HomeMy WebLinkAboutPermit Building 1982-4-5
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RESIDENTIAL
PERMIT APPLICATION
,I nspections: 726.3769
Office: 726.3759
XASSESSORS MAP:
"<LOT: I
/il '5p 35 z..
L~I /e-ru
J- 'I %.9 ~
JOB NUMBERi'5D ~ 5 7~
OCL~ LbcJe f - Ru~/) r.J~,V B'II
BLOCK:
OWNER: "1-:>u fI AI\...U 1c:.~('.vk_A~
ADDRESS:' \110 d(J~ ~A/?v6J (Lrfck...
CITy:,,~nV1/14~ Jri I
-/ ,j f
'"'7;?7tA...[) i€- X -
DESCRIBE WORK:
NEW (
REMODEL
7
t
225 Fifth Street
Sprlnglleld, Oregon 97477
C7:
f
TAX LOT: .
SUBDIVISION: 41'r&-110/111 HP/7iLf5.
PHONE: 1:<~- c2710 t.J-
led.
STATE: () r f> a 0Yl
v
97;.f 7~
ADDITION
DEMOLISH
OTHER
ZIP:
CONST.
CONTRACTOR It
REQUIRED INSPECTIONS
[Ij-Rough Mechanical - Prior to
cover. .
Il..Rough Electrical - Prior to
~ cover.
,/
I vi Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
D Framing - PrIor to cover.
n/WaIl/C'eIJlng Insulation - Prior to
Lp.LJ cover.
~rYWall - Prior to taping.
D Wood Stovo - After Installation.
n Insert - After fireplace approv_al
.~~ an-d'ln-stallatlon of unit. -
G';:urbcut & Approach - After
lorms are erectcd but prior to
placement of concrete.
GL]/Sldewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
EXPIRES PHONE
1-/0 - 75- 1d)./p -c::J.?~ 4
o.lo-C\lo 4f6 \ \L\lp~
/~J/.:L 'i-It:J -'15- ?J<t.;Z11,,~
. .=:-r.::7A.. ....., '1 t-L. I~. ft": ~ ~ 0 \
. ~----=-tT lr_r- ~ C>-\'L}'''-~~~
- OFFICE USE -
QUAD AREA: 4~~ LAND USE: \\W FLOOD PLAIN:
1/ OF BLDGS: \ It OF UNITS: SrJ ZONING CODE: ~
-
OCCY GROUP: Rht ^^ CONSTR. TYPE: 1/ OF BDRMS: 3+3
1/ OF STORIES:' 2.- HEAT SOURCE: Wf-f SECONDARY HEAT:
WATER HEATER: e.. RANGE: _ ~ SQUARE FOOTAGE:~lIY4B
i dZ / /c:l"
f) \C\C\4
.
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspecllons requested belore 7:00 a_m, will be
made the same working day, Inspections rcquested after 7:00 a.m. will be made the lollowlng work day,
r
G~lFlnal Plumbing - When all
. plumbing work Is comple!.e.
c;a--:lnal Electrical - When all
electrical work Is complete,
-)\'olIi
r,.>-
CONTRACTOR'S NAME ADDRESS
GENERAL: DU,...d~ 1r!-~a.~
PLUMBING: (I L.t~-L/~-u J I /,0/1./ n1~/ net.--.
MECHANICAI-' F#:- D;A.~ _ i/!~~
- ()
ELECTRICAL::J:'>~.l-, .c:2,~,~~.I
. J..6~-
o Temporary Electric
~~ite Inspection - To be madc
after excavation, but prior to
setting forms.
o Underslab Plumbing I Electricall
Mechanical - Prior to cover.
[id-Footlng - After trenches are
I excavated.
o Masonry - Steel location, bond
beams, grouting.
~oundatlon - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
[9-'OnderfJoor Plumblng/Mechanlcal
- Prior to Insulation or decking.
[;2I....post and Beam - Prior to floor
Insulation or deck~n..9' _c._.. __"
gFloor Insulation - Prior to
deckl ng,
~nltary Sewer - Prior to lilllng
trench.
~torm Sewer - Prior to 1IIIIng
trench.
. rJ..-Water Line - Prior to filling
4.LJ trench. .
1./1' Rough Plumbing - Prior to
cover.
lk:J Final Mechanical - When all
mechanical work Is complete.
~Uildin9 - 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 Connection - When
blocking, set.up, and plumbing
,Inspections have been approved
and the home Is connected to
the service panel.
o Final ~ Aller all required
Inspections are approved and
" porchos, skirting, decks, and'
venting have been Installed.
. .. ',. II
Lot faccs
Lot sq. ftg.- 1d)14
Lot Ty~
~
7 ;" _ \; '~'.':,~:
Setbacks
I P.L. HSE GAR ACC I
IN
I S I
Iw.1
I E I
\~n.d:i ---ci'N> 1'\ \\t)"-, -\flC\luA6
o?~ ~. ,- 0 ~irtnir tlfA\~Clr~
_ Interior
~orner
Lot coverage
Topography ,
To'" helghl ~)
BUILDING PERMiT
ITEM SQ. FT.
Panhandle
Cul.de-sac
X $/SQ, FT,
c;""~.2. 0
I d 1'0
. , .
VALUE
/2..7.... 2. 1/
\..
~~~.~
Mal,n
2/7("-.
"~~.'
Gar,age
. Carport
"
Total Value
iA?tf!;
CAao
~.\ I
Building Permit Fee
State Surcharge -\-~O
Total Fce
(A)
--..... ,"
SYSTEMS DEVEL<?PMENTC~ARGE~(SD~2 ~'
c. (B) ~?4'2. ~ _ tp
PLUMBING PERMIT
ITEM
FEE.
Fixtures
Residential Bath(s)
N~a
"
"'--~)~
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
MObile Horne
":~~ /
~{.' Plumbing Permit
~~'';f~ .'.
~- ---......."
State Surcharge
+QQb~ I
I
~,
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
C1,CO
(/). CO
Vent Fan ~
NO
Wood S(o'~ellnsertlFlreplace Unit
Dryer Vent
(O.CD
Mechanical Permit
riJ'7,CD
/ /) .00
~.102
301 It J)
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stat/'! ISSll"lnr;e
State Surcharge
Sidewalk \~q It
Curbcut '- ~\ Q ft
~~~B5
\~~O
b
Demolition
0J(rtf\"'~Lb.,O ~ . ~3?fo
Total Miscellaneous ~t~lts (E) _ _
TOTAL AMOUNT DUE (excluding electrical) ~l..\,~
(A, B, C, D, and' E' Combined)
· ( IS THE PROPOSED WORK tN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and 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 the Ordinance
adopted by the City of Springfield, including the
Development Code,ljegulatlng the construction and use of
buildings, and may be suspended or revoked af"a'ny time
upon violation of ..any tfrovlslon~f...s.ald ordinances.
Plan Check Fee: G 2 3 I c:xo . -
Date Paid:
Receipt Number:
R\~lved By:
~J' ffi~ (
~ - '1:J-l
Plans Aevlewed,.By - ,'tit'
~.~ ryqS
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ARDITIONAL COMMEtfrS ,
~A ~ ,f" 6~> \'u\J~
~.:.cAy-r IRJlb~)' 'I
~lm~~ \~~~:
~)\~~\"iJ\~
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby cerll fy that all
Information hereon Is true and correct, and I lurther certily
that any and all work perlormed shall be done in accordance
with the OrdlnanctJs of the City of Springfield, and the Laws
of the State 01 Orcgon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I lurther certlly 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 pcrmlt card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during constrLJr.tlon
I / ~ d~~::' -' '-L ,,~,
SlgnaturE'.At~ -/[~.A'~
" U
Date ~".j-:::: 7s"- .
VALIDATION:
RECEIPT NUMBER
/tb'S~o
~/S-/~.F
'~~,n9_
/p",~
L
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
:,' "\i'.'t'" ,":~ ,....... ~~ t~:,)7~.,
, ;
i. .
~~i-~.~'l
"
JJ..?... Willamalane
'tq Pa,k & Rec'eat;o~ D;st,;ct
Job No.
q5)35L
SYSTEMS DEVELOPMENT CHARGE
W9RKSHEET
NAMWnl\9.c\Zf\i~-k PHONE: \~qti-
ADDRESS:-3lotld5 0~ fbt'. ~d STAThf1tZIP C1418
LqCATION OF PROPOSED BYIL~~G?SI~ /n'/)/')d (', 0 . , In ~ f1,... IIA " /J..L
. Street Address if Known: -11l/U "* '" 6L- J.J JT )C) AAJl~1 LD
Platt~~~J~TaXlotNumber: 17~~ ReD
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.) . .
A. Sine:le Familv - Detached
Single Family home
NO OF UNITS
Manufactured home not in a park
X $400 PER UNIT _=..
$ '.
"
B. Sinele Familv - Attached, '
.
NO OF UNITS
.c!)
X $370 PER UNIT =
. $ 140 ,C{)
C. Multi-Familv Ar;lartment .
NO OF UNITS
X $~77 PER UNIT =
$
. D. Manufactured Home Park
.NO OF UNITS
. .
X $280.PER UNIT =
$
WPRD SDC
.. $ 140.CD
$g
$W{[)
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet . .
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit>
. I rY\ JL C}t}[)fP f)
~~.~,~:." ~M"~"'M A~';F~~v-
-I I S ,?S
n;1tr.> /
Th,o;) following project as submitted has the following
ZC!""ij,.end does (Ioi require specific land use
app,')val.
225 FIFTH STREET , . L- Ptt' .
SPRINGFIELD, OREGON 97477 Zontnp ..;....--
INSPECTION REQUEST: 726s;l~69Lt, 5-'1~
OFFICE: 726-3759 ' . 'iJ bv'\.
. Authorized Signature , - J .
. 1. LOCATION OF INSTALLATJ;.ON
p702-~k;7t:)c/- ALu~~ Cr:A~
LEGAL DESCRIPTI9!}
J 70 2- ~ 4 ""'c-r--
f ,.
&9~
JOB DESCRIPTION .~
~ /lLJUJ&..,PIX- W~
Permits are non-transferable and expire
if vork is not started vithin180 days
of issuance or if vork is suspended for.
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor~~~\~
Address
City
Phone
Supervisor License Number
Expiration Date
ELECTRICAL PERMIT APPLICATION
City Job Number ~~~S-2-
JJ:~J..L ~E SCHEDULE BELO\!
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dvelling
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
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electrician
Ovners Name J~:J~ )::;,/~tf ~S
Address 3cP'" n (" ~/ ~~
Ci ty ~~ Phone 7"2~ -2.'0/'
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:. .
,k-~z! ~~0~
---------------~----~~---~-------------
DATE: ~/s-7,j'"
RECEI. PT #: . ( (/~j~,?_
RECEIVED BY: ~.----.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
<7e:J-tJ"D
;
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
D.
Branch Circuits
L--
,.
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE .
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
,.
no t included)
$
$
$
$
40 H)
'-2JH1
j. -,..0
--4?- ?-a
40.00
40.00
20.00
36.00
... NO. q!5tJ? 61-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: D0 A-~ t:: \(' f,ltC:, l.-t"\ S
LOCATION: Co (()2 ~ Co J 04- . ~Luf:.-e,~.-L.-L-E:.. c.. T .
.
i., 0"'2.. '?444 - OO\<DO
DEVELOPMENT TYPE: LDR - Wf:.W \:)UPL-E:>L
BUILDING SIZE:
1. STORM DRAINAGE
LOT SIZE
SQ. Ft.
IMPERVIOUS SQ. FT.
'2.."?9"Z-
X $0.209 PER sq. FT. ~"\"\~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
?./2-
X $43.26 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
'Z-
X 1.0 t X $436.19
X
X
X $436.19'
X $436.19
4. SANITARY SEWER-MWMC
NO. OF PFU'S ?'2- x $17.19 PER PFU +$10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
\c::::': 4 ~L~ Date:?.J ,"2-1.- ''1~
'-~ Ki~ Burdick . TOTAL SDC
SDC Coordinator '
~B4- ~?)
"--- ~
'C;-~I/~
.............. ..--/
. $
---
$
$ I3foO~
$ Co4 "'3
cG9 S 40
$ 3"ZCoo ~
GI~?~
.............. ~
'34
$ ~41-~ -
FIXTURE UNIT CALCULATION TABLE: Number of New Fixture- v Unit Equivalent =. Fixture Units
:-. .','. .
(NOTE: For remod6is;'calcutate only t, EI additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
Bathtub..... ...... ........ ............. ............................. .........
Drinking Fountain............ ,. ............,.,.-......... ... ...........
Floor Drain.......................... ...........,......,...... .............
Interceptors For Grease/Oil/Solids/Etc........ ...,.....
Interceptors 'For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.............. ......... ............
Clotheswasher -.3. Or More,.,.............,............. ........
Mobile Home Park Trap (1' Pe; Trailer)....~............:
Receptor ForHefrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL........ ...... .................... ,.......... ..,
Shower, Gang............... ..................................... .......
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/W~II............................................... ...... ....
Wash Basin/Lavatory, $ingle...... ....,.......... .............
Toilet, Public Installation.... ....... ........ ........... ......-..
Toilet, Private...............................,................. .:,...
Miscellaneous:
'Z
'2.
'2-
4-
..{...
TOTAL FIXTURE UNITS.
UNIT
EQUIV ALENT
2
1
2
3
6
2
6
G
1
3
2
l/Head
2
2
1
6
4
FIXTURE ,.
UNITS
4
4
4
4:
t<o
7:J'2.
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
1979 or before
1980
1981
1982
1B83.
1984
1985
$3.46
3.38
3.32
3.21
3.06.
2.92
2.73
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
"
"
Credit for Parcel or Land Only If Applicable
G,4(.,,2
Improvement (if -after annexation date)
~~:.;
:, , 4{P X $ \ <t; , Co <6
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
$ io4- (p~