer - Prior to filling
trench,
~atar Line - Prior to filling
trench.
U'Rou9h Plumbing - Prior to
cover,
REQUIRED INSPECTIONS
~ough Mechanical - Prior to
cover,
~ough Eleclr~cal - Prior to
cover. .
G':lectrlcal Service - Must be
approved to obtaIn permanent
electrical power.
D Fireplace - PrIor to facing
materials and framing Insp.
~ramlng - Prior to cover.
[krWaIl/C'elllng Insulation - Prior to
cover,
Q-'OrYWall - Prior to taping,
o Wood Stovo - After Installation,
o Insert - After fireplace approval
and Installation of unit.
~urbcut & Approach - After
forms are erected but prior to
placement of concrete.
~dewalk & Driveway - After
excavation Is compieto, forms
and sub-base: material in place,
o Fence - When completed,
o Street Trees - When al/ required
trees are planted.
[g-Flnal Plumbing - Whon all
plumbing wc;>rk Is complete,
~
~ t-Inal Electrical - When all
electrical work is complete,
r-L..Flnal Mechanical - When all
~ mechanIcal work Is complete.
~nal Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
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 Connecllon - 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
porches, skirting, decks, and
venting have been Installed.
J
''','
lot Type. :'1 . ;,_ THE PROPOSED WORK IN THE,
Lot facos Satbacks
lot sq, ltg, ~erior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography _ Panhandle Iw I Coordinator prior to permit issuance,
Total height k'6' Cul.de,sac
( \\) IE I APPROVED:
"-
BUILDING PERMIT
SQ, FT,
\"E:,?4
.AJS
ITEM
x il~iA = Fic;2\D,~
''\.\D', ~.S
Main
Garage
Carport
Total Value
q 2Zffi
d..\ 1 .
=*~~
Building Permit Fee
State Surcharge ~~
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)..I<:1
.H IS; 1""
(B) "" 2nD -
PLUMBING PERMIT
ITEM
FEE
Fixtures
J1d)q)
Residential Bath(s)
N' .!L
Sanitary Sewer
FT,
Water
FT,
FT.
Storm Sewer
Mobile Home
Plumbing Permit
-.ilia ~cp
=re.8
lId. '
In ,00
4.3J
II? .oc;
State Surcharge
-t 3"6
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
~
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
,~,co
Dryer Vent
Mechanical Permit
\C1.S0
\U~
I-Sf
\-=)( .0/'
Issuance
State Surcharg'e .. 30 b
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
SIdewalk
Ib It
3,Q It
a.\, 'lU.
Vt \'gl
Curbcut
Demolition
L~S\U~h,\?Q~
~O:)
1:1. 'ill
~O
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C, 0, and E Combined)
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 01 Springfield, including the
Development Code, regulating the c01)~uctlon and use of
buildings, and may be suspended or reV,kGd at any time
upon violation of any provisions of said rdlnances.
Plan Check Fee: .. .fl
Date Paid: __" ~~
ReceIPtI\lUm~~~
~~
Plans Reviewed By W
5.~~'~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are beIng Improved,
ADDITIONAL COMMENTS
....~mO. C\ l'\ \o~, 0
\ t\\.r;'\ \\O.~
"- ~ T '. <\'\:1 ft. Q i\\ (l\~ L()
\ CA~ Y ~ \qC\~7 fJ
~~(C\.o ~ru9.'l~
By sIgnature, I state ,and agree, that I have carofully examined
the completed application and do hereby certHy that all
Informatlon 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 tho work described
herein, and that NO OCCUPANCY will be made 01 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.
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I further agree lo ensure lhat all required Inspections are
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 slt~ times dnlngtnstructl:
Slgnaturp \~ ,. t- / .
Oat'"
VALIDATION: f) f\1\c! n
RECEIPT NUMBl~ _, 0..1} )0/
DATE PAID 117,-C{(/J
AMOUNT RECEI'{tjI, ~c, ,\ ,~
RECEIVED BY m(ffi )