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Home My WebLink AboutPermit Building 1995-9-18 ASSESSORS MAP '7 OWNE~Urlu\ F'f\tQ'fO\~ j,~(\' ADDRESS ~q}:{ ~O ....~?f\~ \../.l)U&J. CITY 41\' .f\~ ~ 0 ~ N. STATE ~ lJ'n DESCRIBE WORK ~\ f\(')\O K(\ f'r\ I ~ 1 ~l '-)<o~lo. ~ (\('~ NEW .......--- REMODEL ~ADDITION DE~'S~ RESIDENTIAL PERMIT APPLICATION InspectIOns 7263769 Office 7263759 LOT ~ , SPRINGFIELD ~ BLOCK OTHER ... JOB NUMBER q ::1Jbg 0 225 Fifth Street Springfield, Oregon 97477 TAX LOT nD,O() SUBDIVISI6'!~*\\ G,J\l\r)mJs PHONE 1\4:4 lri~ln lfJ ZIP ~f\4{1~ CONTRACT~~_NAME ADDRESS GENERAI\ ~ ),("10nrf\T, PLUMBING 9~ ~ rt \.'nlta t \ MECHANICA' , Q\() I \r\ j) (\ f i\+, ELECTRIC'^' f AU~ ~i~ CONST CONTRACTOR' q'71IJ~ CS \\?-,\ q t:2DR InRl1-S EXPI RES Ij 2.C\. C\lo C\ \6. C\\n 'I 2q Q(1J qZ3fot002- 0. '\ C\S ,,"lS 7.139 PHONE q 1.3 [n\d')L \o~3 SI\ \n - OFFICE USE - QUAD AREA \..~,,,r LAND USE --11 , I FLOOD PLAIN . OF BLDGS I # OF UNITS ---! ZONING CODE ~ OCCY GROUP Q?-'+M CONSTR TYPE /J;U . OF BDRMS :3 . OF STORIES I HEAT SOURCE (u f.-I SECONDARY HEAT [2 WATER HEATER S RANGE r-, SQUARE FOOTAGE {I ()~-=) To request an InspectIon, you must call 7263769 This Is a 24 hour recording All Inspections requested before 700 a m will be made the same working day, Inspections requested after 700 a m will be made the following work day o Temporary Electric D Site Inspection - To be made after excavatIon, but prior to setting forms D Underslab Plumbmg/Electrlcal/ Mechanical - Prior to cover ~ootmg - After trenches are excavated D Masonry - Steel location, bond beams, grouting ~undatlon - After forms are erected but prior to concrete placement D Underground Plumbing - Prior to fIlling trench [}j-Underfloor Plumbing/Mechanical - Prror to insulation or decking ~ost and Beam - Prior to floor Insulation or deckIng ~Ioor Insulation - Prror to decking ~nltary Sewer - Prior to filling trench ~torm Sewer - Prror to filling trench ~ater Line - Prior to fIlling trench ~OU9h Plumbing - Prror to cover REQUIRED INSPECTIONS ~OU9h Mechamcal - Prior to cover ~ough Electrical - Prior to cover rn::lectncal Service - Must be approved to obtain permanent electrIcal power D Fireplace - Prior to facing materials and framing Insp Q-Prammg - Prior to cover ~all/Cellmg Insulation - Prior to cover Q-DrywaU - Prior to taping D Wood Stove - After Installation o Insert - After fireplace approval and Installation of unit G;:urbcut & Approach - After forms are erected but prior to placement of concrete gSldewalk & Driveway - After excavation Is complete, forms and sub base material In place o Fence - When completed D Street Trees - When all required trees are planted 8Fmal Plumbmg - When all plumbing work Is complete ~lnal Electrical - When all electrical work Is complete Q-:mal Mechanical - When all mechanical work Is complete ~Flnal BUilding - When all required Inspections have been approved and bUIlding Is completed D Other MOBILE HOME INSPECTIONS o Blockmg and Set Up - When all blockl ng Is complete D Plumbing Connections - When home has been connected to water and sewer D Electncal Connection - When blocking, set up, and plumbing Inspections have been approved and the home Is connected to the service panel D Fmal - After all required Inspections are approved and porches, skirtIng, decks, and venting have been Installed Lot Typ< Setb"lcks vi Intenor I PL 1 GAR'ACCI HSE Corner N I Panhandle S I CuI de sac W I E I I"J Lot faces Lot sq ftg Lot coverage Topography \~I Total height ~ ( -=0' ) BUILDING PERMIT sa FT \\~3 5,"0.0 ITEM X $/SO FT 5\.o7D V\. \CL VALUE lo'21lo'ft '1 <60. to Main Garage Carport 'l\~f)D ~~~~.~ ~~I\I)C\~ SYSTEMS DEVELOPMENT CHARGE (SDC) #3 (B) fI; 1'St:l604- Total Val ue Building Permit Fee State Surcharge -1- ~DID Total Fee PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' ~ Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + ~O/D Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' FEE \\ 00 cO \ U,U CD \,'.\ '?0 \I~~ <\ S[) a..cD Wood Stove/lnsert/Flreplace Unit Dryer Vent ?,CC> Mechanical Permit \ \ () SQ IDW \ L~?J a'J' 63 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home Sl.al<' 'oo..o~;.; '/"7"'. /'~ /r-o State Surcharge Sidewalk 1\ 7J ft LV:> ft ~~ Curbcut DemolitIon State Surcharge '-~_ 'Y\t'\~ ~t:lOo0 ~cD Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) @ ~l\ C\C\ (A, B. C. D, and E Combined) -;j>:;(57"-" 3 THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON '" THE HISTORICAL REGISTERlL. I \ D If yes, this application must be signed and approved by the Historical Coordinator prlo[ to permit Issuance APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condltlon that the said constructIon shall, In air respects, conform to the Ordinance adopted by the C,ty 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 ~ ~Cl(\ \\\~~ \1 hi Plans Reviewed By - ... . Date Systems Development Charge Is due on all undeveloped properties wlthm the CIty limits whIch are being Improved ADDITIONAL COMMENTS ,,\0 b\Jr\ :{\ X , <>- "'lA. 0 u n ~ '( l::v 04\. ~{\\\~){ f\~ \ C\ lo() - 0J(\~h \ By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all InformatlOn hereon Is true and correct, and I further certify that any and all work performed shalt 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 701055 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 a.bmes durln~tru.n ~ :::"'"~:~~-U--' VAll DATION /7'09'"/ DATE PAID ~/li?'5"? AMOUNT RECEIVED ..19->.04;-. '.c\ ~ ~:?':;?..0 ~ ~~ // ". RECEIPT NUMBER RECEIVED BY j' 3 NO. '75oC? <;:0 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COI.1PANY I-IAYDE.t0 EJ.JTE:..e..f"R-tSES IAic LOCATION ~?t;o Cf.-u,~O/CE:.E. DEVELOPMENT TYPE L-/7R - tV E=. '^' >FR BUILDING SIZE ((,(a'2-0Co2f - 00,00 LOT SIZE SQ Ft 1 STORM DRAINAGE IMPERVIOUS SQ FT NA X $0.209 PER SQ FT ~-8-) .'-----.. .-/ 2 SANITARY SEWER-CITY NO OF PFU'S 1'3 X $43 26 PER PFU G778(.G (See Reverse) "----- .-/ 3 TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP ~- ~ X 1 0 I X $436 19 \ S 440 55 / ~ X X $436 19 $ X X $436 19 $ 4 SANITARY SEWER-MWMC NO OF PFU'S Iq x $17 19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From item 2 Above) $ ? /q 4-3:- TOTAL-MWMC SDC $ 2.1.,2.;!. ~ ~ $/611...4-Z- MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) ~ :1S.-..___..L-<.L o Kip Burdick SDC Coordlnator X .05 Date. 5"/Z3/vt; c; 75'~ ........ ........... TOTAL SDC $ /58804- F1XTU RE U N,IT G~LCU LA TI n N TAB LE: Number of New fixtures X Unit Equivalent = ~xture Units (NOTE. For remodels. calculate only the. '- additIOnal fixtures) NUMBER OF UNIT FIXTURE, FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub Dnnkmg Fountain Floor Dram Interceptors For Grcasc/Od/Sollds/Etc Interceptor..; For Sand/Auto Wash/Ete Laundry Tub/Clothcswashcr Clothcswashcr . 3 Or More Mobile Home Park T (aD {1 pcr 1 rader} Receptor For Refngerator/Vvater StatlOn/Etc Roceptor For Commercial SlnklDlslwvasher/Etc. Shower, Single Stall Shower, Gang Smk Bar, Commercial, Resldentlal Kitchen Unnal, Stall/Well Wash Basm/lavatory, Smgle TOIlet, Public Installation TOIlet Private MIscellaneous 1.. z. z... 1 OTAL IIAI Uf\!: UI"11 S 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 4- 2 z. "l.- 8 \~ CREDIT CALCULl\TION TAGLE Gased on assessed value If Improvements occurred after annexation date lfl table, calcuhtc credits ..,cpar;:lLcs ,~ Ycm Annexed Year Annc^-cd 1979 or bel ore 1980 1981 1982 1983 1984 1985 Hate pe( ::; 1,000 ^s')c..::scd Value $346 338 332 321 306 292 273 1985 1986 1987 1988 1989 1990 1991 1993 ~I Rate per $1 000 I"\sscsscd Value $246 214 177 1 37 097 061 044 015 '2.'" 2-..z. Credit for Parcel or land Only If Applicable Improvement (If after annexation date) ~ 4" X $ ,. ? 8 (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL = $ 2,,22 Tr(l 0 "W I' ~ , r;r !J,r", ~u,;,,\hc tun....! ll' e ZOt \In~ ~', 'Id .:'(A.~~ rIA -1 af'pro\al ;/"L) K-.. 7omnJ__-- 9~;~~3?69__~-'L- 15 A) A thonzed Slgnc\ture a. u 3. ICOMPLETE FEE SCHEDULE BELOV LOCATION OF INSTAL~~a "?~ .,-;;-::> /Jt;.J& '" A. New Residential-S1ngle or Mult1-Fam1ly per dwelling un1t. Serv1ce Included: 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. \ ~[>)\S~ION C'lJlfO \\o:\.?p JOB DE~CRIPTION A/. c::;- F7L , Permits are non-traftsferable and exp1re if work 1S not started w1thin 180 days of issuance or if work is suspended for ,180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor~\\H.) Flvl'';/~ Address (J SuJ ;J,>;B s,4- Ci ty rr\r0RA"-. 1..j is-cll') q IONn.\ Phone Supervisor License Number Expirat10n Date J n- ) -q':;; Constr Contr. Number {c'671..f..C:: Expiration Date g-l..J-qS; , Signature of Supervis1ng Electrician a/k~ /.CP ~ ~~.a'~~ Owners Name~ ~::6- ~ . '" /-' Address??< <? 3:2 ~9/:-. Ci ty 'f~#/~ Phone ?A4/-d ~ OIINER INSTALLATION The installation 1S be1ng made on property I own Wh1Ch 1S not 1ntended for sale, lease or rent Owners Slgnature: --------------------------------------- DATE: RECEIPT j1: RECEIVED BY: 9-4-'9> /C;>C' .-5L,? /./~. '/- ELECTRICAL PERMIT APPLICATION C1 ty Job Number q 509V 1000 sq.ft. or less Each addlt10nal 500 sq. ft or port1on thereof Each Manuf'd Home or Modular Dwell1ng Service or Feeder B. SerVlces or Feeders Installat1on, Alteratlons or Relocat1on: 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 Sum E;6 30 Cost \ $ 85.00 2- $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Serv1ces or Feeders Installatlon, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Branch C1rcu1 ts $ 40.00 $ 55.00 $ 80.00 volts see "Bit above New, Alteration or Extens10n Per Panel Mlscellaneous (Service/feeder -Each 1nstallat1on Pump or 1rr1gat1on Slgn/Outl1ne L1ghtlng Llm1ted Energy/Res L1m1ted Energy/Comm One CnCU1 t Each Addlt10nal Clrcu1t or w1th SerVlce or Feeder Permlt E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 'I''@'f.'d. ~0 $ 35 00 $ 2.00 not lncluded) $ 40.00 $ 40.00 $ 20.00 $ 36 00 \\~9D ~'4~ ~.",...... 1.a4.W