HomeMy WebLinkAboutPermit Electrical 1996-4-2 (2)
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ELECTRICAL PERMIT APPLICATION
C(~&ql
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
City Job Number
3. COMPLETE FEE SCHEDULE BELOY
1_ LOCATION OF INSTALJd'TION
35'S'S> 1>ou(t-l..A-S ~fZ,.t vE::
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
A.
uni t.
~~tES~f)~O\ ~ O?lli)
\\cA2)0"
Sum
R5
~D
Items
1000 sq.ft. or less I
Each additional 500
sq. ft or portion "
thereofCX '
Each Manuf'd Home, or
Modular Dvelling
Service or Feeder
Cost
$ 85.00
JOB DESCRIPTION
.N ~ FK..
$ 15.00
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
,B.
2. CONTRACTOR INSTALLATION ONLY
.4LJ.B1.,) ;;ud;~
3~ 5/:
Electrical Contractor
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Address / .2
.....vu
Ci ty /<t4T>J2.4~
,L.j 7 \--;)..) 3'1
/G) -=~ 1;
Phone
~,
Supervisor License Number
Expiration Date /0 - / ~ 5',<;-
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
Constr Contro Number tf:>"l? 7~S-
Expiration Date '7 ~ L/ -9 ,-
200 amps"oT less $ 40,00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Signature of Supervising Electrician
II ~..A_ G~--M.rl4J,.d""" D.
Ovners Name 1I~J>A.A.J Ed, ~<::",
Address 'g"'7 t 5, '5.J d s:>/ I
Branch Circuits
"
Nev, Alteration or Extension Per Panel
$ 35,00
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
Ci ty <;:0 pi.,,}
I -
Phone ':J)..JiJ -'b9~
$ 2.00
OYNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/Outline Lighting $
Limited Energy/Res $
Limited Energy/Comm $
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
;;~:--_.zt~~:!Jt\l!~---
RECEIPT #: - l . 'ill
RECEIVED BY: - -
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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Job No. g.SO vcr K
SYSTEMS DMLOPMENT CHARGE
WORKSHEET
NAME:\ Q\('u)c1C f\ <f n+, .' '. PHONE:fY\4 {cAloLo
ADDRFSS, S~~ m. '6?~~I~ STAreJLpClcDB
. '
Lq<:ATION OF PROPOSED BUILDING SITE: ,""",. ',~ 0\.' r-.. )
Street Address if Known: 1JI1C1~ \ ^ ll~n~ ~',' ~
Plan ~am~ A\f'\ . .A 01\ C ~ Lot Number. ~ GiloO()
Y\\ '-l\), \ ~ Ad.d" o2JcO !
1. DEVELOPMENT TYPE (Check appropriate dwelling(sJ. SDC calculations and dwelling type
definitions are on the back.l ' . , ,
A. SiMle Family - Detached
\ ' Single Family home
. NO OF UNITS \
Manufactured home not in a park
$400 9)
X $400 PER UNIT _=.
B. SiOl?le Family - Attached
.
NO OF UNITS
X $370 PER UNIT =
. . $
C. Multi-Family Aoartment ' ,
NO OF UNITS
X $~77 PER UNIT =
$
D. Manufactured Home Pa~
NO OF UNITS
X $280 PER UNIT =
$
,$A\l)oJ
'$' QJ
~:Al:;;:~J ("SOC'OO~OO~;",_? / I~:OV
WPRD SDC
2. SDC CREDIT (If applicable> SDC-payer must furnish proof ofWPRD Credit
approval. See SDC Credit Worksheet. .
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SPRINGFIELD
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CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
(COMMERCIAL / RESIDENTIAL)
Name or Company: HAYDEN ENTERPRISES
Location: 3558 DOUGLAS DR
Developement Type: R Building Size:
Job No.: 950698
Lot Size: 0
l. STORM DRAINAGE
Impervious Sq Ft 0 X 0,209 Per Sq Ft
2. SANITARY SEWER - CITY
Number Of PFUs 18 X 43.26 Per PFU
(see Page 2)
3. TRANSPORTATION
Number Of Units
1 X
X Trip Rate
1. 010 X
X
Cost Per Trip
436.19
$440.55
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
18
Per PFU +
17.190 +
MWMC Admin Fee
10.00
X
X
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) X
0.50
TOTAL SDC
Reviewed By: KIP BURDICK
Date: 07/03/95
Page 1
Sq Ft
$0.00
$778.68
$440.55
$319.42
$26.23
$293.19
$1,512.43
$75.631
$1,588,05
Job Number: 950698
FIXTURE UNIT CALCULATION TABLE
Page 2
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry TubjClotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/Water Station/Etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial
Urinal, Stall/Wall
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
TOTAL FIXTURE UNITS
Number of
New Fixture
Unit
Equivalent
Fixture
Units
2
o
o
o
o
1
o
o
o
o
o
1
o
2
o
2
o
2
1
2
3
6
2
6
1
3
2
4
o
o
o
o
2
o
o
o
o
o
2
o
2
o
8
o
2
2
1
6
4
18
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed: 1960
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
7,580
X
3.46
26.23
o
X
3.46
0.00
CREDIT TOTAL =
$26.23
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
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Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 950698
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726.3769
Location of Proposed Work: 3558 DOUGLAS DR
Assessors Map #: 18020612
Lot: 54 Block:
Tax Lot #: 02600
Subdivision: HAYDEN GARDENS 1
Owner: HAYDEN ENTERPRISES
Address: 899 SOUTH 32ND STREET
Phone #: 744-6966
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: S.F. RESIDENCE NEW
Canst.
Contractor Contractor # Expires Phone
General: HAYDEN ENTERPRI 0092208 07/29/96 923-6607
1511 SW 33rd Redmond OR 977560000
Plumbing: EMERALD VALLEY 0051737 09/19/96 683-5116
2727 N 20th Springfield OR 97477000
Mechanical: HAYDEN ENTERPRI 0092208 07/29/96 923-6607
1511 SW 33rd Redmond OR 977560000
Electrical: ALLEN ELECTRIC 0000968 09/24/90 475-2139
201 N 3rd Madras OR 977410000
QUAD AREA: 3RSC
# OF UNITS: 1
CONSTR, TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 1693
OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
# OF BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: WH
INSUL PATH: Pi
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 work day,
REQUIRED INSPECTIONS ---
FOOTING - After trenches are excavated,
FOUNDATION - After forms are erected but prior to concrete placement.
UNDERFLOOR PLUMBING - Prior to insulation or decking.
POST AND BEAM - Prior to floor insulation or decking.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
SANITARY SEWER LINE - Prior to filling trench.
STORM SEWER LINE - Prior to filling trench.
WATER LINE - Prior to filling trench.
ROUGH PLUMBING - Prior to cover.
ROUGH MECHANICAL - Prior to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
FRAMING - Prior to cover.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
DRYWALL - Prior to taping,
CURBCUT - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in place.
FINAL PLUMBING - When all plumbing work is complete,
FINAL MECHANICAL - When all mechanical work is complete,
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
SPRINGFIELD
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Job Number: 950698
Page 2
Total Height: 15
Lot Type: INTERIOR
Setbk From NPL: 75
Solar Approved: Y
Item
Main
Garage
Total Value
BUILDING PERMIT ---
Square Feet x
1133
560
$/Square Feet
56.20
14.10
Value
63,675,00
7,896,00
71,571,00
Building Permit Fee
Surcharge/Admin
349.00
27.92
TOTAL FEE
(A)
376.92
--- SYSTEMS DEVELOPMENT CHARGE (SDC) ---
(B) 1,588.05
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved.
PLUMBING PERMIT ---
Item
Residential Bath(s)
2
Fee
160,00
Plumbing Permit
Surcharge/Admin
160,00
12,80
TOTAL CHARGE
(C)
172.80
--- MECHANICAL PERMIT ---
Exhaust Hood
Dryer Vent
4.50
3,00
Mechanical Permit
Issuance
Surcharge/Admin
16,50
10,00
1. 32
TOTAL PERMIT
(D)
27,82
--- MISCELLANEOUS PERMITS ---
Sidewalk
Curb Cut
PLAN REVIEW
WILLAMELANE SDC
EL CTRICAL P~
MISCEl~EOUS PERMITS
(E)
20.50
13.90
40,00
400,00
124.20
t~..~f
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
2,764.19
9-t'uf\ .20
--- 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 construction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
Job Number: 950698
Page 3
- - - ADDITIONAL COMMENTS - --
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
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
. w;;; '~O. '""~,;::~)';.". ,",;., 0""'"0';00 Da~e~~ ~~~
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\ - -- VALIDATION
Receipt Number: c-9C'A~ \
Date Paid: 4, L .C\la
Amount Received: rf)f)1 ()CI.?D
Received ~1~LD~
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