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HomeMy WebLinkAboutPermit Building 1995-3-23 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 SPRINGFIELD LOCATION OF PROPOSED WORK: 5~F'LkA lOB NUMBER q~D2..qq 225 Fifth Street Springfield, Oregon 97477 LOT: /z / 7-C;Z- ~-'i$'- 44 ~....2/~,'.~'~~, ~R 9?47a TAX LOT: 0/6 a=-. SU BDIV ISION: ib.tLf3,~~.:4 ~77'b l'-r ~ ASSESSORS MAP: g-r / BLOCK: OWNER: ..::i51'.2..J.,/t'?t=? I' :::Z:>"A-A/,l9- ';l);;>J/~<;'~^~'; ADDRESS: 212.. 7 h';;:>r.~~, S;-, CITY: ~ 'lLEt:?AF;;s: STATE:'r:;P DESCRIBE WORK: /:?A-~//.;~-;4/l~:rr../~~: A-..........A=" NEW ~' REMODEL ADDITION" 'DEMOLISH CONTRACTOR'S NAME GENERAL: 6RD!Jfil7uJk?,.~" /I PLUMBING: II MECHANICAL: ELECTRICAL: ~~P',nL ~~/ QUAD AREA:3R~(,_.... · OF SLOGS, \ ~..l.. OCCY GROUP: ~- , \ II OF STORIES: 6- WATER HEATER: PHONE: -689-...f? 9J9? ZIP: C77404 ~L/90~~~~ OTHER l ADDRESS ...57/2 4l ..aA-;,,./ It' CON ST. CONTRACTOR # 4~4;?z It' EXPIRES PHONE //45 7z.6-Z/7/ It' i'. - OFFICE USE :-:. \\Sn # OF UNITS: \ CONSTR. TYPE: ~, HEAT SOURCE: ~ E ~ LAND USE: RANGE: REQUIRED INSPECTIONS o Rough Mechanical -:- Prior to cover. ' o Site Inspection - To be made 0 after excavation, b~t rior to ~ for s. ~. ~ ~ unde,~~~~t IElec";c"~ Mechanical - Prio cover.VO Rough Electrical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. . o Fireplace - Prior to facing materials and framing Insp. I~, /1' // FLOOD PLAIN: ZONING CODE: \ DR-. # OF BDRMS:, ~ / SECONDARY HEAT: ~ SQUARE FOOTAGE: \lBL 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. o Temporary Electric /' ~Footing - After trenches are , excavated., _ o Masonry - Steel location, bond beams, grou,ting. ~ndation - After forms are erected but prior to concrete placement. o Underground Plu'r'nbing - Prior to filling trench. o Underlloor Plumbing / Mechanical - Prior to insulation or decking. o Post and 'Beam - Prior to floor insulation, or decking., o Floor Insulation - Prior to decki ng. ~anitary Sewer - Prior to filling' ~ ~'ench. . ' r-I--<Iorm Sewer - Prior to filling ~ tr~'nch. ' .-. '~r Line - Prior to filling ~:~~h, o Rough Plumbing ::- Prior to cover. o Framing - Prior to ,cover. o Wall/Ceiling Insulation - Prior to cove~ ' o Drywall - Prior to tap,ing. '0 Wood Stove - After installation. D Insert - After flrepla~e approval and installation of unit. ,/ . I ~urbcut & Approach - 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 completed. o Street Trees - When all required trees are planted. '\ o Final Plumbing - When all plumbing work is complete. o Final Electrical - When all electrical work is complete. o Final Mechanical - When all mechanical work is complete. o Final Building - When all required inspections have been approved and building is completed. D Other MOBILE HOME INSPECTIONS l::::::J Blocking and Set-Up -' When all blocking is complete. .......- b:::j Plumbing Connections - When home has been connected to water and sewer. i1...Ehfctrical Connection - When ~ blocking, set-up, and plumbing inspections have been approved and the/home is connected to the s~rvice panel. 2:1 - After all required G2(i~~~ections are approved and porches, skirting, decks, and venting have been installed. ~. Lot faces Lot Ty~ Lot sq. fig. Interior Lot coverage Corner Topography Panhandle ILV r 11 '1 BUILDING PERMIT Cul-de-sac Total height ITEM SQ, FT. X $/SQ, FT. Main Ga..ge ~.- ~rl M,) Total Value (p,O/X) Building Permit Fee State Surcharge Total Fee (A) ;~~~;!,fL,~'" ' " . ".:;.: . i!ll~;:!llli~.v:;!.~"';.I.""'~:"~ '-" \~.-... :If""'"I'.!' '~l!'~,,: "di:~. f' ", -. ',' " - ~'. ..4 ."j" ii.'i:!1W:\tfSetlJac'ks' ;,\' .;" I' :F{L' HSE GAR I Ac2 I IN \S Iw IE' VAL~Io..^ :13,~ I, O(){) 5QW l 1Qt:D 5.0\ 111f).51 SYSTEMS DEVELOPMENT CHARGE (SDC) , (B) ff>2..'1'E:>~ ~ PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge -\' ~ Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert(Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sldewalkffl Curbcut o?- II ~.-,-.y.;;:~ .::3Qo II State Surcharge FEE 65J:1) &5fP gsOO .~ ~( .()J / ~ \If)~ ~O.OO ~.~ A3 -0::> -~4 .ff) ~;\~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electricaIN~~ .~~ (A, B, C, 0, and E Combined) IS THE PROPOSED WORK IN 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 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 upon violation of any provisions of said ordinances. Plan Check Fee: Date Paid: Receipt Number' Received By: Plans Reviewed By Date' Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS \ --- A.:;\ I, 6l'3\ ~_t{) ,,_Af\\~'{Jd ~t\.LL'. \ C\l Of) ~"'~aJ.JL 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 lime, 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 plan~1 remain :::::u~e al y~zo. . ,- Date ....:r-?~_9S VALIDATION: · 1'7 rz... RECEIPT NUM~R ll()7~ 'DATE PAID O'~2..3-Ck A/\ AMOU~T RECfl~D ' N Lf - _ ~ RECEIVED BY 'eh ATIACHMENT B1 .J NO. .Q602P/9- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: f)OYCr::-.. 4- DIA^-IA DR.L1SW LOCATION: 57Cf'Z. ('A-MC'--Ll-tA Sf. 17az~?4-4 DEVELOPMENT TYPE: LVI(.. - tJ6wrv1AIJU. -I-/OMc P.lV /-J()M E. GNlA6E BUILDING SIZE: /~-I. '2-c, '2ca >< <p5.~'?>. ZZ,l34- LOT SIZE - 0 I b{) 3 SO. F t. 1. SJORM DRAINAGE c(~I?'~ IMPERVIOUS SQ. FT. -Z9 ?1 X $0.209 PER SQ. FT. 2. S8tllIARY SFWFR-ClIi G/f6;; NO. OF PFU'S ('6 X $43.26 PER PFU (See Reverse) '-- .--/' 3. TRANSPORTATION ~o 5?) '-- ~ $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ f ~?;'3~ NO OF UNITS X TRIP RATE X COST PER TRIP I X I. 0 I X $436.19 X X $436.19 X X $436.19 4. SANITARY SFWFR-MWMC NO. OF PFU'S ;<6 x $17.19 PER PFU + $10 MWMC ADMIN.FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWMr: SIX SUBTOTAL (ADO ITEMS 1.2.3 & 4) 5_ ADMINISTATTVF FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 ~~~~ i1P~Qrn i~. ~~ SDC Coordinator Date: NlA~. ~~ 19'15 / IQIAL SOC B2.SDC . $ ?;, I q 4.:! $ ~o~ ($ z:z;,q !2 ) $ "2. b 7 '2. "Z..-.!.- C:lo~;j ---- --- $ "Z If? ~3: FIXTURE UNIT CAlCUlA'T N TABLE: Number of New Fixtur( :'.<1 ... ........,. (NOTE: For remodds,calCulate only the .ufI additional fixtures) NUMBER OF FIXTURE TYPE NEW FIXTURES Bathtub............................................. ............... .......... Drinking Fountain................................. ........... ...... ... Floor Drain...... ..................... ............... .... .................. Interceptors For Grease/Oil/Solids/Etc............ ...... Interceptors For Sand/Auto Wash/Etc..............~::. '. laundry Tub/Clothes.wasl:1er. -........ ......... .~........ ........ 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, Commercial, Residential Kitchen........................ Urinal, Stall/Wair::........ .'.. ........... ......... ..... .................... Wash Basin/Lavatory ~ Single............ ...................... Toilet, Public Installation................................ ....w. Toilet, Private................................................... ,... Miscellaneous: z.. . "'; . . .;. ~"' .. ..'~. I :2--' '2-- TOTAL FIXTURE UNITS Unit Equivalent =. Fixture Units UNIT FIXTURE ,. EQUIVALENT UNITS 2 4- 1 2 3 '6 2 '2 6 6 '1 3: 2 l/Head 2 "2- 2 1 '2. 6 4 ~ If, CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credit:;; separates. Year Annexed Rate per $1 ,000 Assessed Value Rate per $1,000 Assessed Value 1979 or before 1980 1-981. 1982 1983 1984 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 \ Credit for P,arcel or land Only If Applicable 8023 Improvement (if after annexation date) o.4-fo X $ 'Z.?'2- (Rate X Assessed Value) X $_ (Rate X Assessed Value) = CREDIT TOTAL = $ ~c '21 \, f' 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. _LOCATION OF INSTALLATION '~,)3'1Cf1J...... ~(ltJ tv LEGAL DESCRIPTION , 11 6'1; IJIh till tJ I {Po?, .^.. ..,^:.o i_B/~ D7WESCRI ,PTIONV /.' . '1) ~_ 1:/)/1. f'" 'P1JI'- ELEcTRICAL PERMIT APPLICATION Ci tyJob Number at6 OIJA q .. 3. COMPLETE FEE SCHEDULE BELOY c A. New Residential-Single or Mtil ti-Family per dwelling uni t. Service Included: ' .~ Items Cost Sum iooo sq.ft. or less $ 85.00 Each addi tional 500 sq. it or ,portion th~reof $ 15.00 Each Manuf'd Home or .' Modular,Dwelling k jO,~ '. ~.. Service or Feeder $ 40.00 .- -- Permits are non-transferable and expire if work is not started wi th,in 180 days of issuance or it work is suspended for 180 days. 2. CONTRACTOR INST~~TION ONLY Elee t ri eal Con t rae ~ JlJ(\ -\o..l1\9--- 'Address \\J\9 _\. ~ ~Q ~ Ci ty € J... 1) eACLPhone ,,\~. \W S . -L\ N b. , LP~8~npC() uperVlsor lcense urn er Q 4~;J..<:;' Expiration Date \ n. \ .Q5 Constr Contr. Number \p~ \ ~') Expiration Date \ ~ . 8..~' qcq < ; Signature of Supervising Electric~an '~.~ . "t/ .., . ' D. Owners Name ,fJa!:Ju.4.J/([U1.lV DVt.dbot Address~v'.( ~. ' City ~I..vu Phone'~:IJ.~A~aZ, OVNER INSTALLATION Th~ i~stallation is ~eing made on property I own which is not intended for sale, lease or rent. Owners Signature: DA~E~---------~~2J2)..~------7~--- RECEIpT #: I_U _ _ _. \~.J , nurouTupn RY' ~ B., Services or Feeders Installation,Alterations or Relocation: ' 200 amps or less 201 amps to 400 amps 401 amps to, 600 amps 601 am~sto 1000 amps Over 1000 amps/volts Reconnect Only $ 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 Branch Circuits" $ 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 s. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL E. ,Miscellarieous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm $35.00 $ 2 . 00 _t . bO not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~~,~ 4'" , () 'l..:l.ttt ~ ~,.6lf- '1 .t\~ Willamalane ~'W. Pa,k & Recceat;on D;st,;ct Job No. .9S-f)~qq SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: ~ ! pi4KlL l)r"U':-fV1 ADDRESS: .-_~t,J;p1/ "f..qVtJV(/ ~. PHONE: & ~q- ~.!l.E-7.... STATE: 0(4. ZIP q1 L(04 '. LOCATION OF PROPOSED BUILDING SITE: ,; . -Street Address if'Known: 0Jq?/ ~j~)..~ 42....... , , , Platt ~ame: ~{ll...... ~Tax Lot Num~r: \1 D ~ % L/4 () ( &00 1. DEVELOPMENT TYPE (Check appropriate dwelling(s>. SDC Calculations and dwelling type definitions are on the back.) , A. Sim!le Familv - Detached , _,n Single Family home NO OF UNITS 1 B. Sin'!le Familv - Attached \ NO OF UNITS C. Multi-Familv Aoartment Manufactured home not in a park .' ,rf) $MJD., x ' $400 PER UNIT _=.. . X $370 PER UNIT = '$ NO OF UNITS X $~77 PER UNIT = $ 'D. Manufactured Home Park -' NO OF UNITS - IX $280 PER UNIT =, $, , $ '4l)O,cD- . $:tI $~~4-lTI~ - WPRD SDC 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRO Credit approval. See SDC Credit Worksheet. . , 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced (or Credit> ~O~ r,..,..,,....,~;.,, c;,......,;,..,.... n-y.;;,..,", ?;? IIJ.1J I tis nAtr.> ' I