HomeMy WebLinkAboutPermit Electrical 2003-11-17
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3~llOI 00~ .
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ELECTRICAL~IT 'PLICATION .\0\\00,,0
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City Job Number .~'O\Date I ~0(), ) ., 1,0" ,0"'''' 1,.0"
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1. i LOCATION OF INSTALLATION _ "l 3, fCOMPLETEFEESCHEDV'!:<I}.BE!cI'JW
L~~ \T~\l U.XllV
LEGALDE~~P~?N 0' ~
n[')3'~3 \\'2.0
JOBpESCRlP ION ~~
~: non- d eXPir~fwo~k~
not started with' 80 days of issuance or if work is
Suspended for 180 days,
'. )~~r:':: ,-' " CiTY OF_S.L,_dNGFIELD;-OREGbN,~;'--~~ "\'c,;:,;:I'\
. '. . - ~ . " -~ t' . - "" j , . .... . .
2. i' CONTJ0.CTOR IJySTALLATIONONLY I ~,t'?f.:~;'e~ ~r'Feeders - I!lstaUation, Alterations ~r Relocatio!': ',~
\. 'C:I' ,\.' '.' u "0 "/';' 'T, '1,
Electrical Contrnctor ~ ').eo.. '1\1 S '- ~ V&>~Ol)l~;~~le~s
[) Q 0 "" OQl~. 20 I cAmp! to 400 Amps
, Address 1'. e>, \)O'!-- ~ ~ g $" "-'6 ~4of~;;'ps~f8;60'0:Amps
\9..... ~ ;>0 ? '<9. '(9 "
^ 1-60 I> Allps 'to,1 000 %ups.
'-~ ~ (.1 -.:J", v)': ",A .....,. 't~
6>., 0ver"\1000'Amp.slVolts::;' '<>
;'! .~ '''' V_, 'D ",.. <9 ,.,
^Reconnect Oi1.Iy" -'" 0 ,."
"'f> -~ ~ '-0 o~ ~~ :;..";; 'le~
~ '\ 2>.. ~~ G~~ ~..,.. l,;
C I T' !;l,. ,., S", . ,.., ~)E;qb-'
. . . emporary'. .eq:tces~or.... eeu~ers
"0 ~~. "<9 }'" $'.9. <1'", -~, '<"
....::" t't ~ '.ItO l<,'7..,. ~
InstaUa tion;,i\lteration,or'.ReIoca tion
~ '0 -;0 "'/- V. ' . l
200 Amps orT~s:::;~0", ~o? <'<>u- <" ~>"
201 Amps to 400 Ariip's <9 -
401 Amps to 600 Amp~"
City
{Ml:rve.,
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0..'140)-
Phone
Q'3 S- - SSO~
Supervisor License Number
'S'6\~ ~
Expiratioo Date
/6, 01-
200Li
Constr. Contr. Number
0{\ S-7~
Expiration Date
C - AD - ?-ooZ1
Sign~ of Supervising Electrician
D~ ,p .-:
Owners Name t\ctlUa..- ~ t ~
Address ~ 0 l ftxx "14-15
City ~ ~ . Phone 14-4. 'lic&D
OWNER INSTALLATION
The installation is being made 00 property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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A., i, N~w Residential ~ Si~Ie or. Multi-Famil)' per. d,velllng' u!lit. J
Service Included
1000 sq, ft. or less
Each additional 500 sq, ft, or
portion thereof
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K1.LV
$106,00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50,00
$ 63.00
$ 75,00
$125,00
$163.00
$375,00
$ 50,00
$ 50.00
$ 69.00
$100,00
J
ffi .cxJ
O~er 600 ArIiPs or 1000 Volts see "B" above.
D. , Branch Circuits
<'.
Nl1)4~ion or Extension Per Panel
~Wr&i~ $43,00
~ ~~d~nal Circuit or with
'c~~der Pewit $ 3,00
o>."h0:-/'
~49-<;C --
E. ~iI~ll,(,;-p~'(Sen:ice/feeder not included) -Each Installation ~
~ -..-'Y~ . . ,
'"o?l ~'~
Pum~irVlla1?~~ $ 50.00
SignlO~~~~~ $ 50.00
Limited Ener~e~m~ $ 25,00
Limited EOergy/~~i~.' $ 45,00
Minimum Electric perm1Unsaec~ Fee is $45.00 + Surcharg~\
4. I SUBTOTAL OF~~~~-- . i ~\~~
\49\l
f] J .:l{)
NGl .1J
7% State Surcharge
10% Administrntive Fee
TOTAL
Shared Drive(T)/Building Forms/Electrical Permit Application 1.03.doc
CITY OF SAGFIELD SYSTEMS DEVELOPMEN'-ORKSHEET
JOURNAL OR JOB NUMBER: Com2003-0 I 131
NAME OR COMPANY: Future B Homes
LOCATION: 836 River Knoll Way
TAX LOT NUMBER: 17032343 tl 1 1200
DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF: 0 LOT SIZE (SF):
I. STORM DRAINAGE
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" \o'*'~,se
7883
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u:i
E-
ell
G
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DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S,F, x I COST PER S,F, CHARGE I
I 3579,00 l $0,290 I = I $1,037.91
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUS S.F, I x I COST PER S,F, I x I DISCOUNT RATE I 1 DISCOUNT
I 0,00 I $0,290 I 50% = I $0.00
ITEM] TOTAL - STORM DRAINAGE SDC '$],037,9]'
$],037.9]
1070
'2, SANITARY SEWER - CITY
A, REIMBURSEMENT COST:
I NUMBER OF DFU's I x 1
25 I
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 25 1
COST PER DFU
$22,64
$566,00
I
1091
COST PER DFU
$17.21
$430.25
1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = ,
3, TRANSPORTATION
A, REIMBURSEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNITS I
I 9,57 1 1 I
B. IMPROVEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNITS I
I 9.57 1 1 I
ITEM 3 TOTAL - TRANSPORTATION SDC
$996.2S
x 1 COST PER TRIP x INEWTRIP FACTORI
I $17.23 1.00 1 $164.89 1093
x I COST PER TRIP x INEW TRIP FACTORI
I $76,01 1.00 1 $727,42 I 1094
= , $892.3 ]
4, SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's 1 x ICOST PER FEU
I I 1 1 $314,63
B. IMPROVEMENT COST:
INUMBER OF FEU's I x
1 I 1
=
$3]4.63
1054
ICOST PER FEU
1 $214.23
= $2] 4,23 1055
($]7.71) 1054
$]0,00 I 1056
I
J
I
119,82 1079
$52,56 11078
= , $3,620.00
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = ,
SUBTOTAL (ADD ITEMS], 2, 3, & 4) = ,
5, ADMINISTRATIVE FEE:
I SUBTOTAL I x 1 ADM, FEE RATE 1=
I $3.447,62 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$521.]5
$3,447.62
CHARGE
$172.38
Virginia Jurasevich
PREPARED BY
11/17/2003
TOTAL SDC CHARGES
DATE
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW AXTURES x UNIT EQUIV ALENT ~ DRAINAGE AXTURE UNITS II
(NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE .1
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 2 0 3 = 6 ~I
IDRINKING FOUNTAIN 0 0 1 = 0 I
IFLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE lOlL I SOLIDS I ETe. 0 0 3 = 0
hNTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0
ILAUNDRY TUB 1 0 2 = 2
CLOTHESW ASHER I MOP SINK 1 0 3 = 3
----- ----.---.-..
CLOTHESWA'HhK - j UK MUKh LhAl 0 0 6 = 0
IMOBILE HOME PARK TRAPfl PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG I WATER STATION I ETe. 0 0 1 = 0
RECEPTOR FOR COM, SINK I DISHWASHER I ETe. 0 0 3 = 0
SHOWER, SINGLE STALL 1 0 2 = 2
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCiAURESIDENTIAL KITCHEN 1 0 3 = 3
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LA V ATORY 1 0 2 = 2
ISINK: SINGLE LA V ATORYIRESIDENTIAL BAR 1 0 1 = 1
IURlNAL, STALL! WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET. PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 25
.EDU (Equivalent DwellinJ!: Unit) is a discha~ equivalent 10 a single family dwelling unit (20 DRYs) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RA TE/$I ,000 'I
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT?
BEFORE 1979 15,04 (Enler I for Yes, 2 for No)
1979 $5,04 IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? 0
1980 $4,95 (Enter I for Yes, 2 for No)
1981 14,88 BASE YEAR 1998
1982 $4,75
1983 $4,58 CREDIT FOR LAND (IF APPLICABLE)
1984 $4.41 VALUE I 1000 CREDIT RATE
1985 $4.20 $38.49 x $0.46 = , $17,71
1986 13,88
1987 1350 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3.07 VALUE I 1000 CREDIT RATE
1989 12,60 $0,00 x $0.46 ~ I 0
1990 $2.14
1991 11.71
1992 lI.52 I TOTAL MWMC CREDIT = $17,71
1993 $1.38 I
1994 $1.19 I
1995 $1.03 I
1996 SO.87 I
1997 10,68 I
1998 10,46 I
1999 10,27 I
2()()() 10,09 I
2()()I 10,04 II J
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 11 31
COM2003-0 I 131
COM2003-0 11 31
COM2003-0 11 31
COM2003-0 11 31
COM2003-01131
COM2003-0 11 31
COM2003-01l3I
COM2003-0I131
COM2003-01131
COM2003-0 1131
COM2003-0 1131
COM2003-0 11 31
COM2003-0 11 31
COM2003-01131
COM2003-0 1131
COM2003-01131
COM2003-0 11 31
COM2003-0 11 3 I
COM2003-01l3I
COM2003-01l3I
COM2003-01131
COM2003-0 1131
COM2003-01131
COM2003-01l3 I
COM2003-0 11 31
COM2003-0 11 3 I
COM2003-0 11 3 I
COM2003-0 1131
COM2003-0 11 3 I
COM2003-01l3I
COM2003-01l3I
Payments:
Type of Payment
CreditCard
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Receipt #: 2200200000000001832
Description
Addressing Assigrunent
Willamalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Sidewalk Permit
Curbcut Permil
PW Mull Disc - 2nd Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transpo Admin
Annexed 1998
Building Permit
2 Baths One or Two Family
Furnace - up to 100,000 bto
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Gas Fireplace
Heat Pump
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Plan Review - Planning
Paid By
JERRY BRAUNBERGER
Received By
dIm
Check Number
Batch Number Authorization Number
000238 088229
City of Springfield Officiat'Receip~
Development Services Department
Public Works Department
Date: 12/03/2003 2:48:02PM
Amount Paid
Item Total:
8.00
1,000.00
106.00
57.00
50,00
75,00
75,00
(30.00)
1,037,91
566,00
430.25
164.89
727.42
314.63
214.23
10.00
119,82
52,56
(17.71)
978.40
254,00
12,00
18.00
9.00
6.00
4.00
15.00
12.00
10.00
106.50
152.14
59.00
$6,597.04 .
.
.
How Received
In Person
Payment Total:
Amount Paid
$6,597.04 .
$6,597.U4