HomeMy WebLinkAboutPermit Building 1993-12-3
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ASSESSORS MAP' TAX LOT: O-QGlOO
LOT: 77 BLOCK: -L SUBDIVISION:~~~ ~~
OWNER: ,E/LE"'r=,A/ (' E;fIv/~r ~.?~ :;k~~~~ PHONE: ?0/"7-f/2~r::::
ADDRESS:~ \of)l~ ~ _I,\" ,~J\, -3-\\}\G:\- ~' . " . '-,' _ '
CITY ~'\\\\\'\)~9~~ STATE1~~~, ZIP CJ;l<\:"1PJ
DESCRIBE WORK: L~~~q- ~~?/??C':::l ?v:<<#>ff:~~~ 6.//~~-
NEW / REMODEL- " ADD~ON DEMOLISH OTHER
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
CONTRACTOR'S NAME ,) -, ,
GENERAL~~{~V/h,
'PLUMBING: $~~E'
MECHANICAL:,eq~~Ci!!E
ELECTRICAL: t.~ Ai&~~
'. /' o" ..
QUAD AREA: ~:\(..E:P~""")
/I OF BLDGS: \
OCCY GROUP::\~()~\J\_
/I OF STORIES: ~
~
,."'t- ) _ ._... ~~
WATER HEATER:
" ADDRES~, ~
,b~~# /7 ~_..~ '
?;P~L~_ ~a ~>~.
. CONST.
CONTRACTOR /I
-5 pZ, c,)
::>~'3"
~ ,- '2., If
~ - Z';"Z...
j
6)9~ '
'1,0.'8 8~ I'
I ,
tt"XJ~l
ct;:)\()\
- OFFICE USE -
LAN'D' USE: \ \\ \
/I OF UNITS: A. ;,)
V'JV
CONSTR. TYPE'
HEAT SOURCE: b.L:z:--/~0
RANGE: U" ,
JOB NUMBER
9~/:?/;?
225 Fi fth Street
Springfield, Oregon 97477
" "
I 51-. ,:'
A~..
"/
EXPIRES
PHONE
.. .'
/P7/~ ?9'7-C(B7Z--
,~. /8.c(o 34Q.\r)'L~
\.5 .~ \ .Q4 '\ L\ lo-. \ lo'L\
\0 .s .qL\ 'f\,Q. tf)' f)()4~
FLOOD PLAIN: -
ZONING CODE:ill~
. 1.1
/I OF BDRMS: _ "'-.-). -
SECONDARY HEAT: H {J
SQUARE FOOTAGE:c!lLO I cr'
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
[2(] Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
/ IX] Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
I IX] Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
/0
J
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
j [Xl Post and Beam - Prior to floor
, insulation or decking. .
I ./1 Floor Insulation - Prior to
decki ng.
~ Sanitary Sewer - Prior to filling
trench.
IY1 Storm Sewer - Prior to filling
~ trenctl,
IVl Water Line - Prior to filling
~ trench,
. " '.
~ . . .
IVl RoughPllimbing ~ Prior to
,-+-1 cover.
~r
REQUIRED INSPECTIONS
IT] Rough Mechanical :- Prior to
cove~ '
i:P1 Rough Electrical - Prior to
L.4-l cover.
lZJ Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
, materials and framing Insp.
Kl Framing - Prior to cover.
~ Wall/Ceiling Insulation"":' Prior to
cover.
!2J
Drywall - Prior to tapi r]g,
D Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
"
IV1 Curbcut & Approach - After
~ forms are erected"but prior to
placement of concrete.
IU1 Sidewalk & Driveway - After
LR excavation is complete, forms
and sub-base material in place.
o Fence - When 26'mpleted.
"
CEJ
Street Trees - Wl;1en all required
trees are planted, -'-> ".~I.. '.- ,
rYl Final Plumbing - When all
.IL\,J plumbing work is complete.
r71 Final Electrical - When all
~ electrical worl, is complete.
I:Vl Final Mechanical - When all
~ mechanical worl< is complete.
fIVl Fimll .Building- When all
~ required inspections have been
approved and building is
completed.
I.
j'
D Other
~. .
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected to
water and ,sewer.
o Electrical ConnEiction - When
blocking, set-u'p. 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.
Setbacl<s
HSE'GAR'ACCI
~?/'
La'
I/~ )
16'
Lot laces oS Lot Type
Lot sq. Itg. ~? L Interior I P.L.
Lot coverage ~ Corner IN
, ~ Is
Topography Panhan'dle
~tal height ~q/ Cul-de.sac' ,Iw
, UQ,'\.Q.~ C6'y,> IE
,
BUILDING PERM.IT
ITEM
SQ. FT.
'/~ '3'7
6'3&
X $1 S0. FT.
~;2&:-
/~p
lit 7~. '2.i-
~:>.~
VALUE
Main
Garage
Carport
- """c' .... .
-...... .
~7Y6.6r
~.A?
1'y\\-'\
i,~.~~O/ ~
'?bo/.:2~ '
SYSTEMS DEVELOPMENT CHARGE (SDC)
J.L --z..o
(B) ~~?\\.-
Total,Value
Building Permit Fee
State Surch'arge' ,
'.. . -~.
"
Total Fee
(A)
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) NO '3 / -92.5'c:>
Sanitary S,ewer FT
" . JS '\
Water FT.
" ' Storm Sewer FT.
,\
Mobile Home
Plumbing Permit I ~;:;>. _f""'.::r:>
--i. .. _-
State Surcharge 9..3
Total Charge (C) ~'2 .J~
"
':; 1V!:f:CHANICAL PERMIT
~ \ I\.I -, 6. #, t> /.-
Fyr.fiii'ce
Exhaust Hood t/."~
NO -:;r, .". ~"
Vent Fan
Wood Stov~/lnser~PlacejJ.o.l.t./ /~. --
Dryer Vent '3"_c::a-c.
~';, I';
Mechanical Permit 3?~'
/~~ --
1.1 Issuance
State Su rcharge /.88-
Total Permit . (D) ~ 9. ?f~
.,.j
MISCELLANEOUS PERMITS
Mobile Home
, ~
State Issuance
State Surcharge'
Sidewalk
"'7-0 ,ft
~'I' ft
2LP. $"0
/~,/O
Curbcut
Demolition
State Surcharge
~~/h~g
~~~ o-c:s
'"
~3~bC>
~~2 .5'7
Total Miscellaneolls Permits (E)
-'.i
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
'5(:>
,
IS THE PROPOSED WORK IN T~E
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
, ,"
...... """
"
\
APPROVEQ: "
BUILDING VALUE, PLAN CHECK
AND EfUILDING PERMIT
T.ciS perm.!t is grantl:!.d on the express condition that the said
co'nstruction sh~II, in all respects,'coriform to the Ordinance
adopted by the City of Springfield, incltJding the
Development Code, regulating the construction and use of
, buildings, and may be susperide~ or revoked at 'any time
upon violation of any provisions of said ordinances.
Plan Check Fee: ", ~!2',/~
Date Paid: /~e::9~3
Receipt Number' /tP~tj/g
, ."R"~ceiV~'d By, . _ /, ~~ #0
"'&' - .~.- '\
Pk!"~ eviewed(B1' - -~/,~,' ,
,I
,/~~ "3-
-. Date
Systems Development c;harge-Js d,l,le . OIl, all undeveloped
properties within the C!~YJi~,it~ which are being improved.
" .....,
ADDITIONAL COMMENTS
$~~~~~
.~ cM~Q j()rnti,l 19\CD()
~+- \ / d)(); q I 0
\\UJ\~,)~ck. ~\c\~~~~~
By signature, I state and agree, that I have carelully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further certffy
that any and all work performed shall be done in accordanc'e
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and tl:1at NO OCCUPANCY will be made of any
structure wittlout permission of the Building Safety Division.
I further certily ttlat only contractors and employees w\lo
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 f;cint
of the property, and the approved set of plans will remain
:~g~:~u:~~) ?3?;?;t~on
I ~/~ )0 :J,
^.
Date
VALIDATION:
RECEIPT NUMBER
11010')
iJ../ ::?JCJ~
36 $'tf.1Z- ?
O~
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
JOB NO. :3?;; I 7 ( 'L
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: E,Lf..;:::'f\i Lt:A\!/-r( c~ /iTe ~tzG,e.N70N
LOCATION: 51/ CI+~CADt;Df2-1 vrC
DEVELOPMENT TYPE: LVi<-. - Nf:VJ Sf;:f2.
BUILDING SIZE: LOT SIZE SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. ~0 '?'l-- X $0.203 PER SQ. FT. G5'{~ ~~
............. ~
2. SANITARY SEWER-CITY
NO. OF PFU'S ].2;7 X $42.08 PER PFU ~~1~~
(See Reverse) '--- ~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X J.e t X $424.31
X X $424.31
X
X $424.31
~18~
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S /Z7:J x $15.125 PER PFU + $10 MWMC ADM FEE $ '3S--Y<C.:!-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ C::,7 /'2
~ -,?~
TOTAL-MWMC SDC ~qO ~)
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ -2 '2--0 \ \.::
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
}-~' _, ~~cL Je..- i' Iter.. /~3
o Kip Burdick I I
SDC Coordinator
41(O~I~
'-- ~
-2-0
TOTAL SDC $~~
~
FIXTURE UNIT,GALCUL 10N TABLE: Number of New Fixture~ Jnit Equivalent = Fixture Units (NOTE:
For remodels, calcul~te only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTURE
UNITS
~
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
~
Bathtub,..,.......... ..,.,........... ..'....''....''....'.....'.'..'.....
Drinking Fountain, ...........,........,........:'....,.,...,..,.......
Roor Drain..... ......,..................,....".....,.... ..,..,...........
Interceptors For Grease/Oil/Sollds/Ete.........,.......
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/aotheswasher....,.,..,. ...' .... ........... ..,..
aotheswa~er - 3 Or More........_............................
Mobile Hdme Park Trap (1 Per Trailer)..................
Receptor F9r Refrigerator fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Ete..
Shower, Single .Stall....................... .............. .......,....
Shower, Gang................ -.....-.............. .......,..,..........:
Sink, Bar, COmmercial.........._..................................
Urinal, StallfWall.......................... -.. -...,............ .'....,...
Wash Basin/Lavatory, Singlem.............,.....,...........
Water aoset, Public Installation.....................,.......
Water aoset, Private..................... ............., ........,...
Miscellaneous:
L
2.
'2
?
?
('2-
TOTAL FIXTURE UNITS
L-~
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
'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
/ 7 1_2-
.;) . 2-1 X $ kP. q I , to
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $ rv 7. '!:-
Credit for Parcel or land Only If Applicable
Improvement (rt after annexation date)
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
'" ~
~~ lL'!lll!m!!~!!~
Job No. C~\~\~
S,YSTEMS DEVELOPMENT CHARGE
WORKSHEET .
NAME: ~jU\\~nlc)~tt
ADDRESS: ~\f'\ \O\'{\~U\l\ 6t J i ~.~
LOCATION OF PROPOSED BUILDING SITE: a-t ~"
Street Address if Known: .5'\ \ '~.1llJ(\I1Llo' ,'0.\\ \ 1L
Platt Name:~\1'S\fu % \.~ Tax Lot Number: \'\ \)~.~~ ~fdC(llJ
PHONE: rwl-4Q3lo
STATE:fI\L ZIP g%,~g
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. Sim!le Familv - Detached
\ Single Family home
NO OF UNITS
Manufactured home not in a park
X $400 PER UNIT =
$ c\OW
B. , Sinele Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
"
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$4\JlJPO
$ 0
$ \Dr'l00
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. .
,3. TOT At WPRD NET SDC ASSESSED (If.SDC reduced for Credit)
\C\:0 -) ~~ \"
Community se~ ""''I'on
City of Springfield
-',
\~ / 3 / 93
Date
, ,',.;i('o ?r;:,;.~,:\.~':,::~;:~;;.;,;:~::~;::>.~':~t;;~ ';~~~'~)!
225 FIFTH STREET ~';~':,<~;;,.'~:',~:,'.;j~~i;A,;;~f;C '''.:~ ELECTRICAL PERMIT APPLICATION
i~~~~~~:;>REg~~~~ 9~~~~3;;~9 Z":'\li:~~,,_~:D.---,~.__'_'''. Ci ty Job Number q~ ,\'\\~
OFFICE: 726-3759' U;:5:,:,~..~.:?::\3L0.~~> 3. Gin.MEbE-TE-~CHEDULE BELOV
1. L~CAT\ON ~S~~N,~:,:r" 'i.i;:'i\,'.''''\''J'''~:- New Residen t ial-Single or
'- Multi-Family per dwelling unit.
Service Included:
. LEGAL DES~PTION .
\'\()~'3S~ rJAC\OO
JOB DESClqIffION \\
~~~ ~~~~ ~~.d)IQ\98"
Permits are non-transfera~e and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
,
2. CONTRACTOR INSTALLATION ONLY
,
Electrical ContraClt)WN's FI J:CTR/C
PO BOX A 726-7895
Address FALL CREEK OR 97438
City
Phone
Supervisor License
Number .~~,J)?- >
/0;43
Expfration Date
.,
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
.' ,
Constr Contr. Number :J:YO;~~
Expiration Date /~ \(').s.~
Signature of Supervising Electrician
i)~ ~~ ~
Owners Nam~ f1Lo..o..J0I. ~ ~ t ~\ \ \_'
Address\\ \1) \()\1)':\ \ \'\. ~~ ~)\~
City ....~r:;~\~ Phone 'V\f\-~~~\o
\ '
OVNER STALLATION
The installatiori is beirig made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------j~J~I~~-----------------
RECEIPT I: j J ()V;J
RECEIVED BY: \50,0",
~
Items Cost Sum
1000 sq.ft. or less $ 85.00 eKl
Each additional 500
sq. ft or portion 4- \rD
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. 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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
$
~po
. ~.AS
\ ~S::t: ,A,-
40.00
40.00
20.00
36.00