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HomeMy WebLinkAboutPermit Building 1993-4-8 .. RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ~(g'i:17 / ~CJ 2.. tf;> 2... ASSESSORS MAP' \fJ LOT: OWNER: _l2-o~(" , v ADDRESS' '~? (:J - CITY: !-:.// 1iJ" Vl.R - SPRINGFIELD ,r::-zry"'} 1fk,'-7-- 2-2-. BLOCK: _fS cl..- i\ ( f1 /I) tl-r< r vis ()Y') Mfi,~ L~, .cc..r:- ~8 DESCRIBE WORV' NEW /' REMODEL ADDITION STATE" ~ . 'f-~,.. SPZ1" DEMOLISH OTHER ,lOB NUMBER '9 3034~ 225 Fi Ith Street Springlield. Oregon 97477 , TAX LOT' C:;-2.~ , '8t SUBDIVISION: fu ['{'D..nQ..~; I PHONE: 4-1.6 -1i.oJR..../ ZIP: 7'74ffl CON ST. ADDRESS CONTRACTOR . ~},l~%~ 42tjJ:SlNcJ?t2..,-BOX_~62l' f.u7jfll.,DLiLl.t&! PLUMBING:__..C1Y,ITt'lr3 P!JLfjRL^,;:" MECHANICAL: H.fJ,fl..<:;.{./Al L'('~fIN 6 ELECTRICAl' '[:)1 J( /')/1 / ~(,~ C7/C1 C CONTRACTOR'S NAME GENERAL:~US.J:(- QUAD AREA: 4R~, . OF 8LDGS: \. OCCY GROUP: _~?J +M . OF STORIES: ~ ' VVAT~R HEATER: L- - OFF!CE USE - LAND USE \ Il \ . OF L:NI"S:_ \ I CONSTR, TYPE: Y;.../ HEAT SOURCE: _~(... U r-~ANGE: PHONE 6~{'/i16 ~..1t'1t1'i?(') FLOOD PLAIN' ZONING CODE: J n~ . OF BDRMS' -4 ~ SECONDARY HEAT:- (f SQUARE FOOTAGE:,"-~~lU_ To f.;quest an ;r.spe~tion, you must call 726-3769, This is a 24 hour recording. All inspections requested before 7:00 a,m. will be rn<1cJ0 the sam..; working day. inspections requc'sted after 7:00 a.m. will be made the following work day. % TC01p"rary Eiectric ~Sitr,: Inspt:'ction - To bo made )6C "ftel excavation. but prior to seltinu ionns. (ScQ II..) o Ulldl.~rslab Plumbing/Electrical I Mcch.:mical - Prior to cover. I'9f Footing - After trenches f:.re ~ cxcava:p.d. o Masonry - ~tcc: location, I)ond beams, groutll1g. !";?1 Foundation - After forms me ~ erected but prior to concrete placement. o Underground Plumbing - PriQr to fiiling tmnch. KAu ndertloo'.-Plu mb;nfl,.!.lK"cchanic{!.i) ~ _ Prior to Jnsulatlo,', or deCI<tnQ. ';,. Q1' ~ost a,:d Beam -. Prior to floor ~ ln$u!at:Gn or dp.ckmg. r\:7f F~CO.I: lll~ulation - Prior.to ~ cJEc~,lng. ~Sanitary SeWN - Prior io fi!ling ~ trenCh. i':?f Storm S~wcr - Prior to filiing ~ trench. RA"'\Vater Line - P:,:or to filling ~trt1nGh. r'1 Hough Plumbing - Prior to I,.l:S. CO'JAr, REQUIRED INSPECTIONS ~~ough Mechanical - Prior to )6J <?ovc:", . ~.A' Rough Electrical - Prior TO ~ cover. cg[ Electrical Service -- Must be - approved 10 obtai n pcrm::t:1cnl electrical power. o Fireplace - Prior to facing materials and :raming !nsp, ~ Framing - Prier to cover, R71" Wall/Ceiling Insulation ~ Prior to ~cover, .r&l Drywall - Prior to t3pjng, ~ Wood SIov9 ~ After lr.~;tallatlon. ~ ~. rY-', I l'n~;ert -. J\ft,~r lirf~plac'~ ar:pro\':l.1 r:.nd lnst~i!~:io', 01 ur.it. 1'Vr Gt:rocut & J\ll(::-oac!= -- Alter ~~ iQnn5 ;:Hi) .;rccled but. ;J~iO' to p!:>i;crnenl QI :;')ncre;e, ~ Sidewalk & Driveway - ~\ftel ~XC,W8.UO!\ Is cO:;~;J10'.t:. ll'lrnl.:: and 3L!1)-ba~;e mak.:al in p1e-lec. il Fence - V.Jhen cQn',ple:ad. '--' ~ Streei Trc'1s ..- \~,.IIi8'''' all rcqulrt.,j ~ tl~f-:;~ i.'.~~; pLt"l!!':-"':. \. ~ Final Plumbing - When all ~ plumbing work is complet,c. ~Final Electrical - When all electrical work is complete. ~Final Mechanical - When all mechanical work is complete. FV1 Final Building - When all ~reQuired inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS l~ Olocldng ;Jnd Set-Up - Wilen all L- blocking Is com~:J:cie. r~ ?lurTIbing Connections ,- When . heme 1135 o(;cn conn(~clcd to water and sewer. [J Electrical Connection - When blo:-.cking, set.up. and r1umblng inspections have teen approved and the home is ..::onnected to the service panel. r", L.....J Final - After a:1 required irtSpflctlons are aoo,.:.vcd and jJor(;:"ll~S, :kirtir,G,.dr.ckz, aN1 v0nting have been installed. j -AL . Lot faces Lot Type Lot sq, ltg, mO _ Interior Lot coverage 3U% -'t Corner Topography 8>% N. Panhandle ;g:)J Total height Cul.dc.sac BUILDING PERMIT ITEM SQ, FT, '2 S.TS- -.:92L2- X $/SQ, FT. Main Garage Carport Total Value Building Permit Fee " Stale Surcharge Total Fee (A) Setback:.; ,--- I P.L. ! HSE GAR ACC ~----- N I I~ Is /0 W . .. IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? -. SYSTEMS DEVELOPMENT CHARGE (SDC) $ (B) ~ 2"'80 I; PLUMBING PERMIT ITEM Fixtures ~ N' ~ Residential Ba(~(s) Sanitary Sewer FT, \ FT, Water Storm Sewer FT, Mobile Home / Plumbing Permit Stale Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO 4- . Wood Stove/lnsert~ Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ..I-~ It ~5 It Curbcut Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (ex~ludjng e!ectrical) (A, B, C, D, and E Combined) 17 If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. E i/Q____ API'ROVED: VALUE /.~1 S'7r .-!. 3 tJ;77 L1-~"2% Sf-3._zS '? :J/, (p 570, ofl FEE _j(;;;12.~ ~.oe -10-~-~ ~.&-4' 4.5"0 12,0-0 / S (}-[) 3.00 4D.'SO .../0. dO "2. .e;' 5' 2- /53 -3.Z~~_ /~:!~ 53.? 5/' , , BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT T11is pcrrnj~ is granteeJ on tile express condilion thai ttle said construction shull, in all respects, conform to the Ordinance adopted by I~le City of Springfield, including the Development Coeje, 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 Clleck Fee: '=5 5'3,/1 Date Paid ___,$/J~h 3 Receipl Number:___~~~ --4P~ , ~~ ~h:l PIa Rev:cwcd By / ~tc" - Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS CL\~W{L~ ~ \q(dJ ~Si f1}:\f)() Mbs.R1o ;;;i(~ 00 U~ --- -#47U-:l ~~_~)uLf~'Y} ~ ~-~-~~m~~ By signature, I state anu 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 tile City of Springfield, and the Laws of the Slate ?f Oregon pertaining to the work described herein, and...tl1at NO OCCUPANCY will be maae of any structure Without permission of the 8uilding Safety Oivisi.on. J further certify that only contractors and employees who are in compliance with OAS 701.055 will be used on this project. I further agree to ensure that all requirerJ inspections are requested at the proper time, ttlat each addless is readable frOJn,1I1e street, thaI the permit card is located at the front of the property. and the approved set of plans will remain ><.o"~::"::" "~((,g'""'~O , D"~e __~ik-l- f3' VALIDATION: _ _ _r\ REC8PTNUMBER ~ DATE PAID -T. ~ .q ~ AMOUNT REC~ ^t~':::~r()f)_\( RECEIVED BY ~ ) .< ... . ,..JOB NO. ")-;0" <-f S CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET , (COMMERCIAL & RESIDENTIAL) , NAME OR COMPANY: f(06-c./i!.. ~ NA1<J IJIY~/$()N LOCATION: t,g<j7 t=:()~"'-HI,4 DEVELOPHENT TYPE: 'LOt<. - NEE-v-! Sr~ BUILDING SIZE: I. STORM DRAINAGE /'607-0 "Z-?--7- - 5 "2-00 LOT SIZE SQ. Ft. IMPERVIOUS SQ, FT. 2;,5>0'" X $0.192 PER SQ. FT. (f~OI0 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) '2-'-1 X $39.78 PER PFU GqS<-f;Y ---- --- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP I X I. ooS X $401. 05 Ctfo-;~) -- --- X X $401.05 $ X X $401.05 $ SUBTOTAL (ADD ITEMS 1,2, & 3) $ 'Z 0 Is '6 S.z 4, ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 G/O-++3) -- .- TOTAL-CITY SDC $'2.I"l'2..'i~ 5. SANITARY SEWER-MWMC 9'iJ NO. OF PFU'S ?"of x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ;?lo - (Use PFU Total From Item 2 Above) !~~LvL . d Kip Burdick SDC Coordinator "::./7.-</-/1':> $ '/'i n TOTAL-MWMC sacG1 ~ --- .-- .t 17- TOTAL sac $ 1-..., %0- MWMC CREDIT IF APPLICABLE (SEE REVERSE) FIXTURE UNIT CALCULA TIO,," ABLE: Number of New Fixtures X uni6ivalent ~ Fixture Units (NOT~ For remodels. calculate only the NET additional fixtures) ~ FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT FIXTURE EQUIVALENT UNITS ." 2 2- 1 2 3 6 2 2- 6 6 1 3 2 Z. 1/Head 2 L 2 1 4- 6 4 t7. Bathtu b,.............. ......... ............ .............. ......., .....,....., Drinking Fountain..... .....,......,.............,....,...,..."......, Floor Drain.,...."...,..,.............,..,...............................,. Interceptors For Grease/Oil/Solids/Etc................. Interceplors For Sand/Aulo Wash/Etc...........,...... Laund ry Tub /Clotheswasher.,..,.."....,.,."...,... ....,.." Clotheswasher - 3 Or More................:...........,........ Mobile Home Park Trap (1 Per Trailer)............,..... Receptor For Refrigerator jWater Station/Elc........ Receptor For Commercial Sink/Dishwasher /Etc.. , ' Shower, SIngle Stall............,..,.............,.,.......",..,.... Shower, Gang..,..............,.......,..,..,..,..,......,.....,...,.., Sink, Bar, Commercial,......,.:...,..,..,.....,.,....,..,...,..". Urinal, StalljWall...,.:...,....",..,....."",." ".,.""..,...,...,.. Wash Basin/Lavatory, Single.",...,..,."".,.,.."""."." Water Closet, Public Inslallation............................. Water Closet, Private..,..",."."."."..,.".""".".",.",." Miscellaneous: t./- TOTAL FIXTURE UNITS _7_4 CREDIT CALCULATION TABLE: Based on assessed value. calculate credits separates, I If improvements occurred after annexation date in table, Rate per-$~~ Assessed Value Year Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983 1984 $2,83 2,76 2.71 2,60 2.46 2.33 1985 1986 1987 1988 1989 1990 1991 $2,16 1,90 1.60 0,25 0,87 0.50 0.16 1.83 X $ 17,':;'1 L/-q7= (Rate X Assessed Value) X $ ~ (Rate X Assessed Value) CREDIT TOTAL = $ c..{.'f73; Credtt for Parcel or Land Only If Applicable Improvement (n after annexation date) RUNOFF COEFFICIENTS FOR STORM DRAINAGE ResidentiaL......... ....,......... ..... ............ ,.. ....... ,.. 0.4 CommerciaL......................,.,...........,..,............ 0,9 Industrial.... ............... .................,....., ........ ........ 0.45 GovernmentaL..., .............,.......,..,..:........ ........ 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT , ' 'C.C'" > ..V,' *' .,_", _.J' . '0110'" ~ ,-,v' . {) ~ '1,,-0 ' .,f< L> ;;.-- .' 225 FIFTH STREET ,.",,\:;.,1 'c^~'-- r'~RtEcTIuCAL PERKIT' APPLICATION ' SPRINGFIELD, OREGON 974n ,.or.;.-- \'\1 (),~ {] 3"-""'0 AC INSPECTION J\EOUES'j': 726-3769 A \j... -' ~ Ci ty Job Number - \ {J ( -) \ "- ) OFFICE: 726-3759 . ,w~ ' r.I>I\l'. -. \> . oil1..0 51" '. , 3. COMPLETE FEE SCHEDULE BELOll '~~~=r' -~f1) -'~) :,~~:~~'~,~~ \:i. if work is not started within 180 days of issuance or if work is suspended for 180 days. ~ . .;. CONTRACTOR IN: :TALLATION ONLY /' Electr'cal Contra.:tor /'" /' Address City Supervisor Expiration .. "'--..:: '< ~ Expiratio Date Sign~ re of Supervising Electrici~ ~~ fll\ '11 ~h,,^ J D. '~L:' :\Q,..e \.' ~ \ nDl,\ llix. 'l:.li' !lOil AddresLD (Q .~ ~J.rrtL Ci ty PdQ( Xl.o Phone..J.Zfl.J.m. ~ ~NSTALl.ATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE~-----~-~~-~<:7~------------- RECEIPT I: ;~ ~ ~ RECEIVED BY':L.L1 f~ , . New Residential-Single or Multi-Family per'dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 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 l s 40.00 '4/) 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 'Over 600 amps or 1000 vol-ts see "B" above Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ ,2.00 ' E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lightin~ Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 $ 40.00 $ 20.00 4t:OO ~ :f1J SUBTOTAL OF ABOVE 5% State Surcharge TOTAL '