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Home My WebLink AboutPermit Electrical 2005-9-28 CITY OF SPRINGFIELD, OREGON ,.' SPRINGFIELD. ^~~y--.J 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 '-~ '~~ "- .6X',\ . 1" ELECTRICAL PERMIT APPLICATION . i-"~ _r- ./ City Job Number C.yo//6":t Date ~;;2.~o'~ ;.y~ I. i LOCATIONOFINSTALLATION 3. I COMPLETEF~~4;';;'iiBE~~~ bD':f2.... {;) ~ M ~~o"\,,~~'O\ \"Q,/~/ LEGAL DESCRIPTI~:; ~ A.I New Residentii'i~Sing~O:~-.f~oKt~dwelling unit:-l J .Oz.. 0-'< "'~JLU. . /" c;4:1~'- V ~:>T .,.... r:>7 Service Included 'O' <I ~ o ~\'1-0 1000 sq. ft. or less ~"\,,o Each additional 500 sq. ft. or P?rtion thereof \ \p,s {J~~ r_JJ, n.tJd-eL- Permits are nou-transferable and expire if wo'rk is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or $5000 Suspended for 180 days. Feeder . 2. I CONTRACTOR INSTALLATION ONLYx-l,\'<:\'i:.1~~frvices or Feeders -Installation, Alterations or Relocation: ~\~- ~'\ \'" Electrical Contractor ,~/lf'!I. J I.(frlf\ \'~ \) "IJ'20o Amps or less $ 63.00 , 'V'IC:. :\ S,<:\\X x.\' ,\$-.\ 'NIJ'(.S 201 Amps to 400 Amps $ 75.00 Address f~\~'~f~\~'7~ €:!rtf"'~ 401 Amps to 600 Amps $125.00 . . \\\\~,<:\IJ\,\1.'t.~M"'~~Cl.$' 601 Amps to 1000 Amps $163.00 City 0.t r/' 1-.'0 i\\~\1iOh't!~~< - CJO..;2. ~ver 1000 AmpsNolts $375.00 J c,\.)\~ \co\:, Reconnect Only.. . . '-0 $ 50.00 \'.~...-, .. , ' _~,\u~..\~'\ . Supervisor License Number -:> CJ 17 S c. I Temporary Services.o"r Fecder~r .)',.: ^ \oz,'" eO' v -oz"e "~7;\:)v' " I II' '1"" ,,\\ \ ~ ~ "'j . '0, nsts atlOn,'C-A teratlon oIjRelocatioDv\e"j ....v U' 'eo....... se \ '^ U" e (" ",e 2014Amps or'less ",\,o o' ,Q)" 0' ~\ ~'0.o" $,50.00 , \ \"- u-. \ :\ lV.\ 0" ",,\2'01- Amps"'to,400Amp'S' R,eS ~e \e\u.\"X,.\,' $ 69.00 ~\ \\>'- r.\?" "'~'- . ,,0 \)0' ~'U' ~\401 Amps'to,600Amps o'-() "~,\'- ,,' . $100.00 \C ',\c.'I>\'~,'1'\:)u ,0'0" ,'\'I \)'-'" ~"",... ",-,Over600':.\mps,or,l 000 Vplts s,eetB" above. D\.~r,~Dch ~ircuit~ _, ' '.':\V' ".\\'. .,\. ,":) New...Alter~!ion o~\.Extenslon Per Panel One Girc'uit (j' Each Additional Circuit or with Service or Feeder Pennit JOB DESCRIPTION Expiration Date I~- J-IJ ~ Constr. Contr. Number ~ ~.:2 'J Expiration Date /0 '/-0 ~ A: ofsupervisi~l~hiCian (/ _ ) "-1-=:1' ~L, ,x Owners N~ Wt 11\ ~ (\ ~f\ Address ~91f:>? City ~ . Phone 'l:~p,.\{\2l 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 I / a..-. $106.00 2 1'8,BD $ 19.00 !Y $ 43.00 $ 3.00 E.I Miscellaneous (Service/feeder nol included) -Each Inslallation I Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 SUBTOTAL OF ABOVE I I44JO \ O.DJi \4 :1U Jloj. 4<1> 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding FonnsfElcctrical Permit Application I.03.doc .i . CITY Qf StiNG FIELD SYSTEMS DEVELOPME.ORKSHEET 'JOURNAL OR JOB NUMBER: COM2005-01183 NAME OR COMPANY: Ha1::den Homes LOCATION: 6072 q!,artz TAX LOT NUMBER: 1802033400189 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 1642 LOT SIZE (SF): 1. STORM T1RAINAGE 5395 r- I'" I~ ,0 u ~ ~ '" o ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE 2165.50 I $0.323 = I $699.46 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I, x ! COST PER S.F. I x I DISCOUNT RATE I I 0.00 I I $0.323 I 50% 1 = ITEM I TOTAL- STORM DRAINAGE SDC '$699.46 2 SANITARY SEWER - CITY DISCOUNT $0.00 $699.46 11070 A. REIMBURSEMENT COST: I NUMBER OF DFUs I x COST PER DFU 21 I $25.07 $526.47 11091 B. IMPROVEMENT COST: I I NUMBER OF DFU's I x 21 I $19.Q7 $400.47 I 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $926.94 J 3. TRANSPORTATION I A. REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI . I I I $19.09 I 9.57 I 1.00 $182.69 11093 B. IMPROVEMENT COST: I I ADTTRIPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTOR I 9.57 I I I I $84.19 1.00 = $805.70 11094 ITEM 3 TOTAL - TRANSPORTATION SDC =, 5988.39 J 4 SANITARY SEWER - MWMf: I A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I I 582.03 = $82.03 1054 B. IMPROVEMENT COST: INUMBER ?F FEU's I x ICOST PER FEU I I $865.31 = , $865.31 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) , 50.00 I 1054 MWMC ADMINISTRATIVE FEE = , 5]0.00 I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $957.34 I SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) ~ , $3,572.13 I 5. ADMINISTRATIVE FEE' I SUBTOTAL x I ADM. FEE RATE 1= CHARGE $3.572.13 I I 5% I 5178.61 TOTAL SANITARY ADMINISTRATION FEE: 111.10 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $67.51 1078 Cheryl Slaymaker 9/2/2005 TOTAL SDC CHARGES = , $3,750.74 I PREPARED BY DAm II . . ~ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS (NOTE' FOR REMODELS. CALClJLA TE ONLY TIlE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUIVALENT UNITS I BATHTUB - 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESW ASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 " IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG I WATER ST A nON I ETe. 0 0 1 = 0 I RECEPTOR FOR COM. SINK I DISHWASHER I ETC. 0 0 3 = 0 ISHOWER, SINGLE STALL 0 0 2 = 0 ISHOWER, GANG (NUMBER OF HEADS\. 0 0 2 = 0 ISINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 1 0 1 = 1 I URINAL, STALL I WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 21 :EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 JmI10ns per da" MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE I I I I I YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,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 ELGlBLE FOR ANNEX. CREDIT? (Enter I fnr Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000 CREDIT RATE $0.00 x $5.29 .' 2 2 1979 =, $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE I 1000 CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT t ~~, o = $0.00 Notice to Permit Applicant Soils stabilization required for subdivision sites Name of Owner ~ \..\nm..aD Permit: ~CO. n~~ Address of Project \.Dm'L~, nrl? Tax Map: \ <6ctl.o-o'3<\- Tax Lotj)(')\ ~'1 Subdivision ~a.s.ver ~ 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 of the 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 soil 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 aODroved bv this office before footinfl or foundation insoection aDDroval will be flranted bv the Citv Buildinfl 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 ~~A/c Date ?~7--r:tS- Affiliation to owner . 225 Fifth Street' . Springfield, Oregon 97477 , 541-726-3759 Phone . ~~I"Q~ao.. "._. __j ! ......4IIi.I,,; 1 ,____ ""I ; City of Springfield Official Receipt .elopment Services Department Public Works Department Job/Journal Number COM2005-0 1183 COM2005-0 1183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-0 1183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 CbM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-0 1183 COM2005-01183 COM2005-01183 COM2005-01183 COM2005-01183 Payments: Type of Payment CreditCard .' 'j :' 9/27/2005 RECEIPT #: 1200500000000001407 Date: 09/27/2005 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 Gas Fireplace Appliance Not Listed -Mechanical Issuance Fee-- Plan Review Major - Planning + 7% State Surcharge + 10% Administrative Fee Paid By HAYDEN HOMES Received By jmp I of I Item Total: Check Number Aull1orization Batch Number Number How Received 037392 In Person Payment Total: 12:20:22PM Amount Due 31.00 1,000.00 106.00 38.00 80.00 80.00 (30.00) 699.46 526.47 400.47 182.69 805.70 82.03 865.31 10.00 111.10 67.51 659.90 254.00 12.00 18.00 9.00 6.00 4.00 15.00 9.00 10.00 150.00 79.16 113.09 $6,394.89 Amount Paid $6,394.89 $6,394.89