HomeMy WebLinkAboutPermit Building 1993-6-3
RESIDENTiAL
PERMIT APPLICATION
Inspections: 726-3769
OUice: 726.3759
SPRINGFiELD
~.~~,' ~~....-;.c--lIj
(-----c '
LOCATION OF PROPOSED WORK':-~(:;/iil
ASSESSORS MAP:
LOT:
'c><f!:;
BLOCK:
J6E"- StI IF /-!I/Z7E-- _. ---- -----""
HE AND i CONSTRUCTION,INC #71158
84'359 Par kway
PLEASANT HILL,OR 97455
OWNER: _
ADDRESS: -:
CITY:
DESCRIBE WORK:
..sJ:i::>
NEW ')(
REMODEL
CONTRACTOR'S NAME
'GENERAL: - HE and l' - , I
'-:ons'[;., 'nc.
PLUMBING: ----'
MECHANICAJ
ELEC~RICAL: j
I
I
! I
, QUAD AREAc:J
, I
1/ OF BLDGS:!
Bills Electric
Don Lewis Plumbing
Marshalls Oil & Ins.
I
OCCY GROUi
1/ OF STORIES Brooks Excavation
I
WATER HEAT&-,." _--'
'.
ADDITION
DEMOLiSI-j
OTHER
JOB~~Ui'.':BER' t9j 30 ~O'::l
-
225 Fifth Street'
Springfield, Oregon 97477
.. JI
-......
ADDRESS
CONST.
CONTRACTOR 1/
PHONE:
7t51b 3J'9~
96-'/- 76 t/ 7
84959 Parkway 71158
Pleasant Hill, Or 97455
3170 W 11th, 21351
Eugene, Or '37402
500 Greenfield 33076
Eugene, Or 97404
4131IE"St. 25790
Springfield, Or 97478
27661 Crow Rd 55921
Eugene, Or '37402
ZIP:
EXPIRES
PHONE
02/'35
726-3898
04/'34
687-1851
06/'3]
688-1931
12/'33
747.-7445
03/'34
345-7564
J
To request an inspection, you must call/726.3769, This is a 24 hour recording. All inspections requesteo:J 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.
"
D Temporary Electric
D
Site !nspection - To be made
after 8xcavation, but prior to
setting forms,
D
Underslab Plumbingl Electrical/
Mechanical - Prior to cover.
rv1" Footing - After t'renches are
~ excavated,
D
Masonry - Steel location, bond
beams, grouting.
Dr Foundation - After forms are
~erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
U( U nderfl o{l'f""P I u mb~~<M ech an ic..siJ>
~- Prior toln~uldllon or decK:ng.
/'-..,/I Post and Beam - Prior to floor
~insulat.ion or decking.
REQUIRED INSPECTIONS
C><( Rough Mechani'cal -'-"Prior to
, ,cover,
1\./1 Rough Electrical - Prior to
~ cover.
-of Electrical Service"':" Must be
~approved to obtain permanent
electrical power. '
D Fireplace - Prior to facing
materials and framing Ir,lsp,
~ Framing - Prior to cover.
t5<:f Wall/Ceiling Insulation - Prior to
, ,cover.
~ Drywall - Prior t~ taping.
D Wood Steve - l>.,fter installation,
D Insert - After fireplace approval
, and installation of unit,
.', ' ' - .....' .,;-..', .'- >. -.'
t><l Floor Insulation - Pri'or 'fa ,
..decking. _ .,' ~)::urbcut & Approach -:- After
. '. ',~orms are erectecJ but prior to
~ Sanitary Sewer - Prior to filling placement of concret~,
trench. .
1V1 Sidewalk & Driveway - After
~xcavation is complete, forms
and sub-base material in place.
,
fV1 St tormh Sewer ,-:- ~rior t? filling
~ renc. , . !~"- '\ ,
, ):.---...,'
'M Water Line':"'" Prior to filling
~ trench. .
,lX'l Rough PIUlnb;~g ~"';~ior to
'" --...s:;over,
'.
D
Fence - When completed.
@l~treet Trees --- ~hen all reqUi~ed
rees are pi anted,
~ Final Plumbing - When al!
~ plumbing work is complete,
J:;5<J' Final Electrical - When all
. electrical work is complete.
IV1 Final Mechanical - When all
~echanical work is complete.
KAFinal Building - When all
~equired inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - Wheri all
blocking is complete.
D Plumbing Connections - When
home has been connected to
water arid sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Fin<1j - After all required
inspections are approved and
porches, skirting, decks, and
venti01q have been installed. _.--~'~
/ . --,- -, ------- I
.J - -~- ,"
J~ ' ,
9.
S8tbacks'
P,L. HSE GAR I Ace
--- -:--- 'I--
I f:;; -I
I
is I j
I. vv.1 t 2- 12...\,
'!-~~~-I-~-~:- ,
1_, i._~_
BUILDING VALUE, PLAN CHECK;'..,
AND BUILDING PERMIT ' .' ,
VAUDATION'ffl#
_2:2/.7(7 REceiPT NUM[""Rg ~~.,
:3:2~,~O D/1TE PAID () ~ " '-. _( .
/9/ AMOUNT~' C-,.I1E,D ,~ L..-*~,--, 41'
_ __ '~_' TOTAL AMOUNT DUE (excluding electrical) ,..2f1--2- -t-' ;::)1 ~
(A, B,'C,-6:anc(E' CJr?lbir>ed) ______________________,~~CEIVED 8:._-:.::::__~., ..1---, dt61~) ~ .
Lot faces jf~ Lot Type
Lot sq, ltg, 1/!1S ~terior
Lot coverage ;?~p~ Corner
Topography L. 2~o .Panhanclle
Total height ~S' Cul-cle-s,ac,
\
BUILDING PERMIT
ITEM SO, FT. X $/ SO, FT.
N
V A LU E
Main
.' -(S~'~ Sf", , C,()
,- L..{ S?). '".:-, I '-t./ 0
9JPJ~Ltj
~31lL7 ,
Garage
Carport
2-1-c;~(p
-4J6,~
ZO,90
43g, 'to
SYSTEMS DEVELOPMENT CHARGE (SDC) LJZ..
J./ I 8 T"f-'
(B) fP I '11 ~ ..-
Total' Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residenti;,:1 Bath(s)
NO
?
/ G::/) pO
San: lary Sewer
, '
FT.
Water
FT.
Storm Sewer
FT. -
Mobile Home
Plumbing Permit
8!~dt?''''
1~f!:;2~
State Surcharge
- "
Total Charge
(C)
MECHANICAL PERMIT
--~~ -
__f,50
__9. .CJ 0
Fu rnace
Exhaust Hood
Vent Fan
NO ,,3
Wood Stove/'Insertl-Fireplace Unft
Dryer Vent
1St)-()
Mechanical Permit
22;;0
_I c). cl 0
__-' . J 3
33~3
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
~o
3D
__L~, ~_
_J:1-.5'o
ft
Curbcut
ft
Demolition
State Surcharge
-fJ1A-v ~/I?W
Total Miscellaneous Permits
(E)
"
"
IS -I PROPOSED WOI3K IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinafor prior to permit issuance,
APPROVED:
This permit is granted onthe express condition that the said
c~nstruction shall, in all respect's, conform to the Ordinance
adopted by the City 0.1 Springfield, incLuding the
D~:v'clopment Code, regulating the construction and use of
buildings, 8,nd may be suspended or revoked at any time
upon, violation of any provisions of said ordinances.
o ,-, .,., j" 7d
Plan Check Fee: _ ~ /-L-,
Date Paid:
Rec,eipt Number'
Rec~~
Plans R'8viewed By
{<'~ :1
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~ tJnb ):\~\S
~lJ~~ ~cJtuWJ(
,
P/hrt J
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 cor'rect, 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 certi fy ttlat only contractors and em ployees who
are in compliance with ORS 701.055 w"ill 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
frOf'n the street, that the p8rmlt card is located at ~hc front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signature d..~..K?_tL~L~.~L.
Date J:;?~i9 ~ .
'. ~..
-'
f
JOB NO. q?O~OZ
CITY OF SPRINGPIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: /-Ie & L ~tJS--r. I1Je.
,
LOCATION :-8[h'K 13oJ../~/f. LA-kif-
DEVELOPMENT TYPE: LDf.C.. - Nf.W :JrR
LOT m- "',ULE .fA-ilK.
BUILDING SIZE:
l. STORM DRAINAGE
IMPERVIOUS SQ. FT. 'Z-~Sl
2. SANITARY SEWER-CITY
NO. ,OF PFU'S /g
(See Reverse)
3. TRANSPORTATION
LOT SIZE
SQ. Ft.
X $0.192 PER SQ. FT.
c;S'f~ ~
----- ---
X $39.78 PER PFU
c:;,<o~)
--------- ---
NO OF UNITS X TRIP RATE X COST'PER TRIP
I
X / . at) 5
X $401.05 i
'~'~i_l~'A :.1
G:-t ()?:, (J~ )
----- -----
X
X $401.05 $
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ J&.(P,&:!-
, X
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
c0~~
TOTAL-CITY SDC $/75) 03:,
5. SANITARY SEWER-MWMC
NO. OF PFU'S / g x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ '2'?S ';
(Use PFU Total From Item 2 Above)
~,~L~
, Q. Kip Burd i ck
SDC Coordinator
7::J /2 c..J / q "'J
f /
$ 30 O.E.,
TOTAL-MWMC SOC~S~
1'6
TOTAL SDC $ ''11 (, -
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCUU\TIOr-.. _0 ABLE: Numb~r ~f NewFixtures X Unit l valent =' Fixture Units (NOTE:
For remodels, calculate only the NET additional fi~ures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
'2-
2 +
1
2
3
6
2 -z..
6
6
1
3
2
l/Head
2"2-
2
1 Z-
6
4 B
Bathtu b....................,......,........,...."",......."..,.,...."..., ,
Drinking Fountain...................."........."...,..,..."..,....,
Floor Drain............. ,.............., ,.....................,.......,....
Interceptors For Grease/Oil/Solids/Etc..,.....,........
Interceptors For Sand/Auto Wash/Etc..,...............
Laund ry Tub /Clotheswasher....".............",..,..........
Clotheswasher - 3 Or More............,........................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator jWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single StalL. ........ ....,..', ....... ......'"... ...... ..,..
S hower, Gang,.........,.......",......,....." ,......"...,.......".
Sink, Bar, CommerciaL........,.....".............".............
Urinal, StalljWall.. ............... ........... .......,.... ......,.. ......
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation..........................
Water Closet, Private......................................",......
Miscellaneous:
-z..
1
--z..
TOTAL FIXTURE UNITS
/8
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
$2.16
1.90
1,60
0.25
0.87
0.50
0.16
"2. 00
Credit for Parcel or Land Only If Applicable ,2. i:3 X$ / D . G, 70 -
(Rate X Assessed Value)
Improvement (if after annexation date) X . $
(Rate X Assessed Value)
CREDIT TOTAL = $ ~ ~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential.................., ................ ........ ............. 0.4
Commercial..........................~............:.............. 0,9
Ind ustrial................. ...... ........... ..... ..... ,........ .... ,. 0.45
Governmental.............:....,..,..,..............,........... 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
J.1/~/q~,.
; C' ..;., eiO\0;;': <,~, r,~-:~(~;':_~~::.~":(:'~, ;,~~':,' __,J , ....-- ~"~
1y.,~. .1~)llO'r\lh.;~.~.._~ ',~(.'L l:':~~". ,-' ~. ~ ~..
225 FIFTH STREET , ' ZCf':i~~~,;~~~t! Q'oJ' ELECTRICAL P'ERHIT APPLICATION
SPRINGFIELD, OREGON 974Jl't"'- . ~ l-17_~-..--- . 'q n ""JfJVJ
INSPE~ION REQUEST: , 726-3769:;:'/.;~'-\-~-?-- , City Job ,Number ,~_ JU\..Jt.--
OFFICE. 726-3759 ' ['~:(~j_~.l.-._---~. ,',_._____'-
, ' , " ....... I siO':1et:.;,0__- -- .---COMPLETE FEE SCIIEDULE BELO\l
1. hO;G.AU~ Ob~~A~LA'T:~Ower.. '. '>0' , ' , .' ,
cY(J~j)~-=:f JI.liLUD A. NewResidential-Single or
-, Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included: .
~ ~B ',~~Qj~dO~f)fJ2J~OIAff
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 B.
, ElectricalContr~ctorfi// /5 z/ec/:r'/c
Address3/)o b..:) //L-tu
City EuOvu Phone3t/3/353..
/
Superv-isor License Number 9,305
Expiration Date 10-1- CjS
Constr Contr. Number ;;;J/.35/
Expiration Date L/-/-?3
'. Items
1000 sq.ft. or less 1
Each additional 500
sq. ft or portion ,Q
thereof " )
Each Manuf'd Home or '
Modular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations or
Relocation:
200' amp's or less
201 amps to 400 amps
401 amp's to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Cost
Sum
8S
+5
$ 85.00
$ 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
@Z;Pf'~is'n
Owners Na~&t.Q Yi_i
AddressBZf($J-bJ/)).1 ~!!~
Ci tJ-.~ Phone7Lfo ~ ~
OVNER INSTALLATION
The installation is being made on
property I own which is ,not intended
for sal~, lease or rent.
,Ovners Signature:
~~~;~----t~o~~~c:t:=)~~~---~--------
RECEIPT #: . n ,MilfuL
RECEIVED BY: C:1) 1L)(X=-:/~&;=r
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
t
~
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
,;-
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit,
$ 35.00
$
2.00
E. Hiscellaneous (Ser.vice/feeder no t included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res S 20.00
Limited Energy/Comm $ 36.00
5.
\
SUBTOTAL OF ABOVE
5% State Surcharge
. TOTAL
_LJ;FJO-:- 00- "
,- ,-~~~ \.
~/- 'JB.;._:5C:L '