HomeMy WebLinkAboutPermit Electrical 2004-8-3
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (54,l),7Q>>o-3689
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ELECTRICAL PERMIT APPLICATION . / '.O,or;:>- ~O~~{)
City Job Number ~B.&o4 - OOG 83 Date $, "", -o~ /) <1/ 1)0' O':r%
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LEGAL DESCRIPTION
17.02. .32 . 43. O~C:;Db
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1.
A.
ew Res,identilil-
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JOB DESCRIPTION
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Ea'ch Manufact'd Home or
Modular Dwelling Service or
Feeder '
$50.00
~
Permits arJnon-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
B.
.OWNER INSTALLATION
2.
Electrical ContractorEv eN--'oTXw CLzJ ~ ct lv--e...,)OO Amps or le~O\1 \0
. I I J 20~~e~\\~>>\'J
Address P/YlB I 32 b5W-I JJIVI SloJJ.~fego~m~~'~~~g~~p~.
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City E ~N? 97'1cH Phone b~~~f"(~~\5~f\\et. ~~~GQ~~\~~~g,'Il\~~e
'\\Ca\\O (\0"\.00 ~ec8~a~)~e\e\1~ . n
~O\\ gf;)2-v ~\a\f\ . \\,\e . \ca'U.O
Li / 0 ~ Q~~ OU {(\a'l 0 'J~G\e: '\~\f 'l
Supervisor License Number -, b D~~C\.'{ ~ece~tL :~~
/ (') 1// V - ~\\f\g); \\,\e Qte O~. ,
Expiration Date .4ir1(YY-1 ~~'oet~~{\\e' \t.n\t~ation, Alteration or Relocation.
200 Amps or less
I "3 b 3 r; ) 20 I Amps to 400 Amps
1// 1/ JOG :;- 401 Amps to 600 Amps
I ~v~r~88~,~~~,~,\1000 Volts see "B~' abov,e.
Signature of Supervising Electrician D. b!ll~~~:.~lt~~it'
/7 / -/ #/"'-) New Alteration or~~sTO~~er\P~f-
~~J1<. ..z....AL/R#.::t:zr ~\~rre.Cir\Cfit,\\r>-\\. ~~\S?t: \~D rG\"\ $ 43.00
,. ~Q c.~S~dditie?~U<u~ui~0r\wfA~
Owners Name .~_ W I /. ~......,. \\\\~~~~l\oPFe~~'f~I~ii{' $ 3.00
,~~ I\~ ~.~~C.\L'~Q.l(\t\. ..~~.. _,.._..,,~~ ..
t"' ii\;""'tt'\~'\'~~ ~r 0" J_~~;' o"'" '~"'~" :1; -.. ,,"-''',;f "$ , ~&'l*"~''i{ '" "'P~f.t....}~~
Address p{J ,~I'~ ~, ~ ~\~~~{)eMi\~!l}~. ~~rviC,ll"fe~~e~ nott~n~!pd~d),~~~~:~,n!~~~ti,~f.1:.~
City ~uL Phone 5l~-;J~ ~~ump 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
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Constr. Contr. Number
L--' $ 50.00
$ 69.00
$100.00
5"D
Expiration Date
. ~
The installation is being made on property I own which
is not intended for sale, lease or rent.
7% State Surcharge
10% Administrative Fee
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Shared Drive(T:)/Building FonnsIElectrical Penn it Application I-03,doc
Owners Signature:
4.
Inspection Request: 726-3769
TOTAL
~
CITY OF SPRINGFIELD SYSTEMS DEVELOPME~~ORKSHEET
JOURNAL OR JOB NUMBER: COM2004-00983
NAME OR COMPANY: RW Homes
LOCATION: 4556/58 Aster Street
TAX LOT NUMBER: 17023243 Tax Lot 02900
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 2 BUILDING SIZE (SF: 0 LOT SIZE (SF):
1. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIOUS S.F. x COST PER S.F. CHARGE
3984.00 $0.310 = $1,235.04
RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. - x COST PER S.F. x I DISCOUNT RATE I
I 0.00 $0.310 I 50% = I
ITEM 1 TOTAL - STORM DRAINAGE SDC '$1,235.04
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's x
34
B. IMPROVEMENT COST:
NUMBER OF DFU's 'x
34
COST PER DFU
$24.04
$1 &.28
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= ,
$1,438.88 . I
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE . x
I 9.57
I NUMBER OF UNITS I x
L 2 I
COST PER TRIP
$18.30
B. IMPROVEMENT COST:
I ADT TRIP RATE x NUMBER OF UNITS x
I 9.57 2
COST PER TRIP
$80.72
$1,895.24
ITEM 3 TOTAL - TRANSPORTATION SDC
= I
4, SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's x COST PER FEU
I 2 $82.03
B. IMPROVEMENT COST:
INUMBER OF FEU's x
I 2
ICOST PER FEU
$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) = I
5. ADMINISTRATIVE FEE:
I SUBTOTAL x I ADM. FEE RATE
I $6,473.84 I 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$1,904.68
$6,473.84
CHARGE
$323,69
DISCOUNT
$0.00
x NEW TRIP FACTOR
1.00
x I NEW TRIP FACTORI
I 1.00 I
o
$1,235.04
$817.36
$621.52
$350.26
$1,544.98
=
$164.06
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1070
109]
1092
I
I'
]093
1094
1054
= $1,730.62 1055
$0.00 I ]054
$10.00 1056
I
I
189.43
$134.26
11079
11078
Matt Stouder
8/16/2004
PREPARED BY
DATE
TOTAL SDC CHARGES
=, $6,797.53
:,1
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BATHTUB 2 0 3 = 6
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESWASHER / MOP SINK 2 0 3 = 6
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
SHOWER, SINGLE STALL 0 0 2 = 0
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN 2 0 3 = 6
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LA V A TORY 0 0 2 = 0
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 4 0 1 = 4
URINAL, STALL / WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
TOILET, PRIVATE INSTALLATION 4 0 3 = 12
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 34
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
199]
]992
]993
]994
]995
]996
1997
]998
]999
2000
200]
CREDIT RATE/$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 ELGIBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
TOTAL MWMC CREDIT
=
2
2
1979
= ,
$0,00
o
$0.00