HomeMy WebLinkAboutPermit Building 1992-7-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
------=-~
SPRINGf!IELD'
"8c. od:'z;Jg t.. L.E
LOCATION OF PROPOSED WORK: __.6 ?;a?~
17 ~~7. -f3 7"'- t/ V
, .
~
7 ~,?Y/ . 5~~/77/A/ ~~~ . ,
$?~{t/9/ Z~?f~~Z- ~ ':.
.?4' ~;; /' c- STATE" . ~)2?
ASSESSOI'{SMAP:
LOT:
OWNER:
ADDRESS:
CITY:
BLOCK:
'jp~
Jg'~"NUMBER~2~ .,./~
225 Fifth Street
Springfield, Oregon 97477
C'0
./
TAX LOT: B~ ~
SUBDIVISION: ,...f1r7:~#frl{~4F~-S'
PHONE:
..6~ S-~$/
".">.'}
ZIP:
~-771b$
DESCRIBE WORK'
-~~-rl"o /'...T
:5 r ;?'~5~ g/~~--~-;?> 6~~~-
NEW'
REMODEL
ADDITION
DEMOLISH
OTHER
. CONST.
CONTRACTOR'S NAME _ .: - ~ ADDRESS / ~ '" CONTRACTOR /I ' EXPIRES
.AL J// ~ . ~Y:"",('~ff~<2~, -72
:::~::~~~: /~S:/.~:-<<;'/q,'. ~~~:(/A "'<7",p-'7 0~~~=~~:
MECHANICAL: /
_ ,E.LECTRICAL: P'S ~-
M(S0_
QUAD AREA:. .
/I OF -SLDCS: L
OCCY GROll!' _.B6-r ^'"
::;E:'::~::R I V
- OFFICE USE -
1l t (
h OF. UNITS, . . Lt-J"
CONSTR. TYPE: _~v... '
HEAT SOURCE: kc-4~ ,r.4 ..
RANGE:' ~
,
LAND'USE:
PHoNE
"
FLOOD PLAIN: flY)
ZONING CODE: LD~-'--"-
/I OFBDRMS: --3-
SECONDARY HEAT: _ /\
SQUARE FOOTAGE: _]JJz./.tJU
To request an inspection, you must call 726-3769. This Is a 24 hour recording. All inspections requested before 7:00 a,m, will be
made the sarne working day, inspections requested after 7:00 a,m. will be made the following work day.
~emporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbingl Electricall
Mechanical - .prior to cover.
"f.;:;. ..'
'l";7'( Footing - Afte~,,~.;tenches are
~excavaled.
_ CI Masonry - Steel location, bond
.~ -, beams, grouting,
''i)<::( Foundation'- After forms are
. ~erecte(1 but prior to concrete
placement.
o
Underground Plumbing - Prion
to filling trench.
.REQUIRED INSPECTIONS
, r"\71' Rough Mechanical ~ Prior t~
~ cover. ',-- ,
, , .
1""X1 Rough Electrical - Prior to
Y '..cover.
[)<J Electrical Service - Mus~. be
. 'fpproved to obtain permanen.t
electrical power.
o Fireplace - Prior to facing,
, materials and framing Insp.
,
~ 7t.
,M;raming - Prior to cover.
~Wall/Ceiling Insulation - P, rior to
~cover. '.'
..;, ~ .
~ Drywall - Prior to taPing.,
K7r Unde~f1o~IUmbir~echanic~ . ':' ,
)6..l- Prior to Insulallon 0, Utt""'\J. 0 Wood Stove - After installation.
'fX1 Post and Beam -:- Prior to floor
~insulation or decking.
~ Floor Insulation - Prior to
...'~decking,
" \"')(f Sanitary Sewer - Prior to filling
~ trench,
I~
I Storm Sewer - Prior to filling
trenctl, .,
~/wa\er Line -, 'Prior to fllli,ng
trench, " '
'. -~ ..
-: j -' \
~Roligh Plumbing - Prior to ,
~cover. ,-
o Insert - After fireplace approval
.' , and installation of unit. '
1)('( Curbcut & Approach - After
.. - '\ forms are erected but' prior to
placement of concrete, .
'M Sidewalk & Driveway - After
~xcavation is complete, forms
and sub-base material in place,
o Fence - Wilen cor:nPleted.
J;:" .
c0sl,ee, T,ee, - W~e" a". ,.q~"ed
trees are planted, . . ,.'..
, .
~Final Plumbing - When all
(~~Iumbing worl{ is complete,
'~ '
Final Electrical - When all
( lectrical work is complete,
~ Final Mechanical - When all
~echanical work is complete,
M'Final 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.
o Electrical Connect[orl - When
blocking, set-up, ancJ Rlumbing
inspectiom, Ilave been' approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, sl<irting, decl<s, and
venting have been installed.
Lol faces _W-:, Lot Type
Lol sq. ftg. ~LJ4:, Interior
Lot coverage ~ Corner
Topography t!:!ZYD Panhandle
Total height \~' V-Cul.de-sac
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT.
<)b. -::? c
/t/./C>
Main
1'2 ::<,0
0/'10
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
I P.L.
IN
Is
I W IfJ'
~___J
Setbacks
HSE GAR ACC
9~
S THE PROPOSED WORI< IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
VALUE
hS?~</-0;)
--
6:<'6 ~ cc:::"
7~?~
,
-.3 5 :!!::"D€>
L7.90
375.QO
SYSTEMS DEVELOPMENT CHARGE (SDC) JJL
..u I fJ 1'P
(B) ':W I fl"e -
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
/
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Horne
Plumbing Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
MI-V ·
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
gS
24
ft
ft
Curbcut
Demolition
State SurCI"large
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D. and E Combined)
FEE
9/. ZP
,
4,5b
9S,7(P
?,~
4-ro
,=?_co
/500
/ e tJ-o]
.75
" 2S.7~
/s~S'
/ ..~ ,90
2'1/S
&3 'liZ1
5'
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
r APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition tl'latthe said
construction shall, in all respects, conform to ltle Ordinance
adopted by the City of Springf'ield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: 2"'32.?~
Date Paid: 7.-/-9 '"2......
Recei pt Number' 5.1./ <:;!)~
R7~'~~ "'-
Pla~ Review~~ C"2}
.
7-!t.~ 6- 2 ,
II.D~- '
Systems Development Cllarge is due on all undeveloped
properties within the City limits which are being improved.
Ao.p.u:w.NAb. ~ ENTS
:;*~
WWsW.su
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By signature, I state and agree, that I have carefully examined
lhe compleled 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, ane! the Laws
of the Stale of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be 'Hade of any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit ~ is located at the front
of the property, and the app v (j set of plans will remain
on the site at all times d g construction
-----
VALIDATION: ~E::f)/)
::~:':~,:UM81fT~: _ _ i~-~---
:~:~~;oR:c:tbOO 5 31_-~__)_~_
':~/=t
~~. ~ .
225 FIFTH STREET :on;ng:~~~~projGct as ELECTRICAL P'ERHIT APPLICATION,
SPRINGFIELD, OREGON 97477 'PPrOva/. Oes not ra Submitted h '
qUire s . as tf]Qi. /3/.-j /') <::::? J /""11
INSPECTION REQUEST: 726-3769 ZOning ~ifiC/ant1br!Wlhob Number (.....-/~-fllfQ.A
OFFICE: 726-3759 ~t, f1 -
..Autl 0-../~ . PLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATrotfrl'r.ed Sirrn^
07€:-B AZC;-~03e-<< c..-r; Qture
LEGAL DESCRIPTION
)'76!'2',s~' -r--'1 mJstJf
JOB DESCRIPTION
At h,{J <;" F" A?e-:r "
. ;~ ., .
Permits are non-transferable and expire
if work is not started wi~hin 180 days
of issuance or if work is suspended for
180 days.
r 2. CONTRACTOR INSTALLATION ONLY
Electrical Cbntractor~~(Ic.., fJru j
Address~t.j / J-- O()..h It'CA.,, LI/)
Phone t 9J 1:J 'J- e;("9
107?;~S
Ci ty Pl/q..... -'
CI
Supervisor License Number
Expiration Date
/0- 1.- 92-
Constr ContrA Number /700
Expiration Date 1- 2.5'-q ~
Signature of Supervising Electrician
lW~~')(~~ (1
.7 ,()~I~ /<:.o$(c.p.~.. I , .
Owners Name ''',' ',:',' '~-'..6~"C,"" ,',
,/~:.~/ .~.
- /'
Address .5t-\._.......,. ".__ L~_ ,,".i-l"
"& C,cf?t' U/{.A(]A-/PC- -/-laIr" .
Ci ty j:?H<:; Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~;~---------~~~~~~;;~-----------
RECEIPT i: 'r p; 7-.....3 '. .
RECEIVED DY: ~~
New Residential-Single or
ti-Family per dwelling unit.
Service . luded:
Items
Cost
Sum
1000 sq. ft. or less. L-- $ 85.00 '3S-~
Each additional 500
sq. ft or portion
thereof :2-$15.00" 36>,08
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B.
Services or Feeders
Installation, Alterations or
Relocation: '
- 'I
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
\...-.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocatitin:
200 amps or less I ~
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
~Cfj
$ 40.00
$ 55.00
$ 80.00
see "B"
above
Branch Circuits
New, Alteration or Extension Per Panel
. One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00'
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE J S-'')- ~
5% State Surcharge 7, 7~
TOTAL ~~:7J>
JOB NO. 9 -z....o '1 \ 0
)
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: TOM S\E.Iv'\\~S~\
LOCATION: "'-, '08 ~L-\J~ ~E. L.t.-E: C:r. \10'"2- '2:7L.\-44 - ~ at..\-
DEVELOPMENT TYPE: LP~ -'I--!.SW SFtc:-
BUILDING SIZE:
.LOT SIZE
,SQ. Ft.
1. ' STORM DRAINAGE
IMPERVIOUS SQ. FT. "2?S8 , X $0.192 PER SQ. FT.
G:?-Z ,?)
"-- ~
2. SANITARY SEWER-CITY
NO. OF PFU'S \t) X $39.78 PER PFU
(See R~verse)
G"l I <00;;
""'--- ~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRiP
X \.DOS X $401.05
G~O?~
"-- ----
X
X $401.05 $
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ I~I) ~~
X
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
<C1B~
TOTAL-CITY SDC $ \<o'?o~
5. SANITARY SEWER-MWMC
I? :Z.t;
NO. OF PFU' S I ~ x $.l3-M PER PFU + $10 MWMC ADMIN. FEE $Z~'O So
(Use PFU Total From Item 2 Above) .
~-? .
~~LcL-
.' Ki P Burdi ck
SDC Coordinator
7 /~/;17-
$ ?~?2-
TOTAL-MWMC SDC~
"""-- ~
TOTAL SDC $ \ f;>loB ~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
,:)
FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
Bathtub...... ................................,..,...,..................... ...
D rinking Fountain........ .............................................
Floor Drain.................. ..............................,...............
Interceptors For GreasejOiljSolidsjEtc.................
Interceptors For SandjAuto WashjEtc..................
Laund ry Tub jClothesw,asher...,..,...,.............. ...... ....
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator ;Water StationjEtc........
Receptor For Commercial SinkjDishwasher jEtc..
Shower, Single Stall......................".........................
S hower, Gang..........................."..,.",...............,...".
Sink, Bar, CommerciaL..................,...........,.....,......,
Urinal, Stall ;Wall... ..... .... .... .....",..',.. ,., ........, .............
Wash BasinjLavatory, Single..................................
Water Closet, Public Installation.............................
Water Closet, Private...............".,............................
Miscellaneous:
'2-
2 -z..
1
2
3
6
2 2,
6
6
1
3
2 z..
1 jHead
2 z..
2
1 2-
6
4 €>
'2-
TOTAL FIXTURE UNITS
Ie,
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurr'ed 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
~'2.l,,0
2.~:6
2,"1
2.m
2,,16
2.13
1985
1986
1987
1988
1989
1990
1991
I
I
Credit for Parcel or Land Only If Applicable '2.. (.." c... X $ It. c.:, <... 7:;,0 .., ~
(Rate X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
CREDIT ;YOTAL = $ ~O'~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resid ential............................... .............. .,. ........ 0.4
CommerciaL..... ................ ,......,. ............ ...... ..... 0.9
I nd ustriaL..............",."..........,.,... ..... ,................ 0.45
Governmental. .... ......."....,.........,.......,......."...,. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT