HomeMy WebLinkAboutPermit Building 1995-5-31
-- ....~,..l.\
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT:
'7
('
OWNER: ~7:~r.~~~E
ADDRESS:
SPRINGFIELD
BLOCK:
\ 1.\ .---
" '3- 8BeS r
j:
JOB NUMBER
~S-~ <'/;>9
225 Fi fttl Street
Springfield, Oregon 97477
PHONE: 9:~~ ......Y'2 /' ~
~~~c~
DESCRIBE WORK: 4~~?/5'~;:- ,/J~~C~ M,~# ,~~~
NEW REMODEL ADDITION DEMOLISH OTHER
CITY'
STATE:
~
_ ZIP:
~~~-
>/~;::. ,
\
\ :
CONST. <?FiCl- '75'"r-7~')
C. ONTRACTOR'S NA~ME ADDR~.'. ~'CONTRACTOR ,II EXPIRES . PHONE. '
," .8?Y7/~~?J; ~ ~ ,,'
GENERAL:~~ ,,~~-?~9~., '.,. ~:::;>6~_ /.2"2~~ ?o/?-~~~
PLUMBING:~~ eFT~S ~~~Of){p La' \Dq~ \o~' \~CL\
MECHANICAL:
ELECTRICAL:~.~~
'"
QUAD AREl:4~<f:e
II OF BLDGS: ~ \
OCCY GROUP: \\~-t- ,~
\ c "'
WATER HEATER: ( --
II OF STORIES:
\
....
, '6ct\'2.3
~ . ~q liLJ441ll&;
- OFFICE USE -
LAND USE: \ \ ~O
II OF UNITS: A A I
CONSTR. TYPE: V IV
HEAT SOURCE: B'Cq~L'L
RANGE: ,S,
, .
FLOOD PLAIN:
ZONING CO'DE: \ f\ V",
II OF BDRMS: ~~_
SECONDARY HEAT: _, IZ!'...,
SQUARE FOOTAGE: _~ \S~ '
. 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, Inspection's requested after 7:00 a.m. will be made the following work day,
o Temporary Electric
REQUIRED INSPECTIONS
T"x1 Rough Mechanical ~' Prior to
~ cove~ ,
~ite Inspection - To be made r"'C7f' Rough Electrical - Prior to
~~fter excavation, but prior to ./ ~ cover.
setting forms. ~S ; ~/L..
D Underslab Plumblng/Electrical/
Mechanical - Prior to cover.
../ 'C".7I" Footing - After trenches are
~ excavated. '
D Masonry - Steel location, bond
beams, grouting. '
1""'5<( Foundation - After forms are
~rected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~. underflat5i'Plumblng~.chanical
~ - PrloNo~vlI vr decking.
r\:7f Electrical Servlc~ - Must 'be
?J approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wall/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taPI~g:,
D Wood Stove - After Installation.
f";;;7( Post and Beam ~-Prlor to floor
~ Insulation or decking. · . I D. Insert - After fireplace approval.'
f ,,;; I and Installation of unit. ..
, I; I I. ./~. " ' I . . //
'f'x'1 Floor Insulation';'" Prior to' '.', ' :
~ decking. '- '\ -p Curbcut & Appro'ach - After
i) ~forms are erected but pri,or'to
r;;;7T Sanitary Sewer _ Prior to filling !", placement of concrete. -
~ trench. .. '
, IN' Sidewalk & Driveway - After
~excavation Is complete, forms
and'sub-base material in place,
i\:A Storm Sewer - Prior to filling
~ trench. .
M-Water Line - Prior to filling
~ trench.
]';(fROUgh Plumbing --:- Prior to
r cover. . ,'" ..
D Fence, - When cOli1pl~'ted.
f)<1 Street Trees - WhE:ln .al~ requ~red
-" -trees are planted. .. c''''. :' :
M Final. Plumbing - When all
~plumbing w9rl< Is complete,
,,,,/(Final Electrical - When all
~ electrical work is complete.
~Flnal Mechanical - When all
~~chanical worl< is complete.
~Final Building - When all
~required Inspections have been
approved and building is
completed,
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
, 0 PJumblng Connections - When
home 11as been connected to
water and sewer,
o Electrical Connection - When
,f, blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
Ins'pections are approved and
porches, skirting, decks. and
venting have been installed,
.
Lot laces ~
Lot sq. Itg. ~
Lot coverage ,'s~2 /l.
Topography /D ~
rv\ t... I .
Total height Qt::L".)
C~~
BUILDING PERMIT
.. . '" . ~;-.
" ;:-'.., :,C;',r ':i \
Lot Ty Setbacks
Interior I p.l. HSE GAR ACC
\/ Corner I N I~
Panhandle Is 1(;
Cul-de-sac Iw 10 5
'I'E /1,S" /Ib
jlX;iLZ
-H2-~
5S:~{.
b!7. 3~
SYSTEMS DEVELOPMENT CHARGE (SDC) .J.h.
(B) c!\-?~b~'j,. 1P
ITEM
SO. FT.
} '7&1
~lQ3
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
7? 10 -r/,j!-~
Total Fee
X $/SO. FT. = VALUE
610.9.0 9~J31b9
,L\ . \ 0" t,S-z.g
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO 2 X 2-
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge I C:. -r 7r~ ()
Total Charge (C)
FEE
~2.8 .&6
Z5,~O
'!-,4~.~
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge ,?V -f-. Sf
Total Permit (D),
::;2--
Z-
CJ,tJO
~~
3, c:ro
J~.bO
/Qao
- I.H
k/.~~
MISCELL.~NEOUS PERMITS
Mobile .Home
State Issuance
State Surcharge
Sidewalk jSi It
Curbcut ~'fl
Demolition
State Surcharge
~~~
Total Miscellaneous Permits (E)
~I""
.
~~/o
/ 7. 20
'..
.'.
..
~~3G)
3:31/~O
~~a 76:
~-:"~.. L
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
IS THE,PROPOSED WORK tN THE _
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
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 expr~s condition t.hat 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: -Z:!;:. 7,3 :
Date Paid:
Receipt Number:
Received By:
,?3~~
Plans Reviewed By
sfz.-As-
" Dzfe
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITION. AL C.9Jv1ME~~h
~~ ~~///P/ 95i::J~~?
~~?Z:t"-t' 4-r~?) /6~;'5
C1M~
0t~cLLt-
MT'I f> \O)rJPi)
Lf1JltKJA~-1fHL ~". Iq(oO
,"-
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 accordanc'e
with the Ordinanc(;ls 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,tQ~t,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 all ni~es ~rlng construction.
Are m~
Date ( ~ \ \ a( .
VALIDATION: C
/1ECEIPT NUMBER '158
DATE PAID 0 .\.~ \,~ I
AMOUNT RI;CE"VE~ bc:r'''/.::>8
RECEIVED BY O~ \Da_)
;,
,,,;
., .,
JJ.?... Willamalane
't-g' Pa,k & Rec'eat;o~ Distdct
:"'1(1\ ;11 I}' ,~
Job No. Qro411
~, cN(\,L
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:
PHONE:
'q33-~73
ADDRESS:
STATE:
. ZIP
" ::. .1' .
lqCATlON OF PROPOSED By!-l,IJ' ~G Sire, 1111. ','"" rv\ " I')\t\ f\!'i
, Street Add.ress if Known: n l J't\ ~M\I\o V~ lli, _ ~. D.1\ ,txJ l \. ) \: ~
P/attName: "~~du~tnOlL Tax Lot Number: \~'073S33 O~
1. DEVELOPMENT TYPE (cnec!< appropriate dwellingCs). SOC Calculations and dwelling type
definitions are on the back.) , ' '.
A Simz/e Familv - Detached
fl"1
Single Family home
NO OF UNITS.
Manufactured home not in a park
X $400 PER UNIT _=..
, .
$ .
'.
B. Simzle Family - Attached
.
NO OF UNITS
g
X $370 PER UNIT =
. $ 140.cxJ
C. Multi-Familv Aoartment .
NO ,OF UNITS
X $~77 PER UNIT =
$
D. Manufactured Home Park
NQ OF UNITS '
X $280 PER UNIT = , '
$'
WPRD SDC
. '. .
$ ~4D\ro
'g
$
$0-4 ().m
2. SDC CREDIT' (If applicable) SDC-payer must furnish proof ofWPRD Credit
approval. See SOC Credit Worksheet , . . '
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced {or Credit>
\
\C)/l~l/qS
n;1tp
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
3.
~1A~onn~~h"A~FA.
. LEGAL D~<;:RIPT:JAN~ \ ITL .
I ')OfJ. (~EO-(~ (JG~
\. -b;~ 0r~ION A\?:[
Permits \re non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTAL~TIO~ l~NLYh.\... B.
Electrical contrac~rO\\~'\d!~r"&V
Address ~~ ~ la<F)'"'-QQ .
City ~ Phone 'AA. \\\r5
supervi;or\.2icen~umber ~S') ~
\D. \ .~f=)
Constr Contr. Number ~~~~~
0.~'~-Lo _
Expiration Date
Expiration Date
Signature o~supe ising Electrician
~ ~
Owners Name 0Jl b d1n A 0 .J
Address0-(O Pf)4s ffi~ ~ ",i--\o<\ ~&
Ci ty S()hQ n ~ Phone 4334'LZ/J
\ )
OWER I ~STALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
~ATE~~----~l--~~~:>-----~
RECEIPT *: 't- \' \ - \ "~S<1
RECEIVED BY:F"'k \ I ) n ) -
, - ,-- -
ELECTRICAL PERMIT APPLICATION
City Job Number ~E)~
COMPLETE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
f\
a
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
uni t.
Cost Sum
$ 85.00 \r()
$ 15.00 iJe?
$ 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
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 40.00
$ 55.00
$ 80.00
see "B" above
$ 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
5% State Surcharge
3% Administradve Fee
TOTAL .
~G>.~
/~..~~
~..~
, ~/6 . cpo"
"
iB NO. Cf'504- 7'1
CITY OF SPRINGF-IELD, SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 13AI<'T f-IARE
LOCATION: 1641 CItMeL.LlA-.4 5/)4 ~. 7oW"PJ..AUE:. /7()'1.???'?'? -0'5005
DEVELOPMENT TYPE: L/}/Z - NE-~,l DUPLE-:><
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
/:I'2--D?
X $0.209 PER SQ. FT. (&,;."/ ~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
?~
X $43.26 PER PFU
cGS7 3~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
2
x l.o I
X
X $436.19
X $436.19
X $436.19
~~-t~)
'---- . ~
$
$
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S ~~ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ t;;,'2-B~4-
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
/'g
$ 51... -
~
$ '?~84-~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
v~'~~Lc.L
,- -(fKi P Burdick i
. SDC Coordinator
,
,
X .05
Date: 4-/~1 /f1.0
( I
TOTAL SDC
cG~~~
$ ?~~~ l!
FIXTURE UI':f~T CA~~(JliA T"1N TABLE: Number of New FixturE'
(NOTE: For remodels. cal~u(at~ only tL ..I additional fixtures)
NUMBER OF
FIXTURE TYPE NEW FIXTURES
Unit Equivalent =. Fixture Units
UNIT
EQUIV ALENT
FIXTURE ,.
UNITS
2-
2
1
2
3
6
,2
6
6
1
3
2
l/Head
2
2
1
6
4
~
Bathtub......................................................... .............
Drinking Fountain.....__.... __........................... ... ..........
Floor Drain............................................. --. ................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..........__......
laundry T ub/Clotheswasher...................................
Clotheswasher.- 3 ,Or More,.......__:.....,.__.__.__...........
Mobile Home Park Trap (1 Per Trailerh............:....
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL....... ...... .................. .................
Shower, Gang.................. ................... .............. .~.....
Sink: 8ar, Commercial; Residential Kitchen........................
Urinal, Stall/Watl....................................... ......... ..'.....
Wash Basin/Lavatory, Single..... ............ .................
Toilet, Public Installation... .__................ ..--..........-..
Toilet, Private..__......... ........................... ..... ..... .,..'
Miscellaneous:
?
2;.
,. 4- c$
z
4-
4-
4--
4-
/10
TOTAL f-IXTURE UNITS
~0
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
19$3
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
Improvement (if after annexation date)
'3 . 4~ X $ IS. 0 g
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
52/,!-
Credit for Parcel or land Only If Applicable
CREDIT TOTAL
$ 52 '!-