HomeMy WebLinkAboutPermit Electrical 2007-3-14
~ . .
225 FIFTH STREET II
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELECTRlaERM1T APPLICATION
City Job Number 02-00 2Z8" -0 I
L LOCATION OF INSTALLATION
Z I Z 0 tH--oDOht:tV/)~ON
3. COMPLETE FEE SCHEDULE BELOW
LEGAL DESCRIPTION
1'70 S Z'-(I.{ Z
00500
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
JOB DESCRIPTION T., ''''''''''noproieclessubmi'OO()~Ift1I\\lI~9
; ,..ooes nol requireei'c!'ti'fiadffignua~e500
. ., .'"'' LVtZ ~q. fi or portion .
PermIts are non-transferable and expire i'on'"-j_ UI\;I!;VI
if work is not started within 180 days " "? ' ,'I' o:t:'"b HaRuf~ 'L:co'. or
of issuance or if work is suspended for ..' ~odular Dwelling
180 days. .. :.>'gnature Service or Feeder
$106.00
$ 19.00
$ 50,00
2. CONTRACTOR INST ALLA TION ONLY
Supervisor License
B. Services or Feeders
InstallatiN'O'/\'\,"'I!!ons or
Relocation: .
THIS PERMIT SHALL EXPIRE IFTHE WORK
200 amps ~J'f$~ORIZED UNDER THIS PS:WOli IS NOT
20 I amps ~~vll:'\W;ED OR IS ABANOdi~.:9POB-
401 amps tot6~ amp.'., $125,00
601 amps tY'l'6d&QrhjiSY PERIOD. = $163.00 =
Over 1000 amps/volts $375.00
Reconnect Only $ 50.00
Electrical Contractor
Address
City
Expiration Dat
,
Constr contr. Number
C. Temporary Sfrvices or. Fee,1ersrequifes you to
Installatffli1;fiiIttl9t'N;lrlb~liY.llocffiB'bregon Utility
follow rules adopt90tly f h
"'" _....... C."",. ""'" rn..
201 am~AA1953rR@.;1-0010througIt6A s.by--
Over 009th I\(JJJ.QllIj1&I obtain coples'Ot- 8ll.9--
Over 60<ool\ln9lttulflOOIYtltfs ~te. If I tlo
"B" abonumber for the Oregon Utility Not ca n
Center is 1-1l00-332-2344).
D. Branch Circuits
New Alteration or Extension Per Panel
Expiration Date
Signature of Supervising Electrician
Owners Name (;~~y 15b(l.V\ft-+~..k:
Address 2/20 ,2I.-udod"'....d"'-- s-l-
citv S? p;::, Phone 726 - b2i (
One Circuit
-.l $43.00
43
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Each Additional Circuit or with Service /
or Feeder Permit l $ 3.00 ....E....
Owners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting-
Limited EnergylRes
Limited Energy/Comm
$50.00
$50.00
$25.00
$45,00
(}I
1:00:t13IHS\;I:J
: 39N\;IH:J
6g'609 $ 6:0:J3t1 lW\;I
6006 V1 t1\;1W:31\;lO
90~8000-10:#SN\;Itll
Minimum Electric Permit Inspection Fee is $45.00 +
Surcharges
TOTAL
'-19
3'1:>
3'tZ
-6" ~ S-
~ -
4. SUBTOTAL OF ABOVE
7% State Surcharge
80/0 Administrative Fee
..
~
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
- - -
JOURNAL OR JOB NUMBER: 02-00228-01
NAME OR COMPANY: GREGORY BERNATZKI
LOCATION: 2120 RHODODENDRON
TAX LOT NUMBER: 17-03-24-42 TL:500
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS: 0 BUILDING SIZE:
11. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. 1,.1 COST PER S,F. I
I 356.00 I $0.273 =1
I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERV10USS.F. 1,1 COST PER S.F. Ixl DISCOUNTRATE 1
L 0.00 --.-J $0.273 I 50% =1
fITEM 1 TOTAl:.: STORM DRAINAGE SDc - - =1
2, SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's 1..1 COST PER DFU
I 0 I $21.37
B, IMPROVEMENT COST:
1 NUMBER OF DFU's 1 ..1 COST PER DFU J
L 0 I $16.24
liTEM 2 TOTAL - CITY SANITARY SEWER SDC
h 3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE 1 xl NUMBER OF UNITS 1 x' COST PER TRIP I) NEW TRIP FACTOR I
I 9.57 0 I $16.21 I 1.00 =1
B. IMPROVEMENT COST:
I ADTTRIP RATE 1 xl NUMBER OF UNITS I xl COST PER TRIP
I 9.57 0 $68.94
- -
t ITEM 3 TOTAL. TRANSPORTATION SDC
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
III NUMBER OF FEU's 1..1 COST PER FEU
I 0 $332.86
B. IMPROVEMENT COST:
I NUMBER OF FEU's 1,1 COST PER FEU
I 0 $34.83
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL OF MWMC REIMBURSEMENT, IMPROVEMENT & CREDIT
MWMC ADMINISTRATIVE FEE
o
SF
LOT SIZE:
Ixl NEW TRIP FACTOR I
1.00 1=1
=1
ITEM 4 TOTAL - MWMC SANITARY SEWER SDc
SUBTOTAL (ADD ITEMS I, 2, 3, & 4)
5, ADMINISTRATIVE FEE:
I SUBTOTAL 1,1 ADM. FEE RATE
L $97.19 5%
I $:lw<.~
soc COORDINATOR
3/6/2002
TOTAL SDC CHARGES =
DATE
o
$97.19
$0.00
$97.19
=1
$0.00
=1
=L
$0.00
$0.00
$0.00
$0.00
$0.00
=1
$0.00
=1
=1
=1
=1
=1
=1
$0.00
$0.00
$0.00
$0.00
$0.00
$97.19
=1
$4.86
$102.05
SF
CI)
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Cl
o
u
-~
~
CI)
>-<
c.:J
~
II
I 1070
1091
11092
J
I
1
1093
I 1094
1 J
1055
1056
I 1073
J
.
~
'.
r DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS 'j
(NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
( # NEW # OLD ) UNIT FIXTURE
FIXTURE TYPE x EQUIVALENT = UNITS
BATHTUB ( 0 0 ) x 3 = 0
DRINKING FOUNTAIN ( 0 0 ) x 1 = 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 ( 0 0 ) x 3 = 0
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 REFRlG / WATER ST AnON / ETC. ( 0 0 ) x 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. ( 0 0 ) x 3 = 0
SHOWER, SINGLE STALL ( 0 0 ) x 2 = 0
SHOWER, GANG (NUMBER OF HEADS) ( 0 0 ) x 2 = 0
SINK: COMMERCIAURESIDENTIAL KITCHEN ( 0 0 ) x 3 = 0
SINK: COMMERCIAL BAR ( 0 0 ) x 2 = 0
SINK: DOMESTIC BAR ( 0 0 ) x 1 = 0
WASH BASIN ( 0 0 ) x 2 = 0
LAVATORY ( 0 0 ) x 1 = 0
URINAL, STALL/WALL ( 0 0 ) x 5 = 0
TOILET, PUBLIC INSTALLATION ( 0 0 ) x 6 = 0
TOILET, PRIVATE INST ALLA TlON ( 0 0 ) x 3 = 0
MISCELLANEOUS Dru TYPE NUMBER OF EDU's'
0 0 ) x 20 = 0
TOTAL DRAINAGE FIXTURE UNITS =1 0
II *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 OFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEP ARA TEL Y
YEAR CREDIT RATE PER $1,000 I YEAR CREDIT RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
\979 OR BEFORE $4.92 1990 $2.06
1980 $4.83 \991 $1.64
1981 $4,77 1992 $1.45
1982 $4.64 1993 $1.3\
1983 $4.47 1994 $1.13
1984 $4.30 1995 $0.97
1985 $4.09 1996 $0.82
1986 $3.78 1997 $0.63
\987 $3.4\ 1998 $0.41
\988 $2.98 1999 $0.22
\989 $2.52 2000 $0.04
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON)
IL-
VALUE /1000 CREDIT RATE
0.000 x $0.00 =1
0.000 x $0.00 =1
TOTAL MWMC CREDIT =L
$0.00
$0,00
$0.00