HomeMy WebLinkAboutPermit Electrical 2004-4-5
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPliCATION"
City Job NumberCcm2004 _ 002(5l{ Date
F.,,,.....w.-:-.- ;'1\.-.....- ..~.--r~ .......-:' -,--...... ". --'--- - . . _....-~.. -., - -,.-.--..
3. ::C.Oll~l'.i,.ETE;fEl' $CHEPuLf: !lELOM!': '.~ . ..,;"':, 'C
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1. ,LOCATION OF INSTALLATION . :'-. ; ,: I
I..;.._~..~.....:....:.::i.~.;,.:.....+-'- _ _:..:::~....._:.__.:~_......~_=---..:.... _.:'..
4D30 '5 ~cL/oud. ~\
LEGALD\~~( { \t'lJ)')
JOB DESCRJPTION
'_-=-":' ._.,.........-..;:;-..".,.~'i.~:..,... .~-"-l....... h,._:.,",.. :'3'. ~
A. H,.hyReS,iilerit!:i1-;~ingle or IVIiil.~~Family,per d\veUing..unit. i.
.._.'-'"'-___l:"._-..W' ..~_~..t;._,....:~__... _-".._........ .__,n,' _~...... .. ,__ "_~._~
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
$106,00
Povt:'<L
-'-t:\AA. f'
$ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
r:::-~- --" .""'~- ....-,~~.-:-.,..--"...--_..~,'..--------.
2. L 90NTR{1GT()J{ rN.~i~i,!piv"~NL~ j
$50.00
B. [~. ;!~~~'o;:F;~lt~r~';:~~t;i~~;;AI~r~'~,~;ns I~r .Rel~c;tio~~ ,,~
_ ..... _........-.._. _~.-.J
200 Amps or hiss
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNo1lS
Reconnect Only
~\O
C. : TeinPoi'aJm~f~~~~~~eder~. --~ :-.-:- ~ 1
L~#'0~~~~;~~." . -'--. ~--'---'
0~n'Stalla.ti8h\\~~aticyv~.!telocatjOn I
.O~ ~ '0'1 ~'" I"'I~Y\ ,\)\8 5- D
\o~. ~(J ~ 0~<\SS'. \"f:\0 0(10 $ 50.00
...~~-<'. "}'" '3-00 ~r~~~~9~ '3-~O(l $ 69,00
~\~~ ~v ~ (je~~j'At\'JJSq~~qo.~Tf!P\'\'C $100.00
\0" ,;r0-\'O,,,.OO ~'l€\~6.~~"o\~~1'Aod<~\llS see "B" above.
-\O~ ~"tJ- ~'3-'l~~rQ'ffil9."!7'f).'l;.1.' ----""r- ~-~'. --,
\(lO:o.~OU \"f:\~,~..efl'~~~I~~_._L:",__:,,_:_-, ~<_~_:._...J
00 C~\'(\~ ~ \O~'i.",A3teration or Extension Per Panel
_,,'1"'00 r One Circuit $ 43.00
, Each Additional Circuit or with
n \r..)/'R I.)' k Y Service or Feeder Permit
Owners Name '\J V ~ WI e C/ 12./
Address 3)--c Pp..vk.- V-~ \ \s E. ~Mis~c~ifa~~~'(;;r(Sfrvic~ii;;~~~1?~itluJed) :E;ch)~~~lIati~;;J
'~ "'- --- '/..?\\\t\\'--~\\ 1S,~IjL_- -~ -. - '-- - -
City V<Xj1A"'-- Phone h ~ b 9 'I) ? ,,~\~p Qf ~~\'J:....\\\S ?t.?- c.(\ rO\\ $ 50.00
( ~v S ~~~~~~l,)ill'ilti~ t><~I,)()~<-'" $ 50.00
OWNER INSTALLATION \\\~\rWii\ji1,~i5J~~e~~ential $ 25,00
The installation is being made on property I own which ~c.()\\~i~~\,\,,~~mmercial $ 45.00
IS ot IDtended for sale, lease or rent. Mip.iVlul>>~lectric Permit Inspection Fee is $45.00 + Surcharges
r1J7i1Y ':~:~:~APQvE~'=__-:-Ol-:~
u r V 10% Administrative Fee s-oo
Inspection Request: 726-3769 TOTAL <;:8 ~
$ 63.00
$ 75.00
$125.00
$163,00
$375.00
$ 50.00
Electrical Contractor
/
Address
City
Expiration Date
Constr. ctumber
Expiration Date
Signature of Supervising Electrician
$ 3,00
Shared Drive(T:)IBuiJding Fonns/ElectricnJ Pennit Application )..Q3.doc
" . .
CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN~ORKSHEET
JOURNAL OR JOB NUMBER: Com2004-00284
NAME OR COMPANY: Bruce Wiechert
LOCATION: 4030 S Redwood
TAX LOT NUMBER: 18020611 tI 10200
DEVELOPMENT TYPE: SINGLE FAMILY RESiDENCE
NEW DWELLiNG UNITS I BUILDING SIZE (SF' 0 LOT SIZE (SF):
I. STORM DRAINAG(;
DiRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS SF ,I COST PER S.F. CHARGE I
I 3156.00 I $0,290 I = I $915.24
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F, I ,I COST PER S.F, I, I DiSCOUNT RATE I I DISCOUNT
I 0.00 I $0.290 I I 50% = I $0.00
ITEM I TOTAL - STORM DRAINAGE SDC 5915.24
2, SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I ,I COST PER DFU
I 20 I $22.64
B. IMPROVEMENT COST:
I NUMBER OF DFU's I' COST PER DFU
I 20 $17.21
ITEM 2 TOTAL - CITY SANITARY SEWER SDC =,
3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE I ' I NUMBER OF UNITS I
I 9,57 I I I
B. IMPROVEMENT COST:
I ADT TRIP RATE I ' I NUMBER OF UNITS I
I 9.57 I I I
ITEM 3 TOTAL - TRANSPORTATION SDC
5797.00
.1
, I COST PER TRIP , INEW TRIP FACTORI
I $17,23 I 1.00 I
, I COST PER TRIP , I NEW TRIP F ACTOR I
I $76.01 I 1.00 I
= , 5892.31
4, SANITARY SEWER - MWMC
A, REIMBURSEMENT COST:
INUMBER OF FEU's I ' ICOST PER FEU
I I I $314.63
B. IMPROVEMENT COST:
INUMBER OF FEU's I ' ICOST PER FEU
I I i $214.23
MWMC CREDIT IF APPLiCABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER So( = ,
SUBTOTAL (ADD ITEMS I, 2,3, & 4) = ,
S, ADMINISTRATIVE FEE:
ISUBTOTAL I , I ADM, FEE RATE 1=
I $3.143.41 I I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
5538.86
53,143.41
5868
5915.24
5452.80
5344.20
5164.89
5727.42
=
5314.63
Ii'
18
I".,:
I~
'r/j
I~
1070
I
11091
~ 1092
11093
1094
1054
1055
1054
11056
CHARGE
$157.17
= ,
= ,
,
5214.23
50.00
510.00
103.32 1079
$53.8~11078
53,300:Jj
3/25/2004
TOTAL SDC CHARGES
=
Virginia Jurasevich
PREPARED BY
DATE
. . .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW RXTURES x UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS
(NOTE, FOR REMODELS. CALCULATE ONLY THE NET ADDiTIONAL RXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
IBATHTUB 1 0 3 = 3 ~I
IDRINKING FOUNTAIN 0 0 1 = 0 I
iFLOOR DRAIN 0 0 3 = 0
hNTERCEPTORS FOR GREASE / OIL / SOLiDS / ETe. 0 0 3 = 0
hNTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER / MOP SINK 1 0 3 = 3
ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRIG / WATER STATION / ETe. 0 0 1 = 0
I RECEPTOR FOR COM, SINK / DISHWASHER / ETe. 0 0 3 = 0
ISHOWER, SINGLE STALL 1 0 2 = 2
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCiAURESIDENTIAL KITCHEN 1 0 3 = 3
1~i1NK: COMMERCIAL BAR 0 0 2 = 0 I
ISINK: WASH BASIN/DOUBLE LA V ATORY 1 0 2 = 2
ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 1 0 1 = 1
IUR1NAL STALL/WALL 0 0 5 = 0 I
ITOILET:PUBLiC INSTALLATION 0 0 6 = 0 I
ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 I
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 20 :1
'"EDU (Equivalent Dwelling Unit) is a discharge equivalent to a sin~le family dwellin~ unit (20 OFU's) set al 167 ~l1ons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RA TE/$I ,000
ANNEXED ASSESSED V AWE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 0
BEFORE 1979 $5.04 (Enter I for Yes, 2 for No)
1979 $5,04 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 0
1980 $4,95 (Enter I for Ycs, 2 for No)
1981 $4.88 BASE YEAR 1979
1982 $4,75
1983 54.58 CREDIT FOR LAND (IF APPLiCABLE)
1984 $4.41 VALUE / 1000 CREDIT RATE
1985 $4.20 $0.00 X $5,04 ~ , $0,00
1986 53.88
1987 $3,50 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3.07 VALUE / 1000 CREDIT RATE
1989 $2.60 $0.00 x $5.04 ~ , 0
1990 $2.14
1991 $1.71
1992 $1.52 TOTAL MWMC CREDIT = $0.00
1993 5U8
1994 $1.19
1995 $1.03
1996 $0.87
1997 50,68
1998 $0.46
1999 $0.27
2000 50,09
I 2001 $0.04