HomeMy WebLinkAboutPermit Electrical 2005-8-8
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",'\ " ,': ,:, 'CITY OF'. RINGFIELD; .oREGON.!' ':1 ::;,.. , .', . .
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SPRINGFIELD c::;:.,;'~=~
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225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ,; FAX: (541)726-3689 l5i'~..c.:~'C~.:i;i1
ELECTRICAL PERMIT APPLICATION .' i\\e<l(lt.9.\'1:;i\""'-~' ~
,olect as su""'e sgecillc '"
City Job Number ~ S::0o6 rn Date ' ,\,,\~!I~9 9 s not ,eqUll
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LEGAL DESCRIPTION fSrt:4I1"L- tD. r - :)
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JOB DESCRIPTION
~J/'j.f.., t;AJi. J'tMlld ! 7;-1
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days. .
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.\ CONTRACTOR INSTALLATIONONLY.L
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Electrical Contractor L €. E c ltc.J'\\ (
Address q a-- 6 j 3 ,I 0 (\.Q ') Au- -() R d
City Sr~ Id Phone '133-):5'18
Supervisor License Number
4\i'-t-s
01 C
01- ~ c:,dJ-
Expiration Date
10 -
Constr. Contr. Number I D 5l....J '( 5
Expiration Date 'S - 30 - n l.D
Signature of Supervising Electrician
f~
D ~0w~ClN\
Owners Name
Address
City
Phone
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
I
If
$106.00 /C>f.:>raD
$ 19.00 7-/?,oo
$50.00
B. f~s~!;~i;;~}~~F~~~J~i~n~~lt~~~tioris"~tReI6~~~i~J~~~~~~1
tJl.!..::l.:.~'.~"~~:"'~:' ';z._'l':',''i'''''':;::'\_:'.l.';[~J4.:~ ",~""~.,':"l....'" 'l\(~.:::.s.:....l
200 Amps or less $ 63.00
1'1,_........... ~
, :201 A1]1ps to 400 Amps $75.00
n:40F~ll)ps:tp ~90:1fP~x $125.00
"' ~'6ot' Amps !0l!Rq9!if'p~~'RE IF I HE well $163.00
Over 1000 AmpslN'ol~. S ~tl.l;,.1/ I IS l'i0$375.00
Reco~ne~t O~V~ .:"Jt-\I\!UU; ;cU ~Ufl '$ 50.00
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Installation, Alteration or Relocation .
rO,a:;)
/
$ 50.00
$ 69.00
$100.00
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D]~'~'":..>-';!"o;" "':"~:':"':;~':'p::;:';f~'~_~i:r-0~-:~J't..r,"!;J.,r~" ',t.:".: -:::i.,-,,,~..,~',
D. .Branch~Cl~cults;~fk~1::";i:f:-:~~~:"'~"'~" ,t'! ~~; -.;l:~'1t':8':~':~"I':.j
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,
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
~~jt5tSr beeder Permit $ 3.00
f~~T ~'-tlo-,.~.!?SlRrg~::V{f..gJij.r:.--:~,S~ 'J,.,,,:;,~' -::-. r''''''~'''''''-:-:''''' 1
N t.'fl. !fMiS~..ell:l\WJ@(SeAtice/feeder}n'ot'iitclude~):'Each'lnstaU:itioit "
o ItlcatlOn'Genrer:,-'t:l'-<;;""M""'''-'' i'~"""""~..-"":~'c."'~ .~"-,
. IIIU.:>t:: lules ~.j, t
In OAf).'a~-gPi1-rf/!i1igtihrough 0,\>1. $ 50.00
00901'1' S?gLJJOlliYiR[.i!i~'i\tillg')ies of II ,t' ",' -, $ 50.00
ca In~J the center IN(,J'p' 'r~ t I'
,1;1nuted.l:.ne;gjilResiCIential- e ~,,," ' $ 25.00
numtJ"r lunne u,eoon UI'I,',lv" 't I .
L' '\_n FnP' Ie mmerclal'" , 1(,,;,,u:1 $ 45.00
~l5merrs &Y.ou'1J-')')~-<::J44).
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
)?:~:r:..;:~~ :rf. ~':~.: c;:W;;~f '~c;~>.~;::r~C?c~:..: ,f"~r~~ :~;;1
4. :.SUBTOTAL OFAB.OVE,,,; "3~" :,,:' ., "-'" .\.. '
1'.w;......,:.::t.:.:...>~....:.;l--k..~"...:.t:::..:-~l.::;C:~~~-,...l.;::
7% State Surcharge
I 0% Administrative Fee
'23ZOP
/ ". z..<f
23,z'?
.f 7~/ .lfLf
TOTAL
Shared Drive(T:yBuilding FonnslElectrical Permit Application 1..Q3.doc
. CITY 'OF SplGFIELD SYSTEMS DEVELOPMEN.RKSHEET
JOURNAL OR JOB NUMBER: COM2005-00858
NAME OR COMPANY: Tim Peterson
LOCATION: 3348 Raleighwood Ave
TAX LOT NUMBER: Breanne Commons Lot I
DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF; 2690 LOT SIZE (SF):
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I
I 2489.00 I $0.323 I = I $803.95
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
I 0.00 I $0.323 I I 50% = I
DISCOUNT
$0.00
ITEM I TOTAL- STORM DRAINAGE SDC
$803.95
2 SANITARY SEWER - CITY
A REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 24 I
COST PER DFU
525.07
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 24 I $19.07
ITEM 2 TOTAL- CITY SANITARY SEWERSDC = I 51,059.36
,
3 TRANSPORTATION
A REIMBURSEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNtTS I x I COST PER TRIP x INEW TRIP FACTORI
I 9.57 I i I I I 519.09 I 1.00
B. IMPROVEMENT COST:
I ADTTRIPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
9.57 I I I I I $84.19 I 1.00
ITEM 3 TOTAL - TRANSPORTATION SDC = , 5988.39
8810
I
I~
10
18
10::
ILIJ
,I-
16
~
$803,95
1070
$601.68 II00t
$457,68 1092
I
I
5182.69 , 1093
$805,70 1094
I
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
i I I
ICOST PER FEU
I 582.03
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I $865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =,
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = ,
5 AOMINISTRATIVE FEE:
5957.34
$3,809.04
ISUBTOTAL x ! ADM. FEE RATE 1=
53.809.04 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
CHARGE
5190.45
Cheryl Slaymaker
PREPARED BY
7/812005
TOTAL SDC CHARGES
DATE
=
$82,03
t054
=
$865,31
$0,00
510.00
1056
1055
1054
~
I
124.44 I 1079
566.01 11078
=, $3,999.49
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT ~ DRAINAGE FIX11JRE UNITS
(NOTE: FOR REMODELS. CALClJLA TE ONLY TIlE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EOUlV ALENT UNITS
- 0 3 3
I BATHTUB 1 =
I DRINKING FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE I OIL I SOLIDS / ETC. 0 0 3 = 0
I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER I MOP SINK 1 0 3 = 3
ICLOTHESWASHER - 3 OR MORE rEA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRIG I WATER STATION I ETC. 0 0 1 = 0
I RECEPTOR FOR COM. SINK I DISHWASHER / ETC. 0 0 3 = 0
I SHOWER. SINGLE STALL 1 0 2 = 2
I SHOWER. GANG (NUMBER OF HEADSt 0 0 2 = 0
ISINK: COMMERCIAlJRESIDENTIAL KITCHEN 1 0 3 = 3
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
I SINK: SINGLE LAVATORY/RESIDENTIAL BAR 4 0 1 = 4
IURINAL. STALL I WALL 0 0 5 = 0
~TOILET, PUBLIC INSTALLATION 0 0 6 = 0
TOILET, PRIVATE INST ALLA TION 3 0 3 = 9
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0,
TOTAL DRAINAGE FIXTURE UNITS 24
-EDU (Equivalent Dwelling Unit) is a discharRC equivalent to a sin~le familv dwellinR unit (20 DFU's) set at 167 ~lons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
CREDIT RATE/$I,OOO I
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
=
$0.00
'1
I
I
I
I
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
t990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
SO.OO x S5.29
~ ,
SO.OO
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDIT RATE
$0.00 x $5.29
o
II
I
I
I
I
I
I
I
I
I
TOTAL MWMC CREDIT
II
I
:1
I.
I
I
225 Fifth Street ",'
Springfield, Oregon 97477
'541-726-3759 Phone
.
.11lt!'~.RI~~.FI~ -.- - ",.
; '... f
.1
':
- ,
.JiJ.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
GOM2005-00858
L!DP2005-00151
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
CbM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005-00858
COM2005,00858
Payments:
Type of Payment
Check
\
,
8/1/2005
RECEIPT #:
2200500000000001017
Date: 08/0112005
Description
Storm Sewer Each Addtl 100'
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Gas Outlets 4+
Gas Fireplace
Appliance Not Listed
-Mechanical Issuance Fee-
SDC MWMC Administration
SDC MWMC Reimbursement
SDC MWMC Improvement
Plan Review Major - Planning
+ 7% State Surcharge
+ 10% Administrative Fee
LDAP Short Form
Addressing Assignment
Willamalane Single Family
Residence Wiring, 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Sidewalk Permit
Curbcut Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tmnspo Reimbursement
SDC Tmnspo Improvement
SDC Sanitary/Storm Admin
SDC Transpo Admin
Plan Review Residential
Building Permit
3 Baths One & Two Family
Paid By
TIM M PETERSON
CONSTRUCTION
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
vI] 11190 11190 In Person
Payment Total:
Page I of I
1I:16:ISAM
Amount Due
28.00
12.00
6.00
9.00
6.00
4,00
1.00
15.00
27.00
10.00
10.00
82.03
865.31
150.00
114.85
164.07
300.00
31.00
1,000.00
106.00
76.00
50.00
80.00
80.00
803.95
601.68
457.68
182.69
805.70
124.44
66.01
25.35
994.65
306.00
$7,595.41
Amount Paid
$7,595.41
$7,595,41
......