HomeMy WebLinkAboutPermit Building 1993-1-26
ASSESSORS MAP:
., 'LOT:' '" ," It./. '
OWNER:~ -J()f3- HIItTE
ADDRESS:- c?J./C)6Lt/?ffIZ/CZU~ /ZLJ"
CITY: PUIJSIi/JTIfI L(
SF/)
,,..~ .~'
RESIDENTIAL
PERMIT APPLICATION'
Inspections: 726.:j769
Office: 726.3759 .
LOCATION OF PROPOSED WORK:
DESCRIBE WORK'
NEW
IX
REMODEL
CONTRACTOR'S NAME
GENERAL: JI-~y. / {!--&7!}{f
PLUMBIN<L~,LA.o
MECHANICAI./l)4/l.SJlmiJ
ELEC~RICAL: ,8// 1.5
, SPRINGFIELD
.........::,....
BLOCK:'
STATE: &^-
ADDITION
DEMOLISH
OTHER
dULe ~()17 ~~
JOB NUMBER QJ3tY)Q'J
. - - ...;;;.
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
-", -,<", ." --q7'J;'-' fA /) .
SUBDIVISION: ; L-l-(!jJ~.:~ciJ~~
PHON 1='
%2-6 3ft??
ZIP: Q7Y'.53-'
ADDRESS
t?1959 jJ/}lt/~tu'47
QU() lb/lQfL17kLd
, fld i € /i2:I- .
'-- 'r/7L) Cd //16
CONST.
CONTRACTOR #
7/IS~
33Gl'/h
.c9579CJ
dl3~/ .
~~R~'7 PHONE
c:.r7'r' 7~i'9!
0/93 6P<?19S(
':/Of93 .7L/,?-:7r(V5"
Lf"93 ~<[(!S-/3S3
QUAD AREAc2f2JUuJ .:.... OFFICE USE -
LAND USE: I (/ I FLOOD PLAIN:
# OF BLDGS: I # OF UNITS: I J ZONING CODE,~JgJ
\~6'.~_ \1 ^-/ '.
OCCY GROUP: CONSTR. TYPE: # OF BDRMS: r-.
# OF STORIES' I HEAT SOURCE:t=:"'G SECONDARY HEAT: F'V'
WATER HEATER: 0 RANGE: f~ SQUARE FOOTAG E: \q\~
"
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 same working day, inspections requested after 7:00 a.m. will be made the following work day.
~ Temporary Electric
o Site Irlspe,ction - To be made
after excavation, but prior to
setting forms.
o Underslab PlumbinglElectrical/
Mechanical - Prior to cover.
T"V1 Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting. '
1~...(Foundation - After forms are
~ erected but prior to concrete
p~acement.
REQUIRED INSPECTIONS
'IVI Rough Mechanical - Prior to
)LJJ cover.
, I"c;( Rough. Electrical - Prior to
J.6l cover.
'rx1 Electrical Service - Must be
~ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
)R[ Framing"b., Prior to cover:
. l'7r' Wall/Ceiling Insulation - Prior to
~ cover.
o Underground Plumbing - Prior f:::?l, Drywall - Prior to taping.
to filling trench. ~
K/rUncierfloot1>lumbi~anical)' . " ~ " . ,.
~""7 Prior\ tb'l'rrsulation ()r decking. ~ W2~O~ftf:-';~tallatlon.
~ Post ~nd Beam ~ Prior to floor .
~ insulation or decking.'. -0 Insert -' After fireplace approval
and installation of unit.
~ Floor Insulation - Prior to
~ decking.
~ Sanitary Sewer - Prior to filling
~ trench.
~ . ~ ". . . -..
'l'c7'f Storm Sewer - Pri or to fi II i ng
~ trench.
.T'S?f Water Line - Prior to filling
~trench. , .
1'><:. T Rough Plumbing - Prior to
~cover.
K71' C~rb'cut & Approach -'After
~ forms are erected but prior to
placement' of concrete.
r'~{'Sidewalk & Driveway - After
~excavation is complete; forms
and sub~base material in place,
'0' Fence - When completed.
_ ~tree.t Trees .......Wti'~n 'aif'required
~rees are plant'ed. .
I.
~ Final Plumbing - When all
..Y"1~plumbing work is complete, '
'~[ FinaIElectrical'- When all '
~electrical work~s <?ompl.ete.. ,:
l:5<:J Final Mechanical - When all
, ..mechanical work is complete,
,
M Final Building - When all
_~required inspections have been
approved and building is
completed.
./
o Other
MOBILE HOME INSPECTIONS
D 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 - After all required .
" ' inspections areapproved and
porches, skrrting, decks, and '..
venting have been,,installed,
..:t
Lot faces ~'. Lot Type Setbacks fHE PROPOSED WORK IN THE
S:l-tJD ,:4- Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. ftg. IN liP' I THE HISTORICAL REGISTER?
Lot coverage "<S-~ Corner If yes, this application must be signed
j2-~D Is /~' I and approved by the Historical
Topography Panhandle
1 ,~.:) (p' I Coordinator prior to permit issuance,
Cul.de.sac W
Total height t;/ ~' I
E APPROVED:
BUILDING PERMIT
ITEM SO. FT.
Main
~5
427
Garage
Carport
Total Value
Building Permit Fee
State Su rcharge
Total Fee
X $/so. FT.
5"" ~Q
#1'0
(A)
VALUE
~54 S-7
t?020
~cr17'7
~.~
'2D /S'
42.~/S
SYSTEMS DEVELOPMENT CHARGE (SDC) $
(B) IhqOg~
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
?
FT.
FT.
FT.
(C)
NO
'<
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Su rcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
~
~O
ft
ft
Curbcut
Demolition
State Surcharge
J;!J-~.J ./?N1bV
Total Miscellaneous Permits (E)
FEE
/ (',-j)
---,
~~
/6!b~
0CTO
4.50
,
9~
/5.00
~e-o
&.- ,
~750
I
JD,O-O
l~~
4j.?8
)q.O()
-Jif ,5rtJ
4o~
y
~;5O
. '
'Z22 ~1'
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of a~p.rOViSions of said ordinances,
Plan Check Fee\ \:>h 1.1\-/ '2 1M <:P
- - 2LJ~
Date Paid: .,
Receipt Number'
ft:Y~
/h~h 3
I D<;Yfe
Rece~v~~
PI~~V~t" ~-
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
(~l1JlJ)Sln V~ fi 1J li b 0 U
\~Ti
\ \:AMi) >r l,ltrco! \ q,!~~
, .
~ ^Y) 1JlLO 1) ~d(JL2-tlYV2. .U2J
L~):: .7T7 .~~ ~ ~. .,/L/
By signature, I state and agree, that I have carefully examined
the completed applic,Hion 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
herein, and that NO OCCUPANCY will be made 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 card is located at the front
of the property, and the approved set of plans will remain
on the site a~" times ~~ring const:~ction.
SignatureVJ/..fi/dJ//)j LiLuLt, _
~. '-
/-c?b-~~
Date
VALIDATION:
RECEIPT NUMBER "'7 L./~ /'
r '
DATE PAID -? -2 -9~
AMOUNT RECEIVED ~ ~s;..f;1'
RECEIVED BY /.k . ~r""'----;:>
", - , r/ r ~ AY ~
,
".
, JOB NO. Cf?oo'l'i.-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~1Oe. J-lif?-TF:
LOCATION: -?-.7.-t../- ~ 130NN IE- LANE:..
DEVELOPMENT TYPE: L-D/Z. - tJ/3-W 5FI<
,
LeI Ii.{- NfCOU=: ~
BUILDING SIZE:.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. "20Z,?
2 . SANITARY SEWER-CITY
NO. OF PFU'S 1<6
(See Reverse)
3. TRANSPORTATION
LOT SIZE
SQ. Ft.
X $0.192 PER SQ. FT.
c0gLf ~0
X $39.78 PER PFU
G-, t (" 0;;
-- ~
NO OF UNITS,X TRIP RATE X COST PER TRIP
i X /, ~ 5 X $401. 05
X
X
X $401. 05
X $401.05
C1/o300
$
$
SUBTOTAL (ADD ITEMS 1,2, & 3) $ I (Po3 6':::
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
<C f:o_I~)
TOTAL-CITY SDC $ 1(P<t'? ~
5. SANITARY SEWER-MWMC
NO. OF PFU'S IV, x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ 'Zst;,j<O
(Use PFU Total From Item 2 Above)
~~L~
() Ki P Burdi ck
SDC Coordinator
I /~8/ q?J
I I
$~-
~
TOTAL-MWMC SDC\~~~'~)
TOTAL SDC $ /q 0 ~ ~~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
c,
FIXTURE UNIT CAlCULAT7~ TABLE: Number of New Fixtures X I. . Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
'NUMBER OF
NEW FIXTURES
UNIT FIXTURE.
EQUIVALENT UNITS
I
2 2-
1
2
3
6
2 2-
6
6
1
3
2 7.-
1/Head
2 2-
2
1 -z,.
6
4 ~
Bathtub,..... ,.............,.....".......,..................................
Orin king 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 Per Trailer)..................
Receptor For Refrigerator /Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL........ ....... ............. ..... .......... ....
Shower, Gang........... ...... .... ........... .......... ... ... ..........
Sink, Bar, CommerciaL............................................
Urinal, Stall ;WaiL..............,.... ........,......... ....... .........
Wash Basin/Lavatory, Single.................... ....... .......
Water Closet, Public Installation.............................
Water Closet, Private........... ........,.. .........................
Miscellaneous:
I
-z.
z,
TOTAL FIXTURE UNITS
l~
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
$2.83
2.76
2.71
2.60
2.46
2.33
1985
1986,
1987
1988
1989
1990
1991
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
Credit for Parcel or Land Only If Applicable :J.-' I 8 ~ X $ 10, (., ~o
(Rat~ X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = $ ~o-
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R esid ential........................ .....................,.......... 0.4
Commercial........ ..,......,..:... ................. ...",....... 0.9
I nd ustrial....... ..... .,....,',.. ..:..,....,.,............. ,.......... 0.45
Governmental..........,.".,................................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
r
~,A~
~~
225 FIFTH STREET F;~ following project as submitted has 'E.bE<roRw€AL PERMIT APPLICATION
~~~=~~~:;>im~:~~~ 9~~~~37i~;j:~~af.nd does n~ r~ir0specmc la~~ ~~. e JO'~ Number . Cl3rr-:rr ~
OFFICE: 726-3759 Zorllng~_(....,il~ . , . -
l.LOcA:q;Ol' OFWTALLATIO~~e~ d -j})-'2? ~ COHP4lTE .PEE SCHEDULE BELOV
,C\QfJ~('{LD i i,A +'" 7(fJf~re-z-N~ New-Res'i-den-t-i-a-l-Single or
. --:- Mul ti-Family per dwelling uni t.
LEGAL DESCRIPTION.~ '. , Service Included: '
~r/~ ffi~~c~.A-A".Items Cost
"
. JOB~ESCRIPTION
0~ '~OI)}C10 (l~
\Ct\R8'
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days. '
2. CONTRACTOR INSTALLATION ONLY
City ~'J~eP1_n Phone
Supervisor License Number
Expiration Date .' /a- / - 95
Cons t r Con t r . Numbe r ~-I ,35/
Expiration Date L/- /- 9' 3
~.na e of~rvisin E ctrician
~(~ -
Owners Name~)' .)\ ~
Address m ~ ,~~)\'tY~i\e&.
Ci ty \J\ ~ Q ~ Phone 1!Jio'( qR3~
OVNER INSTALLATION
Thei~stallation is being made on
property I own which is ,not intended
for sale, lease or rent.
,Owners Signa ture:
DATE: ~ -";?-?;l
RECEIPT #: ? Yo /
RECEIVED By:~h:..- ~
1000 sq.ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
.~
Sum
$ 85.00
f!J5
30
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 ~mps '
401 amp~ to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 15,00
$ 40.00
$ 50.00
$ 60,00
$100.00
$130. 00
$300,00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less ~
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
4n
above
New, Alteration or Extension Per Panel
One Circuit
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 /5S,CO
5% State Surcharge ~,7S-
TOTAL ./ ~ 2- ,7-s-