HomeMy WebLinkAboutPermit Electrical 1999-5-27
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225 FIFTH STREET ?~o"" ''109 '69v."6..,,/~ ELECTRICAL PERMIT APPLICATI~
SPRINGFIELD, OREGON 97't"IY7 "6", 60'~ (\n T\t'\\
INSPECTION REQUEST: 726-~h9 :06~/;,"~t... City Job Number V\""~ J I
~v. 1'0 '1'6
OFFICE: 726-3759 '6 /61) Fa."" -
~ 3. O'~~TE FEE SCHEDULE BELOII
1.A L NCA, ~~~ :)N T,%ld:Wii-~ A 6
~:t-rRlt;, . Ne.. Residential-Single or
foiloWfUl:lSdOOIl,tluuy ,"we, ,,_.. -tforth ~ ulti-Family per d..elling unit.
~Q\i~~~~Dt:~CRlPTJP~I.es are se Service Included:
:,\('6\~'~\9\~10t~~!O~952,:~02.~ . Items Cost
090 You may obtain COlllb~ UI . ~ r...,_~ -, f
~~m~~~~tt~~one (\'\' A lOQQ...s.,g.ft. or less ----1- $ 85.00
. ;,. . I 1 \ llit~ot~~ ! ,,,,\ \.M E,\!QifKaitttional 500
Center is 1-800,;j32'~~"- . ;;PER~~f...DOJ:t:U),l)... n....
Permi ts are non-transferable and expire reof" ;:n;}Ill't:J\t"'IREI'lJ-tfEWPIlIS.OO
if ..ork is not started ..i thin 180 days fJ Gi!~ef>tdNllDm2TI<lI$PERMITISNOT
of issuance or if ..ork is suspended for C6lMl\1~I\ICSDt~RtS\N8ANOONEOFOJ;l.
180 days. A~~1~!TAfpE~rdB~r ..,~ 40.00
Services or Feeders
,Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractorf}./1fi..Y/p f'"/p("J
Address 2'7..5/4 5aydev prl .
Ci ty .:r L Phone.-kR fj L)Cf...q lj
SupeL'visor License Number .;1_/') () t.. s...
Expiration Date/tJ/111 ::Ln n /
Constr Contr. Number :J /J -/ SfiC
Expiration Date In/I 9C?
/
Signature of Supervising ~le~cian
jJ/h/vfll ~ q~~
O..ners &me _
Address ~~\\\0\rf\ ~
Ci ty ~ ~~Phon;w1 ~Af\5
~N~~ LATION
The installation is being made on
property I o..n ..hich is not intended
for sale, lease or rent.
Owners Signature:
~ATE~;cljt0T~------=-~---------------
RECEIPT! #:.'/ J,.<sc...;-c;<1ft?. .
RECEIVED BY: n . /YIfl r'htJ. U (.)
.B.
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
Sum
~
2Jj
$ 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 I
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 nBII
1ll
above
"
Ne.., Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ..ith Service
or Feeder Permit
$ 35.00
$ 2.00'
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
CO
. JOURNA. JOB NO. ~"o7/q......
ATTACHMENT A
. CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY: ('I'll NIU /VI
LOCATION: 411 ~I /JQ(.fh gj-
DEVELOPMENT TYPE: SF 0
BUILDING SIZE:
LOT SIZE
SQ. Ft,
M'IfI,On\l. STORM DRAINAGE Z4(~)+ '2(40+ ~)+- 44{.3S).... 2C:("I,$")
IMPERVIOUS SQ. FT. 2.1.-/4- X $0.227 PER SQ. FT, $ 502.9i5
-.
2. SANITARY SEWER-CITY
NO. OF PFU'S "ZS
(See Reverse Side)
X $47,14 PER PFU
$!I7f.~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X l.OI' X $475.32
$ 4.8n.07_
X
X $475.32
'$
4. SANITARY SEWER-MWMC
A. REIMBURSEMENT COST:
NO. OF FEU'S
X 277.44 PER FEU
$ 2'"11.44
B. IMPROVEMENT COST:
I
NO. OF FEU'S
X 2.6.:20 PER FEU ,
$ 2'5.:20
< $ t,t/-~ >
$ 10 00
MWMC CREDIT IF APPLICABLE (SEE REVERSE).'
MWMC ADMINISTRATIVE FEE
TOTAL-MWMC SDC
L2.fx--..S'i
$ 241ft 71-
$ /';)..0. 47
/
SUBTOTAL (ADD ITEMS 1.2,3 & 4)
5. ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE) X .05
t/lA 5 L
Date: 51t! Ff1
TOTAL SDC
$ 2630.23
SDC Coordinator
ATTACH' A. WPD
FIXTURE UNIT CAlCUl.'ON TABLE: Number of New Fixt. X Unit Equivalent = Fixture ~nits
(NOTE: For remodels, calculate only the NET additional fixturesl .."
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub.........;...,.,..............................,...........,....,..... .
Drinking Fountain....., ......,... ,............. ...........,....,.....,
Floor Drain.............,..., ..... ,..... .:.......................,.......,.
Inte,ceptors For Grease/Oil/Solids/Etc.................
Inte,ceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.... .........,.... .....,...........
Clotheswasher - 3 Or 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/WaiL...... ....... ...... .............. ............. ..... ...
Wash Basin/Lavatory, Single.................................,
-Toilet, Public Installation, .......,...............................
Toilet, Private., ........... ............. ........., ..................,
Miscellaneous:
Ii
, ,
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4-
,
'2-
I
2..
I
'2..
J 1 J
III
%
/~
TOTAL FIXTURE UNITS
=
2-'5
, CREDIT CALCULATION TABLE:
calculate credits separates.
I
Based on assessed value. If improvements occurred after annexation date in table,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1 ,oo~
Assessed valu: I
1979 or before
1980
1981
1982
1983
1984
1985'" "
1986
1987
1988
$4.27
4.18
4.12
3.99
3.83
3.68
3.48
3.18
2.82
2.42
1989
1990
1991
1992
1993
1994
""; .1995
1996
1997
$1.98
1.55
1.15
0.96
0.83
0.67
0.52
0.38
0.21
II
Improvement (if after annexation date)
4, Z { X$' 16"
(Rate X Assessed Value)
X$
(Rate X Assessed Value)
CREDIT TOTAL
=
fA-OS-
..' -,
Credit for Parcel or Land Only If Applicable
=
= $
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
ResidentiaL.......................... 0.4
CommericaL........................ 0.9
IndustriaL........................... 05
GovernmentaL..................... 0.5
F'XUNIT.WPD
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
..~
. '
"
Job. No. ~\)~ Ar
NAME:
ADDRESS:
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
, tt\\~\\lD'\ '
~'1\~ M
PHONE:14l ~~~
STATE: ..oc..zIP: 01416
LOCATION OF PROPOSED BUILDING SITE: '
Street Address: ~~\ \'\r)'('\1{\ ~~~t .
Plat Name: '\\\~\ff ~_~ Tax Lot-Number: ,\ <:2. NlN.(Nt \?flX)
1. DEVELQPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. SinIJIA-F~milv Op.tR~hp.<i
\ Single Family home
NO. OF UNITS \
Manufactured home not in a park
X $1,000 per unit = $1000 ~
B. Sinole'-FRmilv AttR~hp.<i
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. Manufactured Home Pa(k
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit c $
$ --!QCi) . CO
~
$
2, SDC CREDIT (If appficable) SDc-payer must furnish proof of
Willamalane Credit approval. See SOC Credit Worksheet.
3. TOTAL WILlAMAlANE NET SDC ASSESSED
(If SDC reduced for Credit)
~~m~rtme",
City of Springfield
$ lOCO {X)
I
I
Date
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