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Home My WebLink AboutPermit Building 1995-5-24 RESIDENTIAL PERMIT APPLICATION SPRINGFIELD OWNE~ l_\rW\ F nto y-(f\ ~ j,~(\ , ADDRESS ~q}1 ~\..J :~ ') f\r\ ,-J}JU&J: . . CITY '>..~)\ \.s\~~ Q ~ N. STATE I ~\~("')'(\ DESCRIBEWORK ~\f\T)\() K(\fI\\ ~ t~ ~J:\lo.()Dc9.---- NEW ~ REMODEL ~ADDITION DEAIS~ Inspections 7263769 Office 7263759 ~ . OTHER JOB NUMBER q!Y)( oL67 225 Fifth Street Springfield, Oregon 97477 TAXLOT OJi,c(D SUBDIVISI~--.f\ Gr\J\r\OOS PHONE M4 lnC{ln I t1 T ZIP qf\41]91 CONST CONTRACT~ME ADDRESS CONTRACTOR' EXPIRES PHONE GENERAI\. ~onff\t-, QtJ0[)C? ~ 1.C\. C\lo q 13lo\r6L PLUMBING Y'.ffi,Q 0 rt ~hllQ I \ CS \\'?,\ a... \~C\\() \o~~ S\\ \n MECHANICA" Q\r, ~ j) (\ f JIlT, qt.WR ~ 2q Gto QZ3tofnOZ. ELECTRICAL 1 .Au F ~ ; In'?:,l"\-S l..\ '\ qS <\-l S JJ:l,q - OFFICE USE - QUAD AREA ....~"'r _ LAND USE __ll I I FLOOD PLAIN . OF BLDGS I # OF UNITS I ZONING CODE Lflf2- OCCY GROUP R~+JY CONSTR TYPE U;U . OF BDRMS .'1 # OF STORIES I HEAT SOURCE (1) 1-1 SECONDARY HEAT {2 WATER HEATER S RANGF F../ SQUARE FOOTAGE 1La...G- ~ 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 Electnc o Site Inspection - To be made after excavatlon, but prior to settIng forms o Underslab Plumblng/ElectrlcalJ Mechanical - Prior to cover ~ootlng - After trenches are excavated o Masonry - Steel locatIon, bond beams, grouting ~Undatlon - After forms are erected but prior to concrete placement o Underground Plumbmg - Prior to filling trench @-Underfloor Plumbmg/Mechanlcal - Prior to InsulatIon or decking ~ost and Beam - Prior to floor insulation or deckIng g:loor Insulation - Prior to deckl ng ~nltary Sewer - Prior to filling trench ~torm Sewer - Prior to filling trench ~ater Lme - Prior to flllmg trench ~Ough Plumbing - Prior to cover REQUIRED INSPECTIONS ~ough Mechanical - Prior to cover ~ough Electncal - Prior to cover [g--'Electncal Service - Must be approved to obtain permanent electrical power o Fireplace - Prior to facing materials and framing Insp Q-F-ramlng - Prior to cover ~all/Celhng Insulation - Pnor to cover Q-DrywalJ - Prior to taping o Wood Stove - After Installation D Insert - After fireplace approval and Installatlon of unIt G';:urbcut & Approach - After forms are erected but prior to placement of concrete ~Sldewalk & Dnveway - After excavation Is complete, forms and sub~base material In place o Fence- - When completed [5J Street Trees - When all req u I red trees are planted ~lnal Plumbing - When all plumbing work Is complete ~Inal Electrical - When all electrIcal work Is complete g:lnal Mechanical - When all mechanical work Is complete ~Inal 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 D Plumbing Connections - When home has been connected to water and seWer D Electrical Connection - When blocking, set~up, and plumbmg Inspections have been approved and the home Is connected to the service panel o Final - After all required Inspectlons are approved and porches, skIrting, decks, and venting have been Installed Lot faces Lot Type Lot sq ftg _ Intenor ",-/ Corner Lot coverage Topography _ Panhandle Total height r!~-40 ~().;S de sac BUILDING PERMIT sa FT \\~3 .5\.0..0 ITEM X $/SO FT 5\.o2D V\. \[) Main Garage Carport Total Value Building Permit Fee State Surcharge -\- ~ 0;0 Total Fee (A) I PL IN Is Iw IE Setb"cks I HSE GAR I ACC I I I I I VALUE lo~\..o'lt '1 <60. lD '1\~f)D ....mOO rl f") C\~ of)\O q~ SYSTEMS DEVELOPMENT CHARGE (SDC) -$ (B) fft5850!! PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' ~ Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + S.O/D Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total PermIt (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ISD ft Curbcut .~0 ft Demolition State Surcharge '-~.\>l'I_ I\i\t\ ('\ \)0 ~ FEE \\ DO ~ \ \.DD CO \ :4. ?D \I~&J L\ s[) q . C:f:) ~co \\n SO \\JCO \ L'j~ ~f'J 63 -32- ~ \~qU 4\)cD , S THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON ... THE HISTORICAL REGISTER<' _ J \ n. It 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 tlme upon violation of any provisions of said ordinances Plan Check Fee Date Paid ,,\1"\ ~ Receipt Number .0 ,~ Received By ~ ~()(\ \'\\~ . \ It-! Plans Reviewed By -. Date Systems Development Charge is due on all undeveloped propertIes within the City limits which are being improved ADDITIONAL COMMENTS ,,'wb\JC\ fiX , <>-.\Vlou 'n~Y.tv J..+-r. ~(\\\.~){ 'l~ \ C\ LoD ~(\t-h \ 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 cerHfy 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 II remain ',,\n~e site at al times dUrl~On"IO ~ture a Zij~ Date '1 tfrtu-- VALIDATION ~M rK RECEIPT NUMBER : r\"'\....J DATE PAIr> ~.?~ . 0:;. AMOUNT REC,\I~D ~ ~f) (() \~ RECEIVED BY V\\J.Y\.) . Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) A ~S\ C\O, (A, B, C, 0, and E Combined) I" , The 'oBoy. li1q pro e Zonmy, and does1 n~ ss submrtted h~tl the fefl approval reqUIre Spectf,c lono J~" 225 FIFTH STREET L ELECTRICAL SPRINGFIELD, OREGON 97477 Zon,ng Lno INSPECTION REQUEST: 726-3Tfh -5 - u., ~- C1 ty Job Number OFFICE: 726-3759 ALthorPed Slgna:"r~ --i!L/VfOHPLETE FEE SCHEDULE BELOII 1. LOCATION OF INSTALLATION -:r.4 L.J" /' ~".,KJ$J 7>P. I Qj~GAL DE:l,CRIPTION ..ku?. nlo ').\ ()7 \rf':0 JOB DESCRIPTION A c;;;z. J2 . Permits are non-traftsferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electncal Contractor J:J1I71lJ r-:IIdR/c I~ ~I.LJ ?,~ ~\+, Phone 475"-:2/31 Address Ci ty ~rI, Supervisor License Number / ()()fr,.C, Expiration Date 10-/-95"' Constr Contr. Number loR7tJc;- C}-I../-q<:;, Expiration Date , The 1nstallation 1S being made on property I own WhiCh is not intended for sale, lease or rent. Owners Slgnature: ~j;::=-~iill~--- PERMIT APPLICATION 0\QJlotfJl . A. New Residential-Single or Multi-Family per dwelling unit. SerVice Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelhng Service or Feeder & Cost Sum $ 85 00 ffi $ 15.00 3:J $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary SerVices or Feeders Installation, Alteration or Relocation volt s $ 40.00 $ 55.00 $ 80.00 see liB" above Signature of supervisin~ Electrician 2ILtf/lf%~ ~ ft/i___ " ~!,.' - D. Branch CirCUits Owners Name IjA-l-r:n~A) ~~P~/~:::;;~ . /? --./ 7 New, Alteratlon or ExtenSion Per Panel Address ff9"1 ..,.;S;::) -.sif<C "5f1"? One CirCUit $ 35.00 Ci ty 5";::>F-f:r... Phone 7.aLl -/$...L Each Addlt lonal I .,.." CU.-CUI t or WI th SerVIce 01lNER INSTALLATION or Feeder Permlt B. SerVices or Feeders Installation, Alterations or Reloca tlon. $ 2.00 200 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 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 E. M1scellaneous (Service/feeder not lnc1uded) -Each installation Pump or lrrlgatlon $ 40.00 Sign/Outline Llghtlng $ 40.00 Limited Energy/Res $ 20.00 Llmlted Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE \\S aD 5% State Surcharge ~ ~ T.e'f1\i. "30.0 ~ . ~ c:. \2~ 1.0 NO. 'j5oc::>CLL CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY !-/AYDEN EJ.J,E:.RP1<-/SE:.S INc LOCATION ~4-4-S CH-E-!ZOJ<.e..e DEVELOPMENT TYPE U)f?-. - NE::.W SFR BUILDING SIZE IS,,7-0C,7-/- CJZC,OO LOT SIZE SQ Ft I STORM DRAINAGf; IMPERVIOUS SQ FT NA . X $0 209 PER SQ FT (( -B-~ '-.....-. 2 SANITARY SEWER-CITY NO OF PFU'S 1 'is X $43 26 PeR pru G778(.?) (See Reverse) ~ ~ 3 TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP ~ ~ X / 0 I X $436 19 ~) X X $436 19 S X X $436 19 $ 4 SANITARY SEWER-MWMC NO OF PFU'S /)( x $17 .19 PER PFU + $10 MWMC ADr1 FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ? ,q 4-3-. TOTAL -flWMC SDC $ Z<.,Z;; ~ ~ $ /'51'2.. 4-2- SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) hi,. -p, .. L-J.:..- '-0 Klp Burdick SDC Coordinator X .05 Date: 5/23 /q c; , TOTAL SDC C 75"2-) ......... ------ $ /'5 Be 04- FIXTURE UNIT GALCULA TION TABLE: Number of New Fixtures X Unit EqUivalent = Fixture Units (NOTE- For remodels. calculate only the = additional fixtures) NUMBER OF NEW FIXTURES FIXTURE TYPE Bathtub - Drinking Fountam Floor DraIn Interceptors For Grcasc/Otl!Soltds/Etc Interceptors For Sand/Auto Wash/Cre laundry Tub/Clothcswdshcr Clothcswashcr - 3 Or More Mobile Home Park Trap (1 Per Tender) Receptor For Rclngerator!Watcr Statlon![lc Receptor For Commercial Slnk!DIshwashcrfEtc Shower, Single Stall Shower, Gang Sink. Bar, Commercial, ReSidential Kitchen Unnal, StallfWall Wash Baslnflavatory, Single TOlle!, Public Installation T otlct . Private MIscellaneous 1- z. z. lOT Al ill TUf\[ U, 11 S UNIT EQUIVALENT Z 1 Z 3 6 Z 6 6 1 3 2 1fHead 2 2 1 6 4 FIXTURE UNITS 4- 2 z. '2.- 8 \~ CREDIT CALCULATION TABLE Based on assessed value If Improvements occurred alter annexation date In table, calculate credIts scpar<3Lcs Year Annexed IldcC per $1 000 f\sscsscd Value 1979 or bclore 1980 1981 1982 1983 1984 1985 --. Credit tor Parcel or land Only 11 Applicable '2.,,22. Improvement (If after annexation datel $346 338 332 321 306 292 273 Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 ~ 4{" X $ I' <:>13 (Rate X Assessed Value) X $ (Rate X Assessed Valuel = , Hate per $1 000 As.:>csscd Value $2/,6 2H 177 1 37 097 061 044 015 CREDIT TOTAL = $ Z{,,2~