HomeMy WebLinkAboutPermit Electrical 2000-6-30
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225 FIFTH STREET "4i/(j <'Oi}A l1o'~."~I11" ELECTRICAL"PERKIT APPLICATION .
SPRINGFIELD, OREGON 97477 ~.."" "q 'II'~.. &'lteaJ,11
INSPECTION REQUEST: 726-376~& ~iIle"IQ/""'i\! Job Number 00 -OO9/'t -0 I
OFFICE: 726-3759 (qoo. . .' 1""0 ""'0""" . '.
'c" "". Co~LETE""FE~ SCHEDULE BELOI/ .
1. LOCATION OF. INSTALLATION ", "'~......
Z,?,L/ I 'fa1(},O J1.. ~. 'if-.~eNe~ ntial-Single '0J: -. v:'
~ti~ily.per dwelling unit.
LEGAL DESCRIPTION " Serv Included:'. . . '
"DZ I Cf4?" C>9boO Items Cost Sum
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$ 85.00 ?$S,of)
$ 15.00 3o.(f()
--L
;:)
JOB DE$RIPTION
fA) /I1(){.p h 61AM. lA;--(J?)AA f-'
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor Jt1 ( ~ ~~
Address <PO bo;x 108 fo
City-1lib()(YVVb~~0~;~zJI_q(p7_ ~h17
Supervisor LicenseO Number ;}ffcg.J... S
......... _.
If), 1- DLJ
Constr Contr. Number ~L/2IS (l
!(J-!-OO
Services or Feeders
Installation, Alterations or
Relocation:
200 amps 9r less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnec t ,Only .
$ 50.00
$ 60.00
$100'00
$130.00
. -$300.00
$ 40.00
Expiration Date
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
200 amps or 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"
Signature of Supervising Electrician
X~,(!,~
Owners Name-Rr\^PA ()~ J.4- D.
Address ?O \$ 0)( zocrr.
City roa..v~\ ks. Phone 72b -0330
above
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Add it ional
Circuit or with Service
or Feeder Permit
$ 35.00
OlINER INSTALLATION
$ 2.00
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$40.00
$ 40.00 ;p
$ 20.00 =< --l
......-n
$ 36.00 ~
L.l"'" CI:l
5. SUBTOTAL OF ABOVE / (5. '2() ~~~
" --L JJ :z: I-'
7 ""% S ta te Surcharge, 'X . r.C;... I
TOTAL 31'; C{~ FJ..p ~)f~~g
'TcJ1a) _/~~~~~~
Owners Signature:
---------------------------------------
DATE: 062-900
"'~"J:..ln ii: 'Z'?,.h7
RECEIVED DY: ..D.1<
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DO~Ooql8'~OI
Job. No.
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: ~JV\ \JJ.k. p,w'1.tJ M A
.J
ADDRESS: ' ~Dr::, ~ ;),01-11
c.c1WO..l ,~,:)
LOCATION OF PROPOSED BUILDING SITE:
Street Address: ~ -:!>u,-:J- fGl\~ OI'~.J'oL
Plat Name: -A..1~~ Tax Lot Number: r=tOa lCll.l'l, q~Cl(3
PHONE: :rJG..O}}O
STATE: ()~ ZIP: q:}3~"
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. ,SinoIA-Fflmilv DAtflchAQ
ySingle Family home
Manufactured home not in a park
NO. OF UNITS
\
X $1,000 per unit = $ ,,~
B. SinolA.Fflmilv AttflchAd
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv AOflrtment
NO. OF UNITS
X $692 per unit = $
D. Mflnufaclurecl HnmA PlMli
NO. OF UNITS
X $699 per unit c $
WILLAMALANE SDC $
2. SDC CREDIT (If applicable) SDG-payer must furnish proof of
Willamalane Credit approval. See SDC Credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
$
\.000
I
AJ~~
Development Services OOpartment
City of Springfield
() I liLt 0 C-
Oate
.
.
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER 0000-918-0 I
NAME OR COMPANY: RIVER V ALLEY BUILDERS
. LOCATION: 3347 FALCON DRIVE
TAX LOT NUMBER AMBLESIDE LOT 96
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
DWELLING UNITS:
BUILDING SIZE:
1915
LOT SIZE:
5225
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2627.00
x
$0.232 PER SQ. FT.
$609.46 I
2. SANITARY SEW.':R,-crry
NUMBER OF PFU's
(SEE REVERSE SIDE)
18
x
$48.27 PER PFU
$868.86 I
3. TRANSPORTATION
NUMBER OF TRIPS x TRIP RATE x COST PER PM PEAK HOUR TRIP
x
x
1.01
x $486.73 PER TRIP
x $486.73 PER TRIP
TOTAL TRANSPORTATION SDC
$491.60 I
$0.00
$491.60 I
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's
x
$242.76
PER FEU
. $242.76 I
B. IMPROVEMENT COST:
$22.05 I
$0.00 I
$10.00 I
$274.81 I
$2,244.73 I
NUMBER OF FEU's
x
$22.05
PER FEU
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
TOTAL MWMC SOC
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5. ADMINISTRATIVE FEES:
BASE CHARGE (SUB TOT AL ABOVE) x
0.05
$112.241
~T~
SDC COORDINATOR
06/23/2000
-OATE
TOTAL SDC CHARGES I $2,356.97 I
.
.
PLUMBING FIXTURE UNIT (PFU) CALCULA TION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT = PLUMBING FIXTURE UNITS
(NOTE, FOR REMODEL~. CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
. FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASElOIUSOLIOS/ETC.
INTERCEPTORS FOR SAND/AUTO WASH/ETC.
LAUNDRY TUB/CLOTHESW ASHER/MOP SINK
CLOTHESW ASHER - 3 OR MORE
MOBILE HOME PARK TRAP (1 PER TRAILER)
RECEPTOR FOR REFRlGERA TOR/W A TER ST A TION/ETC.
RECEPTOR FOR COMMERCIAL SINK/ DISHW ASHER/ETC.
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: BAR, COMMERCIAL, RESIDENTIAL KITCHEN
URINAL,STALLAWALL
WASH BASIN/LA V A TORY, SINGLE OR DOUBLE
TOILET, PUBLIC INSTALLATION
TOILET, PRlV A TE INSTALLATION
MISCELLANEOUS:
FIXTURES
NEW OLD
1
UNIT
EQUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1
2
2
I
6
4
2
2
PLUMBING
FIXTURE
UNITS
2
o
o
o
o
2
o
o
o
o
2
o
2
o
2
o
8
o
o
o
TOTAL PLUMBING FIXTURE UNITS=I 18
CREDIT CALCULA TION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL
L YEAR . RATE PER $1,000
ANNEXED _ _ASSESSED VALUE
1979 or before $ 4.47
1980 $4.38
1981 $4.32
1982 $ 4.20
1983 $ 4.03
1984 $ 3.88
1985. $ 3.68
1986 $3.38
1987 $ 3.03
1988 $ 2.62
RATE PER $1.000
ASSESSED VALUE
-
$2.18
$ 1.75
$ 1.35
$1.17
$1.03
$0.86
$0.71
$0.57
$0.39
$0.18
YEAR
ANNEXED
1989
1990
1991
1992
1993
1994
1995
. 1996
1997
1998
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
x
x
$0.00
$0.00
CREDIT TOTAL $0.00