HomeMy WebLinkAboutPermit Electrical 1993-1-11
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225 FIFTH STREET Zonine-b Tl ()<.
SPRINGFIELD, OREGON 9747'7:,.,. 1-11-1'3
INSPECTION REQUEST: 726-3707 SC' Ci ty Job Number
OFFICE: 726-3759 Authorized Signature ")
,!(lBri>ESCRII};rIOp,....j ~/t::.h.1Cf1000 sq. ft. or less
,,')\- \-'Ol\t(lQrla.o.~ \:on 0...J Each additional 500
sq. ft or portion
1.
3.
LOc,Al'ION OF ~A~LATIOau_P(n
y,~((} lllD) J:.S2J)
LEGAL DESCRIPTION
Permits are non-transferable and expire
if work is not started vithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor Palmer/Philips
Address 3170 Meadow Lane
Ci ty 'Eugene
Phone 688-6121.
Supervisor License Number ?71g~
Expiration Date .10/~2 fn-I-ct=)_
Constr Contr.Number 20 ~79C ~4:~ C.
q -IQJ1'j
Expiration Date
10/92
Signature (Of Superv~sing Electrician
/ I. '
, 1)~ .
- Nthant'h~ s ~
Ovners Name f:U i, flf\c::l: t)lrr~M--=>
AddresA~ ((1 t p -L~ rJlthl 2
City S -qOYW ,. Phone345-43l:'7
01lNER ~STALLATION
The installation is being made on
property'I ovn vhich is not intended,
for sale, lease or rent.
Owners Signature:
----------t::/1~~ -, --~--------------
DATE: I~~ .,,~
RECEIPT 1I: t-1 ,,\ \'f'-. )
RECEIVED nY: l:71f ! )0. ) I - -
-
COHPLETE FEE SCHEDULE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items
Cost
$ 85.00
thereof
Each Hanuf'd Home or
Modular Dvelling
Service or Feeder
~
$ 15.00
$ 40.00
B. 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
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
Sum
B5
. toO
4()
$ 40.00
S 55.00
$ 80.00
volts see "B" above
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Chcui t
Each Addi tional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
1f25~
-q.?c::,
~~-
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
. .JOB NO. '1'2-11090
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: c....LI SON ~ PLA--r~ (!f)l../~""" G>.
LOCATION: ~'5G. PAIJt.WAY FLR-c.e
DEVELOPMENT TYPE: U> fZ. - NE::vJ $FJ2...
LeT '2-~ tJAKTIZ.eE
BUILDING SIZE: LOT SIZF SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. '2-1?/ X $0.192 PER SQ. FT, c: .., 1 I.f ,j)
--- ---
2. SANITARY SEWER-CITY
NO. OF PFU'S -ZS X $39.78 PER PFU c; crq",~ ')
(See Reverse) ---- ----
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
f X I,oo,? X $401.05
~O:? .~)
-- ---
X
X $401. 05
X $401.05
$
$
X
SUBTOTAL (ADD ITEMS 1,2, & 3) $ f ~ , ,1.!?.
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
(( <:to t;f)
'- ---
TOTAL -C ITY SDC $ /1 () 1- 2--'1
5. SANITARY SEWER-MWMC
NO. OF PFU'S -z.? x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ?So ~
(Use PFU Total From Item 2 Above)
/,./. ~~tk
(J Kip Burdick
SOC Coordinator
11- 1t7 /,1.-
$ N.4.
TOTAL-MWMC SDC~'50 ~
---- ---
i'l
TOTAL SDC $ 7_'2-<;''2--
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCU~.N TABLE: Number of New FixtUres.t Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional flXlures)
NUMBER OF UNIT FIXTURE
FIXTURE 1YPE NEW FIXTURES EQUIVALENT UNITS
Bathtub......................................................................
Drinking Fountain. ...... ......... .......... ......... ............ ......
Floor Drain... ........ ......... ......... ...................................
Interceptors For GreaseIOil/Solids/Etc.................
Interceptors For SandlAuto Wash/Etc..................
Laund ry Tub /Clotheswasher....... ............................
Clotheswasher - 3 Or More.................,;..................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorjWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single StalL...............................................
Shower, Gang..........................................................
Sink, Bar, Commercial.............................................
Urinal, StalljWall.......................................................
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation.............................
Water Closet, Private...............................................
Miscellaneous:
'Z.
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
I
(
?,
~
TOTAL FIXTURE UNITS
q
7..
'2-
2-
~
1'2-
2S
Based on assessed value. If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates.
r ~
II 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 = $ N. 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
.'.1
. ,
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...:!
RESIDENTIAL
PERMIT APPLICATION
Inspections; 726.3769
Ollice; 726.3759
LOCATION OF PROPOSED WORK;
ASSESSORS MAP'
LOT;
211
.
SPRINGFIELD
9C;~~.~~.
BLOCK'
OWNER: ;P jJP,,,~___...t_r~!Jtj f!n..JtC G,.
ADDRESS: rJ.. <. c>4.'./jA 'I () Q..'\..J:i;_
rPJ. ~"AA ()
DESCRIBE WORK: _B-u:;, M /'n,) A /r ~L-
CITY:
NEW
\(
REMODEL
STATE: ~(/J/<
ADDITION
OTHER
DEMOLISH
· JOB NUMBER~~~qD
225 Fifth Street \'
Sprlngfleld,Oregon'97477
TAX LOT:
SUBDIVISION: ~
PHONE:
-:iilf-s-L.{347
ZIP: -!!Cl'y-QI
CONST.
CONTRACTOR'
co""~ """"
GENERAL: .. ~J &J:
PLUMBING: ~k
MECHANICAL:~' ( -t- .L-..;.
ELECTRICAL: j?,."p A/lARA- P j,;J,tl~
QUAD AREA: ,j. ~ Nu)
l
OCCY GROUP: ()..,?)-tN\
~
-'
. OF BLDGS:
. OF STORIES;
WATER HEATER;
EXPIRES
PHONE
I;;;O_~___7.- (13_-.-3ES~3.IL7
3:30:1<0 (p -q 3 ~8"_~..L.1.~1
5Sfn'ilJ.. hi. - q3 '_4iL..71o ,7
JO-I,qL. Ib-'13 ("R~-t,IZ.1
..
- OFFICE UiE -
LAND LISE: t \ l
. OF UNITS: l, r--.----
CONSTR. TYPE: _\LJ~L _._ ,_ ___
'HEAT SOURCE: F= l1_u
FLOOD PLAIN'
ZONING CODE: .L()R .J
. OF I3DRMS: --:L:f_~
SECONDAr1Y l,tEAf: '-1)f:.- -71-
[;QUARE FOOMGE: g,c:}3:_L_
To request an Inspec~lon, you must call 726.3769. This Is a 24 hour recording. All inspections requested belore 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.
gTemporary Elcclric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
'fVfFooting - After trenches are
~xcavated.
o Masonry - Steel locatlon, bond
beams, grouting.
l'Vf Foundation - AHcr forms arc
~erecled but prior to concrele
placement.
D
Underground Plumbing - Prior
to filling Irench.
K:7l Under(loo:(J~Jumi:)In~9chanic;.nl
~ - Prior to-':;j,:,u.""..Jd or decking.
rvt posi and Beam - Prior to froor
~insulatlon or decking.
1VT Floor Insulation - Prior to
~dccking.
~ Sanitary Sewer - Prior to filling
~ trench.
..:gr Storm Sewer - Prior to filling
Irench. .
fV"1 Water L1no - Prior to rilling
~ trench.
R:71" Rough Plumbing - Prior to
~over.
RANGE:
REQUIRED INSPECTIONS
f;7l Rough Mechanical - Prior to
~cover.
l':71' Rough Electrical - Prior 10
~ cover.
rc;7( Electrical Service - Must be
~ approved to oblain pcrrnancnl
electrical power.
~Fireplacc - Prior to facing
~materlals and fralning Insp.
J3( Framing - Prior 10 Gover.
~ Wall/Ceiling Insulation - "'riel! 10
~covcr.
~Dryw"lI - Plior to Inpill~l.
D Wood Stove - After in~;I:lrrali()ll.
o Insert - Aller flreplace :Ippn1v:lI
and Installallon of unl t.
""F=V( Curbcul & Approach - Allcl
~forms arc erected but prior 10
placement of concrete.
~ Sidewalk & Driveway - Arter
~ excavation is complete, forms
and sub-base material in plnce.
o Fence - When completed.
.
~StrcDI Treos - When;" n:!qllire(J
(.7 trees arc planted.
jgf Final Plumbing - When all
plumbing work is complete.
~ Final Electrical - When all
electrical work is complete.
~ Final Mechanical - When all
~echanlcal work is complete.
fV(Final lJuilding - When all
~ required inspections have been
npproved and bllildin{1 is
COlllplclcd.
l2?:l Other _qAL/...I,v&.__
,
,
MOBILE HOME INSPECTIONS
'--I OIocking emu Set.Up - When all
-- blocldng is complete.
D Plumbing Connections - When
home has been connl':?ctecl 10
water and sewcr.
I 1 Electrical Connection - Wilen
blocking, set.up, and plumbing
inspections havc been approved
and the home is connected to
the service panel.
I I Final - After all required
inspections are approved and
porches, skirllng, decks, and
venting have been in~lalled.
, .
Lot (aces ,~ lot Type Setbacks
J251 , ,
Lot sq. ftg. 1- Interiof ~ HSE GA_f:l_ ACC
Lot coverage aI% Corner _N__~___
Topography -p PanlwmJlc S L$.!?
--- --
Total height ~ Cul.de-sac .Y:L _ ..11-_
~_1
LJ.J.J3~
~'2. 5'0
. ,50
_~1:.'!
.5o.(p,~3
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
JJ. .,q
(B) 1f'Z'Z<7"2.. --
BUILDING PERMIT
ITEM SO. FT.
.;/0),(
53&>
X $/SO. FT.
,ro,2.0_
I '"I. te)
Main
Garage
Carport
T~lal Value
OlJilding Pcnnil Fcc
Stale SurcllC:lI!jC
Tolal Fcc
(A)
PLUMBING PERMIT
o
ITEM
Fixtures
Residential Balh(s)
N' '3
FT. -'ie-
----- ---
Sanitary Scwur
Waler
FT. ~
FT.
'Storm Sewer
Mobile HOlllo
PllJmbing Permit
Slale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
!"~"T~-i-
Wood Slove/lnsert I FilOplacc Unit
Dryer Vent
f\"lcctJanical PClrnit
Issuance
Slale Surcharae
Total Permil
(D)
MISCELLANEOUS PERMITS
Mobile Horne
Slate Issuance
State Surcharge
-9-+~ ft
Sidewalk
Curbcut --;)..,.1- It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, ;md E Combined)
VALUE
____-LI]s.3b,
7'ifff.
FEE
\~.5:"CL
-#.~,...:;
-----
~9,t;>~
_2L2Z!!
_.~ .~d
~~~
j2..qo
--3-,~
:;k5/:'iO
. Lt2,_ eo
.-I,?-~
_3 cp.7~
-2il.~
-/-3,5-~
3-1. '1"
_30~.PJ
. "HE PROPOSED WORK IN THE
HISTORtCAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be slgncd
and approved by the Historical
Coordinator prior to permit issuancc.
APPROVED:
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.
Plan Check Fee: ------3.12~ In
Dale Paid:
Receipt Number:
/
/'2../2..t/~
. IDate
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
W1:Eirt p ) '- CSifiau )(Jj j( )
-;P4Pll /AJ/-,l'_d.?:A.M/AV ~
By slgnaturc, I stale ancl agree, that I have carefully examined
the completed application and do hereby certify that all
informatlon hereon Is true and correct, and I further certify
lhat any and all work performed shall be done In accordance.
wlttl the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and Ihat NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance wilh GRS 701.055 will be used on ttlls
project.
I further agree to ensure that all required Inspections arc
requested at the proper time, that each address is readable
flom the street, ttlat 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 dw-anstructlon.
Signature r!/J/1 .Il^h~
. J' {/-
Dnl'"
(J..-/y~q Z.
VALIDATION: ~ c/ c:::::....
RECEIPT NUM1~Lj-_ I t) _ )
DATE PAID - ~
AMOUNT REC~-r-;;5,.::;z. ~ 0.'2.6
RECEIVED BY ~UJLL../