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HomeMy WebLinkAboutPermit Electrical 1994-4-15 b .tta4..... \;'l~ 1011 The 1ollowing project as suo m~~Hi\~iand zoning. nnd does not require ,...- approval, L D rL 97477 ZoninlL 726-37~te6.-1 S-Ct.q . Ci ty Job Number . , ---' r-- AuthorizedSignalure 3.1- <.Ol......u. .<:i1. ~~HEDULE BELOIl LOCATION O~ INSTALLATION 11 957 r /{)~"'l-ue\()(...~ NU6 A. New Residential-Single or Multi-Family per dwelling unit. Service Included: ., 225 FIFTH STREET SPRINGFIELD, OREGON INSPEctION REQUEST: OFFICE: 726-3759 1. . LEGAL DESCRIPTION, J . /7 03. ~ in I Z. ,...g Z-7 JpI} DESCRIPTION /I .. K~ In~.....u rioO \ ~ Permits are non-transferable and expire if york is not started within 180 days of issuance or if work is suspended for 180 days. ! 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor /L ~ Address 'l;)O;) 0 ~ 11+ ~ity ~lJ(,('J' Phone ~ 'Xfo...;).3bS"' Supervisor License Number .=<:;)!r,;) S Expira t ion Da te 10 - / - c; fa Constr Contr. Number c20 ;'1</',)'(, Expiration Date /0/Q3 , / Sign~~~~lectrician Owners Name mc..~L (' -::0" \~ '\ B. sL...~ .. Address City Phone OI1NER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~ t, ~~~'J15;'~-: RECEIVED BY: ~, -'- llA:.../ ~ ~ - ELECTRICAL PERMIT APPLICATION Q3!L1-8CL I Items Cost Sum 0<"00 1000 sq.ft. or less --L-- $ 85,00 ~ Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 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 . $ 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 $ 40.00 $ 55.00 S 80.00 see "B" ab'Ci'V'e D. Branch Ci rcuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign(Outline Lighting $ 40.00 Limi ted .Energy/Re's, $ .20.00 Limited Energy/Comm - - $ 36,00 ('",..cO 5. SUBTOTAL OF ABOVE <X::I 5% State Surcharge "1-""':5 TOTAL "''':;;</ ~ ~ .""j l' JOB NO. !I~";~ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: LOCATION: t:fS7 tVIl/<.E... f SuE ~W(N;' N~nI,(,lfXTE. /70 ~ ~ l~ - '-f. 2; '2-7.- DEVELOPMENT TYPE: II4Gl..J.Jo/!.<;. eAve.S BUILDING SIZE: 1-U./1J . ,'f;(. to , I. STORM DRAINAGE IMPERVIOUS SQ, FT. '/{;O LOT SIZF SQ. Ft, ot.p P6t.> ~ff, 87-n ~ ~ X $0.192 PER SQ. FT. \.S. ~'!>!:.) 'Z.t9f;' -- -- 2, SANITARY SEWER-CITY NO, OF PFU'S (See Reverse) X $39,78 PER PFU c -) ---- --- 3, TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X $401,05 C; -- ') -- -- X X $401.05 $ ~ X X $401.05 $ ~ SUBTOTAL (ADD ITEMS 1,2, & 3) $ ~ 1l ~; 4, ADMINISTRATIVE FEES c:x.P t.:V~.u..> BASE CHARGE (SUBTOTAL ABOVE) X .05 ~'2? ~ 'Ie) ./~ e?<t? ..... -- ~9. i> <I TOTAL-CITY SDC $ qZ 7<1 "3.(0 5. SANITARY SEWER-MWMC NO. OF PFU'S x $13,62 PER PFU + $10 MWMC ADMIN, FEE $ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~~L~ U Kip Burdick SDC Coordinator s-<f-tj"? $ TOTAL-MWMC SDC~ --~ <., -- TOTAL SDC $ q z 7':!:.. ?,p .. ,_. [ , -. - '" , . FIXTURE uNri CALCULATION TABLE: Number of New Fixtures X Un! uivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE Bathtub.. ......,.. ,.. .............. ,............. ,.. ........ ,................ Drinking Fountain.........,.,...."..........,.......... ....,...,..,.. Floor Drain......,.........................,............,.............,.... Interceptors For Grease/OiI/Solids/Etc..".."..,....,.. Interceptors For Sand/Auto Wash/Etc..........:..,:.., . Laundry Tub /Clotheswasher.....,............................. Clotheswasher . 3 Or More........,..,....,..,.......,..,...... Mobile Home Park Trap (1 Per Trailer),..,........,..,.. Receptor For Refrigerator /Water Station/Etc,......, H~ceptor For Commercial Sink/.DisQwasher/Etc.. Show'er, Single Stall..,...........',...,:.,;,:,...'.,.....,....,......, ShOwer, Gang:..:, ................,. ....,...:....:..,.:..........,..,.... Sink, Bar, Commercial.....,......,....,..,.....,....."...,..,.... Urinal, Stall/Wall.........,.............,.,...................,.....,... Wash Basin/Lavatory, Single",........,..............,......, Water Closet, Public Installation..,....,..,....,........,.... Water Closet, Private.,.,.............,.,..,..,.......,..,.......... Miscellaneous: "'-. . ~ . . ' NUMBER OF NEW FIXTURES UNIT EQUIVALENT ....... , FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table, calculate credits separates, Year 'Annexed Rate per $1,000 Assessed Value '. 1979 or before , ,.1980 ... . 1981 ": '1982 1983 ','\1984 $2.83 2,76 2,71 2,60 2.46 . ,_ 2.33 '. ~. .... '. ~' ~ Credit for Parcel or Land Only If Applicable Improvement (if after annexation date) ,", 'c" ". ~ . ~, . ",!' ~. . ' \ 2 1 2 3 , 6 2 6 6 '1 3 2 1/Head 2 2 1 6 4 : ". ," . ,1. ~. :- ,'" ,"\ , . . ~I ..., :-,.J' " . , " . , TOTAL FIXTURE UNITS Year Annexed 1985 1986 1987 1988 1989 1990 1991 x $ (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL = $ . , y, RUNOFF COEFFICIENTS FOR S,TORM DRAINAGE Residential...,.., .........'...,..,..,.....,..,....... ..,..,......, 0.4 Commercial...,.......................,...........,..,..,......., 0.9 I nd ustrial...,....., ......,.... ......,..,.......... ..,.......,..,.... 0.45 Governmental.................,..,..................,.....,...., 0,5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT Rate per $1 ,000 Assessed Value $2.16 1.90 1.60 0.25 0.87 0.50 0.16 . , ,'. I I RESIDENTI~L PERMIT APPLICATION I Inspections: 726,3769 Office: 726,3759 I . SPRINGFIELD ~~ LOCATION OF PROPOSED WORK: 95;7 ~lJ.w~ e_ ASSESSORS MA'P: \ '"'\ O~ <rl-. ( .... \ ll. ; OWNER' Jt1/f:e.. -i SVe..... MV,'Vt5" ADDRESS: '-1<::7 ,~i-tbJ=ild1--e.. CITy_tfh'i/J" ..t:i;,~:I) /JJ..U~1tJ y--"-L /. / DESCRIBE WORK: ~)c! 61"l ,~WtlY k01Y\ ADDITION ,X- DEMOLISH , &l)L. + j.f.1(CONST. CONTRACTOR'S<NAME All"'. / ADDRESS r~ -'i1it'. CONTRACTOR' GENERAL:Jfb/c.-i!- ~ fS'S"1Lb'.A1~~!3" UOtfl P:UMBING: /Jon l"""Jj" S:OO__~rVlf(/ld1167t MECHANICAL: An e- - ELECTRICA,!.,; !i2/)'L... w.-sJ:.f.w. ~+h /Vt!'V t-tL)/ E7,-c.; c.. LOT: NEW nEMODEL OUAD AREA' . OF BLDGS' OCCY GROUP: _.12' ~"3 . OF STORIES:--1 WATER HEATER' BLOCK' STATE: -tlJ7 i OTHER . C\'J",.f'''-lO'('\ JOB NUMBER' Q.J l"D.......1 225 Fifth Street Springfield, Oregon 97477 ;;~~~.H; /J /TAX~: l\"7-J f6:Z SUBDIVISION: PHONE: -1Z-" - 8'60 I 6-~'2:%S- ZIP' &dh~Wl. I!II1 kl-~,. ) EXPIRES ~~f! 6-in PHONE 7'2.( -9(r;>/ (~-IW 2fJ~ C~G-?16-~ t:.~ c.... I 0-1 Lj $ <- ,/0 ~'i( REQUIRED INSPECTIONS [Xl Rough Mechanic;:al - Prior to cover. . [ll Rough Electrical - Prior to cover. o Electrical Service - Must be approved 10 obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. - OFFICE USE - LAND USE: FLOOD PLAIN' . OF UNITe:. ZONING CODE:_ CONSTR. TYPE: _~ . OF BDRMS: HEAT SOURCE: ~t'?CJ'- iJt;;4? SECONDARY HEAT: t1ANGE: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This is <1 24 hour recording. All Inspections requested before 7:00 a,m. will be made the same working day. Inspection::; rcqllcstcd after 7:00 a.m. will be made the following work day. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical! Mechanical - Prior to cover. [Xl D Footing - After trenches arc excavated. Masonry - Steel location, bond beams. grouting. [4J Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. CKI Underlloor Plumbing/Mochanicar' _ Priol to insulation or decking:' 14l OJ o Post and Boom - Prior to floor Insulation or decking. Floor Insulation - Prior to decking. Sanilary Sewer - Prior !o fitlir:;] Irencl). o Storm Sewer - Prior to fl:l1ng trench. o Water Line - Prlor to filling trench. rVl Rough Plumbing -. Prior to ~J ~over, cg] Framing - Prior to cover. Xl Wall/Ceiling insul;:tion - Prior to cover. CXf Drywall - Prior to taping. o Wood Stove - After Installation, [-lln::;crt -- ,\ftcr (ircpl.1.cn npproval .- <1:1d :l1s~a!li'ltion of (Jni~. Cl Curbcut ..... J\pprOJ~il -- Aitc:- - tarms ar'J ~"'~cted tout prior to placerncnl of C()l1cr.;le, ri Sidewalk & Qrivc.-wav - Alter C>:C3v~lion i:-.> compll.:i0. forms ~nd 3'.:b'U3se 11~::);teria; ]:1 ::!ace, I! Fence - Whon ccmpleted. ~J i -.'" Strpel Trc~s - V':!~C'n ~II rer,g.:ircd --' Ire,;,:.> ~lm ~!anteq. . rY1 Final Plumbing - When all L,C::J plumbing work Is complete, IYI Final Electrical - When all L.,LlJ electrical work Is complete. OJ Final Mechanical - When all mechanical work Is complete. ~ Final Building - When all required Inspections have been approved and building Is completed. OOthcr MOBILE HOME INSPECTIONS fi Blocking and Set-Up - WIlen all blocking Is complete, o Plumbing Connections - When hOr!lc has been connected to water and sewer. o Electrical Cc~ncction - When blocking, set-up. and plumbIng inspections havQ been approved and the home is connected to the service panel. r -I Final - After 311 required inspectlr.)ns are approved and porches, skirting, decks, :md lJe!'ltlng have been inslallcd, J . Lot faces -Lr... Lot Type 7261~ _ Interior 2L ~.~ 13~ I' N , . Lot sq, ltg, P.L Setbacks HSE GAR ACC . IS"rHE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON ' THE HISTORICAL'REGISTER? y :; ~~:~ I -L- ,II.... ~ ~ J, . ~ : {~. A,,: IvV _ ~, , ~.,J" '" ~. ~ -- ---;- - -=*---: : . - ' I E IP__~~, I APPROVED: BUILDiNG VALUEj.PLAN CHECK 'AND BUILDING PERMIT Lot coverage Corner Topography Total height Panhandle CuI-dc-sac BUILDING PERMIT ITEM SO. FT. X $/SO. FT. VALUE,.., Main Garage Carport ~ 3Jl!o ~ ..., 9''I.'5"~ J'.1l<i- .~~~, \ ' SYSTEMS DEVELOPMENT CHARGE (SDC) tJ'-P e"?~~;'A/ew 1.2,7'1(B) . ~::fJ.!..lP, PLUMBING PERMIT Total Val ue '-e1' P N&'W Building Permit Fee8AS~ nS;- 8.?r State Surcharge i"~ , Total Fee (AI ITEM FEE Fixtures ~ ~ #it> - Residential Bath(s) N' Sanitary Sewer FT. . Water FT, Storm Sewer FT. Mobile Home d4V ,yew ....~- Plumbing Permit ~~- ~- State Surcharge ~. /.~ - .sz, Total Charge (C) ..::::..../CJ,5b MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' / Wood Stove/Insert/Fireplace Unit Dryer Vent Issuance ~ .17' /e> .7S'" '7~ -& ~ ';;l~7>(D):27:7> - - Mechanical Permit tP<.v /1> /0 State Surcharge Total Permit MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 9/.~ If yes, this. application must be signed ..and' approved" by, the - Hislorical 'Coordinator pri~r.t~'permd issuance. '! ":rhis permit is granted on the expre~s condition that the said construction shall, in all respects, conform to the Ordinance adopted by tile Cily of Springfiel~:' including the Development Code, regulating the construction and use of bulldin{:ls, ancJ may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Clleck F~c: \ I 3 ,,5 ~~J.3.) c,?, ~IIO Date Paid: Receipt Number" " Rec~ By: ,.-- \DE) ~~Ji : ;- "::",L.Pf"",,~ ~ ::...;7 '~s F-~e~~ --,. /-..... ~ ..~ '-/ .--' D'ate. Systems Development Charge Is due on all undeveloped properties within the Cily limits which are b~ing improved. ADDITIONAL COMMENTS ~~/~ /~/#- / _q,cp/r ~~~.& ~, ~ ~<9? _~A?",-r/~~ .~,;? OA/ye 9':2L??~ I By signatulC. I state and agree, that I have carefully examined the completed application and do hereby cerliry that all information hereon is true and correct, and I further ce~tjfy that any and all worK performed shall be done in accordance wittl ttle Ordinances or the City of Springfield, and the Laws of the S:3tC of O~cgon pertaining to the work described herein, and tHtlt NQ OCCUPANCY will be made of any structure wlthout permission of the Building Salety Division. I furtht:'r cerlify Blat only contractors and employees who arc in compliance with GRS 701.055 will be used on thIs project. I further agree to ensure that all required inspections arc rl:~uested at the proper limo. that each address is readable from tile street, lhat the permit card is located at the front of Ilw property, 3nd th~ approved set of plans will remain 00 the site al "'11lmes during ~~J",U:P~/l Gi~nalurc ~ ~/ I /~? Date ffil/ I / VALIDATION: RECEIPT NUMBER 8 ::5~"3 ~~'T~ "73 DATE PAIr> AMOUNT RECEIVED --d/. & 2- RECEivED BY __~~