The URL can be used to link to this page

Home My WebLink AboutPermit Building 1994-8-31 .' RESIDENTIAL PERMIT APPLICATION Inspections: '726.3769 Office: 726.3759 . LOCATION OF PROPOSED WORK' 4qQ()' ~ '!-ffi rA {Y T " dJ/(/tOe 66ntJ ~5 ADDRES": '6::>0 p:::'/ -'V~ c-r. C~tf5wi.d ASSESSORS MAP: ,# /CJ LOT' OWNER: CITY' BLOCK' (ff32A1cf of'Lk ) STATF' oR DESCRIBE WORK' NEW X REMODEL :5//1/9(':, E /::~"'N'/'~ /Yv ,,.~ CONTRACTOR'S NAME ADDRESS' GENERAl' d2/VtU!. k3rMt.o ~ PLUMBING)k.tLA'~ ,j'4</J1tl1~ (!t:!€ SW('{,(" OJ!. , '/ ' II. - ~2()'7"", 5"" MECHANICAl .b-4;2l€lAy 1'r'~/_ ~~<C.. ",e- , /J./IC .-: /L/....-1A/ R.s>83 ~y 99 ELECTRICAL' #7K- r-""'<-I/"'I..... J!:..u c~ If ~ QUAD AREA: ... ~Q~ · OF BLDGS' \ OCCY GROUP: \..z ~ \ -yj . OF STORIES' WATER HEATER: ADDITION , DEMOLlSI-! OTHER . 9-!-/(JiJo CONST. CONTRACTOR' 94-'3S" 2- g~'7'c:f" $, ' .,,7o-c;;,.c JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 SUBDIVISION' PHONF' 9.5"7-8'332.. - OFFICE USE - LAND USE: _l \ \ \ · OF UNITS: -\ CONSTR. TYPE: ~~ HEAT SOURCE: ~ S C(.--J RANG~' ZIP: 9 ><y2..(O EXPIRES /O/-~~ PHONE :? 57' --J' 3,,n r?7!5 -4-'2. c1 '> 3"7'1' - 2 "10' / >w-tl't7r FLOOD PLAIN' - ZONING CODE: \ AJ{ L.7 . OF BDRMS: . \ SECONDARY HEAT:-.-0' SQUARE FOOTAGE' 'f) f1 S . . -- To request an Inspection, you must call 726.3769. This fs a 24 hour recording, All Inspections requested before 7:00 a,m. will be made the same working day. I~spectlons reQuested after 7:00 a.m. ~1I1 be made the following work day. REQUIRED INSPECTIONS L1J TemporarY Electric o Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical I Mechanical - Prior to cover. rVl Footing -' After trenches are ~ excavated. . D Masonry - Steel location, bond ,beams. grouting. , , rvl Foundation':':'" After forms are Lp....l erected. but prior to'concrete placement. D Underground Plumbing - Prior to filling trench. rYl Underlloor Plumbing/Mechanical .....".. -,Prior to Insulation or decking. rvl Post and Beam - Prior to floor L...p-J Insulation or decking. rY1 Floor Insulation - Prior to '-f'-' decking, " rv'i Sanitary Sewer - Prior to filling Lp.J trench. ctJ Storm Sewer - Prior to filling trench. rn Water Line - Prior to filling trench. A:n Rough Plumbl~g - Prior to ~ cover. rY1 R~U9h Mechanical -.:. Prior to ~ cover. '. rYl Rough' Electrical -;- Prior to ~ cover. . , rYl Electrical Service -Must'be ~ approved to obtain permanent electrical power. ' D Fireplace - Prior to facing materials and framing Insp. ~ Fra.~lng - Prior to ~<?ver.' r'v1 Wail/Ceiling Ins~latlon - Prior to LpJ cover.' QO Drywall - Prl.or to tapfng, D Wood Stova - After Installation. . D Insert - After fireplace approvlll . and Installation of unit. IV1 Curbcut & Appro'ach - After ~ forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. D Fence.- When com~eied.., , ' " fYlStreet Trees...., When all required / trees are planted. c&I Final Plumbing - When all , - plumbing wc;>rk Is complet.e. rvl Final Electrical - When all ~ electrIcal work Is complete. I\7l Final Mechanical - When all L..f"-I mechanical work Is complete, rYl Final Building - When all ~ required Inspections have been approved and building Is completed. D Other MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connect!ons - When home has been connected to water and sewer. . D Electrical Connecllon - When blocking, set,up, and plumbing Inspections have been approved and the home Is connected to, the service panel. D FInal - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. Lot faces Lot sq, Itg. Lot coverage , Topography Total height M BUILDING PERMIT ITEM SQ, FT, Main /2"J!,O 4'7,) Garage Carport Lot'~ype. X Interior Corner Panhandle Cul.de,sac X S/SQ, FT, = .:;'6 ~o /4!. ,,0 ",[" Setbacks. ;.?(;.' \' >~'~:" '1\1'~,'F/ -1 ~,~~,~ ;1?:~i-~'V:{. . ,PP.L. , "'1' - '., - .' N' 1 s' \W IE \ IS THE PROPOSED WORK IN 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. HSE GAR ACe' I I : I 1 I VALUE 7/1s(" '. -.f'rB7i f1) 1~CjI)/"C' 31().~ ~ \'e.,- State Surcharge 1.'h ol1ct\n\'-' \ \ ,"_ Total Fee (A)?Cf\. ~ SYSTEMS DEVELOPMENT CHARGE (SOil , (B) ~~4. Total Value Building Permit Fee PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer, Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' :J FT, FT, FT, ~~~1>U" (C) I Dryer Vent Wood Stove/lnsert/Flreplace Unit N' "?, t Mechanical Permit Issuance State Surcharge Total Permit 6't.~.....t", (D) MISCELLANEOUS PERMITS Mobile Home State issuance State Surcharge Sidewalk lS It, Curbcut 1.:l... It Demolition State Surcharge ' e\II'\"'-. C~~k'tr=~t>> FEE l~.Q2. \(..,(').~ ~~ '-\.=- \ ~ b. cae (;,,9.2 L\,SQ \,c;!Q. 3;~ ~~,~ \D.~ .u. I.. -"'''' L LI ;a. d-.-\. ~ 1<J...'OU- &...l1().5.Q (E) '3, \() l,~ ':tL TOTAL AMOUNT DUE (excluding electrical) ~ \(')1, (A, B, c. D, and E Combined) Total Miscellaneous Permits 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. Plan Check Fee: 24t'J ,SO Date Paid: / Receipt Number: Received By: ~\f, Plal\S Reviewed By '!::'1fGL/ (Date I Systems Developme~t Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS I ci--\-- \ '. \ Q ~;\-.J 4 \ ocr) " cl..t\ J\Q}J {)o.t 0): \ C\ l oc) , " , By slgnature,l 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 certlfy 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 '!hat NO OCCUPANCY will be ,made of any structure without permission of IheBulldlng Safety Division, I further certlfy 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.t.l.me; ~.ha~ 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'wlll remain on the site at all tI~s~rln~O"Ctlon. Signature ~h ---A:')("Id, '~b~9r- DatA VALIDATION: RECEIPT NUMBER I~~,~" DATE PAIr> 1/l-'Y/'"7 r ..::" ' AMOUNT RECEIVED ~ 1. ----' ~ 7'9.0. 31 RECEIVED BY --::{..&lr ,S-'I...-4" ' , lDL - 225 FIFTH STREET r - }'~I~~.B m~CAL PERMIT APqICATION SPRINGFIELD, OREGON 97477 !\J ~ (GIVa A \NY\ INSPEctION REQUEST: 726-3769 1\ "ul~o9 ty Job Number \ \.A..,ll--/ OFFICB: 726-3759 . , '3. COHP~d1l!1Bl SCHEDULE BELOII 1 J.QC.lo.~OI.f.-..QF ~~lJ..T,IIi\Ii,;,,':.~ P, Ull( OlH~' GJfnOOJ IOU ..op PUg 'Bu!uoz . ~ L-\ l ) T\.)(~\.D'\;,f\~ Pjl~Wq'lr".ljfk"~d R~~Ill'~f1'l4al-Single or ~ Hulti-Family per dwelling unit. \ R~~~ f)~qCD Service Included: Items Cost S~~E~~(')()nfQ... \ll(S0 . Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I 2. COtn'RACTOR INSTALLATION ONLY , Electrical Contractor 'ARC ELECTRIC Addres85783 HWY 99 SOUTH Ci ty FIIr,FNE Phone 741-0494 Supervisor License Number 20985 In. I.gs " Expiration Date Constr Contr. Number -- 006'0'3' I/J / UJ 9+ Expi'ration Date OlINER INSTALLATION The, installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: DATE: ' g-"3I'-9'Y RECEIPT, I: 1~,...~'7 RECEIVED 'BY: ~'- ~ . SPRINCFIELD 1000 sq.ft. or less Each additional 500 'sq. ft or portion thereof Each Hanuf'd Home or Hodular Dllelling 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 Sum { c!1 $ 85,00 8S ~ $ 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 ,200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Branch Circuits - $ 40.00 $ 55.00 $ 80.00 volts see "n" ~ above Nell, Alteration or Extension Per Panel Hiscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or lIith Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL . ';Z}J4/;J!> rc~ $ 35,00 $ 2,00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36~ I~. - ~. rj'-7t-$A0 -12:J . " ~ ~ "'0..(. Y4> //'S'. -- . . . . ..' @ !!.'!i!t~!!!!!t\!!~ Job No, Cf'i \ lfiJ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME:t Q\~}9r~_ ~\f\\O [V ADDRESS:\Q~D ,-l{ no, ~li\t PHONE: q~.R~ STATE: lQ,lpzIP~~ LOCATION OF ~ROPOSED BUILDJ.l'lSk'ITE:" ~_, <, 11\ I ^ ) . 50'" Add,~ ,f Kn~' ~ o.() tU(~\ f\l \ H 1 Platt Nam~um..(J~ Tax Lot Number: .w)~rt\CD ~!D mqaJ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back,) A. Sim.le Familv - Detached t Single Family home NO OF UNITS \ Manufactured home not in a park $400.CV . X $400 PER UNIT _= . B. Single Familv - Attached NO OF UNITS X $370 PER UNIT = '$ C. Multi-Familv ADartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SDC $1LO .CfJ $t2f $4DO,a:J 2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit approval. See sac Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit! U ~l Community Services rihl {'If <:;'nrinmiplrt / / Date . . . .OB NO. '1 f/ tJ?J7) CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) . ATTACHMENT Bl .- . NAME OR COMPANY: LOCATION: ~'l'9'~ DEVELOPMENT TYPE: BUILDING SIZE: j?~ /J~ ~{,)..~ . . ". )b;.~~ / '7,c1) tOT SIZF" ~ SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. ;2. 'S' fZ X $0.209 PER SQ. FT. $ S93.98 2. SANlIARY SFWFR-r.TTY NO. OF PFU'S 1'6" X $43.26 PER PFU $ 7- 1 ~. C. "if (See Reverse) 3. IBA~SpnRTATTnN NO OF UNITS X TRIP RATE X COST PER TRIP X X X $436.19 X $436.19 $ 4-1-0.5.> $ $ I X J. ()/ X $436.19 SUBTOTAL (ADD ITEMS 1.2. & 3) $ 4. SANlIARY SFWFR-MWMr. NO. OF PFU'S /'8 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 3/'l. ~2 (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ IJ.8'fL. , , IQIAI .MWMr snr $ 30$".5"? SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 2-/I~. 7? 5. ~nMTNTSTATTVF FFFS BASE ~~VSUY~OVE) X .05 ~~ /~.. Date: /fIary\Hovni9, P.IL.) ,/ SDC CMrdi nator $ IO~-..,~ ;7" - / f1=. 1"'7< TOTAl SDC $ z.2.2-f: 73 B2.S0C . FIXTURE UNIT CALCUL.ON T ABLI~: Number of New Fixt! X Unit Equivalent = Fixture U~its (NOTE: For remodels, calculate only the liEI additional fixtures) NUMBER OF NEW FIXTURES 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/Dishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang......................................................:... Sink: Bar, Commercial. Residential Kitchen............:........... Urinal. Stall/Wall.: ::................................................... Wash Basin/Lavatory, Single.................................. Toilet, Public Installation........................................ Toilet, Private....................................................... Miscellaneous: UNIT EQUIVALENT 2. 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 FIXTURE UNITS 4- 2. 2. "" fi /'6 If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: Based on assessed value. calculate credits separates. II Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 1 I 2... 2 TOTAL FIXTURE UNITS = Year Annexed Rate per $1,000 Assessed Value 1985 1986 1987 1988 1989 1990 1991 1993 $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 Credit for Parcel or Land Only If Applicable = ~. -fc; X $ 1-. Cf'Z/o (Rate X Assessed Value) X $_ (Rate X Assessed Value) Improvement (if alter annexation date) = 13. ~ f-- ------- CREDIT TOTAL = $/:3. 'IT-I-