HomeMy WebLinkAboutPermit Building 1995-2-14
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOT'
OWNER:~ L/.~_
ADDRESS' <;r2') 2 5? j:~;"i
CITY' ~r/"/
DESCRIBE WORK'
A/...,,/
NEW
'L
REMODEL
.
/,,,, //,. ",-
"
R,. e /?V'
STATE: '
OR
!JUJI".}(,
c" ...,~?;.u <.-7/,,;,
ADDITION
DEMOLISH
OTHER
210/ / ~ S' c.4yt?(~
,,,
r 1/-0 ~
PHONE:
ZIP:
9?Y?Y
CONTRACTOR'S NAME ADDRESS
GENERAL: f'y!"r R'llfU.,,~ L, 0l;>,'_-f:....~.~, 1...,,-
PLUMBING: 0.,,,,,/, ?/r/IH;n-......"
'7 ..
MECHANICAl' ,if
CONST.
CONTRACTOR .
Jl./ ~"'7? I
'?f\OH 0
PHONE
? :/-If' -/.f'2.l
(.,fN)-U2r'
ELECTRICAL: .1)." v,'r
EXPI~~
1.t{MIP
~.C1S
;=/~7,;., ('
. .'
.l'11l1....
\\ . \:~,(."\'\ W6'-.l' 9Yz-
QUAD AREA: \ R~
\
OCCY GROUP: \-\'?:>+JJ\
. OF STORIES: A
WATER HEATER: _r"
- OFFICE USE -
LAND USE: ~\? n
. OF UNITS: ~.
CONSTR. TYPE: _J)j\)
HEAT SOURCE: \;) \-\
~/
FLOOD PLAIN'
ZONING CODE: UC2-
. OF BDRMS: ~ + ~_ ..
SECONDARY HEAT: 0
(S?~p,~~T;rfl 0 I { ()
To request an Inspection, you must call 726,3769, This Is a 24 hour recording, All Inspections requested belore 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 B.m. ~I" be made the following work day.
· OF BLDGS'
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
gFOOtlng - After trenches are
excavated.
Masonry - Steel location, bond
,beams. grout! ng.
'rft Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - PrIor
to filling trench.
~ Underlloor Plumbing/MechanIcal
~- Prior to Insulation or decking.
[ZI Post and Boam - Prior to floor
,InSUlatiOn or decking.
bll. Floor Insulation - Prior to
{deCking,
IV1 Sanitary Sewar - Prior to filling
r trench.
V1 Storm Sewer - Prior to filling
f trench.
VI Water Line - Prior to filling
{'t trench.
D Rough Plumbing - Prior to
.r cover.
RANGF'
REQUIRED INSPECTIONS
rVl R~ugh Mechanical --.:. Prior to
r cover.
01 Rough Electrlcal'- Prior to
( cover.
~ Electrical Service - Must be
approved to obtai n permanent
electrical power.
o FIreplace - Prior to lacing
materials and framing Insp.
~ Framing - Prior to cover.
~811/Celllng Insulation - Prior to
( _ ....oyer.
p'DryWall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit,
~curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
PSldewalk & Driveway - Alter
excavation Is complete. torms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
rT7f Final Plumbing - When sll
W plumbing work Is completo,
, ,
~ Final Eleclrlcal - \.IW)en all
~ electrical work 'Is completo.'
@ Final MechanIcal - When all
( --- mechanical work Is complete.
~Flnal 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.
o PlumbIng Connections - When
home has been connected to .
water and sewer.
o Electrical Connection - When
blocking, set,up. and plufl;lblng
Inspecllons have been approve.d
and the home Is connected to
the servIce panel.
o Final - Aller all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
1
".,,' ,f" ~~ :' }?.~ ~; ~""l
'.:'y .::~..:~t'~
Setbacks '
HSE GAR ACe' I
I
': '. :'1:- ; .l::i'.'
~~ype. ",
'..
Lot faces
Lot sq, ltg, _ Interior I'P.L
IN
Lot coverage Corner
Is
Topography , Panhandle
Total height c!J!:[! Cul,de,sac Iw
'-, ~'I E '
. , ~ \. \' ~ '- 1<- .
BUILDING PERMIT
~
ITEM
X $fS~ FT, = I2.Q~2:1 /
M., UJ,'2DT
Main
Gatago
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~"$4S1. 13
PLUMBING PERMIT
ITEM
FEE
Fixtures
.
N' ~'i~
" ~?[)c;t:J
Residential Bath(s)
San I tary Sewer
Water
FT,
Storm Sewer
FT,
FT,
Mobile Home
Plumbing Permit
State Surcharge -t3Ptt>
Total Charge (C)
" 3?D,CO
d.J5. U:O
{)~5.1.~()
MECHANICAL PERMIT
Furnace
Exhaust Hood
q.DO
1~.aJ
Vent Fan
N'
Wood Stoveflnsert/Flreplace Unit
Dryer Vent
loCV
Mechanical Permit
r!Jf) pU
/ [) . CJ()
c!l,/Io
..:3 a . I/Q
Issuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk .(120
Curbcut ~ 0 ft
\C\~
\~~)
It
Demolition
,~rg~~\Dlu0
'1:-D.oU
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B. C, D, and E Combined)
44.~lfV
'_ THEPROPOSED WORK tN 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.
Ptan Check Fee: _
Date Paid: n ,([) \
Receipt Numb~r:nl;.;~\t}_U \..--'"
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
j)1fLl)J)lll2 ,...&ri r uY9-2.LJ
"sA.+T: \ \f)OO ~)
~YICYl+o,,: \~ll3
L
~~or
(-II),()~ QQllt~
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 :he 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 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
i!?n the at all times during construction,
nat 7?"/~ 4~_
, /
, Datp' 1--{:.c/-9S"-
VALlDATJ~:
RECEIPT N f/(l'l.Rq
DATE PAIP , /1: -S:{~
AMOUNT REC:t!!I, ^~~~
RECEIVED B~)(} )
.
','
.
"",... Wi llama lane
'tg' Park & Recreation District
Job No. Ct4 \ log<i{
,'I
',j
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: \t)\\\\Clrr\ (\n.l\.L\'1 J)
- "~
ADDRESS: fB1~~ 9Ym; J ~~ Pctl
PHONE: 12b.I~9. ~
STATE: eR-ZIP~'
LOCATION OF PROPOSED BUILDING SITE: ,
StreetAddressifKnowCl:rO'J']f) 'lt~~ 'Qlli~b ~
PlattName:GJrundLL IT Tax lot Number: \V\[)~Q?~\.~
~ln:t,
1~ DEVElOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Familv - Detached
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached
NO OF UNITS L
C. Multi-Familv Aoartment
Manufactured home not in a park
X $400 PER UNIT _="
. $
X $370 PER UNIT =
, $ 21/).00
.i
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SOC
$ 21tJ .CXJ
$,&'
M n 'a::/
$'rTIJ..
,':1
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet. '
3. TOTAL WPRD NET SOC ASSESSED (If SDC reduced for Creditl
~~~,~~ d I 1-4 I ~
, I
~
, ~'
, '
. -"
.
'. '
J
"' ;.,..~,.
JOB No..'e;I/~ ~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
ATIACHMENT Bl
NAME OR COMPANY: ta~,t./AM C AU..~ V
, LOCATION:.211'l'Lf 5, C.L~IIE.L.J..B;.P .J-oop
DEVELOPMENT TYPE: 11$/0 OuPJ..EJf
BUILDING SIZE: LOT SF> 5Q, Ft. ,
1. ~TnRM nRATN~
2. 4 </0 ' , (S~
IMPERVIOUS SQ. FT. X $0,209 PER SQ. FT.
2. SANTTARY SFWFR..CTTY
NO. OF PFU'S '3 2. . X $43,26 PER PFU ~ rr'!, s ?;
(See Reverse) ~
3. TRANspnRTPTTON
NO OF UNITS X TRIP RATE X COST PER TRIP
~ X /, () I X $436,19 ~3"l?/,/'" ')
~
X X $436.19 $
X X $436.19 $
SUBTOTAL (ADD ITEMS 1.2. & 3) $.2 '17~3?
4, S8MlIARY SFWFR-MWMC
NO. OF PFU'S '?~ x $17.19 PER PFU + $10 MWMC ADMIN,FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MAl -MWMr snr:
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ ~"(),(J?
$ ~"', f'6'
$~f', ~'"i>")
, -
$ 3299.711'
':'.: p.nMTNTSTATTVF FFFS
BASE CHARGE (SUBr ABOVE) X ,05
~ ~ L- 'Date:
/" Ma.ry }IOrni g, P U '
./ SDHoordinator
0:!iJJ-
//- /~-9~
IQIAI snr.
$ ~4s'" 7 3
B2,SDC .
:.;.....;..,.:.:..,..:......:.
~ '
FIXTU RE UNIT 'CALCU LA t N TABLE: Nom',., 0' N.w ""..- Uo;' "0'0,.,00 ". "".., U'",:
(NOTE: For remodels, calculate only the IifI additional fixtures)
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
FIXTURE
UNITS
FIXTURE TYPE
~'. .
2
1
'2,
3
!l
'2
6
'6
1
3
2
1/Head
2
2
1
6
4
.2.
4
Bathtub........,.....,..,......"....,....................................,. .
Drinking Fountain........... ,.....,..,........,.......................
Floor Drain..... ...............,..............,.. ...........,.........,...,
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto' Wash/Etc...........:.:.....
Laundry Tub/Clotheswasher:.. :..... ::-.'.........................
Clotheswasher - 3 Dr 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/Wall. ::.................,...............................,..
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation...................... ............... ...
Toilet, Private......y...............................................
Miscellaneous:' .': " iTAI'I' TtJ,~" ~"'...
..2.
.
2
4
4
4
4-
2
4
.Jb
TOT AL FIXTURE UNITS
=
~2
CREDIT CALCUL~TION TABLE: Based on assessed value, If improvements occurred after annexation date in table.
calculate credits separates,
II
I
Year
Annexed
Rate per $ 1,000
Assessed Value
Year
Annexed
Rate per $ 1,000
Assessed Value
Il
1979 or before
1980
1981
1982
, '9?3
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
"
"
,.\,- "
Improvement'!if after annexation date)
.1.4C, X $ 11,1D"
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
40, of ?
. .'
Credit' for Parcel or Land Only If Applicable
=
CREDIT TOTAL = $ 10. 7'~
l", ..
'. .'~ :
.
The following project es submitted has the f
zoning and does not require specific land use
225 FIFTH STREET ap'pro~al. ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 rvtI>~ nAI' I. or}
IN$PECTION REQUEST: 726-3769 ~zonino /' City Job Number~~~
oFFICE: 726-3759 Dote""::>
3. ,"GOHPLETE FEE SCHEDULE BELOII
1'1\ nIR~TIO<<' ..Q~STALLA1;(pN ~u;.h?1ed Sign.ture UIV'- ,
.dLJ~.rJ ~O}. ~M '- "n l'lD\ Wlf Cl1.-. A. New Residential~Sing1e or
~ Multi-Family per dwelling unit,
r\LEGAL:DESqR!fTION ~ Service Included:
I, d)~Q..~4t,"I, C)O\r{ J Items Cost ' Sum
, (,~~B. ~ION &lo\ \(J~
Permits a)e n~n-transferab1e and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor\'(\\' 'f..~ f kIT
Address4f2.3t"L ~('\{01l\71.P ~lt;g
Ci ty~ rt~ Phone_R=lI~f2.;
supervis~r \li:~nse Number \~f) \ S
\f).\.~~
Expiration Date
Constr Contr. Number \\",\,'2-
\ \. \?-.,.Q~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular, 'Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
-d--
d.
$ 85.00
-ill>
3()
200 amps or less
201 amps to 400 amps
401 am~s to, 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only ,
$ 15.00
$ 40.00
$ 50.00
$ 60,00
$100,00
$130.00
$300.00
$ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
E .1 .
xplratlon Date
Signa~e of Supervising Electrician
~A1,~
o;ners Name~)i.\\\QJ~\ ~
Address ~9> ~ n-<\~~_
Ci ty ~~ p~one-1 tlo .l~
o~ iNSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~----or-:72f .~--------~
RECEtFT 11: , ~- -d \)1()2n1
RECEIVED BY: (~C:;Z) _ ) ·
..... .
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 liB" 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 Addi tiona1
Circuit or with Service
or Feeder Permit
E.
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
~r:D0?
It' ).~
~ ..$.ti5