HomeMy WebLinkAboutPermit Electrical 1992-12-8
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. . I e" "ubmitted haelhe following
The.foIlOVlmdgdPer~Ja'l~t r;qO uire epecific lend ELECTRICAL
zoning. anO ~ .
97/,77 approval. .
726-3769 Zoning l \)12...
Dete \ A - <1.......:'(d 3.
1. LOCATION 01' INSTALLAJ..J9.~thori.ed SignalUre ~.
?2 /~~~ ~ttE A.
225 ('IFTII STRImT
Sl'lUNGFmLll, OlmGON
INSPECTION REQUEST:
OFPICE: 77.6-3759
, ~
J:::L DESCRIPTION
11' _ ~~~ ~EiF
, . .
JOD DESCRIFfION ~ '
~.~~ -?:r;~
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance Or if vork is suspended for
180 days.
"
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City Job Number
'9 z I'!?~ '/
COMPLETE PEE scnEDULE BELOV
New Residential-Single or
Multi-Family per dwelling
Service Included: '
1000 sq.ft. or less
Each additional 500
sq. ft Or portion
thereof
Each Manuf'd lIome or
Modular Dwelling
Service or Feeder
Items
~
unit.
Cost
Sum
I
$ 85.00
as
$ 15.00 !t.S"
$ 40.00
D. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
2. CONTRACTOR INSTALLATION ONLY
Electrical contractor~.u.us t'~./.c..{,)
Address & \ {) \Uo. ~ ~ i 10
Ci ty f.u:v f\ (U Phone \ct\f\-\3\d\
Supervisor ~icense Number _'- q)~ \ ~
\G,\ ,qS
l\ 3f'J \na
\..0 ' G. Cl~
Expiration Date
Constr Contr. Number
Expi ra t ion Date
..;
i~ :
Signatu~ of Supervising Electrician
(&/,~-_. --'
Owners Nam~ f'r\ (\ fuM
~j
~ i
.:.l
{i
~:i
t:-l
r,
!.1
Address
Ci ty
Phone
!i
Ri
1:'1'
~.
,
,.
,
"I
tl
II
,:1
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
\"'5~rs Signe"'~: ^ .
/\ ~ fi9J.,L .
i -~----------------------~--------------
DATE: 0-7.0-:1
RECEIPT #: Ip ClC,I"
HECETVEIl Ily:m. ___" ,__ _._______
..!
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
D.
Dranch Ci rcuits
~ $ 40.00 ~
$ 55.00
$ BO.OO
volts see "R" above
New, Alteration or Extension Per Panel
One Ci.rcui t
Each Additional
Circuit or with Service
or Feeder Permit
$' 35.00
$ 2.00
not included)
Miscellaneous (Service/feeder.
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
LimIte!! Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$
$
$
$
I :/&'. -
/?~~
40.00
40.00
20.00
36.00
. . . . NO. C1'2-I"?b't
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: Goe.DO/J ~ ff:::.1<.t=.SA
LOCATION: <iZ7 r/tlf!:.wA-Y pu'tC-E
DEVELOPMENT TYPE: L:I?/L - Nt::.W L?~f?-
I
o :6!<./EE.tJ
OA<'T"~e
tA>r ~'-I
.,'
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
'-107'-1-
X $0.192 PER SQ. FT.
c:-, €yz. -z.~
--- --
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
1.'7
X $39.78 PER PFU
C;-qq~~
----------
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X /,005 X $401.05
(('-103 00
--
X
X
X $401.05
X $401.05
$
$
SUBTOTAL (ADD ITEMS 1,2, & 3) $ Z1I9'J.
4. ADMINISTRATIVE FEE~
BASE CHARGE (SUBTOTAL ABOVE) X .05
~
--- --
TOTAL-CITY SDC $'2..?,€>B/~
5. SANITARY SEWER-MWMC
NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN. FEE $'??D'?~
(Use PFU Total From Item 2 Above)
"
.
v - ~Lc..k
~ Kip Burdick
SDC Coordinator
ID/~/~Z.
$
TOTAL-MWMC SDC~~~
..... -
TOTAL SDC $ ~<o~9~~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CAlCA.At)N TABLE: Numbe'r of New FiXll.X. Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fIXtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
Bathtub"", ,,",,",,",", ",",,,",,",,,"",,,,,",",,,",", ",,,,,", '" """""""
Drinking Fountain, '"''""''"''''' """' '"' '"' "" ""'""" '","," "" '"'
Floor Drain","" '''' "" '"' '" "" ,,'""" '" ""'"""" ''',,'"'' '" ,,,",' '"
Interceptors For Grease/Oil/Solids/Etc"""",,,,,,,,,,,
Interceptors For Sand/Auto Wash/Etc""",,,,,",,,,",,
Laund ry 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"'""","""""""'"""''''''''''''''''''''
S hower, Gang"" '" '" '",'",'"'''''''''' ,,,,",' '",'"'''''''''''' '"'"
Sink, Bar, CommerciaL,,,,,"',,""""""""""'""''''''''''''
Urinal, Stall /WaiL..", ,",,,,,",'",",'"''''"''''' ,,,",' '"'' """'"''''''
Wash Basin/Lavatory, Single",,,,,,''''''''''''''''''''''''''
Water Closet, Public Installation,,,",,"",,,,,,,,,"",,,,,",,,,
Water Closet, Private"""'""""',"',,,,,,,"""',,,,,,"",,,,,,,""
Miscellaneous:
-z.
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
~
~
TOTAL FIXTURE UNITS
=
FIXTURE
UNITS
y
z.
"2
'Z
?
\'2.
z":>
Based on assessed value, If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates,
I Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
$2,83
2,76
2,71
2,60
2.46
2,33
1985
1986
1987
1988
1989
1990
1991
Credit for Parcel or Land Only If Applicable
x $ =
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $~,A
Improvement (if after annexation date)
Rate per $1,000
Assessed Value
$2,16
1.90
1.60
0,25
0,87
0,50
0,16
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential. "" ,"'.",,,,,,, '" ""' ,,,"," "" """' '"' """" ",,",", 0.4
Commercial, '" '" '" ,,' "" ,,",'" ," ,,""'" """""' "",",'" 0,9
IndustriaL, "" """ ""' '" ""' '" ,," ,," "" '",",'"'' '","," ,,'"" 0,45
GovernmentaL" ,,,,",' ,,,,",' ,," ,,' ''''','''''' ""'" ,,,, ""' 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
LOCATION OF PROPOSED WORt'"
ASSESSORS MAP'
?ll-
LOT:
DESCR'K. WORK:
NEW _ REMODEL __ ADDITION
· J!NUMBER~ \~
2.25 Fifth Street. ,
", Sprlngfleld,.Oregon 97477
j JlLt Y1-u ,:'0 lO 1\ l2-
G . TAX LOT' ~
SUBDIVISION: /~..Jj/J ---
.
. SPRINGFIELD
I'
:....~'.
PHONE: _to,yG (')2.,~
./
ZIP: _tJ71/1J c:;-
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR #
GENERAL: . ~ &j 1/}{QI!f!t!L /il!i.Lq ~
PLUMBING: Rtt/~lJJttf;mm d.J()t.mlft,;,~to 44n\(+.
MECHANICAL: I() tD 'i7ted- Q71 ~()'
ELECTRICAL: ~}41./}1!3 f!b; . ,:;)/() tll1IJ~ 0Zi 'I ':51 LoQ...
OUAD AREA:J Rt\lu__
# OF BLDGS' L ,_. '
OCCY GROUP: ~1Y~_
\
# OF STORIES:
G
WATER HEATER:
BLOCK'
([Jm~-f_ J
STATE: -IJ!J1_
.J
DEMOLISH
OTHER
EXPIRES
~
:~(g;<,
tOj.CJ.3
PHONE
~tX2sq
tjflI-7~
t.fK5 -7!JR
w- /302..
FLOOD PLAIN'
ZONING CODE:
1 0\2J
~
- OFFICE USE -
LAND USE: \ \ \ I
# OF UNITS' \ ~rJ
CONSTR. TYPE: ~ _
"IEAf SOURCE: ~G
V-I
RANG~'
# OF BDRMS:
SECONDARY HEAT: - ~ P
SQUARE FOOTAGE: rif')( tD..
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
rnaclu ttlO same working day. Inspoctlons requested after 7:00 a.m. will be made the following work day.
~ Temporary Eleclrlc
D Site Inspection - To be mado
afler excavation, but prior to
sOltlnO forms.
o Under.lab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
r'Q\ Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - PrIor
10 filling trench,
1"'\71 Underfloor Plumbing/Mechanical
~ _ Prior to Insulation or decl<lng.
~ Post and Beam - Prior to floor
~jnSulatlon or decking.
K:71" Floor Insulnllon - Prior to
.l.C'J decking. .
iY''"1 Sanitary Sewer - Prior to flIUng
~rench. .
T"5<( Storm Sower - Prior to filling
~' trench.
d Water Line - Prior to filling
!.)SJ trench.
.rv( Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
cover.
IDl Rough Electrical - Prior to
~ cover.
[2g: Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior 10
cover.
~ Drywall - Prior to laplng,
o Wood Stove - After I~stallatl~n.
o Insert - After fireplace approval
and Installation of unit.
lEI-Curbcut & Approach - Aller
forms are erected but prior to
placement of concrete.
[3( FInal PlumbIng - When all
plumbing work Is complete,
rvf Final Electrlca' - When all
~ electrical work Is complete.
lB' Final Mechanical - When all
mechanical work 15 complete.
r;;/] Final BuildIng - When all
~equlred Inspections have been
approved and building Is
completed.
fo'~' Iif~ ~\fi1'.U
MOBilE HOME INSPECTIONS
o BlockIng and Set.Up - When all
blocking Is complete,
, J'
o Plumbing Connections - When
home has been connected to
water and sewer.
l . .,. I"
.0 Electrlcal"Co'nnectlon - Wlien
blocking, set,up, and,plumblng
inspecitlons have been approved
and the home Is connected' to
the service paneL
o Fence - When completed. . 0'" .' ., . { , .
, IIlFlnal'- Aiter,.allrequlred" '
, '. ... .," ,." ...J~~PeCll:o;,siare;;.ai?p.!.2ved'a.';d:
rY.1 Streel.Jrees - When all. required ,,,-:, ,..,porct(es;~. s,klrtll1g;"deo~s, BQd. '
~ trees are planted,' . , ';'; " , ",venUng"liave. beenAnstalled:~ . :
r;Q SIdewalk & DrIveway - Aller
L!:l...Lexcavatlop Is complete, forms
and sub-case material In place.
.
Lot faces 4..; ),ot,:.",..
.Lot'~~,'flg\!VJ?i9'>>'t~'f~mW.
. (;~t.~.~~~;;::~:':.:t.~~..:e)4".~. C her'
''''~''''<',.'''' . <1"';:~7;,.-I.t'N.'~
TOPOg;aphY' ~.pan;;ndle
Total height ~ X. C:;;:de'sac
. .
BUILDING PERMIT
~
X,~S~..~b= 10SUOtLD
\4, \()F?'Cft)
-J
ITEM,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
. f,RL~ :HSE1HG'A'F\.I":cc I'
~"~!lJI),.~"'..I'
,~N'::.' ;:;.' '," .~ r,(J! ~,~ '".
I sJ ,,; I
Iw 1:Z~ I
LL- f)/:IVII. ~
m,oll
1./73. St::'
2~~
~~7./$
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
~u.~~
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s) NO ~
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
tJ X "'oj
Vent Fan
NO
Wood Stove/lnser~replace Un,!!:)
Dryer Vent
7~ff~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
State Surcharge
Sidewalk I:,t>
~ft
ft
Curbcul
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
I'9Z5C>
/92,.,;)(:>
9.~~
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;.::. ,.
-
e/., SIP
/2. tI>P
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'3?P
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4''2.5P
jc.p*
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___ "'HE PROPOSED WORK IN THE
_TORICJiLf DISTRICT, OR ON
~ .... <'; ,.... '. ~ . .. l;1",' .
THE' HISmRICALREGISTER?
. I j" '''1. '.";'- " u
I; yes, )hls application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
,~~:
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APPROVEP'
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 01 Springfield, Including Ihe
Development Code, regulating the construction and ueo of
buildings, and may be suspended or revoked at any time
upon violation of any p-rovlslons of said ordinances.
Plan Check Fee: ,1J[)f) .I')ct)
Date Paid: 1~ ,q 'd"
Receipt Number: ~~.llCL
R~~;~
i'1 vi ewed By
I .
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved,
R/7/ ,. ~-
Date
ADDITIONAL COMMENTS
\ ~(\th \
1
~l'L ~)iNO Ol1()t.!J
~f~/~ ~/.~,...;~
'A=~T--::AV,.-s- ~
',,#.L/" ~. ;L~" ,.,~'" \~'l\~?-
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By signature, I state and agree. that I have carefully examIned
the completed application and do hereby cerllfy that all
Information hereon Is true and correct, and I further certHy
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.
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.
Signature .J!lltLlb LI )
Date~zl-9? -
VALIDATION:
RECEIPT NUMBER (oCJS&
DATE PAID I~J! ''''....,
AMOUNT flECEIVED ~~&J~ '2t!:>
RE~EIVED BY GB