HomeMy WebLinkAboutPermit Building 1992-4-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
~t(,
LOCATION OF PROPOSED WORK: 1i'J. 7 \J'N",,7!e C-r-
ASSESSORS MAP:
, d:i. {,t)
LOT: "':
BLOCK'
OWNER:
r.... ..J. '" <. '3 ;..j.. M.R5
~t.....fDI,,,.,D,- .
ADDRESS' .;2. '1 f.;L
CITY: f?"--0<"~L
DESCRIBE WORK'
s-,:::'"R
NEW
)(
REMODEL
CONTRACTOR'S NAME
GENERAL:;:'~ <B. If..
~-
STAT~' O'-(t"/
ADDITION
DEMOLISH
OTHER
-JOB NUMBER!J!l()1:1--7
,
225 Filth Street
Springfield, Oregon.97477
TAX LOT:
SUBDIVISION' "'i?:t,Nbc,-"" [:5-/.....;,...-
"~c:l A-J ~.-t,,).d
PHONF'
l/ <is .s / 7 '"
ADDRESS
d-'i?.J.. l'1elu/'",
JJ-
ZIP' 911{V/
EXPIRES
fo/~3
(pJyi.-
dJ-1 'Pi
7hz.-
PHONE
ll/.r ~Il(.,
<fa S J/ 'I C.
7'/I-oooL
yy,,- - .?r.. 7 '-
\QJ\)l1) - OFFICE USE -
QUAD AREA: LAND USE: 1\\\ FLOOD PLAIN'
. OF BLDGS' \ . OF UNITS: \ vf-! ZONING CODE: ~~
OCCY GROUP: \:{B+ M CONSTR. TYPE: . OF BDRMS: ...
I . r'G
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
f" , F ~ '1~
WATER HEATER: RANGF' SQUARE FOOTAGE:
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 daX' :
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
lXJ Footing - After trenches are
excavated.
-,
o
Masonry - Steel location, bond
beams, grouting.
[EI Foundation - After forms are
erected but prior to concrete '
placement.
[2] Underground Plumbing - Prlor
to filling trench.
rn
Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
rn
Post and Beam - Prior to floor
Insulation or decking.
rn Floor Insulation - Prior to
decking.
[2] Sanitary Sewer - Prior to filling
trench. .
[Xl Storm Sewer - Prior to filling
trench.'
f\71 Water Line - Prior to filling
~ trench.
rn Rough PJu!"bing - PriC!r to
cover.
. C)... 7 If '71J
REQUIRED INSPECTIONS
IT] Rough Mechanical -.Prior to
cover.
IYI Rough Electri~al - Prior to
t..,..q-J cover.
[K] Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
.
I4J Framing - Prior to cover.
Ii7I Wall/Ceiling Insulati?n -' Prior to
~ cove~ .
[A:J Drywall - Prior to taping. .
D Wood Stove - After installation.
D Insert -,After fireplace approval
and Installation of unit.
1\71 Curbcut & Approach - After
~ forms are erected but' prior to
placement of concre.te.
r\:7I Sidewalk & Driveway....;... After
IAJ excavation Is complete, forms
and sub.base material in place.
[Xl Fence - When completed.
rt7l Street Trees - When 'all requi'red
I..d-J trees are planted. ".
rv1 Final Plumbing - When all
~ plumbing work is", complete.
rvI Final Electrical - When all
lA-J electrical work is comP.lete.
lKJ
Final Mechanical - When all
mechanical work is complete.
~
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
bloc~~~g .is co_mplete. _
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
D Final - After all required
inspections are approved and
porches, skirtin.g, decks, and
venting have been installed.
-;-- .2 Jr.,. 3 ) --- __- 5/J-. <J&-
.,'
,
Lot faces
/
/V
Lot Type .
~Interior
Lot sq. ltg.
?9?"
~C>
b~
----..- 7?' -
E -
Cul-de-sac
Lot coverage
Corner
Panhandle
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT.
X $/SQ. FT.
.n90
/'1. 10
Main
:;)).1, 0
~
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N" "'2
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
~,k~.~y/4:'.G
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N" "3)1- "3
cJJood Stov~ Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance -
State Surcharge
,
Sidewalk 7<;;' ft
Curbcut -?g _ lt
_I;'O<RGlitie~rE#Ccr \ {XX:J.
\ ~\(\!\a~
- T~tal Miscellaneous ~ (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
I . THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR ACC
/&,7/-"/
<6
10
t.
5~~.-
I P.L.
IN
Is
Iw
IE
VALUE
.f~bJ'-/
J'rSS
FEE
/6&'
/L:?
n~. 6SC>
&50
~SC>
6,.......
9. ;x::>
~_ C"r:>
/~ cop
"""3'_ ~
-5- ,-: ~
/0. <TD
/.~
4"'9: 3~
/.p
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5". cr.o-
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M.y5"
2972... ~
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 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 any provisions of said ordinances..
Plan Check Fee: '
8.PldP,\~Q9.;>..
.~
.y, :2 -""3"'">_
Date Paid:
Recel pt Number:
Received By: .
//~~--?
Prgfis Reviewed >Ey "/
Date"
=-
9'1 .5~
cI/B; .....
-::<'.:::>. "9..c-
~.so:: 9..P
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
(B) ~-Z'Z-'2-'7~
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
m fllQ.-- UD... H~~. ~\[H\l~1Q
.~nD~l~c>~
\ Y' 1 Lo
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.
rr
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
Date
VALIDATION: ~
RECEIPT NUMBE~l I I) "
DATE PAin \ /~
AMOUNT RECEIV~. 1t?/";;::q~?>\3
RECEIVED BY J
/ -
SI"IIINGr-IELO
The f , wing' project as SfBb . d has the Iollowll1ll tif
225 FIITH STREET ~~~~~~:.nd does not requi B IfIe land USll ELECTRICAL PERIlIT APPLICATION
SPRINGFIELD, OREGON 97477 JQ OQ T'\A.It r1
INSPEGTION REQUEST: !..2te6-p(j'p.9 Ci ty Job Number 0f ( n, /
OFFICE: 726-3759 "" .Q.~in
3. CO!iPLETE FEE SCHEDULE BELOII
1. ~9l( O~Nt1..ST!!-Mff\h 0 Igncluio .
~~ ~)\\J\ A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
sO~E~T)V
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Items
Cost
Sum
1000 sq.ft. or less ......- $ 85.00 $.s
Each additional 500
sq. ft or portion e..! 60
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
C.
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. rf-\ ~- Installation, Alterations or
Electrical ContractorJ \ QQQ..OJK:~, _~elocation:
Address 1Cf1i\.~ \).\1 .31'nccL e~o amps or less
(\ G n .A J""\':2J _? 201 amps to 400 amps
Ci ty \ '. ") m ~hone -1"1 L"'''-''.O 2401 amps to 600 amps
- .', ~- 0-<:: 601 amps to 1000 amps
Supervisor License Number . ~~ Over 1000 amps/volts
\ D \ /J Reconnec t Only
Expiration Date ." L-
. Gonstr Contr. N~mber Sg,~ ~
Expiration Date- {J . a 'LD
Supervis'ng Electrician
\\ ~ ..r,,~~ ,
The .installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~A~;~------~~~l?--~~l-------------
__ - 'I ~ ..,,....,__~
RECEIl'L 11: , I . ~ .
RECEIVED BY: 'dfr-L~.
$ 50.00.
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Branch Circuits
volts
$ 40.00 dW
$ 55.00
$ 80.00
see "Bit above
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 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 <$0
5% State Surcharge . -;:;. 2~
TOTAL /~"2.-:2S'"
CITY OF
JOB NO. 01').0<147
SttINGFIELO SYSTEMS DEVELOPM~ CHARGE
WORKSHEET I
, (COMMERCIAL & RESIDENTIAL)
NAHE OR COMPANY: ru-rUT2-E 13 Hc~r;.
LOCATION: g '2-7 7[A-NAJFj.-rTf; uufL.-r
DEVELOPHENT TYPE: [,DP-- NE.vJ t7F-(2....
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. $TORM DRAINAGE
IMPERVIOUS SQ. FT. ?,'-j-o X $0.186 PER SQ. FT. I~ G.qs'..11
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S ~o X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
3. TRANSPORTATION
Is III ~ I
NO OF UNITS X TRIP RATE X COST PER TRIP
. /
X /. tiOS X $388.61
I~ "3"70 ~
X'
X $388.61
s .
X X $388.61 ~
(See. Attachment; !: To Determine Trip Rates) & 3)' ~ I. or 1 '..1
....... SUBTOTAL (ADO ITEt-\S 1,2, .. ~ ':>
4. ADMINISTRATIVE FEES
'8ASE. CHARGE' (SUBTOTAl ABOVE) X ,05
TOTAL-CITY SDC
Is q'J-~1
. 00;
sIC/ISo -
5. SANITARY SEWER-MWMC
NO. OF PFU'S . "bo
x 513.25 PER PFU .+ S!OMWMC ADMIN. FEE s 2-15 OJ!.
(Use PFU Total From Item 2 Above)
HWMC CREDIT IF APPLICABLE (SEE REVERSE)
~a ~L~
,~ \j Ki P Burdick
sac Coordinator
~/~/ /12-
, {
s -
TOTAL-MWMC sods Z 7.5~1
TOTAL SDC s-z.'2."2-S~
FIXTURE UNIT CALCULA~N TABLE: Number 01 New Fi'1uresX Unit Equivalent = Fi'1ure Units (NOTE:
For remodelS. calculate only the NET Witional (j'1ures) ...
. NUMBEfl OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOU1VALENT UNITS
'2-
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
Bathtub........ ,.. ........................ .................... ...............
Drinking Fountain.......;..............................................
Aoor Drain...........:........:.......................,.. .................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For'Sand/Auto Wash/Etc..........::......
Laundry Tub/Ootheswasher...................................
Ootheswasher - 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, COmmerclal_......................--.......--....
Urinal, StallfWa!' ........-.......
Wash BasinfLavatory, Single._...........
Water Ooset, Public Installation...._............-.........
Water Ooset. Privato -..........-..
Miscellaneous:.
1..
2-
TOTAL FtXTlJRE UNITS
=
...{.
.1-
7-
7..-
-z.
~
.'1--0
!
Based on~""~<:!d value. If.lmprovements occurred after annexation date in.table,
CREDIT CALCULATION TABLE:
calculate crecflls separates.
I
Year
AnneXed
Rate per $1,000
Assessed Value
52.66
2.64
2.53
2.41
2.19
2.04
. Rate per $1.000
Assessed Value
$1.69
1.35
1.15
0.92
0.59
0.23
Year .
A.....:;.........J
1985
1986
1987
1988
1989
1990
1979 or before
1980
1981
1982
1983
1984'
"
Nv ~AJ ViH.~
Credit for Parcel or Land Only If Applicable X S
(Rale X Assessed Value)
Improvement (d after annexation date) , X S =
(Rate X Assessed Value)
CREDIT TOTAL = s
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