HomeMy WebLinkAboutPermit Building 1995-3-22
LOCATION OF PROPOSED ~O~K: ~ 70
ASSESSORS MAP' [,g l)~4tYJ
*&
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
.
SPRINGFIELD
~5r,77-H A.
BLOCK'
OWNER'
ADDRESS'
CITY:
Ki;/U? f1.uuJ ~5
C; 70 P/Ntt:. CT
c.eCc SloC;"..J J.., eN!
STAT~'
O.f
DESCRIBE WORK: ~. \='. \?o [)\.1 0 (\~
NEW X REMODEL ADDITION DEMOLISH
OTHER
L.--"" .
.
1'50/15
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
-
nR-G{(X)
TAX LOT:
SUBDIVISION: _OJ/ 5Hof) Ii-. SmT,; "
PHONf'
9sL-l-c?33 L.
ZIP:
9 "/C/ 2-?,
CONTRACTOR'S NAME ADDRESS
tEII/ C/C ;J; 0z() ~:s
C<h~ p~
(; A1e-t'~ /-I-4--ff7 Nq
GILLS k Ltfcr;e;'c.
CONST,
CONTRACTOR'
(')9q-3S.:z
OOPA:~
1054~
'cO Jl~'5i
EXPIRES
ItJ j;';);s-
1.r].QS ..114, ff/oZ.
/9. ,/1/,45 ~m,.n~/
4. 9KCfS ~g1-/fS5J
GENERAt'
PLUMBING'
MECHANICAL'
ELECTRICAl'
3'LcsQ-
\
R?yt }J\
\
t:-.>
QUAD AREA:
· OF BlDGS'
OCCY GROUP:
· OF STORIES:
....VATER HEATER'
- OFFICE USE -
\ \I \
· OF UNITS' \
CONSTR. TYPE: ~
t:'S
LAND USE:
HEAT SOURCE:
RANGE: __<r ./
PHONE
'lSYJ'352-
FLOOD PLAIN: \
ZONING CODE:-1llV
~
SECONDARY HEAT: ()/
SQUARE FOOTAGE: ~f}O'?-(
. OF BDRMS:
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
o Site Inspection '- To be made
after excavation, but prior to
selling forms,
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover,
l's7f Footing - After trenches are
~ excavated.
o ~asonry - Steel location, bond,
. .beams, grouting.
t'\:;:r Foundation - After forms are
~ erected but prior to concrete
placement.
r""1 Underground Plumbing - Prior
--- to filling trench,
.l\:7f 'Underlloor PlumblngJ Mechanical
~ - Prior to Insulation or decking,
~ Post and Beam - Prior to tloor
~nsulallon or decking.
,
, "
f\:?r Floor Insulation - ,PrIor. 19','
~decklng. . __
f"'iD( Sanitary Sewer - Prior to fllll~'g
~ trench,
I'\:irSlRrm Sewer - Prior to filling
L,C>l. trench,
I"v'r'water Line - Prior to filling
I.6l. trench,
i"\/r Rough Plumbing - Prior to
~ cove" \ '
\
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~ cover.
fVi Rough Electrical - Prior to
~cover.
TVrElectrlcal Service - Must be
~approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to' cove::
K7t Wail/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taping,
o Wood Slovo - After Installallon.
o Insert - After fireplace approval
~nd Installation of unit.
"f':7I' Curbcut & Approach - A~ter.
. '~ forms are erected but prIor to
placemont of concr~te.
I'ii7I' Sidewalk & Driveway - After
~ excavatIon Is complete, forms
and sub-base material In place.
D Fence - When completed.
:,. .
~Street Trees - When all r,equlred
<.J!!7Y trees are planted. . . '. ,
rvr Final Plumbing - When all
~ plumbing work Is complet.e.
r;;::;rFlnal Electrical - When all
~ electrical work Is complete,
~ Final Mechanlcat - When all
mechanical work Is complete,
I':A- Final Building - When all
~ required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPE,CnONS
o Blocking and Set. Up - When all
blocking Is complete.
o Plumbing Connectlons- When
home has been connected t6
water and sewer.
o Electrical Connection - When
blocking, set,uP. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porchos, sklrllng, decks, and
ventIng have been Installed.
Lot faces -S.- Lot Type. Setbacks
Lot sq, ftg, ~O v'lnterlor i :L.l;~ GAR ACC I
Lot coverage ~5'.7o Corner I I 41 I
Topography ..(2.:::'LJ Panhandle I S II II ~ I I
\~:y W S:S
Total he~ ~ (.1\'1' c~~)~c", "~.:.J APPROVED:
BUILDING PER~I; . ~~ . BUILDING VALUE, PLAN CHECK
ITEM SQ, FT, X $/SQ, FT. VALUE AND BUILDING PERMIT
j/5'2.. ~t;C;7(J,fi'
t::;/(.., " 777,60
. I - #
MaIn
Garage
Carport
Totaf Value
~d2loLeI
r '
.51~2?
2$ rl
3U ,,,4
Building Permit Fee
State Surcharge / 7;'70""lo7~
Total Feo
(A)
. SYSTEMS DEVELOPMENT CHARGE (SDC)
~~45..~3
(B)
PLUMBING PERMIT
ITEM
FEE
FIxtures
Residential Bath(s)
2
'/(On
N'
Sanitary Sewer FT.
Water
FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge ~.!/- 1:$0
Total Charge (C)
/ 2. , ~o
_/72. f:,O
MECHANICAL PERMIT
Furnace
ht$o
-Iro
I'o~
Exhaust Hood
Vent Fan
~
N'
Wood Stovellnsertl Fireplace Unit
Dryer Vent
3 .()f)
Mechanical Permit
J"7Ji'o
JO(Jo.()
/,S'7
3../,07
Issuance
State Surcharge ,9~ +-,55'
Total Permit (D)
MISCELLANEOUS PERMITS
Mobtle Home
State Issuance
State Surcharge
Sidewalk 72 fI
Curbcut 20 ft
20, so
/..j.,~o
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
".:35~
-::277~~
TOTAL AMOUNT DUE (excfudlrig electrical)
(A, B, C, D, and' E' Combined)
':: . ;';': ~:'.~' >::
I:: .,
_S THE PROPOSED WORK tN THE, '
"HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
If yes, ,this appflcatlon must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
This pelmllls 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.
Plan Check Fee: ::2 '5 2. 7 ~
::::I::I::umber: ~ 1:i:-7
A"~
"',-
~A'>M
evlewed By"
':( It I'T r-
-/ ~te'
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved,
-'
ADDITIONAL COMMENTS
d+T'.
\ 1\\\f\~',
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lctta)
\ 1)(\ H'I \
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(\11k~rtQ", ~P.LCf}QL .
.D 1:., l)'w1Il' .) ~ t ~ {1V\ Q4\C1L
...
By signature, I state and agree, thaI I have carefully examined
the completed 'application and do hereby certify lhat all
Information hereon 15 true and correct, and I further certlty
that any and all work performed shall be done In accordance
with the Ordinances of the Clly of Springfield, and the laws
of lhe State of Oregon pertaining to the work described
herein, and that .NO OCCUPANCY will be made of any
structure without permission of Ihe 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 10 ensure that all required Inspections are
requested at the proper time, thai 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 ~I:e: du~ng/1structlon.
~gnature./~~
. ----
.J" / Z-Z,./9..>
Oat'"
VALIDATION:
RECEIPT NUMBER / (-./.,., J L
MUm ~;~7r
AMOUNT RECEIVED ~ , .{."
RECEIVED BY , . ~
ATfACHMENT Bl
..JOB NO. 9fol-'fs
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
'. ,WORKSHEET
(COHHERCIAL & RESIDENTIAL)
NAME OR COMPANY: R/A~h-./ L
LOCATION: "t/q'1() q;:-~
v
DEVELOPHENT TYPE: SF R
BUILDING SIZE:
lOT S17"'
SQ. Ft.
1. '~TORH nRATN~
, IMPERVIOUS SQ. FT.
2. -13'2.
X SO.209 PER SQ. FT.
(S;~, r?}
'- -
. 2. SANTTARY SFWFR-r.TTY
NO. OF PFU'S .
(See Reverse)
/'1
. X $43.26 PER PFU
(J~
3. TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
J
X ;,0/ X S436.19
~?a~-s-)
----
X
X
X S436.19
X $436.19
$
$
SUBTOTAL (ADD ITEi",s 1. 2. & 3) s J ...,. 3 ';I'.:? r
4. S8HlIARY SFWFR-~dH(
NO. OF PFU'S J'f x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ '?I'i, -r 2-
(Use PFU Total From Item 2 Above)
HWMC CREDIT IF APPLICABLE (SEE REVERSE) $ /3.? t-
..IOIAL-MWHC SDC ,$(3'''5':.s-,,=>
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 2.~ fi .>s-
5. ~nMTNTSTATTVF FFFS
GE r~OVE) X .05
~ Date:
H rnig, P.L ./
rdinatar--------
r/O.2/? )
- -
---
.:2 - /0 - 9 s
IOlAI SOr..
$ 2/15". r.3
B2.SDC .
F!XTURE uNiT CALCULelON TABLE: Number of New Files X Unit Equivalent c Fixture Unit"
(NOTE: For remodels, calculate onlYlhe tiEl additional fixtures)
, ,', NUMSEf1 OF
NEW FIXTUnES
FIXTURE TYPE
Bathtub.....,..................,."...,.,.,..,..,....,...,...........,..,.., .
Drinking Fountain.., ........ .....,......... .........,.................
Floor Drain. ..................... ..........................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher...... ..... ............... .... .....
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)............:.....
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwa;lier/Etc..
Shower, Single StalL.......................................:........
Shower, Gang.............. ...... ......... .... ..... ,... ... ..... ..... .'..
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, StaIlN~all..:....., ....... .... ......... .... .... ..................
Wash Basin/Lavatory, Single...........,......................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous:' ',TAl'll "'R'.s 5.1'>/):-
UNIT
EOUIV,\LENT
FIXTUf1E
UNITS
I
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
~
z..
/
z
/
z.
I
z..
2.
z.
2.
<;;
TOT /"l FIXTURE UNITS
/:6
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred aft~r annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1~80
1981
1982
1983
1984'
19B5
$3.46
3.33
3.32
3.21
3,06
2.92
2.73
Year
Annexed
-I
Rate per $1,000
Assessed Value
1985
1886
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
3 A' G; 4. tnn; __' /5. 't.A
Credit for Parcel or land Only If Applicable " T X $ . ,..
(Rate X Assessed Value)
Improvement (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $
.
SPR''-ELO
, .
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPEctION REQUEST: 726-3769
OFFICB: 726-3759
1. J.~TION ~ IN~~IilN \
'\-G\ In \'-{)\ ~ ' .1 () )
\ ~6QO\~n1D&qrD
~ DIi$CRInWN ;..ll \{\ r-of2
~ ~~. IXOJ)VIOf\f'Q.... . Il ^
Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuanc~or if york is suspended for
180 days.
I
2. CONTRACTOR INSTALLATION ONLY
,
Elec~rical Contractor
BILLS
Address
3170 WEST 11TH AVENUE
City
1'11r.I'N~ Phone __68.7 _ , R~ 1
Supervisor License Number 980S
Expira t ion Date 10/1/95 ..
"
Constr Contr. Number 21351
Expi'ra tion Date 41?R/qlr
, ~tWu~ctrician
Ovners Nam~ll'fr ~i\&.J\O\\\O.J)JD.
AddressJJ:D \ ~ (\0, 0~Dl-t-:;'
City ~HttnoQO . Phone q~.Y..-=<3?--
OVNER INSTALLATION
The, installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
--~---
.J12.~ p-
RECEIn, I: / /,. '11"'L":1"
RECEIVED BY: . /f"'~:..
DATE:
ELECTRICAL PERKIT APPLICATION
'Ci ty Job Number ctm\\-s
3.
COMPLETE FEE SCHEDULE BELOV
A.
Nev Residential-Single or
Multi-Family per dvelling unit,
Service Included:
Items Cost Sum
1000 sq.ft. or less $ 85.00 f2j"
Each additional 500
sq. ft or portion c9-. ~
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
$ 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
$ 40.00
$ 55.00
$ 80,00
see nnll
above
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2,00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE JI S.#""
5% State Surcharge,s:lr.,..,J,€ "".~
TOTAL . /').t'M)
.
o !!y}!I~m~t\!!t;
.
,
Job No. Cf.5{) tiS
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:~~0&X ~~ ~ 001\0[\ }PHONE: Q~.~3~
ADDRESS:' lll() l\J\X\Q )~")\ dj STATE: Gt.zIP~
,,- \
lqCATION OF l"ROPOSED BUllDJN~I~ " ,",,'
, Street Address if Known: ~' \( ) l Q) )
",tt N'~\ ~ N\l~ f * T~ ld Nom"'" -1~ff\ (f) ~f) lfficb
1. DEVELOPMENT TYPE (Check appropriate dwelling(sJ. SDC Calculations and dwelling type
definitions are on the back.)
A. Single Familv - Detached
\ Single Family home
NO OF UNITS (
B, Single Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SOC
Manufactured home not in a park
$400.0l)
X $400 PER UNIT oF"
.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$4-DOcD
$ft '
II,~' OU
$ \'U .J
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. '
3. TOTAL WPRD NET SOC ASSESSED (If SDC reduced for Credit)
C\lN\. )0\f\\~n f'
ommumtv xrv~ ~n
_ '] / :2...L-i <;;I
Date