HomeMy WebLinkAboutPermit Electrical 1993-4-7
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225 FIFTH STRlmT..' ELECTRICAL PERHIT APPLICATION
SI'IUNGFIELD, 01\EG6~:'97/1 77 . IJ 12.____ .
INSPF.CTION REQUEST:~,,;n6-37~.9 /~~ ~lty Job Number c93tn!Jcz;.<;,
OFFIC~:: 77.6-3759 ',' 'J -, I ~ J
/~ -~ "1 ,yv' '. COHPLETE FEE SCIIEDULE BELOII .
1. LOCATION 01' INSTALLATION .,,;,~;c......-" '
50'7 /fJ/JA 1fi>?""df)& . A. Nev Residen t ial-Single or
( Multi-Family per dvelling unit.
Service Included:
/~4an
- .
LEGAL DESCRIPTION
/7~ ?.<:; 2-4
JOB DESCRIPTION
<:". F AJd<::,
Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ?l7'1i 4~,
?JLrr .1..C}>U15
Phone t,f5(p-O"J05"
Address .J!iLCj'7 70
CityftC;
Supervisor License Number
J Z;~fb S
Expiration Date ItJ/J/'9,,,"
Constr Contr. Numbel' 5~ -13/
Expiration Date ~~?~~~S-
Signatur~Supervising Electrician
-/J:-k//-Z
Ol/ners Name J)JI/<.E I~~
Address
City Phone
OIlNER INSTALLATION
The installation is being made on
property I Ol/n I/hich is not intended
for sale, lease or rent.
Ol/ners SiL~ature:
----------------~l------~--------------
DATE: '1' 1,<13
RECEIPT II: ')((}?;r')
RECEIVED ny: I1tll V'JlJ\I\A.l..
Items
Cost
Sum
1000 sq.ft. or less t-/ $ 85.00 ~5~
Each additional 500
sq. ft or portion
thereof ~ $ 15.00 ~O.~
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
B.
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
$ 40.00 d:t2 (/0
$ 55.00
$ 80.00
volts see "8" above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
/s5.t7"O
7.7,)
;/~-7- .7.5
. . JOB NO. q3oo~S
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: M/KE. SIfUttJ13
LOCATION: 50Q f10...tt:.E-R PAAAWlty EA-~I
DEVELOPMENT TYPE: {....[)/Z. - ;Je:..W 5PR
17 0:' ~ 5"2-4 - 010'-100
.,
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SIZE
SQ. Ft.
'2-1-'2;>lo
X $0,192 PER SQ. FT.
((<l-2.q 3~
-.... ---
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
It
X $39.78 PER PFU
G -?It? 0;;
-- ...-
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I X 1.005 X $401.05 c; t1()3";;
-- ---
X X $401. 05 $ -
X -
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ (5'1~<l-1
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X ,05
c( 77 </-"J:)
, .-
TOTAL-CITY SDC $/~2.S 1l,Z
5, SANITARY SEWER-MWMC
NO. OF PFU'S 19 x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ '255'J::.
(Use PFU Total From Item 2 Above)
v~_~
~ Kip BurdiCK
SDC Coordinator
\ I 2.-... /.,~
I
$ lof ~
TOTAL-MWMC SDC~~O~
"- ---
TOTAL SDC $ J '6 "'" '2.2
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCUu\TI. TABLE: Number of New Fixtures X Uequivalenl = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
Bathtub...... ...... ...... ....... .............................................
Drinking Fountain. ....................................................
Floor Drain...... ...... ...........................,........................
Interceptors For Grease/Oil/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 fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single Stall.............................................,...
Shower, Gang..........................................................
Sink, Bar, Commercia1................,..........,.................
Urinal, StallfWall....................................,.,................
Wash Basin/Lavatory, Single.................,............,...
Water Closet, Public Installation.....................,.......
Water Closet, Private...........................,...................
Miscellaneous:
NUMBER OF
NEW FIXTURES
'"2...
'2.
'7-
TOTAL FIXTURE UNITS
UNIT FIXTURE
EQUIVALENT UNITS
2 <f
1
2
3
6
2 '2.
6
6
1
3
2
1/Head
2 "Z-
2
1 'Z.
6
4 P,
=
I?:.
Based on assessed value. If improvements occurred atter annexation date in table,
,
CREDIT CALCULATION TABLE:
calculate credits separates.
r
L
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
Rate per $1,000
Assessed Value
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
-=
I
I
1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
Credit f?r Parcel or Land Only If Applicable
Improvement (if atter annexalion dale)
-OZ. &~ X $ '5.2-
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
=
I <f 72.
1./7~
= $ ""t'
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL...................... ................ .......... ...... 0.4
Commercia1...................................................... 0.9
IndustriaL.............. ......................... ..... ......... .... 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: ,~ \.
ASSESSORS MAP: \1 Tl"2., 3,S;;LC{-
Yv\~L; ~A)}...;
2.,3,cl~(" -).P/l"'''" -..P__.I"\
. O~
C; l)(';.J~O
. (J
LOT'
OWNER:
ADDRESS:
CITY'
DESCRIBE WORK'
NEW Y REMODEL
s.~Q ,
ADDITION
BLOCK:
STATF'
oJl
.
JOB NUMBER-9~DO~~
U...
TAX LO~~
SUBDIVISION'
P () at-
Olo'-l(){)
DEMOLISH
OTHER
PHONE:
ilfb- '>(69/"
ZIP: qJ l/f)c:...
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXP}RES ) PHONE
GENERAL: )~6 77M~ 8 6;)o~ 'Frt:l~.1't1J/vJ. Eu~~d')a(d,.. 5l)09 6 ( 6-1.{-?J 7'f7- StJ'I6
PLUMBING: A-b~uN Plu,," ~~ '- /
MECHANICAl'" rrtl1Y'fQS HrfrVS br.
ELECTRICAl' ROf'P E(t>r'h~c.
QUAD AREA: \ R.~ '\\. i) U-
. OF BLDGS:~;;) .
OCCY GROUP: R~~ V\
. OF STORIES: d.
WATER HEATER: ~.
- OFFICE USE -
LAND USE: \ \,Q{")
. OF UNITS:
I
u'^J
Lt Jt1ii.. ~
9
FLOOD PLAIN:
ZONING CODE: ~e
W
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: _J Q~/...,
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 a,m. will be made the following work day. .
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbing/Electrlcall
Mechanical - Prior to cover.
~Footing - After trenches are
.J...2S.J excavated.
o Masonry - Steel location, bond
beams, grouting.
l"':71' Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
'!\:71 Underlloor f'l'mD"~~Mechanical
~ _ Prior 10 III.;>,...o....:m or decking.
K::71 Post and Beam - Prior to floor
~insulalion or decking.
rvr Floor Insulation - Prior to
~decking.
l':/'f Sanitary Sewer - Prior to filling
~ trench.
r'VtSlorm Sewer - Prior to filling
~ trench.
.f':11 Water Line - Prior to filling
~ trench.
rvf Rough Plumbing - Prior t:1
~cover.
CONSTR, TYPE:
HEAT SOURCE:
RANG~'
REQUIRED INSPECTIONS
l\::7r Rough Mechanical - Prior to
;a..J cover.
~ough Electrical - Prior to
~over.
?\:7( Electrical Service - Must be
~approved 10 obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
r\:/1' Wall/Ceiling Insulation - Prior to
~over.
~DrYWall - Prior to ta~lng.
o Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
"f;(?( Curbcul & Approach - After
~ forms are erected but prior to
placement of concrete.
f':/1' Sidewalk & Driveway - After
~cxcavalion is complete. forms
nnd sub.base material in place.
o Fence - When completed.
~!reel Trf:'!cs - When al: required
l/:rccs are planted.
K71' Final Plumbing - When all
~ plumbing work is complete.
'K:/'1' Final Eleclrical - When all
~ electrical work is complete.
1
l':7'1' Final Mechanical - When all
~ mechanical work is complete.
l'V1" Final Building - When all
~equlred Inspections have been
approved and building is
completed.
DOther
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 Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - Alter all required
Inspections are approven and
porches. skirting, decks, and
venting have been Inst:llled.
Lot faces
~
Lot Type .
Setbacks
HSE GAR ACC
Lot sq. ltg.
I PL.
IN
Is
Iw
IE
Lot coverage
_ Interior
~ Corner
, .THE 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.
Topography
Totai height
/Ol~b'
(0'
, r'
,Z~, =' I
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT.
s.b.:2.0
-Lf /0
VALUE
~323
I
4230
Main
I c::..2..{,.,
~()
Garage
Carport
9o,S'53fO
~o
20.30
$~30
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
(B) It/ fe., 2.2
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N' ? ~'!O
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Slate Surcharge fl':,tkJ
Total Charge (C) ~CO
MECHANICAL PERMIT
Furnace
Exhaust Hood
"1.>0
900
Vent Fan
N'
3
Wood Stovellnsert/Fireplace Unit
Dryer Vent
-;soo
Mechanical Permit
/&.5:"0
/ D. t90
,B3
27.33
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home I
State Issuance
State Surcharge
Sidewalk
2/
2/
/3/5
/2, .1$
lt
Curbcut
ft
Demolition
State Surcharge
j?/AA) d)5/'.
4D.{) 0
1d"~~0
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical) ZC:;C; 1:.,,!-O
- .
(A, B, C, D, and E Combined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition ltlal the said
construction shall, in all respects, conform to the Ordinance
adopted by the Cily of Springfield, inciuding the
Development Code, regulating the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation 01 any provisions of said ordinances.
Plan Check Fee: .-'"8. u" J~
Date Paid:
Receipt Number'
- ~~
Rcvlcwea By
2---4'-')]
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS P/tTIf .1.
Vl/!) (), h.J IJI",~"" 'l..e4L: t>", APt;' u^-'tL
....pl/\/ ~~LM{l.. '/;J<:.!<p,
C~f\~>;L1 'x'Lto ~, ~ \0(d)
\ ~--\- \ '. f) 2n()
(~ dL' (IJ:c. \ ()..\-OO ')
U
~^~Ac.. {J..:a-t... ~.
:';!L~CLJ~ -1./1 A/J./Jd;""J
~1LJ
By signature, I statc and agrec, that I have carefully examined
the compleled 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 wlll 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 properly, and the approved set of plans will remain
on the site at all times during construction.
( ~ignature ~ 1Jkt>><-<-. I)
Dalp .//c./i]
VALIDATION:
RECEIPT NUMBER
~o(7
-I/h('JJ
7.~4. -"!.o
~~
DATE PAin
AMOUNT RECEIVED
RECEiVED BY