HomeMy WebLinkAboutPermit Building 1993-1-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726~3759 '
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT
8
SPRINGFIELD
~-
~/'-f ~0/)17)~,
'L/CJ1tl IE-
BLOCK:
" ,
OW.NER: ,)OEHI12..7E
ADDRESS: R4C/a-QjJ/ij(kLuffL1 11.-0
CITY: ()/.R.AS4I)T,II/LL
DESCRIBE WORK:
:SFD
NEW X.
REMODEL
CONTRACTOR'S NAME
GENERAL: He 10' ~rnsf
PLU.M~ING: J...Q...LUI-S
MECHANICAL: /l14-/lSHAl.{J
ELEcTRICAL: .15-/ J1 \'
I QUAD AREAr<> RmLU
1/ OF BLDGS: . I
OCCY GROUP: J{~ ~ N\
i
?~,
1/ OF STORIES:
WATER HEATER:
STATF'
CJL
rfftA d()17 ~
, 1
JOB NUMBER q~rn';,
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
, '.; .'
SUBDIVISION: /J) {!()LE M/(I::_
PHONE:
9547faV7
ADDITION
DEMOLISH
, OTHER
ZIP: 97V:3S
I
\
~~~IRES
./9l/
C?/qS
,1~93'.'
0/93
CONST.
ADDRESS CONTRACTOR 1/
61/9S1 jJ~ljMt' 71/~
560 0~/)"c( t::uJ :~~ 70
.1/1.3 I ,E kat Q5 /9Q
3/70 W / )~ c9/36/
REQUIRED INSPECTIONS
["V(RoU9h Mechanical - P;ior to
~over.
~ Rough Electrical, - Prior to,
~ver.
~, Electdcal: Service - Must be
approved to obtain permanent
lectrical power.
D 'Fireplace - Prior to facing
materials and framing Insp.
~raming :- Prior to cover.
1'\71' Curbcut & Approach - .!\fter
~ forms are erected but prior to
placement of concrete.
"dSidewalk & Driveway - After
~ excavation is complete, forms
,and, sub:base material in place,
o Fence - When com'pleted.
,~treet Tr.ees ....;; When aJl'require'(j'
trees are planted. ' ,
PHONE
7db3?92
f:l!R-/~ I.,
7Lf7~7C/'Vg;'
~~3-I353
;.... OFFICE USE -
Lf I I
I '
:~:S~::T:~PE: " V AJ
HEAT SOURCE: ~G
T.J
LAND USE:
RANGF'
To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections req&ested before 7:00 a,m.- will be
, " " " I
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
\
. MWall/Ceiling Insulation - Prior to
~over.
D Underground Plumbing - Prior rvf', [ D"rywall _ Pri~r to taping.
to filling trench. ~
K7l Underfloor1'1Umbi~anic~ -f'7f,' ," '. ',' , : -
~- Prior t~ICHlon or aecKlng. ' ~~t~n)S~lon.
Iv(post and Beam - Prior to floor
~ insulation or decking. D Insert - After fireplace approv?'
and installation of unit.',
~ Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
, setting forms.
D Underslab Plumbing I Electricall
Mechanical - Prior to cover.
ix1' Footing - After trenches are
~excavated., "
D Masonry, -, Steel location, bond
beams, grouti~g. ,
r><t' Foundation - After forms are
t>erected but prior to concrete
placement.
-c:7f' Floor Insulation - Prior to
~ decking.
M Sanitary Sewer ~ Prior to filling
~rench.
."'.... ",", . :-.. .'
m Storm Sewer - Prior to filling
I' "irench.
1'\71 Water Line - Prior to filling
~trench.
,1'\:71 Rough Plumbing - Prior to
~ove~ ,
\ '
IV1Final Plumbing - When all
~ plumbing work is complete,
, m Final Electrical - When all
~electr)cal work is ~omp.I,ete.
'1'71 Final Mechanical - When all
~mechanical work is complete.
~ Final Building - When all
~equired inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all ;'
blocking is complete, !"
D Plumbing Connections - When'
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved'
and the home is connected to
the service panel.
".
D Final - After all required
, inspections areapprove'd and'
" ' porches, skirting, decks, and
. venting have been installed,
Lot faces 0. Lot Type
GIro .jJ Interior I P.L. I
Lot sq. ftg.
,'S5% IN
Lot coverage Corner Is
Topography ~:;z.~ Panhandle
~ Iw
Total height.. Cul-de-sac
IE
BUILDING PERMIT
/6'
L ,--IE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON(\ 1\
THE HISTORICAL REGISTER? \ U)
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I I
HSE GAR ACC
/~:/
0'
(pI C/
ITEM sa, FT. x $/sa. FT. VALUE
Main -1-4-9;; '5 5tb?{) >p)~57
J410 ' ,
Garage 42-7 /dJ71')
Carport
Total Val ue
2;1111
4o~ao
. 2D./~
+23/5
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) tfg
(B) 1U!10(P ~
PLUMBING PERMIT
ITEM
FEE
Fixtu res
Residential Bath(s)
NO
2-
~.oo
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
~60
J h0,OO
Total Charge
(C)
MECHANICAL PERMIT
~
Lt'~O
f
t?60
I
pOO
,~OO
Furnace
Exhaust Hood
Vent Fan
NO
'=s
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
< /. ~O
/0,00
~ ~~
;,
49, "3f6
Issuance
State Surcharge
Total Permit, "
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ ft
Curbcut ~ t) ft
/9,00
14.5",0
Demolition
State Su rcharge
PLA,u A$i;/ i3u:J
~OPD
7-5.5"0
.
~ 2,L). Ct;7(p
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A~ B, C, D, and E Combin~d)
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, regulating the construction and use of
buildings, and may be suspended or revoked at any time
~~:nn ~~:::;O:'~h~~ eo
Date Pa;d, ~ -
Receipt Number'
//2-'lAs
( Dape
Systems Development Charge is due on all undeveloped
properties within the City Iimits,which are being improved.
ADDITIONAL COMMENTS
(lUJLh&t& ~dri,~
"W+ T .1
~~ [)(1 t-CG.' ,a:!LCS
~__ (lD/C!)()/1~~ )
~ ...,
I ,
By signature, I state and agree, that I have carefully 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
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 at all times dtng constructi_on,
Signature~1/)fi..'{ t1})~~
Date /-d26 ~93-
'}304 .
RECEIPT NUMBER
DATE PAID 27~,4-/ c:J'/0-C(~
. ----
AMOUNT REC~IVrcf '-~
RECEIVED B(;;f{.{:j).~)
VALIDATION:
- JOB NO. ~?ooq'~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT ,CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~ot::: UIR-rE
LOCATION: "Z 0 "1 '-f 1~.xnj k.i I E lA-t-J e..
DEVELOPMENT TYPE: LDt<-.- t--\t:::w S~~
BUILDING SIZE:,
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. -z...1?\"1.- . X $0.192 PER SQ. FT.
LC'1 ~ - N l Co L E::f}~R.. \c:.
LOT SIZE
SQ. Ft.
~g/-'~?)
--- ~
2. SANITARY SEWER-CITY
NO. OF PFU I S I <6 X $39.78 PER PFU
(See Reverse)
0/&:v
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
\ X \ .O()S X $401.05
X
X $401. 05
CLf03V
$
X
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ I&'o I ~
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~gO 0"1)
......... ~
TOTAL -C ITY SDC $ I ~S 10+2
~~~cL:~,
f~""(r Kip Burdick
SDC Coordinator
I /";5 /13
I f
$ ~-
~
TOTAL-MWMC SDC\l:-ZS:;)
TOTAL SDC $ /qO& (p~
MWMC CREDIT IF APPLICABLE {SEE REVERSE)
FIXTURE UNIT CALCUU\TI~ .~ TABLE: Number of New Fixtures X lJ ~quivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
'2-
2
1
2
3
6
2
6
6
1
3
2
1 jHead
2
2
1
6
4
'Z
Bathtu b...............................................,......................
Drinking Fountain................. ...... ........... ........ ....... ....
Floor Drain. .,.......;. ........... .... ...... ..... ........... .......... .....
Interceptors For Grease/Oil/SolidsjEtc.................
Interceptors For Sandj Auto Wash/Etc..................
Laund ry Tub /Clotheswasher..... ............ ..... .............
Clotheswasher - 3 OrMore..................~..................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator /Water Station/Etc........
Receptor For Commercial SinkjDishwasher /Etc,.
Shower, Single Stall.. .... .... ... ............. ....... ..... ....... ,..,
Shower, Gang, ............ .... .... ....,.... ........ .... ........ ........
Sink, Bar, CommerciaL............ .:....,........... .........,..
Urinal, Stall fWall....................,........ ...... ........... ..... ....
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation.................,...........
Water Closet, Private............ .............,................. ....
Miscellaneous:
I
z
I
2.-
2-
z.
"2-
D
TOTAL FIXTURE UNITS
l<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 -2, ~ ~ X $ /0. (.,. ~~ --
(Rate X Assessed Value)
Improvement (if after annexation date) X $ ::
(Rate X Assessed Value)
CREDIT TOTAL = $ >0 ,-
. RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resid entia!........................................................ 0.4
Commercial...................................................... 0.9
I nd ustrial........................................................... 0.45
Governmental.. .... ....... ... ........: ....... .......... ..... .... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
"I. Jl!owir.g project as submitted h:.'"1 the folio..", ~f
Z,,:il Irlg , and de as not require spo.;;j':ic IOil,:'; us:} ~
225 FIFTH STREET "approval. (0 " ELECTRICAL PERHIT APPLICATION
'SPRINGFIELD, OREGON 97477 7o":nC! L.j)K ff/1(y"\n.a
INSPECTION REQUEST: 726-3769 :="'1:\'''',- '9'> Ci ty Job Number . '--'I\:) 1 J"J.....-=:)
OFFICE: 726-3759 ' Date d () :>
__ '" ,', gpth rized Signature 3b ~HP,LETE FEE SCHEDULE BELOV
1. k9C<A^I~ OFd~LLATION ,- ."
C-\)C)' A'l ,~ll.n 1 n .f]O ./ A. New Residential-Single or
, . - - - - ~ Mul ti-Family per dwelling uni t.
LEGAL DESCRIPTION, Service,Included:
~~ "00~ \C\\~8'
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
, Electrical contracto~~ c;/"cf
Address 1(}() Wi JT II ~
Phone 3 It) 1'7 f ')
tJfoS
//J-l- '75'
Ci ty <::;: // 6,_
~
Supervisor License Number
Expiration Date
Constr Contr. Number ~ / :3 S (
Expiration Date
'-1-1- '1'
, Signature of Supervising Electrician
~~ ~
::r: Name J\~ ~
Address E'4%q~ lhn y lL~X
Ci t~ P W ~ PhoneGCS4- I1.cftI/J
OVNER 'INSTALLATION
The installation is being made on
property I own which is not intended
,for sai~, lease or r~nt.
.Owers Signature:
-------------Tf--T-----~~-------------
DATE:' C--:/' (()..... q ~
RECEIPT #: IJ << ' J ~zr.
RECEIVED nY\~UJ&' ~ - .
", Items
_1000 sq.ft~ or less
Each additional 500
sq. ft or portion
thereof '
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
, Cost
Sum
t5
~
{
$ 85.00
c4
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
B.
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00 -""
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 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
D.
Branch Circuits
/ $ 40.00
$ 55.00
$ 80.00
volts see "B"
-1D
above
New, Alter~tion 6r Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline 'Lighting
Limited Energy/Res
~imited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit,
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
,~
$ 35.00
$ 2.00
not included)
$
$
$
$
IS-S.O-O
775
~2-.7.j
40.00
40.00
20.00
36.00