HomeMy WebLinkAboutPermit Electrical 2005-5-6
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: ~4i'J;26-36~9 O'OO..o)'~ .
ELECTRICAL PERM~T APPLICATION v00'l~ ~o~,; (9<}' ?::"~oS'
C 'I"'ld"'l ' & 19 .. oS'"
City Job Number .- Vf../Lf '10 Date 0' .s>. &9" .~~,
" J", ~ ~
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1. LOCATION OF INSTALLA170N 3. COMPLETE FEE SCHEDl.J~ 'L - :O&0:;~~oS'
q 13Z,/413J;r J~(5)l\ta. ~. ' S'~ ~~O~:to~
LEGAL DESCRIPTION A. New Residential- Single or Multi-Fa i.''''' eUing 'ftnft()
i ?c '2-'~l;j 1 0 110 ( Service Included
JOB DESCRIPTION ~
J~-,Sjc&rkpJ J\.1 L.va ~"..roD .
Permits are non-transferabl: an~ expire if Glr~ ')
not started within 180 days of issuance or if work is
Suspended for 180 days.
1000 sq. ft or less
Each additional 500 sq. ft. or
portion thereof
2-
4~
2-16Q:;
$ 19,00
,.,. ,', I"h 00
ji ,--,- I liP.
Each Manufact'd Home or
Modular Dwelling Service or $50,00
J:,~.e.~~r
$~,: . -''''''-
., . '."1/ (Jr-r
2. CONTRACTOR INSTALLATION ONLY ;~1~;;~~~~~'~~'3Ei~;~.~~ 1aW~8~1~~i Alterations or Relocation:
Electrical Contractor6Jer/itw fleJ; se{V;~ /Jt(!r; ~doo;;~f4i1~s7~1~;~i;~,~re[JonY~~j~~ $ 63.00
1/1. / - J' i GG9L~0't~i~ 4~1~'tt/pro~lC1~~Aaleset fortll> 75.00
Addressnl;i3f72 h5"tJ-J 1'Ji ,/{SiorJ AJe ca~b1t1~~k~?1~~fe~~"/th~';::J,2-001"$125.00
. _ . . nurr~'fr~:Ji~;@Wg?Wrf1fit:.,~he te!ef:t,~ies by $163.00
City t:U(,,/\i ?7~o~ Phone b01--690g OV&'fOOf)r~~?t~JLliityNotifiBa~:le $375.00
J' Reconnect Only ~332~2344). l\,Jr, $ 50.00
(/6DR :;
jo/l 101
f J
Constr. Contr. Number /3' /'5'7/
<z/iJ/:2Do ~
IJ
Signature of Supervising Electrician
~J~
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Owners Name ~ J'(\ ?J\ \)0 f\S
Add~~~l \ .~ -YU\LLq&-
Ci~\~~M- Phone ~4lfL-4;
Supervisor License Number
C. Temporary Senices or Feeders
Expiration Date
Installation, Alteration or Relocation
Expiration Date
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or I 000 Volts see "B" above,
D. Branch Circuits
J
S:O~tl6
$ 50,00
$ 69.00
$100.00
,_ ,l,'ie,W, AlteJ;:.ttion or Extension P.er Panel
. ~ ~---,::-:~:' :. \ . . '.
,- , ,Ope,.L1,fC~lIt, '- .' -
; :- 'Eac~ '~dditional Circuit or with '
,1_ 8etvioeor Feeder Permit. ,
$ 43.00
$ 3.00
. ~,~.;
E. :Miscellaneous (Service/feeder not included) -Each Installation
OWNER INST ALLA nON
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
The installation is being made on property I own which
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
7% State Surcharge
10% Administrative Fee
~3<3~ ~~.<~
~.lDl6 ~
3'3. ~o '~~I",U
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Owners Signature:
4. SUBTOTAL OF ABOVE
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building Fonns/Electncal Pennit Application I-D3.doc
.r
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541.;.726-3769 Inspection Line
CITY OF SPRING~lJi,LO '
Building/Combination Permit
PERMITNO: COM2005-00430
ISSUED: 05/05/2005
APPLIED: 04/14/2005
EXPIRES: 11/05/2005
VALUE: $ 247,872.00
SITE ADDRESS: 4132 Virginia Ave 4134
ASSESSOR'S PARCEL NO.: 1702323303701
Springfield TYPE OF WORK: Duplex
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Residential Duplex
Owner: SHALLUM BIVENS
Address: 871 S 72ND
, SPRINGFIELD OR 97478
Phone Number: 541-521-9324
I CONTRACTOR INFORMATION'
Contractor Type
General
Electrical
".,.':~._:r
Contractor License Expiration Date
NORDIC HOMES & CONSTRUCTION LLC 156131 07/09/2007
EVERYDAY ELECTRICAL SERVICE 136371 08/12/2005'
I BUILDI~ u~mRNllAqJf!!:l' taw requIres you. ~ '
1Ol10w rules aaopnrc"by the Oregon Utility
# o~)ff~tion Center. Those r~les Iff&\: wJ~rth
HeifitJlA~~1-o010 th2Ql<<Dh O~ ~~sr91oor: ,
Types~~evtiu may obtcW1lnopji6 of ~#lJ~~o~or: "
water;f\9 the center. ~tmthe ts~pllBO~nient:
Rang-n er for the OrelbW~~i\ity NoiitfCltioSge/Carport
Energy at : Center is 1-8~-2~tpther:
Sprinkled Buiffiing: n/a Oc~tip'ant Load: ,~. ;',
Phone
541-521-9324
541-607-6908
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
, Secondary Construction Type:
# of Bedrooms:
2
R-3
VN
4,770
1,056
1,376,
576
6
I DEVELOPMENT INFORMATION.
Front yard Setback: '
Side 1 Setback:
Side 2 Setback: '
Rearyard Setback:
Solar Setbacks:
18.00
5.00
10.00
21.00
35.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
2
Yes
32.20
REQUIRED PARKING
Total: 4
Handicapped:
Compact:
Street Improvements:
Storm Sewer Ayailable:
Special Instruction:
I PUBLIC ~~V.El\1~_L ~~,,\,,\! W ~,,~\i\tl~~
lM\~ I"'Ll\\" il\ 1\..\Ul~~~"(f\\ tl~
Fully Improved AU1KORIIEO UNO \~ ~~i~g~~ ~PfE)ti
Yes 'COMMENCeD O~ \~t}~ownspoutS/Drains:
AN'{ I BO O~" p~" . .
~ -'t
Curbside 5'
Curb and Gutter
Notes: Storm drainage piped to curb face 4/15/2005 CAS
Pae:e 1 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: COM2005-00430
ISSUED: 05/05/2005
APPLIED: 04/14/2005
EXPIRES: 11/05/2005
VALUE: $ 247,872.00
I Valuation Description I
Dwellin!!s
Gara!!e
Tvpe of Construction
V Wood Frame
Gara!!e
$ Per Sq Ft
or multiplier
$96.00
$25.00
Square Footage
or Bid Amount
2,432.00
576.00
Value
Date Calculated
Description
Total Value of Project
$233,472.0.0
$14,400.00
$247,872.00
05/05/2005
, 05/05/2005
~
Fee Description Amount Paid ' Date Paid Receipt Number
Plan Review Residential ,$426.82 4/12/05 1200500000000000439
-Mechanical Issuance Fee- $10.00 5/5/05 1200500000000000579
+ 10% Administrative Fee $209.07 5/5/05 1200500000000000579
+ 7% State Surcharge $146.35 5/5/05 1200500000000000579
2 Baths One or Two Family $508.00 5/5/05 1200500000000000579
Addressing Assignment $62.00 5/5/05 1200500000000000579
Addressing Assignment ' $62.00 5/5/05 1200500000000000579
Building Permit. ' $1,046.65 5/5/05 1200500000000000579
Curbcut Permit $80.00 5/5/05 1200500000000000579
Dryer Vent $12.00 5/5/05 1200500000000000579
.,. Exhaust Hoods $18.00 5/5/05 1200500000000000579
Miscellaneous Mechanical $144.00 5/5/05 1200500000000000579
Plan Review Major - Planning $103.00 5/5/05 1200500000000000579
Plan Review Residential $253.50 5/5/05 1200500000000000579
Residence Wiring 1000 Sq Ft $212.00 5/5/05 1200500000000000579
Residence Wiring Ea Addtl 500 $76.00 5/5/05 1200500000000000579
Sanitary Sewer - Improvement $621.52 .5/5/05 ' 1200500000000000579
Sanitary Sewer - Reimbursement $817.36 5/5/05 1200500000000000579
SDC MWMC Administration $10.00 5/5/05 ' 1200500000000000579
SDC MWMC Improvement $1,730.62 5/5/05 1200500000000000579
SDC MWMC Reimbursement $164.06 5/5/05 1200500000000000579
SDC Sanitary/Storm Admin $162.38 5/5/05 1200500000000000579
SDC Transpo Admin $138.62 5/5/05 '200500000000000579
SDC Transpo Improvement $1,544.98 5/5/05 1200500000000000579
SDC Transpo Reimbursement $350.26 5/5/05 1200500000000000579
Storm Drainage Impervious Area $781.20 5/5/05 1200500000000000579
Temp Power 200 amps or less $50.00 ' 5/5/05 1200500000000000579
Vent Fan $24.00 5/5/05 1200500000000000579
~ Willamalane Attached (duplex) $1,848.00 5/5/05 1200500000000000579
Total Amount Paid $11,612.39
Pa!!e 2 of 4
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00430
ISSUED: 05/05/2005' '
APPLIED: 04/14/2005
EXPIRES: 11/05/2005
VALUE: $ 247,872.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Plan Reviews I
Initial Review 04/15/2005 04/15/2005 APP SKG
Plannin2 Review 04/15/2005 04/28/2005 APP TAJ Partition Plat for SUB2005-00005
recorded by County on 3/23/05
Public Works Review 04/1512005 04/15/2005 APP CAS Storm drainage piped to curb face
4/15/2005 CAS
Structural Review 04/15/2005 04/29/2005 10 LLH Plans forwarded to Jason Bush for
review
Structural Review 05/02/2005 05/04/2005 APP JB Plans approved as noted
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 fo.lowing work
day.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
, Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and filter cloth is ins~alled but prior to backfill.
UnderfloorPlumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Pa2e 3 of 4
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00430
ISSUED: 05/05/2005
APPLIED: 04/14/2005
EXPIRES: 11/05/2005
VALUE: $ 247,872.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Rough Mechanical: Prior to Cover
Final Mechanical: ,When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
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.
~~
---
s/~)r
Owner or Contractors Signature
, -------
Date
Pal!e 4 of 4
.'
CITY OF SV~GFIELD SYSTEMS DEVELOPME~\7?ORKSHEET
JOURNAL OR JOB NUMBER: COM2005-00430
NAME OR COMPANY: Shall urn Bivens
LOCATION: 4132 & 4134 Virginia Ave
TAX LOT NUMBER: 170232330370]'
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 2 BUILDING SIZE (SF: 2000 LOT SIZE (SF):
1. STORM DRAlNAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. CHARGE
I 2520.00 I $0.3] 0 = I $781.20
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS S.F. x COST PER S.F. x I DISCOUNT RATE I
0:00 $0.3]0 I 50% = I
ITEM 1 TOTAL - STORM DRAINAGE SDC '$781.20
DISCOUNT
$0.00
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's x
, 34
B. IMPROVEMENT COST:
NUMBER OF DFU's x
34
COST PER DFU
, $24.04
$]8.28
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= ,
$1,438.88
3. TRANSPORTATION
A. REIMBURSEMENT COST:
ADT TRIP RATE x , NUMBER OF UNITS x
9.57 2
COST PER TRlP
$18.30
x NEW TRlP FACTOR
1.00
B. IMPROVEMENT COST:
I ADT TRIP RATE x I NUMBER OF UNITS x I . COST PER TRIP
I 9.57 I 2 '$80.72
ITEM 3 TOTAL - TRANSPORTATION SDC = , $1,895.24
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's x COST PER FEU
I 2 $82.03
, B. IMPROVEMENT COST:
INUMBER OF FEU's x
I 2
x INEW TRlP FACTORI
I 1.00 I
4770
$781.20
$817.36
$621.52
$350.26
$1,544.98
r/)
~
Ci
o
u
~
~
E--<
r/)
>-<
d
~
1070
1091
1092
1093
1094
ICOST PER FEU
I $865.3]
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
= ,
= ,
$1,904.68
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5. ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE
I $6,020.00 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$6,020.00
CHARGE
$301.00
=
$164.06
1054
1055
I
I 1054
11056
II
11079
11078
Cheryl Slaymaker
TOTAL SDC CHARGES
4/15/2005
PREPARED BY
DATE
=
$1,730.62
$0.00
$10.00
] 62.38
$138.62
= I $6,321.00
___~__I
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY TIIE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 2 0 3 = 6
IDRINKJNG FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER/MOP SINK 2 0 3 = 6
ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
IRECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
IRECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
ISHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 2 0 3 = 6
ISINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LA V A TORY 0 0 2 = 0
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 4 0 1 = 4
IURINAL, STALL / WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 4 0 3 = 12
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 34
OEDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
198]
1982
]983
]984
]985
]986
1987
1988
1989
1990
199]
1992
1993
1994
1995
1996
]997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4 .40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGffiLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE /1000 CREDIT RATE
$0.00 x $5.29
= I
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
=
$0.00
TOTAL MWMC CREDIT
22~ Fifth Street .
S'pringtleld, Oregon 97477
541-726-3759 Phone
f':ity of Springfield Official Receipt
~velopment Services Department
Public Works Department
Job/Journal Number
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
COM2005-00430
CbM2005-00430
COM2005-00430
COM2005-00430
Payments:
Type of Payment
Check
(
5/5/2005
RECEIPT #:
1200500000000000579
Date: 05/05/2005
Description
Addressing Assignment
Willamalane Attached (duplex)
Temp Power 200 amps or less
Curbcut Pennit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transpo Admin
Plan Review Major - Planning
Plan Review Residential
Building Pennit
Addressing Assignment
2 Baths One or Two Family
Vent Fan
Exhaust Hoods
Dryer Vent
Miscellaneous Mechanical
-Mechanical Issuance Fee-
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
NORDIC HOMES CONSTR
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 1332 In Person
Payment Total:
Page 1 of 1
2:45:09PM
Amount Due
62.00
1,848.00
50.00
80.00
781.20
817.36
621.52
350.26
1,544.98
164.06
1,730.62
10.00
162.38
138.62
103.00
253.50
1,046.65
62.00
508.00
24.00
18.00
12.00
144.00
10.00
212.00
76.00
146.35
209.07
$11,185.57
Amount Paid
$11,185.57
$11,185.57