HomeMy WebLinkAboutPermit Building 1992-4-2
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
$//'1 ~N",.-1fe Cou~-+-
ASSESSORS MAP'
LOT: ~~ '~~.J- tALI, ../BLOCK:
OWNER' .~-4...: b ;.k~~
ADDRESS: ,..)v~~M...{..,,/,,~.,.))-
CITY: E..~.. ... (}~,.../
U ' i.l
STAT~'
DESCRIBE WORI<"' <:;:",..h J <-
"
1:_.1. J (i?t~, L.ul<>- /
ADDITION DEMOLISH
OTHER
( S F~)
NEW
y
REMODEL
. CONST.
ADDRESS CONTRACTOR'
~ H..lM..f.4.._.a.. t.. . ('101')' 3(, Y9f
.' . . '0 .
PLUMBING:c.,.~ v.. IJ"._ (, e"'j ("0,)' ~oi1 t./
MECHANICAL:~ ~ dj"Jo ~ 1'Ift. 13""-, ~ doJ. VU
ELECTRICAL:II~ ~ ?f7h3:i.<I ~.i.'t<]}....) c().. .' .~dd3li7
CONTRACTOR'S NAME
GENERAL: bJ;.. ~ Ii
\R~)~ - OFFICE USE -
QUAD AREA: LAND USE: \ \ \ \
. OF BLDGS' _\ . OF UNITS: \;J
OCCY GROUP: +<'~T\\l\ CONSTR. TYPE: V,
. OF STORIES: 1 HEAT SOURCE: ~'F)
WATER HEATER' ~ RANGF' ~
.
o ;).. D ?,s ~
JOB NUMBER
225 Fifth Street
Springfield, Oregon ~7477
TAX I nT-
'SUB~;VISION:'i? ~,.o/~~'
CS/. Ie ~
PHON~'
'f<Jr.317 b
ZIP: 'f'JY~/
EXPIRES
(".IC;~
tn/'i )
..3 If:;'
?/f L..
PHONE
<!6sJ17,h
<.NSIIV(",
7:1/ _iX'O L
rj"'--s(,7?
FLOOD PLAIN'
.,
. ,
U}r7~
.,4.u_,
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT: __,
SQUARE FOOTAGE: 0~ I oR
,
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.
[2Sl Temporary Electric
REQUIRED INSPECTIONS
I7'l Rough Mechan. ical - prior' ;0
LA' cover. . .
o Site Inspection - To be made
after excavation, but prior to
setting forms.
~ Rough Electrical ~ Prior to
L,.L.ll cover.
o Underslab Plumb1nglElectrlcall
Mechanical - Prior to cover.
r-;7I Electrical Service - Must be
~ approved to obtain permanent
electrical power.
IA Footing - After trenches are
excavated.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
~ Framing - Prior to ~over.
~ Foundation - After forms are
erected but prior to concrete
plal?ement.
~ Wall/Ceiling Insulation - Prior to
~ cover. '.
[:zJ Underground Plumbing - Prior
to filling trench.
[Z] Orywall ~ Prior to taping.
IJl Underlloor Plumbing I Mechanical . . ...,
L..AJ,_ Prior to Insulation or decking. D Wood Stove - After Installation.
r-;t Post and Beam - Prior to' floor
L;DJ Insulation or decking. D Insert - After fireplace approval
and Installatlon of unit.
1:71 Floor Insulation - Prior to
L.-4-J decking.
[LSJ Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
,
r--\A Sanitary Sewer - Prior to filling
l....,.4.I trench.
[2] Storm Sewer - Prior to filling
trench.
~ Sidewalk & .Oriveway'- .After
excavation Is complete, forms
and sub-base material In place.
~ Water Line - Prior to filling
trench.
D Ferice - Whe~ comPle.t~(L_
-.
[29 Rough Plum~i~g..-, ~rior to
cover.
~treet Trees - Wh'e" ~II r~qulred
ees are planted. .. . .. 't .. .
7f~ ..
11,.)51. JU - -/tJ't In
;)..'fIPt'
'13 S7J, itl
CZI Final Plumbing - When all
plumbing work is complete.
o Final. Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
.
r7l Final Building - When a('
~ 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,' ski"rting, decks, and'
venting have' been installed.'
.;)n. -? j- .;-,,- ;:.. ..l.<;-(... y'J
.,.- '.~ "U.
Lot faces ~ ~:e! Setbacks . THE PROPOSED WOR~
~ - I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR 0
Lot sq. ftg. p.;)v;--:> IN I THE HISTORICAL REGIS
Lot coverage ~~ Corner ~ If yes, this application must be signed
~~ Is 7.1 I and approved by Ihe Historical
Topography (~/ Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul-de-sac /:Z
IE 6 I APPROVED:
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT
?:>OJ .,
ILl, J
VALUE
,0
Q9.olq
ll?S,I.W
Main
~ 4" 1",'9
~
Garage
Carport
JOCJ.;)lJ ID
.
~",,"~50
'J:2. 7$.
(A) lf7a .'29-,
SYSTEMS DEVELOPMENT CHARGE (SDCk.$
(B) ~"Z ~c+ei-
Total Value
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
FEE
Fixtures
~
~
~C>
Residential Bath(s)
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
Mobile Home
~~ ,~Wa'F
/0
~70
~.~
-k~8-,5d
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
....,.~
r-....
~.5C>
9. ",e;:.
/s:~
3'.-
Furnace
Exhaust Hood
Vent Fan
N' ~ .?< ...,.,
Wood Stovellnsert11'lreol'.'~e~
Dryer .Vent
Mechanical Permit
..",?~o
/ C>.. .....-
/.8.8
$"9. "38
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
Zl5'" ft
-;;'.:::> ft
7:<>. 7~
/~. 5'c:>
->: .-
Curbcut
~....._::.:_..
/,"SKE \ ,ltD.
State Surcharge
~.#/__AL. ?LN.Nkw-~kc
Total Miscellaneous Permits (E)
~.76
f"6. "2?
TOTAL AMOUNT DUE (excluding electrical) ::?12J;;:~
(A, B, C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express co"ndition 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.
~q(.cJ?/ y.)'
4'1 ';)
:>~4>~vE Z" ~
~.az:- ~"" ....<""#
t/ve ~<~ .
Plan Check Fee: :l q.o~ "i?
Date Paid: ~ l,olCl'l.
,,0" :;..
Receipt Number:
Received By: OA
d~-- - ?~~~
.h'ris Reviewed ~i /'
."<5-2~~
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
l,c1\lW Jp,g)J 12):
Io///-I
. .
H- It 17
By signature, I state and agree, that J 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 GRS 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.
Signaturp fR.. ~
Datf"
3//0/f2...-
VALIDATION:
RECEIPT NUMBJR . 4-Q.if).
DATE PAID c.r-~.. .
AMOUNT REC~. - 1l~/~.~?'
RECEIVED B..(7)t~ .
. The foll9Wing prO/act &9 .u~m ad has the fo1loWfne' ,.: . ,
225 ~.L~.o ......,..". zoning, and dooo noI~UI . . c IancbIiIICTRICAL PERKIT APPLICATION. ..
. SPRINGFIBLD, OREGON 97477 approval. .. .. '. n () f"..-= ~ <Ql. ..
. INSPECl'ION REQUBST: .726-3769 ..%coW.. _ . City Job Number , '"\L.L.A... ~'C."\
OFFICE: . '726-3759 , ' . -4. :?-.(.. . . '. .
. . ,Date . . I ft COKPLETE FEE SCUEDULR BELOV .'.. .
1. ~.~ 9NlOF,I~li{AIhLAJ.I~O 'O.slgn.clur. -A'.
. ~\'-1 ,\~' II }'O ~ ~ 0 . New Residential-Single or
Kulti-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
2. "u.....ACfOR INST:A\ON ONLY B. Services or Feeders (10 Branch Circui ts
-1\ included). Installation, Alterations
Electrical Contractor, 00 fJ() ~(_~ _ or Relocation:
Address I~()? \)\1 St'NY~J/tR\100 amps or less $ 35.00
(\ r nAf\.-:." - .~01 amps to 400 amps $ 60.00
City \' ,\.\\r"'tlP .,Phone ~~la 401 amps to 600 amps $ 90.00.
. . 1\ n/'\o<:::. 601 amps to 1000 amps $130.00
Supervisor License Number ~JL/~~ Over 1000 amps/volts $300.00
. . I q^ Reconnect Only . $ 35.00
Expiration Date / D . , rJ-..
.Constr Contr. Number ?:;/f\~,:3( /)
Expiration Date r<)./J .q~ '
Si~e.of sup.ervising.Electrician
..~. ~ ~\\-.. - ,.J. .,
lm'e~ J ~ 0 D Branch Circuits
::::::sNa~'!M01 illS . New, Alteration or Extension Per Panel
. . c:..', VA IJ /i ,,;. .' A <?1i!:' ":::lI One Ci rcuit .
City . ~ Lk:..J>hone~( )'\. 'y 7( .,...Two ,to ten Circuits'
. II. .- lp Each Addt'l ten or
. .. OVNBR IIiSTALLATION . portion thereof
. . . ...IOB DEWPTIO~ . .
~\==- ~() t'.~a\) f\D~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
The installation is being made on
property. I own which is not. intended
. for sale, lease or ren t ..
Owners Signature:
DATE: 4. ~_ .C-f.f.-... ~)
, RECEIPT I:' 'M
RECEIVED BY: ~
Items
Cost
Sum.
/&>at>
~ sq;ft. or less ,~$ 85.00 .$5:.-'
Each additional 500
sq. ft or portion
thereof ~ $ 15.00 .7.~.se>
Each Manuf'd /Iome or
Modular Dwelling.
Service or Feeder $ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
0./
$ ~ 00 /.Ia D<*
$ 40.00
$ 80.00
see nBn above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps.
Over 600 amps or 1000 volts
$ 35.00
$ 50.00
$.15.00
E~ Kiscellaneous (Service/feeder
-Each .installation
Pump or irrigation..
Sign/Outline Lighting
Signal Circuit or
limited. energy panel
not included)'
$ 36.00
$ 36.00
$
36.00.
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
-:Z'~. 0<:>,
/t::' . ..->
"2/b...re>
JOG NO. "I.-Z-O"?'?e,
t
CITY OF SeNGFIELO SYSTEMS OEVELOPM. CHARGE
WORKSHEET '
.. (COMMERCIAL &. RESIDENTIAL)
NANEOR COMPANY: F"u"i""u\Z.E:- "b l-+o,,^~~
LOCATION: B \'" :fA t-lN. E,Tlt. <:.oull.,
DEVELOPMENT TYPE: Lt>~ - NEw <?rR
'.
BUILDING SIZE:
LOT SIZE
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. ~?""2.. XSO.I86 PER SQ. FT. $. ~I?I!
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S "2.0 X 538.55 PER PFU
(See Reverse To Determine Total PFU'S)
$ (""I~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
. I
X \.00 S X $388.61
$ ~"'.SS.
- ~o:-
r
$ .
.-. .,.
- .
4. ADMINISTRATIVE FEES
.BAsE CHARGE (SU~TOTAl ABOVE) X .05
TOTAL-CITY SDC
s "'~,.:!
s ''2.0,' ~ ....e.
5. SANITARY SEWER-MWMC
.'
NO. OF PFU'S "'2-0
....
x SI3.25 PER PFU + 5!0 MWMC A-OKIN. FEE S ~1S--
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
s
-
~...,~L'~ ~/ f1 /"1'2---
, . -r Kip Burdick
SDC Coordinator
TOTAL-MWMC SD~ S z.,S~
TOTAL SDC S 2?'fB~
FIXTURE UNIT CALCULATION TABLE: ;'umber of New Fi'1uresX Unit Equivalenl = Fi,1ure UnilS (NOTE:
For remodels, calcu1a1e only the N.ilion21 fi'1ures) . ..
NUMBEf1 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
-+
Bathtub.....................................................................,
Drinking Fountain..:...:..............................................
Floor Drain...........:........:...........................................
Interceptors For GreaseIOU/Solids/Etc...............:.
Interceptors For'Sand/Auto Wash/Etc..........:.......
U1undry Tub/Ootheswasher...................................
Ootheswasher - 3 Or More................._..................
MobUe Home Pari< Trap (1 Per TraUer)..................
ReCeptor For Refrigerator JWater StationfEtc...:....
Receptor For Commercial Sink/DishwasherfEtc.:
Shower, Single StalL..............................................
Shower, Gang........_._....:......................-.._.........
Sink. Bar, Commerclal._. .---......
Uriilal. StaUJWaJl ..-..--.-.--
~sh Basinflavatory, Single.___
Water Ooset, Public lnstallation._._...__.._._.........
Water Ooset, Private_....___._._..__
Miscellaneous:."
-z.
"2..
I
z
oz.
""Z-
'1.-
e,
TOTAL FIXTURE UNITS
=
20
"
CREDIT CALCUlATION TABLE: Based on assessed value. Iflmprovements ~ after annexation date in.table,
cala.da1e crecfds ~parates.
52.66
2.64
2.53
.2.41
2.19
2.04
Year' ..
A.......J
1985
1986
1987
1988
1989
1990
INFD AIIAII-A8LE:
X S
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
. Rate. per S1,OOO,.
. Assessed Value
Year
AnneXed
Rate per $1,000
Ji,'o,....J Value
1979 or before
1980
1981
: 1982
, 1983
,1984
$1.69
1.35
1.15
0.92
0.59
0.23.
-,
1-/0
Credit for Parcel or land Only If Applicable
=
Improvement ("If after annexation date)
=
: S
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL.....................................:............... 0.4
COmmercic.L................:................................... 0.9
IndustriaL.............................. .......................... 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT