HomeMy WebLinkAboutPermit Electrical 1995-7-6
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,~~' oWing proJ~ct as submhted h..s the fdiowin,
zon",g, ~nd does not require sneclfb '''nd'u''e> .g
approval. " .. ''''',. "
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225 FIFTH STREET . ,
SPRINGFIELD, OREGON IVfmcpd SIgnature kJ ~
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. ~~ M~lcj
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Permits ~re non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2.
r-
CONTRACTOR INSTALLATION ONLY
< '.. ;.. ....., <:~. o~t C I '_
BILL'S ELECTRIC
31,70 W 11TH AVE
EUGENE O~'974-62
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d. SUPERVISOR Lie. #.980S
" EXP. DATE 10/30/95'
E' CCB.#21351
I EXP. DATE4/28/9~ .-
(,v&-aw~...-A.-_~ ..-,"-..-~.-:--&-.,......:..;."':--_,_"'~----.-'
-~
Expiration Date
. .
~7re ~ sUPHr)ectrician
"1:5 - R..t \ V J.1...".. _ D.
Owners Name ""')\ lJ.UL)
Address 4C\~. ~\~J .
City ~)\{)~P_. Phone ~Af\-.62fo 7
OVNER INSTALLATION
The installation is'being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------------71------~-- --------
DATE: . I. t.o.
RECEIPT #: ~' f f'_~ -, K W~/?
RECEIVED BY: V V'----/ -
J -
ELECTRICAL PERMIT APPLICATION
Ci,ty Job NUmber C\ ~D
3. COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cos t
Sum
1000 sq.ft: or less I $ 85.00
Each additional 500
sq. ft or portion
thereof -2 _ $ 15.00
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder $ 40.00
~
.sD
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/lOOO 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, Al~eration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Circuits
,.
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
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limite~ Energy/Res
Limited Energy/Comm
40.00
40.00
20.00
36.00
not included)
5.
$
$
$
$
~~
~:L"-
~ ~""
'CJ~.U2
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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fi Y.,\;{ilIR~cr;m~!g!!i~
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Job No. C\QMO
SYSTEMS DEVELOPMENT CHARGE
\\'ORKSHEET
. .
NAME:0).\~f\~ ~\llJ PHONE:\'\~ .~'llo_
. ,
ADDRESS: lo~n \)\ ~. ~l'\1.rl:1 b. ~ STATE:~ ZIP Q11tit.
'.
tqCATION OF ~ROPOSED BU1L9J~g SIlE:r-"....... . l..~'
Street Address if Known: ~ 't\~ 'tt j\S\.A\ t a I
. . ~ ..
PlattName: ~~ TaxLotNumber: \~1fj\{X) ~o'Ozqcp
1. DEVELOPMENT TYPE (Check appropriate dwellingCs). SDC Calculations and dwelling type
definitions are on the back.) . .. .
A. Sim~le Family - Detached
l . Single Fan:tily home
.. NO OF UNITS
Manufactured home not in a park" , ciJ
X $400 PER UNIT _=.. ... $ ,.@. ..
'.
B. SinQ'le Family - Attached
.
NO OF UNITS
X $370 PER UNIT =
. $
. C. Multi-Family Aoartment. .
NO OF UNITS
D. Manufactured Home Park
X $777 PER UNIT =
$
NO OF UNITS
X $280 PER UNIT =
$
3. TOT At WPRD NET SDC ASSESSED (If SDC reduced for Credit>
~ \ t,\~d)
r"n-\..,,,,,.,,:t-., <:;':~~~~('i"n
. rJjcD
. $~ .
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit, . ff
approyal. See SDC Credit Worksheet.' $
AtOPU
(L ~Jq')
WPRD SDC
n;1tp
v
'.
.
.. 1 NO. C(5{)roqO '
/
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
,WORKSHEET
(COMMERCIAL & RESIDENTIAL),
NAME OR COMPANY: f0v6/Zr3etJDI-!-oNJeS
LOCATION: 4QE;S FOfZ-~Y{t-IIA '
/ Y: () "2- ()4 () 0 -0 ~'1 00
DEVELOPMENT TYPE: LOt<: - NEW '5:?F1?-
, BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. ~TORM DRAINAGE
IMPERVIOUS SQ. FT.
'2-444
X $0;209 PER SQ. FT. 010~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
IB
X $43.26 PERPFU
cG1B V
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X /, () f X $436.19
X. X $436.19
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S _ \8 x $17.19 PER PFU + $10 MWMC ADM FEE $3tq42:
(Use PFU Total From Item 2 Above) ,
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 1.'3 5?4-
. TOTAL~MWMC SDC ~
SUBTOTAL (ADD .ITEMS 1,2,3 & 4) $'1....o? 5~
X "$436.19
G~5~
'---- ~ :
$
$
5 ..ADMIN iSTRATIVE FEES,
BASE CHARGE (SUBTOTAL ABOVE)
k~Lt.k' .
, (f Kip Burdick .
SDC Coordinator
X .05
Date: 5/'2:3/1'5
;' / '
TOTAL SDC
C;:OI ~)
"-- -----
$ 2., ~ 1 ?~
...
.. ."' .....". ..'~C:~,,";, ;',: ..... .,. - ~'. . ~ . ,
F()(TURE UNJJ CALGULA-. _ dN'T ABLE: Number of New Fixture~Unit Equivalent =. Fixture Uni~s .,.:'
(NOTE: For remodels, calCulate only th< \:: additional fixtures)
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQU\V ALENT UNITS
1..
2
1
2
3
6
2
6
6 -,
1
3
2
1/Head
2
2
1
6
4
4
Bathtub.................................................................... eo
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/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall....................................... ..........
Shower, Gang.. .................................................. .......
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall.......... ...................................... ..'.....
Wash Basin/lavatory, Single... ......... ......... .... .........
Toilet, Public Installation................... ......... ........-..
Toilet, Private............. .... ...............................,..,...
Miscellaneous:
1..
"Z
~
z.
'Z..
~
TOTAL Fl>:TURE UN!TS
\8
~-, .
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
J calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000,
Assessed Value
",
1979 or before
1980
1981
1982
1983 .
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
;i
,\
Improvement (if after annexation date)
3 . +'- X $ 4 ,6
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
/~r4
Credit for Parcel or land Only If Applicable
CREDIT TOTAL
= $
/:3 164
y
RESIDENTIAL
PERMIT APPLICATION
DESCRIBE WORK:
NEW ~ REMODEL
CONTRACT~~_ J\
GENERAL: V \~ (\0
PLUMBING: ~~
MECHANICAL: Q~Lt)t\..u
ELECTRICAL: ~,,\\~, ~
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JOB
NUMBER qr:{) loC\CJ
225 Fifth Street..
Springfield, Oregon 97477
,
\j \0--:X LO]' V{ ) ORD
SUBDIVISION:\~\ ~'r\tJ?
PHONE:-m 62Jo 1
STATE:
.~
ZIP:
C{,'\1-\JJ
OWNER:\\~}\ltJ ~~()., ~~. 0 S
ADDRE~: \_O\'CJ \~\XS\L ~.t\Jj)J
CITY: \,~\QJ:)Llu Q Q
~ ~ \~.t~\ruN'o
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ADDITION
DEMOLISH
OTHER
.CONST,
. . C2\'3~/I ,EXPI~ES~_, P~NE
._g__,_~_..- .,.\\:).\\$ C\3 .~
\7~.2\ .QS ~ q }2.~(
~~\ ' ?J<\!4S 10~. \xSI
LZJ Rough Mechanical -Prior to
cover, ';
[~
Rough Electrical - Prior to
cover,
ADDRESS
1\)~~
'A~\~S\
3~ - OFFICE ,\E -
QUAD AREA: LAND USE: ~\\ FLOOD PLAIN:
/I OF SLOGS: \ /I OF UNITS: , ZONING CODE: LD~
OCCY GROUP\\~+ tJ\' CONSTR, TYPE: VAl /I OF SDRMS: ~
\ ~f / ----
/I OF STORIES: HEAT SOURCE: SECOtyDARY HEAT: lid!)
WATER HEATER: C(> RANG E: U SQUARE FOOTAGE:
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
mad~:the same working day, Inspections requested after 7:00 a.m, will be made the following work day,
REQUIRED INSPECTIONS
[:;KJ Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing I Electricall
Mechanical - Prior to cover,
r\/t Footing - After trenches are
~ excavated, "
o Masonry - Steel location, bond
beams,- grouting,
Q
Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
'~
Underlloor Plumbing! Mechanical
- Prior to insulallon or decking,
IVl Post and Beam', - p.rlor to floor
(-"e Insul~tlon or de'cking>"-. '" .,','
~ - ----,----':.; ':, :.:) - ~~ i . \ '.,.' "} ~ i.'>
M Floor Insulafion -::'Prlor to
'----F decking,
M SanitarY'oSewer - Prior to filling
I trench,
rv\l Storm Sewer ~ Prior to filling
L,L::{ trench.
~
[]I Water Line - Prior to. filling
trench, , !,
. -', I .
f'l!l ROUgh, i?lumbI'Jg .-:..: Pr.ior t'o
LpJ cover, .
fV1 Electrical Service - Must be
LN approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp,
~ Framing - Prior to cover,
I'Jl Wall/Ceiling Insulati9n - Prior to
Lf'J cover,
IX) Drywall - Prior to tapin'g,
"
o Wood Stovo - After Installallon,
o Insert - After fireplace approv&1
". and installation of unit.
m Curbcut & Approach - After'
~ forms are erected but prior to
placement of concrete,
'.
IYl Sidewalk & Driveway - After'
'--f'.J. excavation is complete, forms
and sub.base material In place,
o Fence - Whe,n comp!eted,
f\ll. Street Trees - When all required
~ trees are planted, ",'.',
M Final Plumbing - When all
~ plumbing worl< is complete,
f\7l Final Electrical - When all
Lf>J electrical work Is complete,
rYl Final Mechanical - When all
/ mechanical work Is complete,
I'll Final Building - When all
~ required Inspections have been
approved and building is
completed,
D Other
MOBILE HOME INSPECTIONS
D 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 servic~ panel.
Cd
Final ~, After all required
inspections are approved and
porches, skirting, decks, arid
venting have been installed,
/
.~
/
.'
~
'; ," l'.\ ~ '.'1'
<.
Lot Type, Setbacks
~Interior I p.L. HSE GAR ACC'
Corner IN \R I
Is - I
Panhandle tD
Cul.de,sac Iw 5 I
IE \S I
Lot faces
t--!
(00 (b
S.:J.
Lot sq. Itg.
Lot coverage
Topography
Total height t~'
, (~'-)
BUILDIN~ PERMIT
\\~S
<\~
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
Xfu~W =lfi~
\'\.\0 " \.Q ,4l~
11,~-Ho,~8
(A)
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Resident!al Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
FEE
~
\ "Cj ,00
(C)
\ (()(J. SO-
\bl.~
\ l.~. ~
'3.~ ~J..\.~'
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stove/lnsertl
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
~s -\- .S"
Total Permit
:l.
~,~
4. S.-9
C:. _ C.Jb
3.~
Mobile Home
MISCELLANEOUS PERMITS
(D)
\'\. SO
la. ~
\,~
~ l .b~t
State Issuance
State Surcharge
Sidewalk
~~ ft
~ft
Curbcut
Demolition
State Surcharge
\~,~S
v-\. &6
~~,b;
~~~~~S~
Total Miscellaneous Permits (E)
~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
,03 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 iJ,suance,
J .
APP.ROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the c.ol)struction and uS,e of
buildings, and may be suspended or revoked at any time.
upon violation of any pr?{if{ons of said ordinances.
Plan Check Fee: ()f~4 ,qO '
, . e:. .2-2 . t 1,~
Date Paid: _\-) -U
ReceIpt N"mb__-- \l~lo.- - 0
Received By, ruM ~~
- (
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within tho City limits which are being improved,
A~~~l COMMENTS _
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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 Building Safely Division,
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
~:~::~ON:MBER _ _ ~,~W(p
. DATE PAID '7 .ft? ~Lf..S I,
, -l .-' 1 I
:;::'~;DR:~gJ~">0;4r6i.~
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