The URL can be used to link to this page

Home My WebLink AboutPermit Building 2002-5-3 New printed _mit copy for file - Plueing contractor change to Home Comfort. See original permit for validated original. Change made 5/23/02 ... .. SPRINGFIELD ~ 225 Fifth Street Springfield, OR 97477 . . Page 1 of 4 I Job# 02-00310-01 I CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00310-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 5995 Obsidian Ave Spr Assessors Map#: 18020300 Lot: 19 Block: Addition: Owner: Address: Tax Lot #: 00507 Subdivision:Jasper Meadows Hayden Enterprises 2622 SW Glacier Place #110 Phone Number: 541-923-6607 City/State/Zip: Redmond, OR 97756 Value: $84,827 Scope Of Work: Single Family Residence Glacier SFR same as 02-00303-01 NO HOOK-UP FOR SANITARY & STORM UNTIL INFRASTRUCTURE IS ACCEPTED BY CITY. Contractor Type Contractor Registration # Expiration Date Phone General Contr Hayden Enterprises 92208 7/29/2003 541-923-6607 2622 SW Glacier Place #110, Redmond, OR 97756 Christenson Electric Inc 458 111 SW Columbia St Ste 480, Portland, OR 97201-5886 Mechanical Contr Home Comfort Heating & Air Conditioning 184164 Po Box 24205, Eugene, OR 97402 Plumbing Contr Home Comfort Heating & Air Conditioning 184164 Po Box 24205, Eugene, OR 97402 Electrical Contr New 5/1/2003 503-241-4812 6/25/2003 541-345-2838 6/25/2003 541-345-2838 To request an inspection call the 24 hour recording at 726,3769. All inspections 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 working day. Verify Ground Rod Footing Foundation Post and Beam Floor Insulation Ceiling Insulation Shear Wall Nailing Framing Wall Insulation Drywall Final Building Rough Electrical Required Inspections I Buildinq I -Install ground rod affooting, and call for inspection in conjuction with footing and/or foundation il -After trenches are excavated. ,After forms are erected but prior to concrete placement. - Prior to floor insulation or decking, - Prior to decking. - Prior to cover. -Before covering sheathing with finish materials. - Prior to cover. - Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete, Electrical - Prior to cover. .. - . . Electrical Service Final Electrical Job# 02-00310-01 I Required Inspections I Electrical I -Must be approved to obtain permanent power. - When all electrical work is complete. I PlumbinQ - Prior to insulation or decking. ,Prior to cover or placement of concrete. - Prior to cover. - Prior to filling trench. - Prior to filling trench. - Prior to filling trench, -When all plumbing work is complete, I Mechanical , Prior to insulation or decking. - Prior to cover. -When all mechanical work is complete. Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Final Plumbing Underfloor Mechanical Rough Mechanical Final Mechanical Street Improvement: Fully Improved Curb Cut?O Improvement Agr.?O San Sewer Depth (Ft): 6 4 Storm Sewer Available? 0 Special Req.: Security Required: Bond Begin DateTime: 00/00/0000 00:00:00 ' Special Instructions: Other Utilities: Project Supervisor: Sidewalk Type: Additional ROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Page 2 of 4 Curbside - 5' o 8 To Curb and Gutter 6 00/00/000000:00:00 ' Types Of Warning Devices Reqd. Zoning: LDR FloodPlain? 0 Wetlands? 0 Journal numbers 1: 2: Comments: Overlay District: # of Street Trees: 3: Planner: Sam Gollah Urban Growth Boundary?O Quantity Of Fill: Supplier: Drainage: Floodway FEMA: X-White Additional Requirements: Glenwood Area? 0 Required Attachments: Source Locn: Material: Land Use: Single Family Dwelling Pave Driveway? ~ Flood Plain FEMA: 1166 of 2975 .. ,- . Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 2 Handicap Access? D rArea (Sq. Feet) Main: 1032 Accessory:400 Fee Same As Plan Review Total Plan Check Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Total Building Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft State Surcharge, Electrical 8% Admin Fee, Electrical Total Electrical Two Bathrooms State Surcharge, Plumbing 8% Administrative Fee - Plumbing Total Plumbing Hood and Exhaust 8% Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Dryer Vent Mechanical Issuance State Surcharge - Mechanical Total Mechanical Residential, Single Family - Storm Residential Improvement MWMC MWMC Administrative Fee SDC Administrative Fee Residential Sanitary MWMC Residentiai - Improvement Residential - Reimbursement Sanitary Sewer SDC Reimbursement Sanitary Sewer SDC Improvement Total System Development Job# 02-00310-01 I . Page 3 of 4 Private Garage/Carp/Stor # Of Stories: 1 Height (feet): 17 Current Units: Proposed Units:1 Census Code: New SF - detached Total:1432 Paid On Receipt# r-- Plan Check 05/03/2002 8834 Building 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 Electrical 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 Plumbing 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 Mechanical 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 System Development 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 05/03/2002 8834 Value/Quantity I 1 84,827 1 1 1 1 1 3 1 2,610 1 1 1 1 1 20 20 Fee Amount $100.00 $100.00 $507,15 $35.50 $40.57 $583.22 $106.00 $19.00 $8.75 $10.00 $143.75 $254.00 $17,78 $20,32 $292.10 $9.00 $3.60 $12.00 $18.00 $6.00 $10.00 $3.15 $61.75 $712,53 $34.83 $10,00 $132,87 $332,86 $659.76 $155.13 $427.40 $324.80 $2,790.18 tAl ,tIf . . Page 4 of 4 Job# 02-00310-01 Fee Paid On Receipt# Willamalane SDC 05/03/2002 8834 Value/Quantity S,F. Residence, Willamalane Total Willamalane SDC 1 Planning Plan Review Total Planning Planning 05/03/2002 8834 1 Address Assignment Total Permits w/o Srchg Grand Total Plan Check Type Permits w/o Srchg 05/03/2002 8834 1 Checked By Date Completed Comment Initial Review-Res Engineering-Res Planning-Res Structural-Res Lisa Hopper Bob Kettwig Sam Gollah 04/04/2002 04/15/2002 04/10/2002 04/12/2002 Tom Marx 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 Community Services Division, Building Safety. 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 that 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 site at all times during construction. Signature Date Fee Amount $1,000.00 $1,000.00 $55.00 $55.00 $8.00 $8.00 $5,034.00 225 Fifth Street Springfield, OR 97477 'JOb# 02-00310-01 I . Page 1 of 4 rRANStl. 0'[ ~1COF:: :j/~ DATH.iFI! 03 ~ldO; :i:rr f\t~] r;HfiNGf:. CAS'IIE:~ OJ:: CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00310-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 5995 Obsidian Ave Spr Assessors Map#: 18020300 Lot: 19 Block: Addition: Tax Lot #: 00507 Subdivision: Jasper Meadows Owner: Hayden Homes Phone Number: 541-501-4332 Address: ,\' I EO. B.ox 883., " ., . ,L ;~" J~ !~lI':,t,.', City/State/Zip: Springfield, OR 97478 0,'1 ....,,,'c..' 'H1t!ntPcj bV ihe Oregon Utllll~ Scope Of Work::'Slngle'cF.amlly ResJcenceas are 53t ~orNew Value: $84,827 NotificRtlun ar.lt,. lIIU~1;i ...... in oAR~9Le1J01-0010 through O.A~ 952~Cr.1.- 0090.SftRlsarTle:as;02-00303:01. t~~_rul:: bi ca,t'!.9JI;l,Q.QIS;UP.'-F\ORtS~!'II:rA~y:t&;ST~RM UNTIL INFRASTRUCTURE IS ACCEPTED BY CITY. Contractor Typ_enb€.Cimtractor3gcn Utility NOllflcatlc" Registration # Expiration Date Phone General Contr Rayo'eii'R6M'X.':"1'),?'W,\). 92208 7/29/2003 541-501-4332 PO Box 883, Sprin9field, OR 97478 Electrical Contr Christenson Electric Inc 458 5/1/2003 503-241-4812 111 SW Columbia St Ste 480, Portland, OR 97201-5886 Mechanical Contr Home Comfort Heating & Air Conditioning 184164 6/25/2003 541-345-2838 .I~o Brc2~205, Eugene, OR 97402 Plumbing Contr 1~~~dfi~~n~~,*AtrleEXPIRE IF THE WO~570 12/15/2002 541-895-3758 6~~WdWiE[~~"ID[GfEiWJ&IIP<li~MHd% N MU'I . _ . <''''I'''1nl,~n enD r..lj~un IoJ "un ,"'- t_t. . . To request an inspecti !l.. ~lfWlording at 726-3769. All inspections requested before 7:00 a.m. will be made the'ls"S'fu I tJl.iIi \:jay: mspections requested after 7:00 a.m. will be made the following working day. Verify Ground Rod Footing Foundation Post and Beam Floor Insulation Ceiling Insulation Shear Wall Nailing Framing Wall Insulation Drywall Final Building Rough Electrical Electrical Service Required Inspections I Buildin!! I -Install ground rod at footing, and call for inspection in conjuction with footing and/or foundation il -After trenches are excavated. -After forms are erected but prior to concrete placement. -Prior to floor insulation or decking. - Prior to decking. -Prior to cover. -Before covering sheathing with finish materials. - Prior to cover. - Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete. Electrical - Prior to cover, - Must be approved to obtain permanent power. Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Final Plumbing Underfloor Mechanical Rough Mechanical Final Mechanical 'JOb# 02-00310-01 I Required Inspections I Electrical , When all electrical work is complete. I Plumbing - Prior to insulation or decking. - Prior to cover or placement of concrete. - Prior to cover. - Prior to filling trench. - Prior to filling trench, - Prior to filling trench. ,When all plumbing work is complete. I Mechanical - Prior to insulation or decking, - Prior to cover. - When all mechanical work is complete. Zoning: LDR FloodPlain? 0 Wetlands? 0 Journal numbers 1: 2: Comments: Street Improvement: Fully Improved Curb Cut?D Improvement Agr.?D San Sewer Depth (Ft): 6 4 Storm Sewer Available? 0 Special Req.: Security Required: Bond Begin DateTime: 00/00/000000:00:00 ' Special Instructions: Other Utilities: Project Supervisor: . Page 2 of4 Sidewalk Type: Additional ROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Curbside, 5' o 8 To Curb and Gutter 6 00/00/0000 00:00:00 ' Types Of Warning Devices Reqd. Overlay District: # of Street Trees: Land Use: Single Family Dwelling Pave Driveway? 0 3: Additional Requirements: Glenwood Area? 0 Required Attachments: Source Locn: Material: Planner: Sam Gollah Urban Growth Boundary?D Quantity Of Fill: Supplier: Drainage: Floodway FEMA: X-White Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 2 Handicap Access? 0 rArea (Sq. Feet) I Main: 1032 Accessory:400 Flood Plain FEMA: 1166 of 2975 Private Garage/Carp/Star # Of Stories: 1 Height (feet): 17 Current Units: Proposed Units:1 Census Code: New SF - detached Total:1432 'JOb# 02-00310-01 I . Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount I Plan Check Same As Plan Review 05/03/2002 8834 1 $100,00 Total Plan Check $100.00 Building Building Permit 05/03/2002 8834 84,827 $507,15 State Surcharge For Building Permit 05/03/2002 8834 $35.50 8% Building Administrative Fee 05/03/2002 8834 $40.57 Total Building $583.22 Electrical Wiring Footage 1,000 Sq Ft or Less 05/03/2002 8834 1 $106,00 Wiring Footage Each Add'l 500 Sq Ft 05/03/2002 8834 1 $19.00 State Surcharge - Electrical 05/03/2002 8834 $8,75 8% Admin Fee - Electrical 05/03/2002 8834 $10.00 Total Electrical $143.75 Plumbing Two Bathrooms 05/03/2002 8834 1 $254,00 State Surcharge - Plumbing 05/03/2002 8834 $17.78 8% Administrative Fee - Plumbing 05/03/2002 8834 $20.32 Total Plumbing $292.10 Mechanical Hood and Exhaust 05/03/2002 8834 1 $9.00 8% Administrative Fee - Mechanical 05/03/2002 8834 $3.60 Less than 100,000 BTU 05/03/2002 8834 1 $12,00 Vent Fan to One Duct 05/03/2002 8834 3 $18,00 Dryer Vent 05/03/2002 8834 1 $6.00 Mechanical Issuance 05/03/2002 8834 $10,00 State Surcharge - Mechanical 05/03/2002 8834 $3.15 Total Mechanical $61.75 System Development Residential - Single Family - Storm 05/03/2002 8834 2,610 $712.53 Residential Improvement MWMC 05/03/2002 8834 1 $34.83 MWMC Administrative Fee 05/03/2002 8834 1 $10,00 SDC Administrative Fee 05/03/2002 8834 $132,87 Residential Sanitary MWMC 05/03/2002 8834 1 $332.86 Residential - Improvement 05/03/2002 8834 1 $659.76 Residential, Reimbursement 05/03/2002 8834 1 $155,13 Sanitary Sewer SDC Reimbursement 05/03/2002 8834 20 $427.40 Sanitary Sewer SDC Improvement 05/03/2002 8834 20 $324,80 Total System Development $2,790.18 Willamalane SDC S.F. Residence - Willamalane 05/03/2002 8834 1 $1,000.00 Total Willamalane SDC $1,000.00 Planning Planning Plan Review 05/03/2002 8834 1 $55,00 Total Planning $55.00 Fee 'JOb# 02-00310-01 Paid On Receipt# Permits w/o Srchg 05/03/2002 8834 . Page 4 of 4 Value/Quantity Fee Amount Address Assignment Total Permits wlo Srchg Grand Total 1 $8.00 $8.00 $5,034.00 Plan Check Type Checked By Date Completed Comment Initial Review-Res Engineering-Res Planning-Res Structural-Res Lisa Hopper Bob Kettwig Sam Gollah 04/04/2002 04/15/2002 04/10/2002 04/12/2002 Tom Marx 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 Community Services Division, Building Safety. 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 that 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 site at all tir;nes during construction. ~n~ lN~ ~ ~) Ut- ~e-3--o~ .' . ~~~w' ".'. I" ... ~I'- . lama ane . . '"t, .! Park & Recreation District Job. No. ffim<.310 .n, ;,W SYSTEM DEVELOPMENT CHARGE . . WORKSHEET NAME:\_~~~fJ PHONE: ffi'5.~_ ADDRESS: Q.~.~ BeE) J ~ STATE: BL. ZIP:Q-l-\.ll LOCATION OF PROPOSED BUILDING SITE: Street Address: 5'1QS- nOs,; h:1t1tI ~ Plat Nam . ~ _ Tax Lot Number: \ mWl 1.DEvELq .ENT TYP~. (Check appropriate dwelling(s). SDC calculations and dwelUrig t ype definitions are on the back.) A ~lnoIA-FRmllv DAtRc:hAO . , \ Single Family home . NO. OF UNITS \ Manufactured home not in a park X $1,000 per unit = $ U:LO.cO B. SinolA-FRmilv AttRc:hAQ NO. OF UNITS X $924 per unit $ C. Multi-Familv Aoartment NO. OF UNITS X $692 per unit =. $ D. MRnufaclurecl HnmA PArt<, NO. OF UNITS . WILLAMALANE SDC 2. SDC CREDIT (ll appficable) SDCilayer must lumlsh proolol Willamalane Credit approval. See SOC ptedit Wot1<sheet. $ 3. TOTAL WtLLAMALANE NET SDC ASSESSED (II SDC reduced lor Credil\ \ t~~aclC j Development SelVices~partment City of Springfield o,3,rU. Date ~ '\ CITY OF SPRINGFIELD S-IEMS DEVELOPMENT CHARGE _RKSHEET JOURNAL OR JOB NUMBER: 02,00310,0 I NAME OR COMPANY: HAYDEN HOMES LOCA nON: 5995 OBSIDIAN AVE TAX LOT NUMBER: 18-02,03,00 TL:00507 JASPER MEADOWS LOT # 19 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS: 1 BUILDING SIZE: 1752 SF LOT SIZE: . I STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEN I IMPERVIOUS s.F'1/1 COST PER S.F. 1 I 2610,00 $0.273 =1 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS 1 IMPERVIOUS S.F. 1.1 COST PER S,F. 1.11 DISCOUNT RATE 1 0.00 I $0.273 50% lITEM I TOTAL - STORM DRAINAGE SDC r2 SANITARY ~,FWFR ' rTTY A. REIMBURSEMENT COST: I NUMBER OF DFU's I.' COST PER DFU 1 20 $21.37 B, IMPROVEMENT COST: I NUMBER OF DFU's 1.1 COST PER DFU I 20 $16.24 LITEM 2 ~OT AL - CITY SANITARY SEWER SDC ~ TQANSPORTAT.llllf A. REIMBURSEMENT COST: 1 ADTTRlPRATE 1.INUMBEROFUNITSlxl COST PER TRlP Ix!NEWTRIPFACTORI 1 9.57 I 1 1 $16,21 I I 1.00 1=1 B. IMPROVEMENT COST: 1 ADT TRIP RA TEl: I NUMBER OF UNITS I x 1 COST PER TRIP 1 9.57 I I 1 $68.94 lITEM 3 TOTAL - TRANSPORTATION SDC 4 SANIT~RY SFWFR - MW~ A. REIMBURSEMENT COST: 1 NUMBER OF FEU's I: I COST PER FEU 1 1 I $332.86 B. IMPROVEMENT COST: I NUMBER OF FEU's 1 x 1 COST PER FEU I 1 1 $34.83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL OF MWMC REIMBURSEMENT, IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE lITEM 4 TOTAL - MWMC SANITARY SEWER SDC I SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5 ADMINISTRATIVF Uf; I 1 NEW TRIP FACTOR I x 1 I 1.00 1=1 =1 H SWv~ T e-mp'Urlt SUBTOTAL $2,657.31 ADM. FEE RATE 5% =1 TOTAL SDC CHARGES =1 04/15/2002 SDC COORDINATOR DATE 1;- o o u ~ ~ r-< CI) ...... I' Cl ~ 6952 SF $712.53 =1 =r $0.00 $712.53 I , ] 11070 =1 $427.40 =1 =1 $324.80 $752.20 $155.13 $659,76 $814.89 =1 $332,86 =1 =1 =1 =1 =1 $377.69 =[$2.657.31 1091 I II 1092 .1093 1094 $34,83 I $0.00 I $367,69 1 $10.00 . 'l' J 1 $132.87 I $2,790.1Sl 1055 Itl56 1073 . . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE I NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE ( # NEW # OLD ) UNIT FIXTURE FIXTURE TYPE x EQUIVALENT = UNITS BATHTUB ( 2 0 ) x 3 6 DRINKING FOUNTAIN ( 0 0 ) x I 0 FLOOR DRAIN ( 0 0 ) x 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. ( 0 0 ) x 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. ( 0 0 ) x 6 = 0 LAUNDRY TUB ( 0 0 ) x 2 = 0 CLOTHESW ASHER / MOP SINK ( I 0 ) x 3 3 CLOTHESW ASHER - 3 OR MORE (EA) ( 0 0 ) x 6 0 MOBILE HOME PARK TRAP (l PER TRAILER) ( 0 0 ) x 12 0 RECEPTOR FOR REFRlG / WATER STATION /ETC. ( 0 0 ) x I 0 RECEPTOR FOR COM, SINK / DISHWASHER / ETC. ( 0 0 ) x 3 0 SHOWER, SINGLE STALL ( 0 0 ) x 2 0 SHOWER, GANG (NUMBER OF HEADS) ( 0 0 ) x 2 0 SINK: COMMERCIAURESIDENTIAL KITCHEN ( I 0 ) x 3 3 SINK: COMMERCIAL BAR ( 0 0 ) x 2 0 SINK: DOMESTIC BAR ( 0 0 ) x I 0 WASH BASIN ( 0 0 ) x 2 0 LAVATORY ( 2 0 ) x I 2 URINAL, STALL/WALL ( 0 0 ) x 5 0 TOILET, PUBLIC INSTALLATION ( 0 0 ) x 6 0 TOILET, PRIVATE INSTALLATION ( 2 0 ) x 3 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU's' ( 0 0 ) x 20 0 TOTAL DRAINAGE FIXTURE UNITS =1 20 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY YEAR CREDlTRATEPER$I,OOO II YEAR CREDIT RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 1979 OR BEFORE $4.92 1990 $2.06 1980 $4.83 1991 $1.64 1981 $4.77 1992 $1.45 1982 $4.64 1993 $1.31 1983 $4.47 1994 $1.13 1984 $4.30 1995 $0.97 1985 $4.09 1996 $0.82 1986 $3.78 I 1997 $0.63 1987 $3.41 I 1998 $0.41 1988 $2.98 II 1999 $0,22 1989 $2.52 2000 $0.04 VALUE / 1000 CREDIT RATE 0.000 X $0.00 = 1 0.000 X $0.00 =1 TOTAL MWMC CREDIT =1 $0.00 $0.00 $0.00 'f\~'O-\'l>{\'" <i'~e6 eC\~\C . s~'O. es9 _ 225 FIFTH STREET . ,'0S" ~\', .', EleECTRIC~RMIT APPLICATION SPRlNGFIELD, OREGON 9741;h9' es.<:f" ,,' , INSPECTION REQUEST~\~0~~ '"i, ' "Job Number O~ -OV01O - o~~NS~ 01-0008834 OFFICE: 726-3759 .~~ \"~"~,;~, '~ ' ,.,', ' UHTE :MAY' 03' 2002 -' , ."ar;fI<a~0, ia"'<:' ";" ,COMPLETE FEE SCHEDULE BELOW AMT RECD: , . 09." ' ,.' " CHANGE: . :, I. LOCATION pF INSTALLt\TI "'~0i.~<. ~",',..,"" ., ' 5<1 q 5' ' OBSi1:;~'~' .' ~Cl.,......-C>' ~\'."NewRcsidential~Single or..... , .. CASHIER :032 - ~''''o<... !\1ulti,Family per dwelling unit. " , ~ Service Included: B. Seryiees or Feeders Installation, Alterations OJ:, ", '," Relocation: i'l'.f.-:.' ",,'."..' . ~ ' J': f . ~ . . . c . ;' ~... ; Addressi2~1\1"t~~\ Drive /{t~\>., 200 amps or less-:~..?\ ~.:' ":i\'~3.00:" ~,): , .F . ".0 0 . ',. ''',$,,75'.00._' ,!.,' . . ,v~ :1' c, '/}f" >J,.e,.':-.... 2 1 amps to 4Q. ~mps : ' , CIl)"",,,?<>n<> "1)" .-'phone (~4r)hRR.i:h12l. . '. '. 401 amps to 60.0 amps . --.:...$125,00; -97li02 ,,;;' /~', :,"> ";,' '~~'~Ql ampsllj:jOOOamps," ,';-.' . ,$16~,.oO~ Supervisor License'NlUnber ?71 <it: ' , :' ,:", Qver 1000 amps/volts ' '$375,00' ~1'" ~,\. .,J ""~J' ,~.,~ .:, .~-._.... ~ '.~;;-, ReconnectOnly~' ~', .'~'-:--$.50.00'~'<1' . II "::r" .,,,-: ..' ~. .... 'f- - .-"'~,: Expiration Date ~. l(TffilJ,Ol "1 f" ','., .-. r' < 0:' , .,' I , " L'~ . . - ..., .... Mo.:H.I.hJj'/'\Jl.(\" , ,..~, ,'" ','..,.. , .. .'" ,.~'." fl" ,. ~ ''-i@"iIlempo<ar,.l't.ServicesorFeeders'" " . ,", ' C~nsir'Co~tr. :N~ber~_1u.~P..OW ~ules i>dQPte~StaIJ~ti&hAlier'Jiion~or Reloc'ation ' :'~'i':!., -'----::...It; ",,':,., .'\fl'l"'<fuQo'Cellter'rbo";,~':~)c.',,'l!-QI1U.fllll.l"'''' .,';." ',; ',", ,. ,,',,/' '- '- '.'." ''.l~tiAR95''I' . " 'Hl \=,u esar'.l""...tm, . , . .. ;,;'~' .' :-;.Expiration Date 1 n1bILD?~ :,. ..' "'-V01~1-!lthtOal~i's.'fJ~s,,~,;, '., . '.:., -.' --.:.. ~50,00, ~ ""':':;,',, "~'" VV'i:1V..l'6Y-mat"l-ital"" 21Iam'Sfto:400,amps','.., '. "~$69,00'~' \ , ~'" '. .0",. ....~II th llftV..~...nooJ?' sat l),-nl1 1.. . ..' ',.' \. i ,.; ,,:.; Sig~ature,of_~upervising Electrician Jng e Center, (l\fQf~' t $;,40, ~Jup~p.s.. " . : . " :-i-'- SlOO.OQ._..:.":; ,,:..~"" ~'." ',".:',.'-,,_ numberfortheQ avt'f!r 6'OO'larnpsJir 1000 volts see '." _ "". " ,. .". , ..,.~ regon llfB'it'O., "f' --~ ., ", ,. ((' .. ~,' C ~''''llcat' -...... "" ., ':" , ,,' , .-", ." .,,, -... ente . 1 va"" Ion --............ ' "".' . ,', .".",>.,..y,<(.;",.:". ""',f'>;,".,/, .,~'>- liS -800,33223""'\ -' '. ";-0 ''f'''~' ,'~ '\ "',-, ~~''-~.~..-;...,,~,...~.. ~ ~4' \' I ,'~, ",',::";" ,." ~:~,~; ,.... ;/.~;:.,~ ~'.~i;~';~ ...... ',~/'''' : "::l~ '.',.. /,~:~.,I/ ';'J " . ~.. .: ;;....,~~.:.: ~. ~:..~.cj .:'i-.,j:;.'l JOB DESCRIPTION NOT/CIE: \43t, 1000 sq. ft. or less S. ~,e.,,>;~~/S PERMIT SHAll EXP/,f,.?ch additional 500 , AUTHORIZED UNO ~Ili dJiIDrW@RK Permits are rion-transferable a'OOM'Mt ER THIS fNiRMIT IS NOT if work is not started within 1811.4&Y~ NeED OR IS ABANf'!fJ1.IkNli'lllhd"fl'ome or of issuance or if work is suspehliU fdllO DAY PERIOD ~ro'dUfar'D\f!lling 180 days. ,', :i-: . Service or Feeder ;-r: LEGAL DESCRIPTION )'ii.Q?. 01.' 00.00'$"0"1 2. CONTRACTOR INSTALLATION oM. Y Christenson Electric, Inc. D.B.A. e." ,'..;., Electrical'Coniractor ".:: Philios Electric . ,;'.'"",,." ,;," ,.,,' ,,:(I',,;.,;Natnan,t'n~l~ps ~',f'.. .-'- :;" ". 'I,'f- :.~ '. "._ ".' :'~J~';' ..- A,(':t-.....\.~""~.\. . .:~.~'--...~,_ "Olvners Name' ~1 ~ ._~""'r;"......Ul.~ '::"':"":;":"':';6';;~i,c;.-,6.;:.. ':;'3.'.:\ '::', < >. A~d';e~s. r.:f:~:~h:'/,'~ ?~::'.; ;,," '. . Ci;;' ~lj..>::'; ';P?rin~'gq~'53W "'.-"\ .... ~.~"~~'",..,' .., '.,:,."\;.~('."'<~ . . 'OWNER INSTALLATION< f\,": . '," The.iitstalIatii:mistieing' iriade'on. 'c' ' property I.owri:whichis'notintendea....., . ,,:.'" :~. '~f6rsale,' ~h~ase'or,r.ent"-'\'~.,..;..:- ;'-~:'::' ~''"' :....' ,., ., . . '.,' . . ': ,. . ",. . ~". ,. " ,,'} ":1:':> O~vn~rs Signatiir~: '-'" , . " . ...,;.<',",',. J .~'- ". , .";~~ > ;,....~.. - . " ~~J(b<O ; . ' 't\ ,&\.cr?> " .~, . " , J. ' Items Cost Sum..'. .J....$10600 \O(O~ ~.(,O I $ 19.0.0 " .: $ 50.00 , . .... .. .' '.' " '" ) D. Branch Circuits , ,;;,; , .' ,~:, ,r, NewifJterntion or J;:xtension Per Panel "" ~//j~ '-, :~\ :.:!~ I,~~::,l'~:~ <.':, '\ .: One Circuit .',' , , $43.00 , " . :~j ..,., . , .. ,~ j..." ,..' ,.'.:,.,: <, . . ~ ' ,_f Each Additional Circujt or with Service' or Feeder;P~";mit , '$ 3,00 ,I; E. !\1iseellaJi.~ous (Service/feeder not included) ,Each installation, Purrip.br irrigation . SignlOlltlineLighting Limited EriergyiRes . :Liinited Energy/Comm' $50.00 $50,.00 $25.00 $45,.00 , , Minimum Electric P~rmit Inspection Fee is S45.00 + Surcharges 4. SUBTOTAL OF ABOVE 7% State Surcharge 8%'Administrative Fee, I~~ \4:~ TOTAL