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Home My WebLink AboutPermit Building 2002-9-4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: 02-01021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3577 OSPREY Dr ASSESSOR'S PARCEL NO.: 1702194305400 TYPE OF WORK Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Lot: 111, Subdivision: Ambleside, Land Use: Single Family Dwelling, Zoning: LDR, .,. .Ai 1'1, ' 'VI/. -'VI /'l/O/i,/* rl.J.I 101 k' , , If)a 7C'o~. leS '1...1.. !4 <;(elOI) Cia' ~&(" OOo~ f:1.Q~( 0.0';\ 0,0/.0_, I, 'L' ~- . ~'b- 'un.,,:, '/t:Jt .,..; Oy tl;, (,''r<.. I ContraQ~~\f9~~~B?7~t. OSf.r,,~Ors"~" " ~rt, e 'cup 'hro", .es 'gOt-, t.J. Contractor Os or'becie/; (!rI.~~f;0-4~~pj.r~ti9n Date Tom Wirfs Enterprises Inc 'lJte,. is :t'eOo Ole: II), 'oS' Of II;, 95<2, f~f"; Home Comfort Heating & Air Conditio 1,.q/h,~ Ulilt{ye lele; IlJlesOO t, Bills Electric'?::>'::>?<1I1!Otift: if}ol)e 6..1' TOM WIRFS ENTERPRISES INC 32947J), C~riOh 06/2912004 I B1liii~G ll~t<U.K.l\1ATlON I ) tt/S ~: 1 4UJj Ptljil Stories: '1 R-~041, ItOt9/~ih$.!if~Structure 21.00 U;a.AI :.1ttltt, TiP!t~~ti:: Forced Air Elect v'Mvy 18, C~a e I' :,tP/J9, Electric '0 {)4~a ~/; erlt/S '(/1' IpElectric 3 if~y. Pt/Y. 'It Math 1 Vo. ItOOM 'A1/'/SrYUIII( 'tn.f:.; N!);", I DEVELOPMENT INFORMATIO~ )1 Owner: Tom Wirfs Enterprises Inc Address: Po Box 237 Springfield OR 97477 Contractor Type Mechanical Electrical General # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Hillside 3 Yes 38.00 20.00 Phone Number: (541) 747-8704 Phone (541) 747-8704 (541) 345-2838 (541) 687-1851 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1,650 476 REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: 1 PUBLIC IMPROVEMENTS I Fully Improved Sidewalk Type: Curbside 5' Downspoutsillrains: Curb and Gutter Applicant can take storm to private storm line along 36th Court if they can get fall, if not to the street. Notes: Description I Valuation Description I $ Per Sq Ft Square Footage Type of Construction Total Value of Project Page 1 of 4 Value Date Calculated Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description Multiple Permit Discount - 2nd Property Annexed 1997 State Surcharge - Mechanical 8% Administrative Fee - Meehan One to Four Outlets Dryer Vent Address Assignment Hood and Exhaust Mechanical Issuance MWMC Administrative Fee Less than 100,000 BTU + 7% State Surcharge + 8% Administrative Fee State Surcharge - Plumbinl!: Vent Fan to One Duct 8% Administrative Fee - Plumbi Residential Improvement MWMC 2nd Driveway/Overwidth Appl Fe State Surcharge For Building P Temp Power 200 amps or less 8% Building Administrative Fee Planning Plan Review Residence Wiring Ea Addtl 500 New Sidewalk New Curbcut Residence Wiring 1000 Sq Ft SDC Administrative Fee Residential - Reimbursement Two Bathrooms Residential Sanitary MWMC Sanitary Sewer SDC Improvement Sanitary Sewer SDC Reimburseme Building Permit Residential - Improvement S.F. Residence - WiIlamalane Residential - Single Family - Total Amount Paid Residential Plan Check Total Fees Paid Prior to 10/2/02 -$30.00 -$18.19 $3.43 $3.92 $4.00 $6.00 $8.00 $9.00 $10.00 $10.00 $12.00 $14.91 $17.04 $17.78 $18.00 $20.32 $34.83 $35.00 $47.10 $50.00 $53.83 $55.00 $57.00 $75.00 $75.00 $106.00 $153.17 $160.87 $254.00 $332.86 $335.80 $441.80 $672.90 $709.81 $1,000.00 $1,055.67 $5,811.85 Fees Paid Prior to 10/2/2002 $437.39 08/2312002 $437.39 Fees paid' Amount Paid Date Paid 10/02/2002 10/0212002 10/0212002 10/0212002 10/0212002 10/0212002 10/0212002 10/0212002 10/0212002 10/02/2002 10/02/2002 10/02/2002 10/0212002 10/0212002 10/0212002 10/02/2002 10/0212002 10/0212002 10/0212002 10/0212002 10/02/2002 10/02/2002 10/02/2002 10/02/2002 10/0212002 10/0212002 10/0212002 10/02/2002 10/0212002 10/0212002 10/02/2002 10/02/2002 10/02/2002 10/0212002 10/0212002 10/0212002 Plan Reviews I Page 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: 02-01 021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 Receipt Number 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 2200200000000000001 Received By djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb djb 10400 CITY OF SPRINGFIELD Building/Combination Permit Status: Issued PERMIT NO: 02-01021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Engineering-Res 09/03/2002 Wait VJ Plans show a 30 foot driveway. Applicant has not applied for overwidth driveway. Left message with office and faxed a copy of overwidth application 6:04 pm 9/3/02. Applicant must complete and sign and overwidth application prior to BUILDING PERMIT ISSUANCE. The application must have an attached drawing that is separate from the BP. Engineering-Res 0911112002 Appr V J Initial Review-Res Planning-Res Structural-Res 08/27/2002 08/30/2002 09/09/2002 Appr KW Appr AD Appr TM To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. I Required Inspections ~ 1 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 2 Footing: After trenches are excavated. 3 Foundation: After forms are erected but prior to concrete placement. 4 Post and Beam: Prior to floor insulation or decking. 5 Floor Insulation: Prior to decking. 6 Shear Wall Nailing: Before covering sheathing with finish materials. 7 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 8 Wall Insulation: Prior to cover. 9 Ceiling Insulation: Prior to cover. 10 Drywall: Prior to taping. 11 Rough Plumbing: Prior to cover and including required testing. 12 Water Line: Prior to filling trench and including required testing. 13 Sanitary Sewer Line: Prior to filling trench and including required testing. 14 Storm Sewer Line: Prior to filling trench. 15 Final Plumbing: When all plumbing work is complete. 16 Underfloor Mechanical. Prior to insulation or decking and including required testing. 17 Rough Mechanical: Prior to Cover 18 Final Mechanical: When all mechanical work is complete. 19 Temporary Electric: Approval required prior to Utility Company energizing pole. 20 Rough Electric: Prior to Cover 21 Final Electric: When all electrical work is complete. 22 Curbcut - Overwidth: After forms are erected but prior to placement of concrete. 23 Sidewalk - Setback: After forms are erected but prior to placement of concrete. Page 3 of 4 CITY OF SPRINGFIELD Status: Issued Building/Combination Permit PERMIT NO: 02-01021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 701.005 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. Owner or Contractors Signature Date Page 4 of 4 \~ Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: 02-01021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 SITE ADDRESS: 3577 OSPREY Dr ASSESSOR'S PARCEL NO.: 1702194305400 TYPE OF WORK Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Lot: 111, Subdivision: Ambleside, Land Use: Single Family Dwelling, Zoning: LDR, Owner: Tom Wirfs Enterprises Inc Address: Po Box 237 Springfield OR 97477 Phone Number: (541) 747-8704 Contractor Type Contractor Tom Wirfs Enterprises Inc Home Comfort Heating & Air Conditio Bills Electric TOM WIRFS ENTERPRISES INC I Contractor Information I License Exviration Date Phone (541) 747-870' (541) 345-2831 (541) 687-185] Mechanical Electrical General 32947 06/29/2004 I BlJILJJl1'1tJ INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: SETBACKS # of Stories: 1 Lot Size: Height of 21.0~o\} \C8q Ft 1st Floor: Type of Heat: ~\).\'i.eS U,\\\\\'q;t 2nd Floor: Water Type: ~$~'i.e O'i.eQP'(\ se\~]!BaSement: Range T~,,-~,p\e~Oo 'O~ \'{\e ~eS 'a.'i.e 9C5~U;arage/Carport E~~N\liuo~\e "\'lOSe 'i.~ 1<\O~~ 'i.~bther: ~ ' ; '(\).\eS~e'(\\e'i. :~()\'{\'i.0\).~ s 0\ \"\'Ie n'{~ol'Ptrvious Surface ..roW;) ,,;. ''', ..'.;.._nn~ ~\e e~p.\e~{~:r>k\Q'(\ .- .."."..CI' ~"J.;': iJ/'r. .'\,\, :\p DEVELOP ",v~9~~ a~ 0'O"o.'~~ ~'\\\\\~~~~. , '$)9()~X''(\~ \"e'(~"\'Ie ?'i.~.~r-.('\~~??-??:> REQUIRED PARKING Over'j'ay...Jl,@l~O ~\.v;>,~ ,c Hillside Total: # Stree'fTree~e 3 Handicapped~~ Paved Drive Rqd: Yes com.D~~~ ~ % of Lot Coverage: 38.00 \~'i:. \T \ ~ \~ ~~ _ ,,~. 't \ \.. 'i:.i.~ c. ~t.~~~ c.<\\\ U\\\it r fl.'.\\ ~\." ~~ \((.. t)\\t.C. " ..J~t.""~' \j~$~ ~~~\) '''' ~t)~~~~ Curbside 5' ~\j\ ~ ~\\iins Curb and Gutter Applicant can take storm to private storm line ~ ~ '0 r if they can get fall, if not to the street. ~~'( VN R-3 1,650 476 3 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 20.00 1 PUBLIC Street Storm Sewer Available: Special Instruction: Fullv Improved Notes: Desc ription Type of Construction I Valuation Description I $ Per Sq Ft Square Footal!:e Value Date Calculated 1 of 3 '... CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: 02-01021-01 ISSUED: 10/0212002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fees Paid I Fee Description Amount Paid Date Receipt N um ber Received By Multiple Permit Discount - 2nd -$30.00 10/02/2002 2200200000000000001 dib Property Annexed 1997 -$18.19 10/02/2002 2200200000000000001 djb State Surcharl!e - Mechanical $3.43 10/02/2002 2200200000000000001 dib 8% Administrative Fee - Mechan $3.92 10/02/2002 2200200000000000001 dib One to Four Outlets $4.00 10/02/2002 2200200000000000001 dib Dryer Vent $6.00 10/02/2002 2200200000000000001 dib Address Assil!:nment $8.00 10/02/2002 2200200000000000001 dib Hood and Exhaust $9.00 10/02/2002 2200200000000000001 dib Mechanical Issuance $10.00 10/02/2002 2200200000000000001 dib MWMC Administrative Fee $10.00 10/02/2002 2200200000000000001 dib Less than 100,000 BTU $12.00 10/02/2002 2200200000000000001 dib + 7% State Surcharl!:e $14.91 10/02/2002 2200200000000000001 dib + 8% Administrative Fee $17.04 10/02/2002 2200200000000000001 dib State Surcharl!e - Plumbinl!: $17.78 10/02/2002 2200200000000000001 dib Vent Fan to One Duct $18.00 10/02/2002 2200200000000000001 dib 8% Administrative Fee - Plumbi $20.32 10/02/2002 2200200000000000001 dib Residential Improvement MWMC $34.83 10/02/2002 2200200000000000001 dib 2nd Driveway/Overwidth Appl Fe $35.00 10/02/2002 2200200000000000001 dib State Surcharl!:e For Buildinl!: P $47.10 10/02/2002 2200200000000000001 dib Temp Power 200 amps or less $50.00 10/02/2002 2200200000000000001 dib 8% Buildinl!: Administrative Fee $53.83 10/02/2002 2200200000000000001 dib Planninl!: Plan Review $55.00 10/02/2002 2200200000000000001 dib Residence Wirinl!: Ea Addtl 500 $57.00 10/02/2002 2200200000000000001 dib New Sidewalk $75.00 10/02/2002 2200200000000000001 dib New Curbcut $75.00 10/02/2002 2200200000000000001 dib Residence Wirinl!: 1000 SQ Ft $106.00 10/02/2002 2200200000000000001 dib SDC Administrative Fee $153.17 10/02/2002 2200200000000000001 dib Residential- Reimbursement $160.87 10/02/2002 2200200000000000001 dib Two Bathrooms $254.00 10/02/2002 2200200000000000001 dib Residential Sanitary MWMC $332.86 10/02/2002 2200200000000000001 dib Sanitary Sewer SDC Improvement $335.80 10/02/2002 2200200000000000001 dib Sanitary Sewer SDC Reimburseme $441.80 10/02/2002 2200200000000000001 dib Buildinl!: Permit $672.90 10/02/2002 2200200000000000001 dib Residential - Improvement $709.81 10/02/2002 2200200000000000001 dib S.F. Residence - WilIamalane $1,000.00 10/02/2002 2200200000000000001 dib Residential - Sinl!:le Family - $1,055.67 10/02/2002 2200200000000000001 dib I Plan Reviews I 2 of 3 -, CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: 02-01021-01 ISSUED: 10/02/2002 APPLIED: 08/23/2002 EXPIRES: 04/02/2003 VALUE: $ 132,420.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. I Required Inspections I By signature, I state and agree, that I have carefuUy examined the completed application and do hereby certity 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 ofthe 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 certity that only contractors and employees who are in compliance with ORS 701.005 wiD 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 perm~' 0 ted at the front of the property, and the approved si:t f p,;;a will remain on the site at all times during constr ion q A? ~f(./ l/ I'J~ Owner or Contractors ~~ Date I I . 3 of 3 CITY OF SPRINGFI~~~i:':';'SYSTEMS DEVELOPMENT CHi ;E WORKSHEET JOURNAL OR JOB NUMBER: 02-01021-01 NAME OR COMPANY: Tom Wirfs Enterproses Inc. LOCATION: . 3577 Osprey Drive TAX LOT NUMBER: 17021943 t15400 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS: 1 BUILDING SIZE: 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. COST PER S,F. x 3743,50 $0,282 =, $1,055.67 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANI)ARDS IMPERVIOUS S.F. COST PER S,F. DISCOUNT RATE x x 0,00 $0.282 50% ITEM 1 TOTAL - STORM DRAINAGE SDC 2, SANITARY SEWER - CITy' A. REIMBURSEMENT COST: NUMBER OF DFU's COST PER DFU x 20 $22.09 B. IMPROVEMENT COST: I NUMBER OF DFU'sl x COST PER DFU I , 20 $16,79 I ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3, TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE NUMBER OF UNITS x 9.57 1 B. IMPROVEMENT COST: ADT TRIP RATE NUMBER OF UNITS x 9,57 1 I ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMB URSEMENT COST: I NUMBER OF FEU's x COST PER FEU ' 1 , $332,86 B, IMPROVEMENT COST: NUMBER OF FEU's COST PER FEU x 1 $34,83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL OF MWMC REIMBURSEMENT, IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC I SUBTOTAL (ADD ITEMS"i, 2, 3, & 4) 5. ADMINISTRATIVE FEE: ',", SUBTOTAL ADM. FEE RATE x $3,063.45 o SF LOT SIZE: x COST PER TRIP $16,81 x NEW TRIP FACTOR 1.00 =, x COST PER TRIP $74,17 x NEW TRIP FACTOR 1.00 ,=1 =1 5% =1 TOTAL SANITARY ADMINISTRATION FEE: , , TOTAL TRANSPORTATION ADMINISTRATION FEE: I Steve Templin SDC COORDINATOR 9/3/2002 5712 SF =1 =, $0,00 $1,055.67 =, $441.80 =1 =, $335,80 $777.60 , $160.87 $709.81 $870.68 =1 $332,86 =, =1 =1 =1 =1 =1 $34.83 ($18,19) $349.50 $10.00 $359.50 $3,063.45 $153.17 103,85 $49.32 TOTAL SDC CHARGES = $3,216.62 DATE C/) ~ Cl o u ~ ~ ~ C/) ~ Cl ~ ~ 1070 1091 1092 1093 1094 1055 1056 I l 1079 I 1078 -, 1 " I w-}>\(~ ~ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = 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 ( 1 0 ) x 3 = 3 DRINKING FOUNTAIN ( 0 0 ) x 1 = 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 ( 1 0 ) x 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) ( 0 0 ) x 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) ( 0 0 ) x 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. ( 0 0 ) x 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. ( 0 0 ) x 3 = 0 SHOWER, SINGLE STALL. .' ( 1 0 ) x 2 = 2 SHOWER, GANG (NUMBER OF HEADS) ( 0' 0 ) x 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN ( 1 0 ) x 3 = 3 SINK: COMMERCIAL BAR ( 0 0 ) x 2 = 0 SINK: DOMESTIC BAR ( 0 0 ) x 1 = 0 WASH BASIN. ( '0 0 ) x 2 = 0 LA){AJ'ORY ? ( 3 0 ) x 1 = 3 URINAL; STALL / WALL ( 0 0 ) x 5 = 0 TOILET; PYBLIC INST ALLA TION , ( 0 0 ) '~ 6 - 0 TOILET; PRIVATE INSTALLATION ( 2 \ '.,.". ,0 ) x 3 6 = ; . -~, 'C,. MISCELLANEOUS DFU TYPE NUMBER OF EDU's* .,-! ..,., ( 0 0 ) x 20 = 0 .... TOTAL DRAINAGE FIXTURE l[JNIT~ =, 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 COUNTVASSESSED VALUE IF IM~ROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY YEAR CREDIT RATE PER $1,000 . 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 $I.31 1983 $4.47 1994 $1.l3 1984 $4.30 1995 $0,97 1985 $4.09 1996 $0,82 1986 $3,78 1997 $0,63 1987 $3.41 1998 $0.41 , 1988 $2.98 1999 $0,22 1989 $2,52 2000 $0.04 VALUE /1000 CREDIT RATE 28.872 x $0.63 =, 0.000 x $0.63 =, TOTAL MWMC CREDIT =1 $18.19 $0.00 $18.19 ,; . \0" ~ra >s-0 0 yj 'l>c" .~~ . ,225 'FIFTH STREET 1\,eo'<kf\JI . SPRlNGFIELD, OREGON 97477 , ~'Q~~ c,,<<\.X, y INSPECTION REQUEST: 726.37~c,,0o.~$6 ", OFFICE: 726-3759 ~6\0\,O'~. "";:~\~~~00c,,: i', ' 1, l19CATIO$O~, '~1I.tiAT ' :.t-5ll' I "~1"'0~\~ '. '--" .. ~. [~ v'- 'l>~ ~ LEGAL DES~~TlON , c cf:J\~'" - \lOfJ(rf0 ~ J~B~D~CRlPTlQN\ ~ J-l~lY \ ~ J') ,-+ ,-0 ff\^ n T, . VI ~\ Permits re non-transferable and ex~re if work is not started within 180 days of issuance or if work is suspended for 180 days, 1000 sq.fL or less Each additional 500 sq, ft or portion thereof Each Manufd Home or Modular Dwelling Service or Feeder f TRIeAL PERiyHT APPLICATION ~ Y Job Numb,,. OAf) \ ~( 0.1 OMPLETE FEE SCHEDULE BELOW,' " "",200 amps or less:!",:n:,::';:, 201 amps to 400 amps': ., '.,' (' ~S.igna,tllr~~J Sll]lcn~iSi ,g E nv'Ciil/1l ' , O\'-e[ 401 to 600 amps ;, , G/', O\'cr 600 amps or 1000 volts see' ' "B" above " , /:- '~ ~ ~~" D. Branch CirCllits Owners ~me~HVJJ 1HIS P:~MIT SHAteE~~r~tWor8EtOO5~Kerp'1nel Addl'ckVQ \ ~~ 0 ~'"A ) ^ AUTHORIZED UN01if?e ~iPERMIT IS NOT ~\ " ~ v "". ~ ~ A- ~r~ENCED OR IS ABANDONED FOR Cify ~u: ,Phone ',' "->>J' 0 DAY PEmoo.AdditioI1a,i Circuit or with Service J ,\ I' " or Feeder Pernllt ' OWNE :mSTALLATION The installation is being made on propelty I 0\.\'11 which is not intended for sale, lease or rent, Nell' Rcsidential-Singie or Multi-Family per dwelling unit. Sen'icc Included: 2, CONTRACTOR INSTALLATION ONLY Electrical contractol3l !Is k lee/riG Address3XVtJ Hit II tf.; ',.,.' " Ci~'&ir~ j}Rphone5t>kr$J~b: stlPmis01Li'cel1~Nll,~ber~f'~':',';,', ,.... ExpirationDate It),~ 0/...;'0,''1'::1:;, Constr Contr,Null1b,er;~ iE:i-Z., :.: ,< Expiration Date q - ;;tg~i.i:0:' B. Services or Fecders: Installation, Alterationspr RcloCllti on::". :;,,'!,'::/i .4",'" "'" , ' :'j::".:.'.>I" ' 200 amps or less..,,, ,.. ,'.~ 201 amps to 400amps'.::~,";;",':'i'> , 401 amps to 600 amps;'<"n,~"r ,.. :2;>:"%;i~!.~t~~~~W?,~~"', '. . C.'Tcniporai'} Scrvfcesor.Fecdi,:l:s;:;' ':.!nshl1Ution, Alt~J'ation' 6r.iRelo~atiori: '. :>>~:'>-',~, '''', "'. '."~. ~\<,:' ;,:.?:~r"';;~>>:' ,:~' '; . . ''':;: Items Cost SUI:ll, t ,:3 INQ~ D1.dJ $106.00 $ 19,00 $ 50,00 :$ 63,QO >$.:15,09 , ; $1.25;00 ,$163.06. $J75.00 .$".50:9'0 . , . , ,-., ..' : ').';:;;:..' ,!' ';;., .}:':;".~ .::"'..;.' ", ',: . '" :.' ", ';'" . ,"... .-' . .~ 'l... . ", ::" ';~,j,;i; , , 't:i~(,') nF), ,;\'!ctS50,OO ...1 ./, IV\..; "~"$69.00 ';;;<$]00,00 , " " :.:~;::;;~;:. :" ': ~~:.'~:,~ :~~. '.,," .:. . . '. I :_",~~,; .. ; $43,00 . :.~. $ 3.00 E. Miscellaneous (Scnicelfccdcr not included) -Each installation , Pump or irrigation Sign/Outline Lighting Limited EnergylRes Limited Energy/Comm Owncrs Signature: $50,00 $50,00 $25.00 $45.00 Minimum Electric Permit Inspection f'cc is S45.00 + Surchargcs il ~3~ - \'1 .~ ~4'\' ~~ 4, SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fcc TOTAL