HomeMy WebLinkAboutPermit Building 1993-5-26
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~ESIOENTlAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
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LOT:
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BLOCK:
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ADDR~
CITY: -'
HE AND 1 CONSTRUCTION,INC i71158
84959 Parkway
PLEASANT HILL,OR 97455
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DESCRIBE WORK:
8f=D
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9'3ifH1)
JOB r..JUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
nl~~K
PHONE:
7r9.1o 3gCj~
ZIP:
NEW V REMODEL ADDITION DEMOliSH OTHER
7 CONST. /' ,
CONTRACTOR'S NAME ADDRESS CONTRACTOR 1/ EXPIRES PHONE
GENERAL: _ -------
const., Inc. 84959 Parkway 71158 02195 726-3898 _t
HE and i
PLUMB'ING: ~ Pleasant Hill, Or 97455
MECHANICAl 21351 04/94 687-1851 I
Bille Electric 3170 W 11th, I
ELECTRICAL: Eugene, Or 97402
I
Lewi5 Plumbing 500 Greenfield 33076 06/93 688-1931 I
Don
'OUAD AREA: _ Eugene, Or 97404 i
1/ OF BLDGS: I Mar5halls 011 & Ins. 4131IE"St. 25790 12193 747-7445 I
I springfield, Or 97478 r--
OCCY GROUi I
27661 Crow Rd 55921 03/94 345-7564 I
II OF STORIES BrOOKS Excavation I
I Eugene, Or 97402 I
WATER HEATE
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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.
I KI Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing I Electrical/
Mechanical - Prior ,to cover.
~ Footing - After trenches are
~ excavated,
o Masonry - Steel loc'ation, bond
beams, grouting. , _
'I':7l" Foundation - After forms are
~rected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~ Underfloo~lumbil1~~chani~
~ - Prior to insulation 1Jr decking,
~ Post and Beam - Prior to floor
~insulation or decking. "
"
1M Floor 'l-nSUI~ti~~ ~ Pri'or,'to' ,
~decking, .
l'vf Sanitary Sewer - Prior to filling
~ trench.
1'\71 Storm Sewer - Prior to filling
9 trench.
,
I"'XI' Water Line -:- Prior to filling
~ trench.
.. . " '"' . ~ .
FV1' Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS,
.1':71 Rough Mechanical - Prior to
~ cover,
1""X'r"Rough Electrical - Prior to
~cover.
/ ,
~l Electrical Service - ,Must be
~approved to obtain permanent
eleytrical power. .
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
IX1 Wall/ Ceiling Insulation :.......:. Prior to
" cover.
~ Drywall - Prior to taping.
,? ," .
@ioOd Stove - After installation,
o Insert - Alter firep!ace approval'
and installation of unit.
~ Curbcut & A'pproach - After
~ \" 'forms are erected but prior to
placement of concrete. -
~ Sidewalk & Driveway - After
~excavation is complete, forms
and sub-base material in place.
o Fence - When cOl1)pleted.
~treet Trees ~ When all required
" trees are planted.
"
TXl Final Plumbing - When all
~plumbing work is compl.ete.
K;r1=inal Electrical - When all
~ electrical work is complete,
I5<f Final Mechanical - When all
( . mechanical work is complete.
~;' ,
, ,Final Building - 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,
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 are approved and
porches, skirting, decks, and
venting have been installed.
. ~. !
~b_tType __
-1!2 Interior
Lot. tJces _~_
Lot sq. Itg. ~
Lot coverag,e:3~%
Topograph'y' L2f')o
Total height W'
Corner
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM
SQ. FT.. '. X $/SO, FT.
Main
/31:, ~
5'"2~
Garage
Carport
-
Totai Value
BUil~ing per~ee
State Surcharge
'Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO'
z
Sanitary Sewer
FT.
Water
".
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
"c
Exhaust Hood
Vent Fan
NO
.'<
Wood Sto~e/lnsertlFireplace un'{f'
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
. Mobile Home
State Issuance
State Surcharge
Sidewalk
~rJ
30
ft
ft
Curbcut
Demolition
i,
I:
State S~rcharge
pi Ax.> ~CVI e7A.J
Total Miscellaneous Permits
(E)
I P,L,
I
I
IN
I
Is
Setbacks.
IHSE GAR Accl
,~
\ fi!/!:;E PROPOSED WORK IN..;fHE
HISTORICAL DISTRICT, OR ON -
THE HISTORICAL REGISTER?
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SYSTEMS DEVELOPMENT CHARGE (SDC) #3
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, (8) '1f ,qZI-
~UJ7 L.J
.
DATE PAID h - / S- - 5' "3
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, ;a --13 AMOUNT RECCiVF.D ____.2:. '7 ~ 2-,
TOTAL AMOUNT DUE (excluding e!eclr,cal) ~ --f... - ~~
lA, B, C, D, and E Combined) , 8lCE!VED BY -..----.- --
, '__ ___. __ ____ __, _______ . _..1,_- ______. __ --
E
VAl\.JE
-ZC:,t)g 2-
--7d..lk
FEE
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-.1$.00
_/45.0
4n,~
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.'
IS
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I
BUILD.ING VALUE, PLAN CHECK
AJ\JD BUILDING PERMIT
Thjs per~it is granted on the express c'ondition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
De'veloPfnent Code, regulating the construction amj use of
bu'ilding's, and may be suspended or revoked at any time
pppn ,Vi,?lation of any provisions of said ordinances.
APPROVED:
Plan Check' Fee: - ;
Date Paid: ;fb-iiL~
.-
Receipt Number'
Re7~~~
Plans'-Reviewed By
~fi.Jh]
I Daie/'
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
.._,
,
ADDITIONAL COMMENTS
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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 certjfy
that ar,y and ail wor!< performed shall be done in accorC1ance
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 c,ertify that only contractors and employees who
are in ~'ompliance 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 ~ "rr:. ~~
6/~6j9~
Date
VAliDATION:
RECEIPT NUMBER
/8
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"-JOB NO. Q'!J074D
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CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
.' jio',WPHKSHEET""
(COMMERCIAL & RESIDENTIAL)
'NAME OR COMPANY: --1de i r CDk/ST. _ riVe.'
. : . i ~_' . .;_
LOCATION: /_ D q '2- B-ONtJ lIE LPt/..JE
DEVELOPMENT TYPE: L{)fZ.. - NE;W ~Ff<.
Nf GD L- E:. flt~ - L-t,.,. <1
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 'Z. 5 8.~ X $0.192 PER SQ. FT. ' c; 'T'l f, f i:)
-- -------
2. SANITARY SEWER-CITY,
NO. OF PFU'S /<6 X $39.78 PER PFU 0/G/~?)
(See Reverse) ------ ~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X /. ~() 5 X $401. 05
X X $401.05
~ ..'
,
X X $401. 05
003 .~)
$
$
-
SUBTOTAL (ADD ITEMS 1,2, & 3) $ {(PI? 1.-~
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~&o ~)
'-- --
TOTAL - C!TV SDC $ I re,tf 5 '!.!
5. SANITARY SEWER~MWMC
, ,,' J (p
NO. OF PFU'S I ~ x $13.62 PER PFU+ $10 MWMC ADMIN.. FEE $ 2.SS -
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
'.2.. 06
$ -",D-
JOTAL..,MWMC SDC~
TOTAL SDC $ I q 2-1 ~
~r--D ,&', ~L~
'-~~ ,Kip Burdick
SDC Coordinator
FIXTURE UN IT CALCU LA TI~ ABLE: Number of New FixturesX ~valenf = Fixture Units (N~~E": ::
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
I
2 ~
1
2
3
6
2 ?.
6
6
1
3
2
1/Head
2 "2.-
2
1 Z
6
4 Sf
Bathtub.., ,........ ,... ........... ................,....... ....,.......".....
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 ;Water Station/Etc........
Receptor For Commercial, Sink/Dishwasher /Etc..
Shower, Single Stall.... ........ ,.......,.... ....... ........... ......
Shower, Gang,..........,...........................,..... ...... .......
Sink, Bar, Commercia!................. ............................
Urinal, Stall ;Wall. .... ............... .......,.,..... ..." ...... ,.. ......
Wash Basin/Lavatory, Single..............................,...
Water Closet, Public Installation.............................
Water Closet, Private................ ....,. .......................,.
Miscellaneous:
'L-
J
7-
'2-
TOTAL FIXTURE UNITS
{1>
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after <,lnnexation 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
$2,16
1.90
1.60
0,25
0.87 '
- 0,50
0.16
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-- -" .. -"
Improvement (if after annexation date)
'2.~~ X$}fJ,G, ~~
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $ 3-0 ~
Credit for Parcel or Land Only If Applicable
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential............... ........... ...... .......... .............. 0.4
Commercial..............................~....................... 0.9
Industrial............... ........... .... .............. .... ........... Q.45
Governmental....... ..... ............. .......................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less ( $ 85.00 85
Each additional 500
sq. ft or portion () ~b
thereof $ 15.00
Each Manuf'd 1I0me or
Modular Dwelling
Service or Feeder $ 40.00
. ; ...quire 8,:.e~I'L.... .. '
. 225 FIFTH ~;TREET
SPIUNGFIELl>, OIlEGON
INSPECTI ON REQUl~ST:
OFFICE: 716-3759
97~77 ~DlZ-
7 2~:~76~ LK~:7
Authorized Signature \,:)Q:,3 .
1. )y~~~ OF _~^ALLATION ,
0')( H e>\ ( JL.Un n ) V
LEGAL DESCRIPTION
).O~ESCRI!:tION 18':L4.cr
6 '" JVl'l j) \().. qf\tQ ."" "1.: Q m_p
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
100 days.
2. CONTRACTOR INSTALl.ATION ONLY B.
Electrical Contr'actor 8/1(:' t5/ecf-nL
Ao(l1:ess3170 West 1 t t"h
Phonr3l/~/35 =?
Supervisor License Number ,7 () caLj C
Expiration Date I!)-(- 13
Ci ty.cur; W~
Constr Contr. Number.2J~~1
Expiration Date 4- / - qcj
~r1; litrv. sin
, ,- ~ (_ '- ~+..J _ D.
Owners ~-:-U2--,~
Add ress 81C15Q \. '()JLtuJ:l.v )
C i tJ1 t'-(i! lIJ12- Phone _1!J b-, 'WlBJ .
OYNER INSTALLATION
The installation is beirig made on
property I own which is not intended
for sale, lease or rent.
O....ners Si(ITlature:
---------------------------------------
t,. I'
DATE:' p;!:"
RECEIPT #:
HECETVf:D BY:
~-1.r~)3
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Temporary Services or Feeders
Installation, Alteration or Relocation
40
City Job Number
COMPLETE PEE SCnEDULE BELOY
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
C.
200 amps
201 amps
Over 401
Over 600
or less
to 1.00 amps
to 600 amps
amps,ot 1000
Branch Circuits
$ 50.00
$ 60.00
$100.00
$130.00 'i
$300.00
$ 40.00
I
$ 40.00
$ 55.00
$' 80.00
volts see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous ,(Service/feeder
-Each installation
P~mp or irrigation
Sign/Outline Lighting
Limited Energy/Res
Li~ited Energy/Com~
, ;" :
5.
SUBTOTAL OF ABOVE
5%' state Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
J 5S.tJ()
7.75
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