HomeMy WebLinkAboutPermit Electrical 1995-7-28
.""
The, following project as submitted has the following
zoning, and does not rsquire specific land use
approval. '
ZoninQ M D/'2-
225 FIFTH STREET Date]...-LJ.( ...--''1~
SPRINGFiELD, ORESO.N, 971l~~orlzed~ nat - N "'^
INSPECTION REQUEST: 7'26-3/6'1 9 ure ,-,
OFFICE: 726-3759' ,
'1. .4to~f\~ 4\D~I1\ &Qv
- -
t1r)'t~~~ON ~D3
~~::~=~~~~nd expire
if work is not started within 180 days
of issuance or if work ~s suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor~(')0 \A(i-ej f/~d'J)\c
Address~O. Box Q..dd.ol
Ci ty ~~evte O,7yo:J Phone C,<{3 -61373
Super:visor License Number 595d-. c../ ~
Expiration Date Icycr5
Constr Contr. Number 759/0
6/0;(,
Expiration Date
Signature of Supervising Electrician
0~A, ~ life
::::::sNa~~'!:ff~ifJ
City ~tliL- Phone]jb.w'Ol1
OVNER nJTALLATION
The installation is being made on
property I own whi~h is not intended
for sale, lease or rent.
Ovners Signature:
~~i~ti::~:~--~A--~-'jt~~
~BJL)
ELECTRICAL PERMIT APPLICAT~~ i..
r;~y Job Number ~~ ,
3.
COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dwelling
Service or Feeder
B. '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 amps/volts
Reconnect Only
Items Cost
Sum
cQ
~
w
ro
$ 85.00
$ 15.00
S 40.00
S 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
,..-/
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less l ' $ 40.00 -.10
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
C.
D.
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res '
Limited Energy/Comm
E.
5.
SUBTOTAL'OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$ 36.00
d49.,~
~~_"clu
~()
40.00
40.00
20.00
q~4
SYSTEM DEVELOPMENT CHARGE
~1 I WORKSHEET
NAME: cj0l1UflL ~ PHONE: 'r41o -{o521.
ADDRESS: ~ ~4 ( /J \'\\BJ\ ~ \r{\ STATE: l5f2-ZIP: Cl147<6
..:
LOCATION OF PROPOSED BUILDING SITE: ^
Street Address: 4\o~fJ ~4-to~ ~f\S~O ,
Plat Name: L ~\-\- ful_L Tax Lot Number: II O'2-3~3lX1{G3
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling,!
ype definitions are on the back.)
A. Sinale-Familv Detacheq
Single Family home
Manufactured home not in a park
, NO. OF UNITS
X $1,000 per unit =
$
B. Sinale-Familv Attached.
!A
NO. OF UNITS
X $924 per unit =
$ 100,CO
c. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. Manufact\.Jred Home Park
3. TOTAL WILLAMALANE NET SDC ASSESSED
~iOorc
Development Servi&
City of Springfield
X $699 per unit = $
$ 1B48.CLJ
r;;i
$ 1B48.0cJ
I /f~1 C\S
$
NO. OF UNITS
WILLAMALANE SDC
2. SDC CREDIT (if applicable) SDC-payer must furnish proof of
Willamalane Credit approval. See SDC Credit Worksheet.
f}
Date'
'":,.N"' -. 'l '~.'~
. . ,~w._
-"I
:.~
. lOB NO. Q5CJ'j7'-/-
\l-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL ~ RESIDEN~IAL)
NAME OR COMPANY:
L. A IJ fl. r!:M C
t.5AfC: s
,
LOCATION: 'I~~7 ~'. lf~5<7
A-sruz.
s-n<.EE-r
90 3 ',,:
/7 0 Z. 3. Z 'f 3 901- I
DEVELOPMENT TYPE:
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT~
.,.. t/, / /'\
--7 ! IZ-. ~5Q !
~. \ /'
i'~~4'
I
LOT SIZE
" 'I
.' /.Q t' ') I
r.. Z8 ';( ~. ,/ !
,
+- /7.. ~ /8
SQ. Ft.
;
.".. iSLc'f
(3Bq~
X $0.209 PER SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'3 Z-...
X $43.26 PER PFU
o 3el9'
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
.-'7
.~
X :j. 0 I
X $436.19
X $436.19
X $436.19
cGBt ~ :;
$
, $
X
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S b~ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From ,Item 2 Above) .
o€ ~
$ 5~o -
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
co v'
$. 'fZ-'-
~
'-- . ------ ./
o e, (/'
$ 3, i 13 -
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
,5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
'.{iCQ,\ " j\/V-t\l..USltrt.. Date: -7~1/CJ5
'. Kill Qyvlfisk " 'TOTAL SDC
. SOC Coordinator,
0~&~
~
$ :3, 3-;, I 7!- .
., -"';':.f-:f' <. . ,". . . .-., - ", '., , . . ....,.'-!'fi>t:~'.i.~;\'ij. _~~~l:,___~;', .. , . .
FIXTURE UNIT CALCULATION TABLE: Numb~'r'of'NcwFixture~ X Unit Equivalent =, Fixture Unit's
(NOTE: For remodels. calculate only , ~ additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
, 1-f
Bathtub..................................................................... .
Drinking Fountain................................ ..... ....... .........
Floor Drain.................................................... .,~..........
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
laundry Tub/Clotheswasher................................... ~ y.
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................... ..... ........................ '
Shower, Gang .............................................. ..... ~~.....
Sink: Bar, Commercial, Residential Kitchen..............,.......... 'Z. )0.
Urinal, Stall/W all............... ~......................... ........;.....
y.Jash Basin/lavatory, Single.................................. z...,. z
Toilet, Public tnstallation....~.......... .... ........... ......-..
Toilet, Private..................................................:,... '2- y. Z.
Miscellaneous:
TOTAL FIXTURE UNITS
UNIT
EQUIV ALENT
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
FIXTURE "
UNITS
Lj
1./
4
"f
1l.D
3z,
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
'1Z~
~ .,,. --~
ICJiP 0 --"-"..
Credit for Parcel or land Only If Applicable ~ I.t.. 1'10 X $ 3.'1(0
(Rate X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
=
=
CREDIT TOTAL = $
~
'fz.
OWNER:laU-f'el!) e '/5a ~
ADDRESS: . 73 '-It.. Ih lA. V .r toY!
CITY: (~a.ltVl 4_tr(? (J ___
I (/
DESCRIBE WORI<~ COVlS"-trVC c L NeuJ
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
..,'
LOT~,
NEW X
F1EMOD[L
/
CON ST.
CONTRACTOR'S NAME J [. ADDRE.SSl-lnb. '., CONTRACTOR /I
G EN ERA L rVvt e i0L Jk-f-Lj Ie m:: er I 'he (Jt,h_7S"'O.
PLUMBING: - 0 --li-Ylef I+tti__.&c It , ~'~ n/I)ffj1 ,l ,,3 ~ \
-bk1- (J ,'f'
MECHANICAL: I,
ELECTRICAL: Crou) , (J/Jf,1Le):f Eler:;,frlc,L1::)Q\()
/
QUAD AREA: ~
/I OF BLDGS: 1_
OCCY GROUP: ~3-.1:i(\
· OF STORIES, ---fl.- fj
WATER HEATER, _.. __'__'____
6fJ 'fI ~
SPRINGFIELD
\,-
I!d
STATE: ()y
, Ou fie k
ADDITION
DEMOLISH'
JOB NUMBER
/~ '1&1
q~1
~-;,~
- OFF~EI\\SE -
LAND USE: ~\JLV _
~, "
CONSTR. TYPE: vl\J
HEAT SOURCE: \~
RANGE: f /
II OF UNITS:
, TAX LOT:
SUBDIVISION:
PHONE:
ZIP:
cr 7 Cf7,?'
OTH E R
~IRrS
, 6//(/9b 7Lf{j-c/0Clf"
5,. f) .q(p 74h.OI gi
PHONE
to'63.)S31S
,/
iFLOOD PLAIN:
('ZONING CODE:-Ml)f...
II OF BDRMS: 3-t'3' ,
SECONDARY HEAT: ~Ai2....
SQUARE FOOTAGE: alo~
To request an inspection, you must call 726,3769. Ttlls Is a 24 hour recording, All Inspections requested before 7:00 a,m, will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
~ernpOrilry Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o
Underslab Plumblngl Electrical!
Mechanical - Prior to cover,
~otlng -;- After trenches are
excavated,
D Masonry - Steel locatlon, bond
beams, grouting,
~T~~I~undatlon - After forms are
erected but prior to concrete
placement.
~dergrOUnd Plumbing - Prior
to fllllnQ trench,
[2]4JnderJloor Plumbing I Mechanical
- Prior to Insulation or decl~lng,
ca10st and Beam: -' Prior to floor
Insulation or decl<lng,
~!IOOr Insulation - Prior to
decking,
G2J:Sanitary Sewer - Prior to filling
trench,
~torm Sewer - Prior to filling
trench, .
I VI Water Line - Prior to filling
trench,
~OU9h PIl!lllbing - Prior to
cover., ,
REQUIRED INSPECTIONS
G2f:lough Mechanical -' Prlor,to
cover.
~ugh EJect'rical - Prior to
cover. ,
0'!lectrlcaJ Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
...--'
~ Framing - Prior to cover.
~all/Celllng Insulation - Prior to
cover. '
~ywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
C!:Jfurbcut & Approach - After
, fqrms are erected bu t prior to
pl~1gemont of concrete,
.;;...,~ .
~dewalk & Driveway - After
excavation Is compiele, forms
and sub-base material-In place,
o Fence - When completed.
o Street Troes - When all' requlr~d
tr.ees ,are-planted.
~Inal Plumbing - When all
plumbing worl~ is complete.
~"nal Electrical - When all
electrical work Is complete,
~Inal Mechanical - When all
mechanical work Is complete,
~al Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete,
o Plumbing Connections - When ,//
home has been connected to/
water and sewer, ,i~l"-
. -.:~J'.
o
......~.;.
.,-;~" "
Electrical Connection - When
blocking, set.up, and plumbing
,Inspections have been approved
and the home is connected to
the se"rvlce panel.
o ,Final - Atter all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Tvpe Setbacks
", ,terlor I P.L. I HSE I GAR I ACC i
_ ,Corner I N I I I I
i2" Panhandle I S I I I I
Cul-de.sac I W I I I I
( \0't)1 E I I I I
Lot sq, fig.
, Lot coverage
Topography
Total height ~'l'
,--1\.09,n; 4.5' -_))
BUILDING PERMI
::I~ a1\S~ GL X!];'?A = l2i1.t\ \
5'\lo \~. \0 " ~~2.
Garage
Carport
l3Otn3 '
5DX~5
:l. 5. ''1:
, <. - I~
5~i .<=\1
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8) 33~ \.~
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO~-\-d
'- ~f)~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permlt-
0c9.([u
( In.CO
~JoQ
3~.~o
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
:. . ." ..~ ",.'
E~,!1aust Hood
Ven t Fan
~.%
NO
4
Wood Stove/Insert/Fireplace Unit
Dryer Vent
LPro
Mechanical Permit
0)'] .00
I (). aJ
,..~-
~. ((0
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surch~r~e
Sidewalk &t It
Cur~cut ~ ft
Demolition
-~ .\cD
\~.\cD
,,~\t\c~\,QO .
TOt~t ~~scellaneo:~
Ad)~
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, 0, and E Combined)
~:)9lo.lc4
is THE PROPOSED WORK IN THE
.. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGiSTER?
If yes, tt11s application must be signed
. arid approved by the Historical
Coordinator prior to permit Issuance,
,~~ ' APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to 1/1e Ordinance
adopted by the City of Springfield, including the
Development Coele, regulating the cOr)struction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee: .._.._..__
Date Paid:
"__n.__...___,__~___
Receipt Number:.__
~~.
Plans Ro"ewod 8y if1A
~c_s
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
~
VLl40
\ CU oc)
By signature, I state and agree, that I have carofully examined
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
heroin, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify tllat only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
I further agree to ensure that ail required inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card is located at the front
.of the property, iJnd the approved set of plans wiil remain
;(:e":~e at all timo, d"AiIflon
'0trl
VALIDATION: \ 0"'rd
RECEIPT NUMBER~, .. C~[D
DATE PAID \ .7/<(;, S'
AMOUNT ~ECEJV'1' ~\Ao'\-1:)' ~l.o
RECEIVED BY -~ll~- _~