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Home My WebLink AboutPermit Electrical 2005-9-21 CITY OF SPRINGFIELD, OREGON ~I tiY~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 :o(\\\Q- . - -, ELECTRICAL PERMIT APPLICATION c\0-~~~o.-i\'.'" ".., A...... ,010 0\,0 City Job Number r.~ -0111')) Dat!<<-~9..~'" ./ - ~("I\\O~ ...6 l>- ./' - ./' 1. i LOCATIONOFINSTALlATION 3. I COMPLETEFE1i'S.9JlED[J~rprlfEL ./ I ~ .' u '",99'- 1-0" ./ k:7C/l?' G.1I1J~r:., ~ __,0 LEGAL DESCRIPTION A. I New Residential- Singlr.-rMn1'tf-F:lIIli1y per dwelling unit. JI!>D 2-0 1''1 Dol 436 . . Service Included ,..O\,f"O JOB DESCRIPTION 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof 5J,,<~ f-.../L, ruJ~ Permits are non.tratsferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CONTRACTOR INSTALlATION ONLY I Electrical Contractor 7;':/t'J1?x.J L?J Ai Address .1?3 At'))C C; /) 51 '-/ ~ City Y/jJ/ Phone 979'8...>- Supervisor License Number .:3c9 / '/ S Expiration Date /GJ - /--- !) b Constr. Contr. Number / /h :~ .d 9 . Expiration Date //J ~ /- 1";) k> , . Signature of Supervising Electrician ~~^,W~/s.~ v1 ) L> - -- o~nersName ~o~rJ Address ~~ '0e3 City ~l~ Phone ~1!t'\C161 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 J 2... J"_DO -:r." DC> $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B.I 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 AmpsNolls Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. I Temporary Senrices or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. I Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 E. I Miscellaneous (Service/feeder nol included) -Each Inslall:llion ] Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 SlJ1HU1ALOFABOVE I \~rJJ ~ .00 tt :10 ("B.4B 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnsIElectricnl Pennit Application 1-03.doc CITY OF aNGFIELD SYSTEMS DEVELOPME.ORK~HEET JOURNAL OR JOB NUMBER: COM2005-01185 NAME OR COMPANY: Hayden Homes LOCATION: 60669uartz TAX LOT NUMBER: 1802033400188 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF: 1536 LOT SIZE (SF): I. STORM DRAINAGE 5388 r; I~ ,0 U 0:: ~ tIl G ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I I 2090.00 I $0.323 I = I $675.07 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 1 I I 0.00 , 1 $0.323 I I 50% = I ITEM I TOTAL - STORM DRAINAGE SDC $675.07 ~ 2 SANITARY SEWER - CITY DISCOUNT $0.00 $675.07 11070 A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 20 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 20 $19.07 ITEM 2 TOTAL - CITY SANITARY SEWER SDC COST PER DFU $25.07 5501.40 11091 I 5381.40 11092 = , $882.80 A. REIMBURSEMENT COST: I ADTTRIPRATE I x 9.57 I B.IMPROVEMENT COST: I ADTTRIPRATE I x 9.57 I I NUMBER OF UNITS I x I I I I COST PER TRIP $19.09 x INEW TRIP FACTORI 1.00 I , 5182.69 1 1093 I 3 TRANSPORTATION ITEM 3 TOTAL - TRANSPORT A nON SDC I NUMBER OF UNITS I x I I I I = I COST PER TRIP $84.19 5988.39 x !NEW TRIP FACTORI 1.00 5805.70 1094 4~ SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER ~F FEU's I x ICOST PER FEU I I $82.03 = 582.03 11054 B. IMPROVEMENT COST: I INUMBER OF FEU's I x ICOST PER FEU I I I I $865.31 = 5865.31 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) 50.00 1054 MWMC ADMINISTRATIVE FEE 510.00 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , 5957.34 I SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 53,503.60 J 5 ADMINISTRATIVE FRR', -I I SUBTOTAL x I ADM. FEE RATE 1= CHARGE I I $3.503.60 I 5% I $175.18 I TOTAL SANITARY ADMINISTRATION FEE: 107.18 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $68.00 1078 Cheryl Slaymaker 9/2/2005 TOTAL SDC CHARGES = $3,678.78 PREPARED BY DATE . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTIJRE UNITS (NOTE FOR REMODELS. CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 2 0 3 . 6 = I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 !INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR. SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER / MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 !SHOWER. SINGLE STALL 0 0 2 = 0 ISHOWER. GANG ~BER OF HEADSt 0 0 2 = 0 ISINK: COMMERCIAURESIDENTIAL 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 2 0 1 = 2 IURINAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INST ALLA TION 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 single familv dwcllin,g unit (20 DRJs) set at 167 ~Ions ner day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/SI,OOO 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 IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE 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 AITER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 o TOTAL MWMC CREDIT SO.OO = Community Services Division -.dingSafetY/BuildlilgCOdeS "PRIN.O ,..."... -'-'JI..'J:1i-"1:1:n"l~;I:J/..~'J:{';;e:J.'h'~ ~ DEVELOPMENT SERVICES DEPARTMENT -a:: *' ~"""""'~""""''''''''''''''I (541) 726-3753 FAX (541) 726-3676 Notice to Permit Applicant Soils stabilization required for subdivision sites Name ofOwner~1l\ ~ Permit: ~..\)~S Address of Project: \Om12\.o ~,\YH.t~ Tax Map: _ '0')~ Tax LotIDCCf6 Subdivision ~( ~ The building site at the above address is located on property that has soils prone to shrink-swell or other potential movement. Excavations, placement of fill materials and drainage for this site must be done under the direct supervision of a properly licensed Professional Engineer or Architect to verify the stability ofthe resulting building pad and the site. The owner, or the owner's qualified agent, is responsible to obtain the services of the appropriate professional engineer or architect (design professional). The design professional shall provide direction for the stabilization methods to be used for the building pad (and surrounding site, when site stabilization is also necessary). The geotechnical report, which was prepared for this subdivision, may be utilized to provide appropriate guidance for the methods of stabilization and required compaction for the specific site. The engineer or architect shall prepare a report to be submitted to the City stating how the soii stabilization is being accomplished, including requirements not yet completed (if any). A signed and stamped report from the engineer or architect must be received and aoorDved bv this office before fDotim! or foundation insoection aooroval will be f!ranted bv the City Buildinf! Insoector. ACKNOWLEDGEMENT: The undersigned acknowledges the forgoing requirements for soil stabilization, including excavation, fill, soil compaction and drainage, as provided in the geotechnical report for the subdivision. The stabilization will be accomplished under the direction of a licensed professional engineer or architect as noted above. Signature Name ~ 4 --:-/).4, ~ , J Date q:-2?-o:J Affiliation to owner 225 Fifth Street. . Springfield, Oregon 97477 54':1-726-3759 Phone , . .!"",,~'.__Q!1~ ___ _ "_. Wit-.' , - , ~ i 'WI ' "H'" :i Job/Journal Number COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 CbM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 COM2005-01185 Payments: Type of Payment CreditCard .( 9/27/2005 RECEIPT #: 2200500000000001346 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit (Street) 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 Building Permit 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Heat Pump -Mechanical Issuance Fee- Plan Review Major - Planning Appliance Not Listed + 7% State Surcharge + 10% Administrative Fee PaId By JEFF HARRISON HAYDEN HOMES Received By ddk Check Number Batcb Number Page I of I ~ty of Springfield Official Receipt .velopment Services Department Public Works Department Date: 09/27/2005 Item Total: Authorization Number How Received In Person 037841 Payment Total: 12:14:20PM Amount Duc 31.00 1,000.00 106.00 38.00 80.00 80.00 (30.00) 675.07 501.40 381.40 182.69 805.70 82.03 865.31 10.00 107.18 68.00 633.90 254.00 12.00 18.00 9.00 6.00 4.00 12.00 10.00 150.00 9.00 77.13 110.19 $6,289.00 Amount Paid $6,289.00 $6,289.00