HomeMy WebLinkAboutPermit Electrical 2002-6-3
,i,
225 FIFTH STREET .
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRIePERMIT APPLICATION
City Job Number OZ-o D I..{OO -0 I
3. COMPLETE FEE SCHEDULE BELOW
200 amps or less
20 I amps to,400 amps
40 I ar~p,s~t~~\60'0~mps
6p ~ aiil~s.toJ.O~~~mps
~ 0ver'l 000 'iiml!S!volts
t~'" v rn.' ~...- r ~-
...,,?- '{Recon-nect:Oiily}0 0
,,';'- '0'1 ~\)'- Or' '" '. o~ -
- .oJ' ",0 r;"'.r!i' !\~ o~ 'i!,0~
. ,.~., "0~'I. ~'(\O,C()\.Tcmporaf'y'.Services or Feeders
. \'.1 'l).v ,. \'" .-''C.I P." ~'\\"
.<-,' ~",,,, ;<:o,-e !;)'-() Installation,'J\lteralion or Relocation
\,,,, ~~ ~~ ~ G~()...<;j ::o'-~~ ~0,-0~~v.\~f)I><"
Expiration Date ,~~o ,:",,-\0 b(IP ~'\ 0 :l.e'2~PI,a~ps 'Or less -L
~o"" ~<?o 9J oY> ~ e C.e~ (20 ~;~mps to 400 amps
Signature of Supervising Electrician .,,0 ,,:-l ,,~,~'" '0~er 401 to 600 amps
\" R>v .~..." ,0' ~'
()<:5 c.~\..e~ 0~,-0 Over 600 amps or 1000 volts see
{\Y>~v G "B" above ^-'\-
. ~v~
d 1 I f D. Branch Circui~~ .;@
Owners Name-r; d t.J c- '7 "I e...r-- New Alteration o....~~~~r Panel
'7? ' L -(,~~<:o.((.
.Do......... ,-(;' V One Circui~ <t~' _ $43.00
Phone 71(./;- b$7b EachA~~~~uitorwithservice
orF~~~ . _$3.00_
~..;:s 9:0 ~
~ ~s (Service/feeder not included)
~~ - Ion
;...~ ~l;" of gation _ $50.00_
;j;) ~ine Lighting - $50.00
~d Energy/Res $25.00
Lllroted Energy/Comm $45.00
I. LOCA1'ION OF INSTALLATION
?:.l/7~ FALLOlo/ /)(l
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
/702. 19 Lf3
037()C>
JOB DESCRIPTION ;A -. ~~)l2.9h!goo,~uftwiJIgless
SF rL. W,*,.r&l6fi[ 'u~t require)lPeclBadlllfllllllfo~al 500
zonlOg. a sq. ft or portIon
Permits are non-transferable and'~~Pl~', vD,.t.. th ..~
if work is not started within 180 days zonlO~ .... ~ _ c> l. .Each MonnPq Wome or
of issuance or if work is suspen<\9dtIC- -K~odular D~elli.ng
180 days. Authorized Signature ~". vIce or reeder
2. CONTRACTOR INST ALLA TION ONLY
8. Services or Feeders
Installation, Alterations or
Relocation:
Electrical Contractor
Address
/
~
City
Constr Contr. Number
Address
J 777
S f?FD
City
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~
/
Items Cost Sum
$106.00
$ 19.00
$ 50.00
$ 63.00
$ 75.00
$125,00
$163.00
$375.00
$ 50.00
$50.00 SO
$69.00
$100.00
Minimum Electric Permit Inspection Fee is $45.00 +
Surcharges
;:;m
0~'6001 $
;:;00;:; m Nnr
1ji;>~6000-1O:~N\i~1
4. SUBTOTAL OF ABOVE
7% State Surcharge
80/0 Administrative Fec
TOTAL
:>0
'3:>.;>
'-{ou
(iS7~
.
6(.
,
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER: 20040001
NAME OR COMPANY: TODD WAGNER
LOCATION: JJgL..<- u ~ ............... I
TAX LOT NUMBER: i7=ul:19-43 TL:3700
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
I NEW DWELLING UNITS: 1 BUILDING SIZE: 2803 SF LOT SIZE: 6571
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I I IMPERVIOUS S.F'I xl COST PER S.F. I.
I 3096.18 $0.273
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUS S.F. 1..1 COST PER S.F. 1 xl DISCOUNT RATE J
L 0.00 $0.273 I 50%
I ITEM 1 TOTAL. STORM DRAINAGE SDC
2, SANTTARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's 1..1 COST PER DFU
I ~ ~137
B. IMPROVEMENT COST:
I NUMBER OF DFU's I " I COST PER DFU
I 29 $16.24
I ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3, TRANSPORTATIOI':!
A. REIMBURSEMENT COST:
I ADTTRIP RATE I "I NUMBER OF UNITS I xl COST PER TRIP I.INEWTRIPFACTORI
I 9.57 I I $16.21 1.00 =1
B. IMPROVEMENT COST:
I ADT TRIP RATE 1..1 NUMBER OF UNITS I x I COST PER TRIP J'
I 9.57 _ I I $68.94
I ITEM 3 TOTAL - TRANSPORTATION SDC
4, SANTTARY SEWER - MWMC
A. REIMBURSEMENT COST:
I NUMBER OF FEU's 1 " I COST PER FEU
I I $332.86
B. IMPROVEMENT COST:
I NUMBER OF FEU's 1 x I COST PER FEU
I I I $34.83
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL OF MWMC REIMBURSEMENT. IMPROVEMENT & CREDIT
MWMC ADMINISTRATIVE FEE
I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
-
I SUBTOTAL (ADD ITEMS 1.2.3. & 4)
5. ADMINISTRATIVE FEE:
SUBTOTAL I'l ADM.FEERATE
$3.109.66 5%
:r1191.(
~A '~CtV 1\(
I NEW TRIP FACTOR I
1.00 =1
=1
r.I)
w
Q
o
SF U
'0::
~I~
.:U r.I)
$845.26 I S
~
I
I 1070
=1
=1
=1
$0.00
$845<26
'Bj
1091
I
l
1092
=1
$619.73
1093
$659.76 _L 1094
$814.89 I I
l
4/23/2002
=1 $155.48
TOTAL SDC CHARGES =1$3,265.14
=1
=1
$470.96
$1,090.69
$155.13
=1
$332.86
= I $34.83
=1 ($18.87)
= I $348.82 I 11055
=[ $10.00 I 1056
T$358.82 --n
=1$\109.66 II
I
I
I
~~
SDC COORDINATOR
DATE
1073
.
.
:- .
,.
. DRAINAGE }fIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW RXTURES x UNIT EQUlV ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL RXTURES)
NO. OF FIXTURES DRAINAGE
( # NEW # OLD ) x EOU~ENT = FIXTURE
FIXTURE TYPE UNITS
BATHTUB ( 2 0 ) x 3 = 6
DRINKING FOUNTAIN ( 0 0 ) x I = 0
FLOOR DRAIN ( 0 0 ) x 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. ( 0 0 ) x 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. ( 0 0 ) x 6 = 0
LAUNDRY TUB ( 0 0 ) x 2 = 0
CLOTHESW ASHER / MOP SINK ( 2 0 ) x 3 = 6
CLOTHESW ASHER - 3 OR MORE (EA) ( 0 0 ) x 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) ( 0 0 ) x 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. ( 0 0 ) x I = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. ( 0 0 ) x 3 = 0
SHOWER, SINGLE STALL ( I 0 ) x 2 = 2
SHOWER, GANG (NUMBER OF HEADS) ( 0 0 ) x 2 = 0
SINK: COMMERCIAURESIDENTIAL KITCHEN ( 1 0 ) x 3 = 3
SINK: COMMERCIAL BAR ( 0 0 ) x 2 = 0
SINK: DOMESTIC BAR ( 0 0 ) x I = 0
WASH BASIN ( 0 0 ) x 2 = 0
LAVATORY ( 3 0 ) x I = 3
URINAL, STALL / WALL ( 0 0 ) x 5 = 0
TOILET, PUBLIC INSTALLATION ( 0 0 ) x 6 = 0
TOILET. PRIVATE INSTALLATION ( 3 0 ) x 3 = 9
MISCELLANEOUS DFU TYPE NUMBER OF EDU's'
( 0 0 ) x 20 = 0
TOTAL DRAINAGE FIXTURE UNITS =1 29
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DAJ's) set at 167 gallons per day
MWMC CREDIT CALCULA TION TABLE: BASED ON COUNTY ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEP ARA TEL Y
YEAR
ANNEXED
1979 OR BEFO~
1980
1981
1982
1983
1984
1985
1986
1987'
1988
1989
CREDIT RATE PER $1,000
ASSESSED VALUE
$4.92
$4.83
$4.77
$4.64
$4.47
$4.30
$4.09
$3.78
$3.41
$2.98
$2.52
I CREDIT FOR LAND (IF APPLICABLE)
CRED~FOR IMPROVEMENT (IF AFTER ANNEXATION)
YEAR
ANNEXED
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
CREDIT RATE PER $1,000
ASSESSED VALUE
$2.06
$1.64
$1.45
$1.31
$1.13
$0.97
$0.82
$0.63
$0.41
$0.22
$0.04
VALUE /1000 CREDIT RATE
29.952 x $0.63 =1
0.000 x $0.63 =1
TOTAL MWMC CREDIT =[
$18.87 I
$0.00 I
.$18.8I--1