HomeMy WebLinkAboutPermit Building 1992-8-31
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
~.
LOCATION OF PROPOSrP WOR';: t':5"" r
ASSESSORS MAP: I' I n3~~4At
LOT: Y1.?~d /.l. A L {/., / BLOCK'
J'a.. A/ ,v, 7ft; CI
.z? I L/"? I
OWNER: hi" '-' K d......., r-
ADDRESS' .;J..'llj~M....r.r'..,r D-
C;TY: G'~J<.vL, O~._'
DESCRIBE WORK' ~ ~ R .
NEW
v
REMODEL
CONTRACTOR'S NAME
GENERAL:_~ g~
PLUMBING: (u ~./"p- ?t..._ /"~J
MECHANICAL: gp.", ~~ ~;"'r
ELECTRICA' . AIr.:i....cJ €/rA:':
~
QUAD AREA: \ Rn) ( ;)
I
OCCY GROUP: Q;=<)+}J\
j)
-M
. OF BLDGS'
. OF STORIES:
WATER HEATER:
ADDITION
STAT'"
DEMOLISH
OTHER
-JOB NUMBER9Q I ( (()D
225 Fifth Street
Sprlngfleld,Oregon'97477
TAX LOT:
SUBDIVISION' ?",;Vbc...,.l ~.:S"fc..4 S-
PHON'" l/-d>S" -.? (] Ie
ZIP: ,97 </0 /
CONST.
~ CONTRACTOR'
7'(.J(
";9fJ.~. ~.. 311'1"f?
V. ~rI f'.L I/qO
;ntJ c;: /"ft. ~<-.J
7f 1~ 1 -II V S J-. fi.cL U-
ADDRESS
a.:J/ 7 if
d).OIl )/,')
.3J'F..Jro
- OFFICE UiE -
LAND USF' I \ \
. \ I
CONSTR. TYPE: V N
HEAT SOURCE: I=' G
o
. OF UNITS:
RANGE:
EXPIRES
"If ~
I_/y.?
3/Y.J
till Y.?
YYl-fb 77
PHONE
U.I,-JI) ("
'-lislIv(_
\
7tL/-c/o<) L
FLOOD PLAIN' . "1
ZONING CODE: LU r u
'OFBDRM~ ~ -
SECONDARY HEAT: Fl)
SQUARE F~~TAGE:~ I I .
To request an Inspection, you must call 726-3769. This ]s a 24 hour recording. All inspections 'requested before 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.
00 Temporary Electric
.0 Site Inspection - To be made
after excavation, but prior to '
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
lZl Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
[Li] Foundation - After forms are
erected but prior to concrete
placement.
[L(] Underground Plumbing - Prior
to filling trench.
[2]
Underlloor Plumbing/Mechanical
- Prior to insulatlon or decking.
w
Post and Beam - Prior to floor
Insulation or decking.
r7l Floor Insulation - Prior to
lL.\-l decking. .
Gl Sanitary Sewer - Prior to filling
trench. .
caJ Storm Sewer - Prior to filling
trench.
n Water Line - Prior to filling
~ trench.
IT] Rough Plumbing - Prior to
, cover.
REQUIRED INSPECTIONS
r-11 Rough Mechanical - Prior to
L,4J cover.
rIYl Rough Electrical - Prior to .
~ cover.
G1] Electrical Service - Must be
approved to obtain permanent
electrical power.
rhl Fireplace - Prior to facing
l.L.\-J materials and framing Insp.
lA Framing - Prior to cover.
[A Wail/Ceiling Insulation - Prior to
cover.
[4J Drywall - Prior to taping. .
D Wood Stove - After Installation.
D Insert - After fireplace approval
and installation of unit. l
IV1 Curbcut & Approach - After
l,Ll..J forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
~ excavation Is complete, forms
and sub-base material in place,
rtJ Fence - When completed.
[Xl Street Trees - When all required
trees are planted. .
rn Final Plumbing - When all
, plumbing work is complete.
rI71 Final Electrical - When- all
W electrical work is complete,
[Z] Final Mechanical - When all
mechanical work is complete.
rA7l Final 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 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,instarred.
'-/ E) ~ 7" io
lJype · ~J "'..--
Lot faces E Setbacks I . THE PROPOSED WORK IN THE
Lot sq. ftg. ~ ~"Interior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
6"~ 1/// J THE HISTORICAL REGISTER?
Lot coverage ~ Corner N 1/ yes, this application must be signed
I . I
W Panhandle S 5,0'//$' and approved by the Historical
Topography lw I Coordinator prior to permit issuance.
Total height ~ Cul-de-sac :ab~"
IE I:.?/ ' I APPROVED:
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT. = VALUE
~.W --85~li7
"14-, fO ID,58
6(0.'21) .t=..3~n0
. ~/
(30t. <( \ -) JAg p5'0
-5o/',.t;.-!:o
Main /f/9
Garage 7'i-(P
Carport
. Ib.{ ~ ''''" ~<(lLt
Total Value
Building Permit Fee
State Surcharge
77 :za.
Total Fee (A) 5"72. 7~
SYSTEMS DEVELOPMENT CHARGE (SDC)~
, (B) #Zt':>16"1!
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' -:2
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
/<92,,),=
M~;. HOI'}"~ \
.~},.\ t J\. . Ql\U
Plumbing Per t
/0, ....D
2'Q:z 50
/P. /3
2J2.b~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
tC,. C>"'"
Furnace
Exhaust Hood
~cp
/2, .s-e.. '
Vent Fan
N' "/)( 3
Wood Stove/lnsert/Flreplace Unit
DJler Vent ,"'"
/I??I../~c~w~7
-4,/.4:;:; ?~~'
Mechanical Permit
?~
~.~
-::5.0.50
/0.-=
/.53
q';Z, <='"7
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS Q ~~
~ /7P~7}"-d/c r<-7..-v
5,.tn I.B"aDC..R.FW~ ~ '16 /3
State Surcharge
Sidewalk
~B
--;;b-
1 -?~
/9.7'c:>
It
Curbcut
ft
Demolition
Stat
SlIrChfv\m;
,~CD
75: 7g
(E)
TOTAL AMOUNT DUE (excluding electrical) ""'3'-1/'7./5"
(A, B, C, D, and E Combined)
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 Springlield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked,at ~ny time
upon violation of any p~}S\o~ ~~ ordlnanc:s, :-
Plan Check Fee: "'0..J () "&: ,,) ~ ~ ~v..
C1. n{){), ~;>5"Y.~g
Date Paid. T..J 0' .-\ ;d
Receipt ~umber' ,,1, 1'\ n'1 ~-l
Received By: _:J;;1~...J(J\.J
/ZA=?~~~?
P~s-Revlewed By' /'""
&:"-?/-~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
,
, <A~ T-.:" Rot 0l\~
\. ~l'\.nQ,\{... \ l{,iL.f
- I
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 OAS 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
on the site at all times during construction.
Signature &I~
Datp
.1j /If /9 L-
VALIDATION:
RECEIPT NUMBER
DATE PAID
w)h9
>80/3//'72_
3~z~/S--
~~
AMOUNT RECEIVED
RECEIVED BY
. .OB NO. C)711foS ......
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: FUl'll g.E. 'f::> WoM E. S
LOCATION: B?'1 "SANI4!::TTt:. C-,. nO~?y.7..<-l-
DEVELOPMENT TYPE: L-DI2- - NE:.w "7F~
'.
BUILDING SIZE: LOT SIZE
l. STORM DRAINAGE
IMPERVIOUS SQ. FT. "2.."1\::2::> X $0.192 PER SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S "1.../ X $39.78 PER PFU
(See Reverse)
3. TRANSPORTATION
SQ. Ft.
C7'?9~
........ ---
~O"'-1:0b')
--- ..--'
NO OF UNITS X TRIP RATE X COST PER TRIP
X. l.ooS X $401.05
c::=ro300
~ --
X
X $401.05
$
X
X $401. 05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ 2o'?G,,'+"Z.
4. ADMINISTRATIVE FEE~
BASE CHARGE (SUBTOTAL ABOVE) X .05
(\0Is0
TOTAL-CITY SDC. $~I~~~
5. SANITARY SEWER-MWMC
NO. OF PFU'S Z, . x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ?-n'"
(Use PFU Total From Item 2 Above)
.v~~~~
,- - (} Kip Burdick
SDC Coordinator
~/-Z-~~2-
$
TOTAL-MWMC SDC~'"1~
--- ---
TOTAL SDC $ 2..?\?"\~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
.
FIXTURE UNIT CALCU LA TION TABLE: Number of New Fixtures X _ Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
Bathtub...................... ........ ........................................
Drinking Fountain................................................ .....
Floor Drain.................. ........,........................... ..........
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laund ry Tub /Clotheswasher...................................
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single StalL................................................
. Shower, Gang..........................................................
Sink, Bar, CommerciaL............................................
Urinal, StallfWall.. ................... ..................................
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation.............................
Water Closet, Private.......... ....................................
Miscellaneous:
,.
2
'?
">
TOTAL FIXTURE UNITS
UNIT
EQUIVALENT
2
1
2
3
6
2
6.
6
1
3
2
1 /Head
2
2
1
6
4
FIXTURE
UNITS
q..
z
z.
2.
os
Ioz.
Zi
Based on assessed value. If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates.
I 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
1-.\0 \>.IFt> "''''''\LA~
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 = $
Rale per $1,000
Assessed Value
1
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
.,
~
--
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
The fOlloWing pr .
Zoning, and doe~l~~~ as -~~bmitted has t ,
225 FIFTH STREET approval. ~~r. c 't'fE~'l'OMl
SPRINGFIELD, OREGON 97477 rt!ing
INSPECTION REQUEST: 726-3769 Dnte. . .q'7: '.toy Job Number
OFFICE: 726-3759 ,- -- . (./
1. LO~~))f INS'\l\LLATION ~utc~e~ Sige3!;"e~TE FEE SClIEDULE BELOII
,---)~<./I '- \nf\f\O lA. 0 ~ A. New Residential-Single or
- -- Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
/7..-o'3-~Y<:?'7/, all-/3/
r
C' -lllll DESC~PTION ",I _ '" ^ _ P- f"\ I ( JY
~\- . \ .J(JI J:'111 JUIllA.Q ~ ".:..J::Y.
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Constr Contr. Number
Expiration Date
Sig
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Sirrnature:
-------------------0-- -.-'--------------
DATE: B/?/ 5'2-
RECEIPT #: .; '~~9
RECEIVED JlY:_.__~~
Items Cost Sum
I . ([1
$ 85.00 D.~
1i $ 15.00 ~.'l
$40.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
2. CONTRACTOR INSTALLA~ION ONLY B. Services or Feeders
~ _",A Installation, Alterations or
Electrical Contractor~~ poqn/IUA../ Relocation:
Address ~O ~q~-=1J ~g~ amps or less
Ci ty C' r ~ Phone G4A.-?io l~l ::~~ ~~ ~gg ::~~
"I-, " ne,<2 601 amps to 1000 amps
Supervisor License Number ~- I ~ Over 1000 amps/volts
\ n. \ . Cf (\ Reconnec t Only
Expiration Date rJ...
:\~~
<9 . jl i~ ~
super~\sing ElecArician
{\-'~
111 J ~<tA~Branch Circuits
T'\ nq LS W \f\I\ j; \' '11 C' New, Al tera t ion or Extension Per. Panel
Address C'I('-1 (~\...~ \ \n~A1) II_!-,;)
c 0 IIOc::::... Q nln One Circuit $ 35.00
Ci ty.J 1 U QJ\ . ,thone"\ e:-...... J cJ I \f' Each Add it ional
- (j Circui t or wi th Service
OVNER INSTALLATION or Feeder Permit
volts
$
$
$
see "n"
~1
40.00
55.00
80.00
above
$
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 ~~~ ...
5% State Surcharge t',. -
TOTAL ~C_-