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HomeMy WebLinkAboutPermit Electrical 1995-2-23 .;t:,!;~~~'" ;J..........r'~i7...l i-f5225/r...~..<1 STREET ',li-tS'p~!>FIJ;:LD, OREGON 97477 , j 'D /? (\'~,....,r-n4 ';II!.l:S<,6"uON REQUEST: '726-3769 Zoning \../ r~ Ci ty Job Numbe; '-'\~J.. y\ ',;[[OFFICE: 726-3759 ' . 'J L"> r.. --- ' :t;c';",.,'.i,": 'Dale~:/ 9-Vt) 3. COMPLETE FEE SCHEDULE BELOV ..',~;"(i~,:'!iQ<(ATIQ!f OF INST~TIOlJI.ut...borized Signature (J ~ . .:'~~~; ;L\A~\ 'I '\=fJK\\,rD \( R 7 A. New Residential-Single or 't~~~ '. ~ Multi-Family per dwelling unit. ~,,';fi;,,'i.'~'~..Jl~~ClW'AION Service Included: "'(::\'\'0 )H\ )'f'l'~ - 0040], Items (;,~:',:)2 ~~) - /~:.. '"":'..:.!OB DE~PT~~ _ ' .e- :'\'>;::'~-O ~ \.10 J::\ruD~ \or::s::\ 't~:~~~i~~_\~~> ~,,' _~'~'" . - 'i.;S~Permi ts are non-transferable and expire t;:;~{f.work is not started within 180 days .~~~~~{ofilssuance or if work is suspended for ,f,::J;~:.:.I'180"days . ~~.,~,:,:.,......,.,-",lo, :,"';7'''~'~ ~~~''''.~'- ,'; .:'\t~i:;.i ,2-; '" CONTRACTOR INSTALLATION ONLY .. :'-~~.,<;*':~-.' .., - " .' .?~;f~~'igi~ctrical Contractor R,r)se- C.orp. ~?~~~t:;{~~~i~~S~{b ))~ ~~ ' ,~~~~ttc~\~~~ )~l OR Phone fn8&,- 0Cta.&) "/'*^:f~4~t~;i~isor License Number 15'&" 'V~~i~~tion Date JO/' /'15 ,~}f~'!;\~:T';' c. 1t~f?~~,t,~ Contr. Number ~ ~O~J5.3 ~ "~;:E~;iration Date Q/30/ q 5' 1_J:;'),:,_'~ ....L':~- . . "":.t ,,;ii~4si~~ture of ervising Electrician Ij~:"t';i~';'P' ,,;;:'.,' /J' ~ "i_"i;:-.'~'~",:,,\~~'~..~"-'~-" . . '" ?/ ~~ j:'-;,;"'::1~?':"/.' s', r,/-'....'A< - - D. Branch Circuits ).,~'j~!lZ~:o~rie.rs Name M1'\.D:l..On \\W.O ~ '"',''',',;',~$,;:';',, '." _'V;;, _f'\Q r- , hI OJD ^....... New, Alteration or Extension Per Panel }S;;::p.~il'Addre.ss~ \ l1f' 1'1\ I \A1! . ~ IVL,.. 1A:';~~".~~1't:t;~-IA~ PhOn~()~q'l ~~~hC~~~~~~onal $ 35.00 .;:"~'.. ~L) LI.../"'\Il a.. Circui t or wi th Service };;'~<i1lNER I TALLATION lU LZ....) or Feeder Permi t $ 2.00 , . "..,... .' ~" ."" ~ 1 :i~l~h~~;nstallation is being made on "..{iti~1ipro~e:rty I own which is not intended ........,. '~"'ti.~,"f" 1__ - _.'-- 1 1 ''''f'~.~~.~. "}" or~,sa e, ease or reo t. ~~~:~~:t<t?~;f':".~~;;:~ ..; Hh;\";~""~"'OWn'-" . S' t ~<<;:~.;:(, ,ers 19na ure: [~.j,:'~.:r~'~-': <. .' . ~" .::'.~~~~~-:23~~-'~:;-~~~~-=~;--' 5. . . "" 'RECEIVED BY: ~.I'V'---/u - ' J ~;.... :~: :',.' Iv - . . . .. .' Temporary Services or Feeders Installation, Alteration or Relocation 4D 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: 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 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000, "":: ;;.t(~,":qi~i~~~f~ ,': ". d, ""r ",v.r"'I' , :'_. ,J,"," .~,~/". '."'. " <." S. . ~I },,:..;"*,.~~..,'r-l~~~~~~'~"'i ' , ." "'-lL ~hl1 ~.'-" ~;::":"'~l~~.,,:,"'i!"; t .:~;;:<:'" ! " Cost Sum $ 85.00 B; cQ $ 15.00 dtL $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 \ $ 40.00 $ 55.00 $ 80.00 see "B'" above volts not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation : Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ ~15,CO '\{)oQ ,"'):~...... ;)JlJc/J. .;-'1 ~'::.. -\. ~4 .;.IT) ') 40.00 40.00 20.00 36.00 r . ATTACHMENT Bl , .OB NO. '75"007''1 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMpANy: ~ ,i).-UJ. LOCATION: 1/ 5'0 F~. ,. DEVELOPMENT TYPE: S/ I) BUILDING SIZE: /951f.u..;u.) LOT SIZF' SQ. Ft. 1. ~mRM nRATN~ .~ IMPERVIOUS SQ. FT. ..t. 2f / X $0.209 PER SQ. FT. $ 1'1?i2 ,2. SAtilIARY SFWFR-CTTY . NO. OF PFU'S (See Reverse) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP If' X $43.26 PER PFU . .' s7!;r 'i. C. 6 . I X /,0 I X $436.19 $ +-10. S' :> X X X $436.19 X $436.19 $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) Vb..9~.of 4. SANITARY SFWFR-M'..JMr. NO. OF PFU'S l'i x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ '1/f',"/2. (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~J.~o . IQIAI -MWMC snr. ~~ S'.8Z.~ SUBTOTAL (ADD ITEMS 1. 2 . 3 & 4) $ / f ~~. '11'7 5. ADMTNISTATTVF FFFS BASE-QtARGE (:'TOT~OVE) X .05 ~ #V~ Date: ;;L-/3-?5~ / Harry Hornig, P.E~ SDMordinator $ '1 '1./ r IQIAI snr. , $ ;;'0 4"$. 0" B2.SDC . , , 4It . F!XTURE UNIT CALCUIrION TABLE: Number of New Fixtures X Unit Equivalent ~ Fixture Units (NOTE: For rcmodels. calculate only the tiEl additional fixtures) , , NUMBER OF NEW FIXTUI1ES :~~ '?i~;~l;O::-C:~'::::<'::;;~ _::".<:.~-.,~, ki _. . ' FIXTUI1E TYPE Bathtub............,........,.,.........,.,.,....,............,............. . Drinking Fountain.... ........ ..... ....... ..... .............:.......... Floor Drain................................................................ Interceptors For Grease/Oil/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher................................... Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailerl.................. " Receptor Fer Aefrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang.....".... ................................................. Sink: Bar, Commeicial, Residential Kitchen........................ Urinal, Stall/VVall. .:.................. .................................. Wash BasinlLavatory, Single.................................. Toilet, Public Installation.............:.......................... Toilet, Private:.................................................. ..... Miscellaneous: ',TANI TOJ?'.s S/;/J::' ~ I. z 2.. TOTAL FIXTURE UNITS VNIT EOUIVAlENT 2 1 2 3 6 2 ,6 6 ,1 3 2 1/Head 2 2 1 6 4 ~ ~ 1 FIXTURE UNITS 4 z 2. 2.. ~ /r CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. 'I Rate per $1,000 Assessed Value Year Anne,xed . .1979 or before 1980 1981 1982 1933 L'1984" 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 Credit for Parcel or Land Only If Applicable . Improvement (if after annexation date) 3..f~ x $ r. '7/0 (Rate X Assessed Value) X $ (Rate X Assessed Value) = = Rate per $1.000~1 Assessed Value $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 J ). ,,() ~ CREDIT TOTAL = $ 3$..~o -- . ~ o !!!il\i!"!!,~~!!~ Job No. q~4 SYSTEMS DEVELOPMENT CHARGE WORKSHEET N~~M, ~Q~ PHONE:MlDGHf)4f)J8 ADDRESS: ~ l-pfl\b\.Q. \Jt ~)~ - STATE: WAzlP qR2.,~\a' LqCATION OF "'ROPOSED BUILDING SI~: - t)~ ' , Street Address if Known: 4 \~) tfJ~ ~ \ r\ ) Platt Name: --U-(X"':\n , Tax Lot Number: JPI::ld\Jf:\ f\ (\ . \~ ~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back.) A. Sinl!le Familv - Detached Single Family home NO OF UNITS I B. Sinl!le Familv - Attache<! NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS Manufactured home not in a park $4If)~ X $400 PER UNIT .=., . X $370 PER UNIT = '$ X $277 PER UNIT = $ X $280 PER UNIT = $ WPRD SDC $ 4f1)fD $r:Y $4fx.)cxJ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit! ~~~~ ~ ,,9,?-J,Gt"i RESIDENTIAL PERMIT APPLICATION Inspections; 726.3769 Office: 726.3759 LOT' NEW . SPRINGFIELD BLOCK' OTHER . q 5Dr:Pv1 JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: CD'\D';') SUBDIVISION: ZIP: C{2\. ~L\; LP CONST, CONTRACTOR' EXPIRES ~() ... ~.~.qs CONTRACTOR'S NAME \\. .~. ADDRESS GENERAL:\,\t).ill M .J\.JLU'_., ' PLUMBIN(>' ~~b ~ ~ 4 f'i\I)~ MECHANICAl' Ul\ M r\ Y\ ~ ~ ELECTRICAL:\ ~r)~ (~~ QUAD AREA:';:;''V...S~ . OF BLDGS: l OCCY GROUP: ~3 1- ~ c9, B . OF STORIES: WATER HEATER' ?SCl52Jo . 'l)L\4,~ \ - OFFICE USE - IU I . OF UNITS: l CONSTR. TYPE: J~ HEAT SOURCE: 1-'>= .'"' 9~ LAND USE: RANG~' PHONE cOil) .1nS ~.~s.qs ~ql).1f)2Pl q . &J.q:; 1o~~y{'~l'5 FLOOD PLAIN' ZONING CODE: ~ . OF BDRMS: 3 SECONDARY HEAT: -.ff SQUARE FOOTAGE: 19CB- TO request an Inspection, you must call 72~.3769. This !s 8,'24 hour recording. 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. D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms, ~nder$18tiPiumblnh"1h=lectrical J ~ ~echanl~~ cover. r:-:::y"'Footlng - After trenches are L:J ~xcavated. D Masonry - Steel locatlon, bond .beams, grouting. 0~oundatlon - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench, .0' Underlloor Plumbing/Mechanical , '.- Prior to Insuletlon or decking, [3 Post and Beam - Prior to tloor Insulation or decking, rr;:Y'F!oor Insulation -\ Prior to'. \ ~ decking, : .. ,- o Sanitary Sewer :.- P;tor' to filling' tr-ench. @Storm Sewer - Prior to filling trench. ......;, " .....,( Water Line":' Prior-to' filling ~ trench. '..' ~.. m -.J . , .I, . Rough Plumblng'-'Prlor to cover. . , REQUIRED INSPECTIONS ~OU9h Mechanical -.Prlor to cover. ~ough Electrical - PrIor to cover. W":lectrlcal Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~Framlng - PrIor to cover. ~all/C'elllng Insulation - Prior to cover. [LJ15ryWell - Prior to taping. D Wood Stovo - After Installation. D Insert - After fireplace approv~1 end Installation of unit. , .. ~ ~Curbcut & Approach - After forms are erected but prior to placemont of concrete. ~dewalk & Driveway - After excavation Is compiete, forms and sub.base material In place. D Fence - When completed. D' Street Trees - When all required trees are planted. .' . ill Hnal Plumbing - When all plumbing work Is complete. ~Inal Electrical - When all electrical work Is complete. W'!lnal Mechanical - When all mechanical work Is complete, ~nal Building - When all required InspectIons have been approved and building is completed. DOthar MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected 10 water and sewer. D Electrical Connection - When blocking, set-up. and plumbIng InspectIons have been approved and the home is connected to the service panel. D Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Lot faces L?t sq. ltg, Lot coverage Topography Total helghl( GS.Er _ r9$~ ~",~J' '. I BUILDING, PERMIT ITEM 'SQ, FT, , J LPCf1 ~~ Main Garage Carport Total Value Building Permit Fee I Stale Surcharge: 1- -oo;D, '. I . Tolal Fee Lot TY. _ Interior ~ Corner Panhandle Cul.de.sac Selbecks I PL. I HSE GAR I N I S I W I I I I ~I &PD =q~~ It.IO-', 'lnrBi (A) - i / ... 1M 4L\j 15C\ .'l:) , ~~C::) .13 . "::LILt .CG I , SYSTEMS DEVELOPMENT CHA,RFE (SDG) . . I' . (B):? !O ,/[3. 0<;' PLUMBING RERMIT , ITEM I FEE Fixtures , ,I Resldenllal Bath(s) l Sanitary Sewer 'I I I , I I ! , I I Water Storm Sewer I Mobile Home Plumbing Permll State Surcharge :-+ 3% I , Total Charge I (C) 1 MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan ! Wood Stovellnserl/Flreplace Unit Dryer Vent I I Mechanical PermW Issuance State Surcharge Total Permll N' --Q FT. FT, FT. N' (D) I MISCELLANE9US PERMITS Mobile Home State Issuance State Surcharge Sidewalk \ rz\?~ 'ft Curbcut :El'J It Demolition )/~O,dJ 1LolJ.cO (rG.~ /7ri.'tP to.CO 4-.~ C\cD ,3.00 r--~ .~ JD .m 1 g( 34,~1 ~.M '\4.S) r\ate sUrCharge, I \ A ) _ Ui) \A'lX\ f\. C\X' ),:. no > [J.I. . Tolal MlscellaneoJjmils (E) TOTAL AMOUNT DjE (excluding eleclrlcal6B1? ~ (A, B, C, 0, and' E' C?mbined) _'_n~_.n_ _.. I / , '. \','." . I, IS THE PROPOSED WORK IN THE. . "HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. Accl I I ,APPROVED: , BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permll is granted on the express condition that lhe said construction shal!. In all respects, c()nform to the Ordinance adopted 'by the City ,of. Springfield, including the Development Code, regulating the construction and use 01 buildings, and may be. suspended or'revoked at any time upon vlolatlon of any provisions of said ordInances. " ' ..?- Date Paid: , Receipt Number: ~ Received By: ~ . Plan Check Fee' / Plans Reviewed 8y Date , Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved, ADDITIONAL COMMENTS ~ T: <--\' r"J \ f) \,~f\f\g '}L lO:/ rf') ~1\D..Dldr'? :~k\o.~ \ j)()bh \ By signature. I state and agree, that I have carelully 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 01 the City of Springfield, end the Laws of lhe Slate of Oregon pertaining to the work described herein, and that 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 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 properly, and the approved set of plans will remain on the site a all times during construction. Slgnat ~Cio /Vlb^ ./ Date Feb ;)d): ) q 96 VALIDATION: 1\ /'\ '2.0Ci RECEIPT NUMB~ r'V s...X ( \ DATE PAID 0) A\~.L1... '\ AMOUNT R';;Jrn~l a.loO RECEIVED U)~