HomeMy WebLinkAboutPermit Electrical 2003-3-20
: '0 CITY OF S.... ~JNGFIELD, OREGON .'
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:,~~6-3 89
ELECTRICAL PERMIT APPliCATION o..;\"~100~
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CIty Job Number Date ~,,0 ,,,Q,' 0\' ""Q,
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A. ! N~w ResideDti~t"::.Sin'gle or Multl"Family per dw~lIing unit.
iiJ fl.'I:einpora.,y ::iiervices or Feeders .: .
"It/Si{t~ation, Alteration or Relocation
Cl?{jllt~ ~ps$.Jr less $ 50.00
41'1041416 fitPPJ,/f4l!p n'!S $ 69.00
Y IOe/', '!itJr!P.s@,fJIJOlJJ:'!"?t $100.00
&'1r ~p$~~{$QO~~~ikB" above. ,
n.I.Br"nQfi~~.u!W,l)O~~/flll/(.(,; ,'i
New Alteration or Extensi~r l",J;el
One Circuit
Each Additional Circuit or with
Setvice or F ceder Permit
L ! 'LiJeA.'[:ION OF iNST.A.tLATiO]ir'
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LEGAL DESCRIPTION
JOB DESCRIPTION \~
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~non-t~ferable a~pire if work is
not started within 180 days of issuance or if work is '
Suspended for 180 days,
2. I ~01YTRAcrO~1iVSTALLATIiJN"ONLr j
Electrical Contractor rh'r; c:!t-oncu"\n 1<'10(" tr; r
Address 1?qR ?,pth~ivp
City -Eugp,.,p Phone S6.1-f'.RR-f'.12l
Supervisor License Number
17SgS
Expiration Date
. 10/01/04
Constr. Contr. Number
?f'.- 11.(~
Expiration Date
10/01/03
Signature of Supervising 'Elec~(j
T "''''''Y f1:lapn"'" 11
Owners Name~t\ I ~ Cl.f\~Q~ ')
Address ~ "~ ~ .'
City ~hone ~.\a...O\
OWNER INSTALLATION
oJ
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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Service Included
1000 sq. It or less
Each additional 500 sq. ft. or
portion thereof
( $106.00
'2- $ 19.00
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Each Manufact'd Home or
Modular D~IJ.iij8J~9rvice or
Feeder tOI/OW rul urv:Ure'90
',. e~ ",., n /"....
, " ""<W " . ~I;\." !."l' ......'~':I.UII>>. .
8, 'Ser.\i~1'W st,~~iflT.~1~I{~tlji,*,tW~!atIOR~~QI.1Jh~location:
vU90, 'y01~"-VU7-00~"v"'e rUle;'i'g"" Utilit
200 An1p.!l,orJes~ may Obt ,0 throunj, ,,-.arSl6a;Qlfo~'
'InrI. tl-JA""'- am c ,-' ~I'1R..r.u- . ,j
201 A1nPMl'e4UU~u(J~lter OPlfl., -', ~>I14-\.1~01
401 Amps to 'lP&'N!nPSOre' (Note: th,,-; ,:'l~~(6)QPb'
(~"Ilt, gOn Ut' "J'~n" J
601 Amps to 100u ~psI-800 littv ^'Gt'~;Sl'68'.OO
Over 1000 AmpsNollS -332-23d-i.'SYfil;eo
Reconnect Only . $ 50.00
$50.00
I
'(1,..<:1
$ 43.00
$ 3.00
E.I'~c~~~l!eouS(S.ert;c~lleed~r not}richid~(h~Eai:h'i.list81latioi'l
Pump or inigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. ;:~ulJJ:OT.At;9f~O,,~. ., :':..~':'" :.':j
7% State Surcharge
10% Administrative Fee
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/00"6
J't 'f U
/btlfY
TOTAL
Shared Drive(T:}IBuilding Fonns/Electrical Permit Application 1~3.doc
CITY OF IIINGFIELD SYSTEMS DEVELOPMEtWORKSHEET
I JOURNAL OR JOB NUMBER: Com2003-00I40
NAME OR COMPANY: Hayden Enterprises
LOCATION: 5905 Pumice PI.
TAX LOT NUMBER: 18020300TL00510
DEVELOPMENT TYPE:
NEW DWELLING UNITS BUILDING SIZE (SF) 0 LOT SIZE (SF):
I. STORM DRAINAGE
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DIRECT RUNOFF TO CITY SroRM SYSTEM
I IMPERVIOUS S.F. ,I COST PER S.F, CHARGE I
1 2202.00 ( $0,282 1 = I $620.96
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUcrED ro CITY STANDARDS
1 IMPERVIOUS S.F. I ,I COST PER S.F. I, I DISCOUNT RATE I I DISCOUNT
I 0.00 I $0.282 I 1 50% = 1 $0.00
ITEM I TOTAL - STORM DRAINAGE SDC $620,96
2. SANITARY SEWER: CITY
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6570 ~
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$620,96 1070
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A. REIMBURSEMENT COST:
I NUMBER OF DFU's I ,I COST PER DFU
I 21 I $22.09 = $463.89 1091
B.IMPROVEMENTCOST:
I NUMBER OF DFU's I , COST PER DFU
I 21 $16.79 = $352,59 1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $816.48 I
3. TRANSPORTATION I
A. REIMBURSEMENT COST: I
1 ADTTRIP RATE I ' I NUMBER OF UNITS I ' 1 COST PER TRIP , 1 NEW TRIP FAcroRI
I 9.57 I I I $16.81 I 1.00 I = $160,87 1'1093
B.IMPROVEMENTCOST:
I ADTTRIP RATE I ' I NUMBER OF UNITS I ' I COST PER TRIP x INEWTRIPFAcroRI
I 9.57 I I $74.17 1.00 I = $709.81 11094
ITEM 3 TOTAL - TRANSPORT AnON SDC = , $870,68
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I , ICOST PER FEU
1 I 1 1 $332.86 = $332,86 1054
B.IMPROVEMENTCOST:
INUMBER OF FEU's I ' ICOST PER FEU
I I I $34.83 = $34.83 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) = $0.00 1054
MWMC ADMINISTRATIVE FEE = $10,00 1056
I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $377.69
I SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = I $2.685,81
5. ADMINISTRATIVE FEE:
ISUBroTAL I , I ADM. FEE RATE 1= CHARGE
I $2.685.81 I 5% $ I 34.29
roT AL SANITARY ADMINISTRATION FEE: ,. 83.63 11079
roTAL TRANSPORTATION ADMINISTRATION FEE: $50.66 11078
D, Wright 3/3112003 TOTAL SDC CHARGES = $2,820.10
PREPARED BY DATE
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVAlENT = DRAINAGE FIXTURE UNITS
(NOTE: RJR REMODEL<;. CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EOUIV ALENT UNITS
IBATHTUB 2 0 3 6
IDRINKING FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE lOlL I SOLIDS I ETC 0 0 3 = 0
IINTERCEPTORS FOR SAND I AUTO WASH I ETC 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER I MOP SINK 1 0 3 = 3
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
IRECEPTOR FOR REFRIG I WATER STATION IETC 0 0 1 = 0
IRECEPTOR FOR COM. SINK I DISHWASHER I ETC. I 0 0 3 = 0
ISHOWER. SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCIAURESIDENTlAL KITCHEN 1 0 3 = 3
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2
ISINK: SINGLE LA V ATORYIRESIDENTlAL BAR 1 0 1 = 1
IURINAL, STALL I WALL 0 0 5 = 0
ITOILET. PUBLIC INSTALLATION 0 0 6 = 0
ITOILET. PRIV ATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 21
.EDU (Equi...aJem Dwelling Unit) is a discharge equivalent (0 a single family dwelling unit (20 DRJ's) set al 167 gallons per day
MWMC CREDIT CALCULA TION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RA TE/$I.000
ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 0
BEFORE 1979 $4.92 (Enter 1 fnr Yes, 2 for No)
1979 $4.92 IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? 0
1980 $4.83 (Enter 1 fnr Yes. 2 for No)
1981 $4.77 BASE YEAR 1979
1982 $4.64
1983 $4.47 CREDIT FOR LAND (IF APPLICABLE)
1984 $4.30 VALUE I 1000 CREDIT RATE
1985 $4.09 $0.00 x $4.92 = , $0.00
1986 $3.78
1987 $3.41 CREDIT FOR IMPROVEMENT (IF AFfER ANNEXATION)
1988 $2.98 VALUE I 1000 CREDIT RATE
1989 $2.52 $0.00 x $4.92 = 0 I
1990 $2.06 I
1991 $1.64
1992 $1.45 TOTAL MWMC CREDIT = $0.00 I
1993 $1.31 I
1994 $1.13
1995 $0,97
I 1996 $0.82
1997 $0.63
1998 $0.41
1999 $0.22
2000 $0.04