HomeMy WebLinkAboutPermit Building 1992-7-6
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Oltice: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
L/.O
OWNER'
r:. ;." '-< is
')""~,J.. x~.ft,(f<<'
E-~_t, ~~r./
sFR
ADORESf"
CITY'
DESCRIBE WORK'
NEW ./ REMODEL~_'
ADDITION
.
'SPRINGFIELD
Ji' t./ k" ::r h A/ H<. ttz
Cou _ T--
BLOCK: .
()Vu/
STATF'
DEMOLISH
OTHER
.'-
JOB N'UMBER~
225 Fifth Street
Springlleld, Oregon 97477
TAX LOT'
SUBDIVISION: ~ ..."f:,e~ i?.r /-. -k.....
~P~.
PHON'" ad.r~ I 7 Jo
ZIP'
CON ST.
CONTRACTOR'
3"'oI~f
~j,""i 7 c/
.)0 L-I{<.:>
ADDRESS
_...3~('~ 'Wl.'.P...
CONTRACTOR'S NAME
GENERAl' ru.li;.1, ~ d -!
PLUMBING: c... r~tlJ.. '4 : ;>) o.L;- x;:.L. ..-1 '101
MECHANICAL: ~ ~ J ]170 G!V1i; . e'l
ELECTRICAl .<:$J )~.Ir~ 7i' J~ :;;';.Pd. Ill., I.l_
QUAD AREA: \ Q~) \A)
- \
OCCY GROUP: K~~ N\
. OF STORIES: \.. ^
Y
. OF BLDGS:
WATER HEATER'
.Ih .('101 \
?.f~",~
- OFFICE USE -
LAND USE: ~ \ \ \
. OF UNITS: \ - ~. '\
CONSTR. TYPE: V IV)
HEAT SOURCF' '\=-f
f,
RANGE:
EXPIRES
"/~3
~/.; t..-
.? It; .3
7/~ L
PHONE
t../.f" __In lor
W ~- /II/" (..
7'1/-(;00 L-
~v '- -.567--.,
- '"-
FLOOD PLAIN: ")
ZONING CODE: ;\ Ul/. )
. OF BDRMS: ~"ll'l
SECONDARY HEAT: _.\"t'"
SQUARE FOOTAGE: ~ SW-
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.
[X] Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab PlumbinglElectrical1
Mechanical - Prior to cover.
[Xl Footing - After trenches are
. excavated.
,....",......
o
Masonry - Steel location, bond
bea~s, grouting",
(1) Foundation ~ After forms are
erected but prior to concrete
placement.
[ZJ Underground Plumbing - PrIor
to filling trench.
[2l
[2]
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
Insulation or "decking.
00 Floor Insulation - Prior to
deckl ng.
IYl Sanitary Sewer - Prior to filling
l,LU trench.
171 Storm Sewer - Prior to filling
Llli trench. .'
rm Water Line - Prior to filling
lftJ trench.
[lJ Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
r-:A Rough Mechanical - Prior to
L..,.LJ cover.
[Z] Rough Electrical - Prior to
cover.
r71 Electrical Service - Must be
~ approved to obtain permanent
electrical power.
[4l
Fireplace - Prior to facing
materials and framing Insp.
~
Framing - Prior to cover.
I7l Wall/Ceiling Insulation - Prior to
~ cover.
12(] Drywall - Prior 10 taping.
D Wood Stove - After Installation,
o Insert - After fireplace approval
and Installation 01 unit.
rAIl Curbcut & Approach - After
L...4-J forms are erected but prior to
placement of concrete.
r7l Sidewalk & Driveway - After
7'\ excavation is complete, forms
and sub.base material In place,
lLEl Fence - When completed.
lXl Street'Trees - When all required
trees are planted,
00
Final Plumbing - When all
plumbing work Is complete.
[l] Final Electrical - When alt
electrIcal work is complete.
171. Final Mechanical - When all
LAJ mechanical work Is complete.
IV1 Final Building - When all
~ required Inspections have been
approved and building is
completed.
DOlher
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 installed.
Lot faces ~ ~pe. Setb,cks I . THE PROPOSED WORK IN THE
2!lSP I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN I THE HISTORICAL REGISTEfl?
Lot coverage ~ Corner If yes, this application mu e signed
Topography $~ Is I and approved by the Historical
Panhandle Iw I Coordinator prior to permit issuance.
Sj1 Cul-de-sac
Total height IE I
APPROVED:
BUILDING PERMIT
sa. FT: X $/SO. FT.
/-922L x.... $ ~'
,s-t7C 2-5'" ><. LI'I. (
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
/12,7 d?~
. ~
'7L2.~/'~.:J
-
II~!I.LU:J
t./7g.~~
'2~. 90
~~ /. 9~
SYSTEMS DEVELOPMENT CHARGE (SDe) ,.b
III i<f I'P
(B) If 1:2,0"\ -
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO "3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
~~U\t1\~
Plumbing permlt1)
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO tI)( ':J
~'(~rr~~d/(.C;;"{C_ :;""
Dryer Vent
-
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
;57E
'2)
It
~t~t;'~ (\~
~scellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/9"2.5?>
/.0
7~Z, 52>
/ ,(). 1.2
212.63
~.~C>
_'I. ~
/'2. ~t>
3.;1:>
3.~
_. -= :..
ZR. $"0
/P.~
-:: I.'f?
-g9. 93
/ J:? .A::>
It.f,~S-
~ b. t:f(:F
D~
7 7. 7~
:3'P ?" /. 7.-'5'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thaI the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, inCluding the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of anx ~rovi~ns ,of said ordinances.
Plan Check Fee: ~~_ t?tft .
Date Paid:
Receipt Number'
'~;w~~r~ ?
7--?'-'7'2-
Date
Systems Development Charge Is due on all undeveloped
properties within the City limlts which are being improved.
ADDITIONAL COMMENTS
C\~~_\nt-02: \G\lln
r_~~ \
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.
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 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
::";;;~'~;f~"'";~::'~ -
Date .~
VALIDATION: t;:!.11 A e;!-...
RECEIPT NUM\!Sf u\)-J
DATE PAID f I .-(()-C(~
I . -
AMOUNT REC~ .~ 2 :?~. ~O
R~CEIVED BY('7\U )(\_J
JOB NO. "l20i '!>"l
CITY OF S~INGFIELO SYSTEMS OEVELOPME~ CHARGE
WORKSHEET I
, (COMMERCIAL &. RESIDENTIAL)
NANEOR CONPANY:
Fu-r1J et= ~ 1-IoM.E;~
LOCATION:
'i5'f}J :JANl2iTE: CT".
DEVELOPNENT TYPE: LDe. - f...l~V\J SF'f{.
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. '2-z.~? X SO.186 PER SQ. FT.
(See Reverse For Runoff Coefficients If Actual Imperv. Area
A:2<1 (,~ ).
Is tt.."-uvnll)----
2. SANITARY SEWER-CITY
NO. OF PFU'S z.S X 538.55 PER PFU
(See Reverse.To Determine Total PFU'S)
cG." ?~ "''0
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
(
X I,OD5 X 5388.61
~~O~
$ -
X - X 5388.61
X X $388.61
(Se~ Attachmen~ ~ To Determine Trip Rates) .
-'. . . . _ _ SUBTOTAl(AOO HEMS 1,2,
i
--.
.'
&. 3):Ln1.~"I::!- "
4. ADMINISTRATIVE FEES
BASE. CHARGE (SUBTOTAl ABOVE) X ;05
C 85'13')
'1
TOTAL-CITY SDCS /8<07 8~
5. SANITARY SEWER-MWMC
NO. OF PFU'S . 2'5
x 513.25 PER PFU .+ S!()M"~1C ADMIN. FEE S r;:" -z..o;)
------
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
I~~L~
<J Kip Burdick
sac Coordinator
(,. /17 1<17--
I I
S
TOTAL - MWMC sac s "3 <./ J 0:-
TOTAL SDC 5 '220'1:j:
FIXTURE UNIT CALCU ~O NT ABLE: ',umber of New Fi'1ures .1il Equivalen1 = Fi"1ure Unils (I,OTE.
For remodels. calculate only the NET additional fi"1ures) .
NUMBE~ OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub........................ ,..... ............................ ............
Drinking Fountain.......:..............................................
Aoor Drain...........:........:...........................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For'Sand/Auto Wash/Etc..........:.......
Laundry Tub/aotheswasher...................................
Ootheswasher - 3 Or More...............................,.....
Mobne Home Park Trap (1 Per Traner)..................
Receptor For Refrigerator /Water Station/Etc.....,..
Receptor For Commercial Sink/Dishwasher/Etc.:
Shower, Single StalL.......:......................................
Shower. Gang.................................-.......--_.........
Sink, Bar, CommerciaL......................_..._......_....
Urinal, StallfWall..................:....................--..........
Wash BasinJLavatory, Single.__......,...____.........
Water Ooset, Public Installation..._......................
Water aoset, Private._..._.__...._.__....
Miscellaneous:.
2.
h
..,
'-
TOTAL FIXTURE UNITS
2
t
2
3
6
2
6
6
1
3
2
t/Head
2
2
1
6
4
=
of
2..
z..
2.
""
/7-
25
Based on~esse<i v.lIue. If .knprovements cx:curred alter annexation date in .table,
r
CREDIT CALCULAllON TABLE:
calculate creOlts separates.
I'
1979 or before
1980
19B1
1982
1983
1984'
S2.66
2.64
2.53
2.41
2.19
2.04
Year'
Annexed
1985
1986
1987
1988
1989
1990
N<> II-IPt> AIIPtil..A-E!.L.:f=
X S =
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = S
Rate per $1,000.
Assessed Value
Year.
AnneiEid
Credh for Parcel or Land Only Ii Applicable
Improvement (If after annexation date) .
. Rate per $1,000.
Assessed Value
$1.69
1.35
1.15
0.92
0.59
0:23
J
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL..................................................... 0.4
CommerciaL................................................... 0.9
I ndustrial....... ................................. ........ .........-- 0.45
GovernmentaL................................................ 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
,.----------..--
SI.IIINGt"IELU
. . tI~.
225 PIFTH STREET ~~~Ollowing project as ELECTRICAL PERHIT~PPLICATION
SPRINGFIELD, OREGON 97477 appro~~~nddoesnotreClSU~?ll$thefOI/OWln. ? f\ 9Q 0
INSPECTION REQUEST: 726-3769 CIQ~'t9Jl Jo~ Number 1 ) ~ \l I \
OPPICE: 726-3759 Aoni
Date 'I. .:.o;rPLETE 'PEE SCHEDULE BELOI/
1. ...4.0C~'tI.QN Of _INSTAL~.&i ho.[t 1 _ - /-I..., I
~n '\..'0 f\ f\1J ,~ ' ~gneture~.
LEGAL DESCRIPTION
br fOr ??~-'~-(~/ =:::;;;:;~p
~J~ D~~~(\O 0C\_O )~53C/?!
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~OC\(\l\~
Address'\C\l(j'?J \\.\I.~\'\\\\(]6L.tc:\
Ci ty Q..G ,\\\\.p Phone G4fL... 3\olt..
Supervisor License Number cD 1')08.5
\\\\.qf)
Constr Contr. Number !; ~ 8'&lD
c:9 tD. - q~
Expiration Date
Expiration Date
Sig~ of Supervis{ng Electrician
~"^ .1\, \~ LL;r;~.
Owners Name \1 k ~l J\ 0 . n .
Address ~~ ffiOtrl\'\ l B-
Ci ty -Il:f'l{ V\ <LJhone 4RS .~ \llt;
OIINER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~ATE~==-~-~-~Z1~~-~~-~-~---------
RECEI!'l II: I . ""''<?14~
RECEIVED BY: ~ ~tt-...: '
New Residential-Single or
nulLl F~mi1y"'per dwelling
Service Included:
uni t.
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 .85
4-
$ 15.00 be>
$ 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
D.
200 amps or less / $ 40.00 '-/t:?
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permi t
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
jump 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
TOTAL
/&5'. ar:e>
"9. L.S;-
/9C/.ze:-
,
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