HomeMy WebLinkAboutPermit Building 1993-9-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
\ C( 60
ASSESSORS MAP: '
t.f
LOT:
OWNER:
ADDRESS'
CITY'
[)tAP \.p_~
DESCRIBE WORK:
NEW K REMODEL
ADDITION
CONTRACTOR'S NAME
- -"......,..,....-.~-
SPRINGFIELD
~
<O)L\ 4
JOB NUMBER ~ /2'/7
225 Fifth Street
Springfield, Oregon 97477
f0.
JCJ~
TAX LOT:
i,'
BLOCK'
SUBDIVISION:
U\(Q)l ~
DEMOLISH
OTHER
A'n~~5..\-
% ><~hq'f>~~
O. ~ ' STATE: ~
ADDRESS
- '-C-oNST,
CONTRACTOR II
I HE and i Const.,Ine.
84959 Parkway 71158
Pleasant Hiil, Or 9j45S
02/~35
Bills Electric
3170 W 11th,
EUgene, Or '37402
21351
04/'34
Don Lewis Plumbing
500 Greenfield
EUgene, Or '37404
33Q76
06/'34
Marshall s Di 1 ~(Ins. 4131IE"St. 25790
Springfield, Or 97478
12/'33
55'321
03/'34
PHON E:
,7d.6&~~
ZIP: ~~4---SS
EXPIRES
PHONE
726-38'38
587-1851
688-1'331
747-7445
345-7564
27G51 Crow Pd
EUgene, Or '37402
, .' , '" ' ' ,.. ,,' ,~' ." ~ ' .. . , ,,-,--
~'-To request-an-rnsp-ectro'h, 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.
Brooks Excavation
~ Temporary Electric
f':7l'Site Inspection - To be made
,~after excavation, but prior to
setting forms. :5~S
o Underslab Plumbingl Electrical!
Mechanical - Prior to cover,
~' Footing - After trenches are
~xcavated.
o
Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~ erected but prior to concrete
placement
D Underground Plumbing - Prior
to filling trench.
1Vf' Underflo~lum~ Mechanical
~ _ Prior to insulalion or decking.
I":7f Post and Beam - Prior to floor
~ insulation or decking.
~ Floor Ins~'lation - Prior to
I~decking.
15<1' Sanitary Sewer - Prior to filling
. .trench"
/VI Storm Sewer - Prior to filling
~ trench.
15<1 Water Line - Prior to filling
. trench,
TV/' Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
K7f Rough Mechanical - Prior to
~ cover.
~I Rough Electrical - Prior to
~cover. ,
l'V'r Electrical Service - Must be
~approved to obtain permanent
electrical power.
1><1 Fireplace - Prior to facing
. materials and framing Insp.
~ Framing - Prior to cover.
,,1':71 WalllCeiling Insulation - Prior to
~ cover.
!><:t Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
1Vf Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
WI Sidewalk & Driveway - After
'~excavation is complete, forms
and sub.base material in place.
o Fence - When completed.
W"
'S Street Trees - When all.required
trees are planted.
'K7(' Final Plumbing - When all
~ plumbing work is complete.
~. Final Electrical - When all
)L-~Iectrical work is complete.
~ Final Mechanical - When all
~ mechanical worl< is complete,
JV1' Final Building - When all
~ required inspections have been
approved and building is
completed.
D Other -
MOBILE HOME INSPECTIONS
[J 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 are approved and
porches, skirting, decks, and
venting have been .installed,
Lot faces
I
~,
~
$S!)o
L..Z ~()
OS;
Lot Type Setbacks
~ Interior P.L. HSE GAR Accl
~ C~rner N 5
, Is J~ /8
Panhandle
Cul-de-sac Iw ~A
IE IM./!:A.,
Lot sq. ftg.
Lot coverage
Topography
Total height
/
, '
BUILDING PERMIT
-:..
ITEM
sa. FT.
/~a~
? 6"7; -$:
. _#tI/o
x $/S,Q, FT.
VALUE
Lo~I!iZZ.
. "
-ILL." 2- '
Main
Garage
Carport
JLSN0i
~1.&O
::23,1-5
(A) 13 '24$
SYSTEMS DEVELOPMENT CHARGE (SDC) /f3
( (B) #O(P'f'3 ~
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
'\...,\.
FEE
Fixtures
Residential Bath(g)
NO /2.)( J?~
}- , ,
FT.
3?O,OO
Sanitary Sewer
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
J~fJO
~,%~O
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
CJ.~()
.
---L2 .0-0
'. Vent Fan
NO 4-
Wood Stove/lnsertlFireplace Unit
Dryer Vent
fr::"O,C)
Mechanical Permit
2'1.(!Je;J
e
/ to ~-()
. - J ~, )'
2,.fh J ~
~. '-- I
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk Lh ~ ft
Curbcut -0~- ft
:< 4.iS
I ',-
jQ,7S
Demolition
State Surcharge
pLtv. ) .~~
301~S'
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
~~I
IS THE PROPOSED WORK IN THE
, HISTORICAL DISTRICT, OR ON h C'..
THE HISTORICAL REGISTER~~ .r;
If 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 condilion 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 any provisions of said ordinances.
Plan Check Fee: f;1J4.S.s-
Cd I__
Date Paid: --r"f5/"l 1'-7:::;;
Receipt Number:
Rec::;~~~
Plans 1:::::wed By -
9A-g,/~3
, Date( -
Systems Development Charge is due on all undeveloped'"
properties within the City limits which are being improved,
ADDITIONAL COMMENTS,
" -, ~
(WJlJX)11i Q )j~lI fifv.Y1Jl/t.) ,
- v--
u4+ --r: '_~ -Ll\- ~~~
~~f\Q)( CD, 0"), \C1r\'S _' ,
Pkt71 .1
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 during construction,
Signature ~~/./~(~,~"
&"-ci~-93
Oat"
VALIDATION:
RECEIPT NUMBER
1-'1'-/ :Leo
q !-:l0 lq?;;>
t::::/ 2. / . S- /
'-'h)B
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
'OB NO. Cf?J/21,
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: \, AI-\ L-~U 1-::'\
LOCATION: lot (PO ~ONtJ IE- ~ -z.. \ t1 Lf I'--l. ~o T~
DEVELOPMENT TYPE: LD~ - ~E;lN 1)lJ Pl--E.-'Jl
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
,LOT SIZE
,SQ. Ft.
?1Cf"7 ??
X $0.203 PER SQ. FT. 00G.~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
?'Z--
X $42.08 PER PFU
0"~ $V
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S 3"2. x $15.125 PER PFU + $10 MWMC ADM FEE $ '11"'- 6~
(Use PFU Total From Item 2 Above)
MWMCCREDIT IF APPLICABLE (SEE REVERSE) $ ~+b.!..
. TOTAL-MWMC SOC 0.5'1'2)
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ ~'I7o ~
X $424.31
~~1 I?)
'-- -.--/
$
$
'Z.
X t,ol X $424.31
X X $424.31
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~,.L~ ~ !~I i:;'f,
. ~. Kip Burdick I f
SDC Coordinator
C1~€)
,,~
JOTAL SDC $ "2;Jt::,&-/- ~ -
d
.1
't ", ,. , ~'. . . ,"(
FIXTURE UNITCALCULft ,)N TABLE:,NUmber of New Fixtures
. - ,
For remodels, calcul~te only the NET additional fixtures)
lit Equivalent = Fixture Units (NOTE:
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
2.
2
1 .
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4-
Bathtub.......................... ...... ..,......................... ..........
Drinking Fountain....... ........ ...... ,................ ...............
Roor Drain........... "'." .... ....... ..........,.....:...... --..:. ..... ,.
Interceptors For Grease/Oil/Sollds/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
laundry Tub jaotheswasher...................................
aotheswa~er - 3 Or More.................~'...................
Mobile Hdme Park Trap (1 Per Trailer)..................
Receptor F<?r Refrigerator /Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single' StalL.......................................... ....
Shower, Gang............ ............ ..........:........... ..... .,......
Sink, Bar, CommerciaL............................ ................
Urinal, Stall /Wall.. ...... ......... ......;......................... ......
Wash Basin/lavatory, Single..................................
Water aoset. Public Installation.............................
Water aoset. Private..................... ....... .... ...............
Miscellaneous:
2-
2.'
""
'f
A/-
If-
'f
Ih
TOTAL FIXTURE UNITS
72.
CREDIT CALCULATION TABLE:
calculate credits separates.
I"
Based on assessed value. If improvements occurred after annexation date in table,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
19~
1984 '
, '1985
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
1986
1987
1988
1989
1990
1991
1992
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
.~. ""1'
Cr~it for Parcel or Land Only If Applicable
Improvement (If after annexation date)
~.1,...' X $ \o.(p
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
3Lf 0 ~
= $ ~+~
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
'. d has the 'o\io'N\\\ ~,A
S $ubml\.c nd uno ~j
. I \loWing prolec\ a . u1ra specnic la . '-'1
225 rIFTH ~TREET :~~\~~g. e.nd does not reo. , ELECTRICAL P'ERMIT APPLICATION
SI'IUNGFIELD, OIlEGON 97/17iiJ;iJfOVe.I. 1-1)0 - (7J 1
. INSPECTION REQUEST: 726-3769Zof'lin;].~ City Job Number ~131jj ') .
OFFICE: 726-3759 D~e_~.~~ r-Ol
-- "leD ~D~P~'iL ~E scnEDULE DELOY
1. IIAq~T(I)O(N, A: ~ I~S!~L~1lJJ_f.J4t1f.~d S(\iGl~'O~rQ~A.
LjLy \tfA'-r~ II~ I -, N New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
\\ JOD DESCRIPTION " f) 1_t::.l\ry
~Ii ~[)l OJ{, c+ ll_0.(Y12P QUJc. ~
pcrmit~are non-transferable and expire
if work is not started within 180 days
of issuance or if w6rk is suspended for
100 days.
2. CONTRACTOR INSTALLATION ONLY n.
Elenrical Contractor (B) 'lis E/~/c..
Address3/70 Wd J/-th
City CL!9f.ne. Phone 3l.J3/353
Supervisor License Number 208'-1 G
Expiration Date 1()-/-CJ3
Constr Contr. Number.213.s (
Expiration Date
L/-J - qt)
Sig~t(.;e,OfItU~ing Electrician
~CAY r~~
Ouners ~mdh 19WJ5l:l~<JI-1i
^ddressR49~~(~1-L
c i t * A~ tlLQ~ Phon~9 ~\o- 2-ff5
O~NER INSTALLATION
The installation is being made on
property I own which is not intended
[or sale, lease or rent.
Owners Signature:
~~~;~--~-~--0/~~1~~------------------
RECEl PT #: 'I 04).(p
HECETVED BY :,IS:2B_ ____
1000 sq.ft. or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
~
rJJ
/10
80
$ 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
200 amps or less 1
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
4 (~)
$ 40.00
$ 55,00
$ 80,00
see "nil above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Com~
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ADOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40,00
$ 40,00
$ 20,00
$ 36.00
~D.oO
I~,OO
a~.CD