HomeMy WebLinkAboutPermit Building 1995-5-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
ASSESSORS MAP'
/
LOT:
'"
~~h'
BLOCK-
OWNER:
ADDRESS:
CITY-
F /,bLA-.h ~€/Z> {/,k:
-;Pp /?~X 2~5~ / '.
~Y~E~
STATE'
~.
-"
~
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JOB NUMBER
9'76'.'>~
225 Flflh Street
Springfield, Oregon 97477
/A/.
TAX LOT: r~jqm
SUBDIVISION:~~_' .~~1i""
PHONE:~5~:Y/~>
ZIP:
'7"/9'd9
DESCRIBE WORK: /N~~~h1'#-~~ ~/'77F .? ~>'F~"'7 ',-/' ?/h-~~~
NEW .Y REMODEL ADDITION DEMOLISH OTHER
CON ST.
CONTRACTOR'
CONTRACTOR'S NAME ~ ' ' , ADp~/~"d9'
GENERAL0..':"......T.~ ~";:-i5.:-~ 4"'?'V~
PLUMBING'
MECHANICAl'
ELECTRICA' '
. ;J. P. N IfJ
QUAD AREA: __ ,
. OF BLDGS:
OCCY GROUP'
,
~~t1Y\
I
. OF STORIES:
WATER HEATER:_F
~VY"7.
, /-
- OFFICE USE -
LAND USE: ---11 66
· OF UNITS: I
CONSTA. TYPE: --.JL,N
HEAT SOURCE:--..f.F.
E
RANG~-
EXPIRES
PHONE
h".s:5:"7 -.7A;;;<>
:5'-?~
,
FLOOD PLAIN:
ZONING CODE: ~t-
. OF BDRMS-
SECONDARY HEAT:
.~
SQUARE FOOTAGE:
I CJf1 (p,
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requesled 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.
D Temporary Electric
o Site Inspectton - To be mado
after excavation, but prior to
settln~forms.
rtJ undersY~Electrlcall
T Mechanical - Prior to cover.
7';;;7f Footing - Afler trenches are
~excavated.
o Masonry - Steel location, bond
.beams. grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
- Prior to. Insulation or decking.
",
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation -- Prior to
decking.
K?1' Sanitary Sewer - Prior to filling
~ trench.
~ Storm Sewer - Prior to filling
~ trench.
K:;:(Water Line - Prior to 'filling
~rench. '.
D Rough PI.umblng - Prior to'
cover. .
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o RoughElectrlcaJ - Prior to
cover.
D ElectrIcal Service - Must be
approved to obtain permanent
electrical power.
D FIreplace - Prior to facing
materials and framing Insp_
JZlFra~lng - Prior to cover.
D Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approvlSl
and Installation of unit.
D Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
D SIdewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - When completed.
~treet Trees - Wh~~ all required
~ees are planted.
o Final Plumbing - When all
plumbing w9rk Is comp/at.e,
o Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
"ts?f Final Building .":,,When all
~requlred Inspec'tlons have been
approved and buildIng is
completed.
o Othor
MOBILE HOME INSPECTIONS
I'Vl'Blocklng and Set,Up - When all
~blocklng Is complete.
KAPJumb~ng Connecllons - When
~home has been connected to
water and sewer.
~Electrlcal Connection - When
blocking, set-up. and plumbing
nspectlons have been approved
and the home Is connected to
the service panel.
1'9( Final - After all required
~Inspectlons are approved and
porches, skirting, decks, and
venting have been installed.
r
~. ".'." ::~ -: ~ :~. ..,' ";:" ~.tH~;. .THE PROPOSED WORK tN THE.
Lot faces ~ Lot Ty_ Setbacks,
Lot sq, Itg. ~'b Interior I P.L HSE GAR ACe' I HISTORICAL DISTRICT, OR ON
- IN I THE HISlORICAL REGISTER?
Lot coverage !k.2S~ Corner /t:) If yes, this application must be signed
L2.?r Pan"handle Is ~ I and approved by the Historical
Topography Iw I Coordinator prior to permIt Issuance.
J7j . V /0 I'C
Total height ('[.1/) Cul-de-sac ~ 2..4..1 ~
APPROVED: .
BUILDING PERMIT
ITEM' SO. FT: X $/SO. FT. ~ VALUE
~ajn., .~~ l~~ ]/?tfi-..-"
i.;:J Zo /Y: /0 "-1./2.8," ..
Carporl~~.?;"'" /O."e, ~Y;2!;l.--
~p~. &'/?/8.-
/O/tDO
~>-o
~:fS
~.9S
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) *'\9"l?~-$
Total Value
Building Permit Fee
State Surcharge # J"...2.tc2..
Total Fee
(A)
PLUMBING PERMIT
ITEM
~ Fixtures
Residential Bath(s) N'
Sanitary Sewer FT, /' -:;0
Water FT. L5'Q
Storm Sewer FT, .?- So
Mobile Home
FEE
:Z~ B-O
.....;;z..soo
2-5'00
/<.E;dlJ
Plumbing Permit
9,0'-
7.2"
C) 7,. :u
A,S-.Q~ .., ,710
State Surcharge { ,~
Tolal Charge (C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.~NEOUS PERMITS
Mobile .Home
Slate Issuance
/o~#
:;UO."d
S.~
\'S.1S'
'~,'70
~~S' 3',J"
State Surcharge ~'__ -r _ -"
Sidewalk ~ ~ II - .
l~'-ft""-'
I Curbcut
'-Dem,OI,liion
-
State Surcharge
Total Miscellaneous Permits .(E) l3~
TOTAL AMOUNT DUE (excluding electrical) ~'A~-A~
(A, B. C, D, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
constructlon'shall,ln all respecls, conform to the Ordinance
adopted by the City ,01 Springfield, Including the
Development Code, regulating the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation 01 any provisions 01 said ordinances.
Plan Check Fee'
~~. ~-=s
'~--5'-~
.
5fr'~A:s-
7 ~~e
Syslems Development Charge Is due on all undeveloped
properties within the City IImlls which are being Improved.
ADDITIONAL COMMENTS
t1f): fP { (p ,/)8,f) IX) ,
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(lJ'1Yt1W-H&z.L ardJ) " 1C((D - (C(0f
JJ4'ba.l!.t..- }//Ijjj/(IY
\ a Q Q aJ\-1. t' n \) f)i ~~j'
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By signature. I stalo and agree, that I have carelully examined
the completed application and do hereby certify thai all
Informatlon hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordlnancos 01 the City of Springfield, and the Laws
of the Slale 01 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 thai only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agreo 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 01 plans will remain
~e, site al a;'; ;!o/S during constr~ct~. , ~
Slgnatur~ w;L ~~(h( ~
'. e
Date~/9- 07
(' r
VALIDATION:
RECEIPT NUMBER /7.,t~/
D~E PAin. ~ 'j' /J'.r
AMOUNT RECEIVED.J:} . _ 9D
~.
RECEIVED BY _
\,
..
...
SPRINGFIELD
The following project as submitted has the followi
225 FIFTH STREET zoning, and do.. not require sp6Cific land ~l'.ECTRICAL PERMIT APPLICATION
approval.
SPRINGFIELD, OREGON 97477 I "f!,- q~,,~aa
INSPECTION REQUEST: 726-3769 Zonina L-;"l;/ Ci ty ,Job Number ',~ T \
OFFICE: 726-3759 Dol. &-'1/1/4)
1.cIJ~ O~iz.dSignature
.
~ COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
dt5~~WFTION()C\ C\cn
~D~I~
Permits are non~a~sferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTAL~TIO~ ONLY
Electrical contractot1\Q,~
Address \\1\9 _l ~ ~o ~
CityLk'DU'\CL Phone ,\~', \qf)
. ~' lP ~ 8; jfQCo
SuperVlsor LIcense Number CI. 4~",
Expiration Date \ n. \ .q ~
Constr Contr. Number \03\ ~'1
Expiration Date \~ .8..~.C{1
."
.'
Signat~erVis~ian
owner: Nam~ €-: ~ ~d
Address \) .( () .~ ~~
Ci~~ ~ Phone lo~3.~\\o\
OIlNER I>>STALLATION
The installation is 'being made on
property I own which is not intended
for sale. lease or rent.
Ovners Signature:
D~~E~--------1l0:~l(J~~~-----------
RECEIPT 11: 'Ie l......--J"\ ~
DUrUT1.Wn R'v. ~ -'
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular, 'Dwelling
, Service or Feeder
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
.:..1
Cost
Sum
$ 85.00
$ 15.00
<9..
$ 40.00
~o
$ 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
$ 40.00
$ 55.00
$ 80.00
see "Bit above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Ehergy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
aJ
.
.~'. .'. '.,
'.B'~O:"'5~?l?<j
~ITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 6, NOLAN 'SL.+--fl::.., D SR.
LOCATION: 2-G."f ~ GAP-SON L../TtJE..
l{o3~(,,1/ - D"I9oo
DEVELOPMENT TYPE: LDR - !Jt:.J/lJ AlIA-AIl!. I-I-oME.
I-\<>Mc 'v.W, CAp.,/~T'j!.,
BUILDING SIZE: :211<A.8. 11><.";00. ,;>o",rz.~? LOT SIZE
. .
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
lq",,~
X $0.209 PER SQ. FT. ~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
\<b
X $43.26 PER PFU
(-nB~~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
J
X
I ' 0 , X $436.19
X $436.19
X $436.19
G 44-osi)
------- ------
$
$
X
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S I~ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ ~\",,4-:
TOTAL-MWMC SDC
$ 55 4-3
~
---- ---
$ I""OO"?8
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~. ~"P-: ",LJt.. Date: sii' fa!"!'?
.---cJ' K;p Burd;ck I I TOTAL SDC
SDC Coord;nator
G ""~~
'- .-/
$ Iq",,?~
~
FIXTURE l!~.I! .<?~L<;lJLA.T ~BLE: Number of New Rxture. Equivalent = Rxture Units
(NOTE: For remodels; calculate only th dd.tlonal fixtures)
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
..,-_:~-:,-:'-'
2.
2
1
2
3
6
2
6
6'
1
3
2. .
'1/Head
2
2
1
6
4
4-
Bathtub.........................,............................... .... .........
Drinking Fountain....... ................ ............... ..... .........-
Floor Drain..... ...,............ ..........."............,.... .............
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors 'For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher."......,.........".......,...... .
Clotheswasher - 3 Or Mqre................,...,...,........,.."..
Mobile Home Park Trap (1 Per Trailerl..,.....:..:..:...
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Oishwasher/Etc..
Shower, Single StalL................................................
Shower, Gang...................... ......... ....................;......
Sink: Bar, Commercial, Residential Kitchen.............:..........
Urinal. Stall/Wall.......... ...,.... .... ... ....,.... ...,. .... .......:.....
Wash Basin/Lava.tory, S)ngle...,..............................
Toilet, Public Installaiion....,.,.............".,...,...........,
Toilet, Private..................................................:,...
Miscellaneous:
l.
"Z.
" .'
. ,:'..
'Z
2-
"Z.
<6
TOTAL FIXTURE UNITS
18
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Rate per $1,000 --I
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
19BO
1981
1982
1983
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
"
r
Improveme!,t (if after annexation datel
3.* X $ !fp,Ot.--
(Rate X Assessed Valuel
X $ =
(Rate X Assessed Valuel
~5 4-3
Credit for Parcel or Land Only If Applicable
CREDIT TOTAL = $ 564-~
: '.L
..
..
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o !L'!.,ilIA~m!!t1;!!;~
"
Job No. ~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEIT
NAME: 7" ~~ ~J PHONE: \~"3.'\\1o(
,'. '\,j,
ADDRESS: ({)() ~' ~qS~ U '0-' STATE:Gt:-ZIP QlmL
, I ~
.-.- -.
'0
. .
lq<:ATION OF PROPOSED B~lDING SI~ ". n ' \
Street Address if Known: nl\rf\~ (~C'0\.~~
~'''N""","~(\ ~~
~ropriate dweJlirig(sl. SDC Calculations and dwelling type
Platt Name:
1. DEVELOPMENT TYPE (
definitions are on the back.l
A. ~inl1'le Familv - Detached
. Single Family home
, NO OF UNITS
( Manufactured home not in a park" , a)
X $400 PER UNIT _=', $' 4ft) , .
o.
B. Sinide Familv - Attached
.'
\
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv Aoartment ' .
NO OF UNITS
X $~77 PER UNIT =
$
D. ManufactUred Home Park
NO OF UNITS
X $280 PER UNIT =
$
. $.1fJ)fQ
$' jY
$4-fYJ.CO
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet. '
3. TOTAL WPRD NIT SDC ASSESSED (I( SDC reduced (or Creditl
~ I tb~r'ti,t
r"..............n;h' ~I'\",:,..I'\~ ~n
t[; I / I I IS
n~l(>
.
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
FAX (503) 726.3689
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield Development Code, I understand and agree
that with the approval of the attached permits, one of the following
manufac tured homes will be placed at 2L;,J'9:, &'..-k>.f'o.U L.().
Springfield, Oregon, City Job Number ;'€)L:'fi'6;'
~ Type I Manufactured Home. A multi-sectional (double wide or wider)
unit with an enclosed tloor area of not less than 1,000 square feet,
that has a nominal roof pitch of 3 feet in height for each 12 feet in
width, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have an exterior thermal envelope
meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family
dwellings constructed under the State Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width
wlth an enclosed tloor area of not less than 500 square feet, that has
a nominal roof pitch of 2 feet in height for each 12 feet in width and
that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided with the
following information:
- Manufactured Home blocking
- Yater line connection
- Street tree standards
- Sanitary sewer connection
- Electrical connection
- Minimum requirements for permanent steps
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the perimeter with stone, brick or other masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade.
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