HomeMy WebLinkAboutPermit Building 1992-7-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORt<.
ASSESSORS MAP:
/.....d-i- 1./-/
LOT'
.
SPRINGFIELD
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BLOCK:
OWNER:
r....fu. <-<
13
;:h,A.-I'r"
.:JrjlfJ M.. f-o{,,,-y LL.
ADDRESS'
,..'
CITY' {;...... jl.'!. PC-
DESCRIBE WORK: S f6C
NEW / REMODEL
STATF' O-c .0#
~
ADDITION
DEMOLISH
-JOB NUMBER q!Jn 831<"
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION' K~,.vh-,b kt.-J3~ tl4Id
PHON~'
l./Jr-317v"
ZI P: '1 7 <,(E.J
I
~,
OTHER
CONST.
CONTRACTOR' EXPIRES PHONE
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doJ.-'I'v SN3 7 ~/-ooo 1-
3<f-tf fV 7/9 '- (j</ L- 3" 7 .l-
CONTRACTOR'S NAME ADDRESS
. ./ ./
GENERAL' r...L.. gl1~-:- ~H'/.- jt,.rc~.f2., 's.", <./.>/
/J ' (].
PL~MBING: C,,- ..I-e_ p/"_/.,,..-, .l~ {J K. (Z;,. Cu.. </UI
MECHANICAL:~f-~' J3:no ~ ~T+ /<//"1;. .Ve~
ELECTRICAl' ;It..~a_1 EiY~,; 7f}(,J D t/-sd.. f.c!... [&-
QUAD AREA: \ ~ \'0W
. OF BLDGS: \ .
OCCY GROUP: \~ ~-T ~
# OF STORIES: . ;)
WATER HEATER: cr-----,
- OFFICE USE -
LAND USE: \ \ \ \
. OF UNITS' \" \
CONSTR. TYPE: \J \\J
HEAT SOURCF' ~ <r- J
V
FLOOD PLAIN'
ZONING CODE: -ill.\2....J
# OF BDRMS' ~~
SECONDARY~EAT: f~
SQUARE FOOT~E:rJ~ 'K'K'
I
I
To request an Inspectlon, you must call 726.3769. This Is a 24 hour recording. All Inspections requested bef9re 7:00 a.m. will be
made the same working day. Inspectlons requested after 7:00 a.m. will be made the following work day.
Q(J~orary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab PlumbinglElectrical1
Mechanical - Prior to cover.
IXI Footing -" After trenches are
excavated.
o Masonry - ~teel location, bond
beams, grouting.
[l] Foundation - After forms are
erected but prior to concrete
placement.
[Zj Underground Plumbing - Prlor
to filling trench.
[ZJ
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
~
Post and Beam - Prior to floor
Insulation or decking.
,.--;71 Floor Insulation - Prior to
'-?'\-' decking.
rJI1 Sanitary Sewer - Prior to filling
I trench.
[] Storm Sewer - Prior to filling
trench.
rt7I Water Line - Prior to filling
L4-J trench.
IV1 Rough P,lum.blng. ~ Prior to
~ cover.
RANGF'
REQUIRED INSPECTIONS
171 Rough Mechanical - Prior to
~ cover.
[Xl Rough Electrical - Prior'to'
cover.
r-v1 Electrical Service -" Must be
LAJ approved to obtain permanent
electrical power.
n Fireplace - Prior to facing
L,.LU materials and framing Insp.
[lJ Framing - Prior to cover.
r71 Wall/Ceiling Insulation ~ Prior to
L,LlJ cover.
[JEI Drywall - Prior to -t.aPlng.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
m Curbcut & Approach - .After
forms are erected but prior to
placement of concrete. -
ITl Sidewalk & Oriveway.- After
l...LU excavation Is complete, forms
and sub.base material in place.
lL] Fence - When completed.
C!) Street Trees - 'When all required
trees are planted:. ..&
Jl7I Final Plumbing - When all
L,A.J Plumbinfwork is complete.
Final EI ctrical - When all
CAJ electric I work is complete.
\
"--
QfJ
Final Mechanical - When all
mechanical work Is complete.
. rn'f Final Building - When all
LA.J required inspections have been
approved and building is
completed.
o Other \
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking is complete.
D Plumbing Connections - When
home has been connected to
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
"' . porches, skirting, decks,"and
venting have been installed.
Lot faces 6- Lot Type . Setbacks I . THE PROPOSED WORK IN THE
Lot sq. Itg. ~o ~ Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR OM
./b% IN ;7' 1 THE HISTORICAL REGISTEg.
Lot coverage Corner Is 12' 1 II yes, this application must be signed
Topography t?--29c> _ and approved by the Historical
Panhandle
mi.,' ~ Iw I~' 1 Coordinator prior to permit Issuance.
Total height Cul-de-sac
IE I. ~:?' 1
APPROVED:
BUILDING PERMIT
so. FT. X $/SO. FT.
~ itJbJ" .( ~~.b.2~
L/..33. 5" K 1'1. I
ITEM
Main
Garage
Carport
}vJ H,,__ J./3
x ~~2D
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
~$'55~.
6/J.~. "ilS"
%5;h~P.~
.j//t"!S,q!?
,-
//lfo.OI:'"
~_dO
'1~. e=C
SYSTEMS DEVELOPMENT CHARGE (SDC) oU
Jj I"!oW
(B) If'Z-l \4 -
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ""3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
~~~(fi~)
Plumbing permlU
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N' t/X""':j'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
g~ft
-:;z..6 f t
?~ ~CW'C.:<.J
Curbcut
DQ.....~litiQ--
\
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/9:7.,'5Z>
/.0.-
-;2b2.50
/0./37
::< I :2. 63
c..-
I/.. 5 C>
/2. -e>
~.~
'75"'. $'0
/0_-
/.:::<$
--:?b.. 7~
/'5: ~
/9'. :70
<y.::p,-
,
S.UU
7<1.60
'4<7-:2-/.1<(
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: ~O. =
Date Paid: ~ 0 r ,\.. ~ f1'\ I T'--
Recei pt Num~~~
Receive By: ~ -
~~
'PIa<\: evlewed B1 /"
?-"2.~~
Date
Systenis Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
\d~l\~ V \)l1tu "
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,I-j\ffio, (\ ~ ?3S\ n ~ ill h.Q 0
(C\li\
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 the 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 wlll remain
on the site at all tImes during construction.
Slgnaturf" If. ~
Date
o,/u/UL--'
I
VALIDATION: LA A 4
RECEIPT NUMBERS ,,:),
DATE PAID ~ - Co . V\ 'l-
AMOUNT RECEIi'"D .:::, t:P57. 0 "I
RECEIVED BY C'1\ l f"{).../
j
SI.IIINGt=I~LO
ti,
225 FIITH STREET ,g~~""'\:~:'~('roJe<:l~HY~Wl\\ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9747W~t'~\'UI ,.'....<l~~nQ((<lI\~ .. ~~tIM.'RIllIWIml O^()Q..f)Q
INSPECTION REQUEST: 726'::3769' . '!IO!I'~'~Y.~Tty" Job Number -/0( c).:::r"')
OFFICE: 726-3759 ~nj " -
0%. ~OHPLETE FEE SCHEDULE BELOI/
1. ~~~ ~"'M\Ir~~_ 1-41. .,. ''''',.''''-Sl..'' .,
~ ~""'''":''IIPY per dwelling unit.
LEGAL OESeR! N Service Included:
L.ur <(/ ;?A"/~64> t....."";/'.A-./r-= ~ Items Cost Sum
~~ D~~Ci~ i\f\ Q ~ 2.?~~It'
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
ElectriC~l Contractor ~ 0.0 no f\~
Address\~lffi \J.\\, ~~~\ .~&-..
City ~. C"\~hone q4fl..-~\P11.
Supervisor License Number c-Q r\n~S
\\). \,C\2..
Expiration Date
'Constr Contr. Number ~R~c:>LD
A.A,Cl~
Expiration Date
Signa~ of Superv~\ing Electrician
L/ A-r^ (\. \cl ~~ ~L
Owners Name \1 \ \\ t ~_ \~ ~\1.i0'
Address~C\C\ n.' f\\QJn \\ Q~
City h, ,)~ffi-~hone -~3S,-~ \l \.0
OI/NER INSTALLATION
The "installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
------------c--- . ---~--------------
DATE:_ fJ. 17. ,YO- :.
Rr."t.J.r1 II: , p _ _ .c:;q..ry
RECEIVED BY:CJ\\LXfi.. _ . .
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
~5":~
B.
Services or Feeders
Installation, Alterations or
Relocation:
$ 15.00
~
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
C.
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
Alo
above
New, Alteration or Extension Per Panel
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
.Pump or irrigation $ 40.00
Sign/Outline Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
j=JP. ~...
0""'""~
0b- :>C>
CITY
JOB NO. <120%""5
OF StINGFIELD SYSTEMS DEVELOP~H:t CHARGE
WORKSHEET J
, (COMMERCIAL &. RESIDENTIAL)
NAME.OR COMPANY:
F u.. -f!..( /Z...t:= 1'b J-/..o All E. S
LOCATION:
~'5 <f SANA.! E-rT1::.
DEVELOP~lENT TYPE: L..D ja. - t..)E:..v-I c;.r~
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ.FT. -Z? '+1 X SO.186 PER SQ. FT.
(See Reverse For Runoff Coefficients If Actual Imperv. Area
2. SANITARY SEWER-CITY
NO. OF PFU'S --Z:? X S38.55 PER PFU
(See Reverse To Determine Total PFU'S)
~~ c,i)
...... ----
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x
X $388.61
~
S
I X / ,Ej() 5 X $388.61
x X $388.61
(Se~ Attachment C To Determine Trip Rates)
..... . . . SUBTOTAL '(ADD ITEMS 1,2,
i' ~'
'. . 70
&. 3)'Lnr~-"
4. ADMINISTRATIVE FEES
BASE. CHARGE (SUBTOTAL ABOVE) X ,05.
~ ,; _ b~)
. S 0':>-
\ -
TOTAL-CITY SDCS 17C}"'I ~
5. SANITARY SEWER-MWMC
NO. OF PFU'S
x S13.25 PER PFU .+ S!O.MWMC ADMIN. FEE S ~\,-\1~
(Use PFU Total From Item 2 Above)
V'.~L..L-
(j Kip Burdick
SDC Coordinator
t.,/',/'1v
I I
S
TOTAL-MWMC S~ ~I~~
TOT AL SDC S '2.- I \ '-l- 0-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCULA.N TABLE: Number of New Fi,1ureS .i1 Equ~'alenl = Fi'1ure Units (I,OTE:
For remodelS. calculate only the NET additional li>.1ures) ,
. NUMBEf' OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
1
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
'2-
I
Batht ub........... ......,....... ...... .... ....... ............. ..............,
Drinking Fountain..:...:...... ........ .......... .............. ........
Roar Drain..... ..... .:........: .... ..... .......................... ....,...
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For.Sand/Auto Wash/Etc..........:.......
Laundry Tub /Ootheswasher.................... ...............
Ootheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receplor For Refrigerator JWater Station/Etc........
Receptor For Commercial Sink/oishwasher IEtc.:
Shower, Single Stall..........:......................................
Shower, Gang.............................................._..........
Sink. Bar. COmmercial.............................................
Urinal, StaIlJWall........................................._..........
Wash Basinflavatory, Single..................._............
Water Ooset. Public Installation.............................
Water Ooset. Private................................
Miscellaneous:.
. -z..
./
1.
I
'2.
?
?
?
17..
TOTAL FIXTURE UNITS
'2'7
r
. CREDIT CALCUlATION TABLE: Based on assessed value. If.lmprovements ~rred afler annexation date in.table.
calcu\ate credits separates.
1979 or before
1980
1981
1982
1983
1984
Rate per $1.000
Assessed Value
$2.66
2.64
2.53
2.41
2.19
2.04
Year'
Annexed
1985
1986
1987
1988
1989
1990
Rate per 51,000.
A~~"" Value '. .'j
$1.69
1.35
1.15
0.92
0.59
0.23
Year
Anneiect
No IN rD 4VA-IL,4-S<...E.
Credit for Parcel or Land Only If Applicable X $
(Rate X Assessed Value)
Improvement (If after annexation date) : X $
(Rate X Assessed Value)
. CREDIT TOTAL = s
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL...................................................... 0.4
COmmerci21...................................................... 0.9
Industrial.............. .................... ........... .............. 0.45
G overnmenl2.l...... ....... ....... ...................... ......... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT