HomeMy WebLinkAboutPermit Building 1995-4-3
LOCATION OF PROPOSED WORK: ~'
~SSESSORS MAP' 1F!n!),(J~'f;
LOT: ;':Z BLOCK'
OWNER: --/J4#.1! V
ADDRE~".I ,/..., ~
CITY' e () IrE.1E:.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
..~ u;75't:. /VV
, , TAX LOT: D\~r()
SUBDIVISION:~ ,~
.
~
-,...,
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L ,4 II f1 >>~;/-'L
M/ W 94- D,{L
I)r-
DESCRIBE WORI<"
(fu,'))
NEW x---- REMODEL
,
STATE: ---o.~
111.... /
f1 <7 1-11-<..
.
9~60~7
ADDITION
DEMOLISH
JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
~
PHONE:
r u )-- ~'-4-P
. ,
ZIP: _C?7 4_..1..2..1
. ,
OTHER
CONTRACTOR'S NAME
GENERAL: f1 tu.;;
f
f
PLUMBING:
MECHANICA' .
ELECTRICA' .
QUAD AREA: 4~SE
_\
OCCY GROUP:'\\-;),... \oJ\.
. OF STORIESr:J -\ 'D~
C(./ '
. OF BLDGS'
WATER HEATER:
CON ST.
CONTRACTOR'
f,07-Lr.,
- OFFICE USE -
\ \ \ \
\
VtJ
LAND USE'
· OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:-1;kJ;;rUeMA:Sr~..rf1
RANG~' :./
EXPIRES
/- Lr:::.f (,
PHONE
~4 7-5'<./77
- I - ,
FLOOD PLAIN:
ZONING CODE:
'. OF BDRMS:
l,DU
~
ADDRESS'
L A- V 4.,..U.E' c/4
("""'" .
~A~A _
. /"1/-'
-
SECONDARY HEAT:
,'SQUARE FOOTAGE:.s0 7") \5
To request an Inspection, you must cafl 726,3769. This Is a 24 hour recording, AII,Jnspectlons requesled belore 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,
~ Temporary Electric
)X1 Site Inspection - To be made
after excavation, but prior to
setting forms.
O Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
't71 Footing - After trenches are
~ excavated. .
o Masonry - Steel location. bond
beams, grouting,
~ Foundation - After forms are
~erected but prior to .concrete
placement.
REQUIRED INSPECTIONS
~R~ugh Mechanlca' ...: prl~r to '
~ cover. .
'f;?f'Rough Electrical - Prior to
~cover.
M Electrical Service - Must be
~approved to obtain permanent
electrical power.
o FIreplace - Prior to faCing
materials and framing Insp.
~ra~lng - Prior: to cover.
)<;;:7f Wail/Ceiling InsJlallon - Prh>r to
~cover.
o Underground Plumbing - Prior '1\7f Drywall _ Prior to t,aplng.
to filling trench, ~
O Underlloor PlumbIng/Mechanical
-.Prlor to In,5ulatlon or decking.
o Post and Beam - Prior to floor.
Insulation or decking,
o Floor Insulation - Prior to
deckl ng.
'Jv1Sanltary Sewer - Prior to filling
~ trench.
~Storm Sewer - PrIor to filling
~rench.
~water Line -'Prior to filling
trench.
, ,
Rough PlumbIng - Prlor:to
over.
o Wood Stovo - AUbr InstallalloA,
o Insert - After fireplace approv41
and Installation of unit. .'
~. ,
Curbcut & Approach '- Afte,
forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
~excavatlon Is. complete, forms
and sub.base material In place.
o Fence - When ~ompleted,
ffi'ktreet Trees - Wh~n all ~eq.Ulred
~trees are planted.' .
~ Final Plumbing - When all
~plumbln'g Work Is complele.
. ~ Final Electrical - \AIohen all
.~electrJCal work Is comple.te. C
l"i7i Final MechanIcal - When all
~~9hanlcal work Is complete.
~Inal Building - When all ' '
re:qulred Inspections have been
pproved and building Is
completed,
DO'her
MOBILE HOME INSPECTIONS
o 'Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When
. home has been connected to .
water and. sew?,. ,.
o Electrical Connection - When
blocking, set,up. and plurgblng
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skirting, deCks. and
venting have been Installed.
~
:
--0--
" Lot sq, Itg. /-~<2,0
Lot coverage 2=!,~%
Topography ~
Total height
. r: Il,s" ')
'---
BUILDING PeRMIT
ITEM SQ, FT.
23'?4
4.'34
Lot ~yp.
Interior
K Corner
Lot faces
Panhandle
Cul.dc.sac
f\1aln
X '$/SQ, FT, a
<:;"('",,?-'"
---,-~"p "
Gacage
Carport
~o-T
5~~D
/ /)-"2 to
I P.L,
IN
Is
Iw
IE
VALUE
/3{/7()
. ~~24
579"fbtp
i7S'~g,O
Building Permit Fee ~7'oo
32. .;.r+-/917 5.;' (n_
State Surcharge . .':. ,
Tolal Fee (A) -7tl,''J_92-
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
, (B)l~c, y6.c" f-
Total Value
PLUMBING PERMIT
, ITEM
Flxlures
,
Residential Bath(s) N' ~
Sanitary Sewer FT,
Water n
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge q.~3+ 5.76
Total Charge (C)
MECHANICAL PERMIT'
Furnace
Exhaust Hood
Vent Fan
N'
4
Wood Stovellnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State :Surcharge / ,Z 2> +- .77
,
Total Permit (0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
I"~
.
32..
It
It
Curbcul
Demolition
State Surcharge
FEE
j"j;2 f.:J
/ S .-11
'7.87.1'/
&, 6-0
4,)"0
/2,40
--::<~
2C;;-,S-O
/D.lJr:>
? oS"
~7~r
, ~4 7.r
'-L4-.60
,47',55
TOTAL AMOUNT DUE (excluding electrlcalt, ~7
(A, B, C, 0, and E Combined)
Total MIscellaneous Permits
(E)
~
.' ..:.:" '::",:\1':.\,;
. THE PROPOSED WORK. IN THE " '
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit IsSuance.
Setbacks '
HSE GAR
ACe' I
I :.!
I
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 -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: J.:z1. i!!.5' . ./
Date Paid: / j J 3;1'5" (
(j ,
Receipt Number' 5"5?J-
Received By: # ~
Plan<~' L
~
2/e/J..r
. D.l!'te
Systems Developmenl Charge Is due--en all undeveloped
properlies within the City limits which are being Improved.
ADDITIONAL COMMENTS
f~u\~ ,...~INO tJ"'o\)X
- - - - .
,t9\+T O?~ cy}()
l~N\QlI: \ n1b;. \C\I\?,
i :
j:J A77f.:[
By signature, I_stale and agree, that I have carefully examined
the completed application and do hereby cerlify that sll
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordlnanc~s of Ihe City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thaI NO OCCUPANCY will be made of any
~tructure wIthout permIssion of the Building Safety Division.
I further cerlify that only conlractors 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 st the front
of the properly, and the approved set of plans will remain
on the site at all times during ~structlon.
~gnatur;I.#'//"l_./ /&..-... .
'--1_ 1- ef r-
Date
VALIDATION:
RECEIPT NUMBER Uf7R~
DATE PAir 4. 'l, .ac; "
AMOUNT RE~EI~~ ~ Uffi15:i7 "
RECEIVED BY - , -I
i
/
. ATTACHMENT B1 .
\", '- B NO.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
95-0039
/
NAME OR COMPANY: d/ 2.. t/~
/:::...- ' nq I (\ , I). -/J..... I ~
LOCATION: 99t:J_'J...-~._/?~ 1 0' I 0 ",:::::il)1 .L~~O A ~
o ~- VW
DEVELOPMENT TYPE: '5;<= /)
BUILDING SIZE:
1. SIQBM DRATN~
IMPERVIOUS SQ, FT,
I,OT SIZ(
SQ. Ft.
Z130
X $0,209 PER SQ, FT.
$~r.0
2. SANTTARY SFWFR-r.TTY
NO, OF PFU'S
(See Reverse)
3, TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
:l-'1
X $43,26 PER PFU
'cm?~
I
X /. 0 ( X $436.19
X X $436,19
$~
L---
$
X
X $436,19
$
SUBTOTAL (ADD ITEMS 1. 2. & 3) LY/ c. . -9 ~
4. SAMlIARY SFWFR,HWMC
NO. OF PFU'S :l-t x $17.19 PER PFU + $10 HWMC ADMIN,FEE $ "1?'?,/3
(Use PFU Total From Item 2 Above) ,
MWMC CREDIT IF APPLICABLE (SEE REVERSE> $ 79. # r
"IQIAI,HWMr. snr n9~,';S")
SUBTOTAl (ADD ITEMS 1.2.3 & 4) $ .z 5"//,0 f
5. AnMTNTSTATTVF FFF~
BAS~GE (SciBT TAl ABOVE> X ,05
~J4 / r
~~ /-/~ Date:
~ary\Hornfg. p,~, \
/ SDC CW'rdi nator V
csJ 2 ~ - S':,"')
-
/-;;ZC-'1~
mIAI snc
$ 2 C. 3C:;. (;7"
B2 . SDC .
fIXTURE UNIT CALCULelON TABLE: Number of New FiX. X Unit Equivalent '= Fixture Units
{NOTE: For remodels, calculate only the liE! additional fixtures) ~
, NUMBER' OF
NEW FIXTURES
FIXTURE TYPE
Bathtub..",."."",..."...."."",......"..".",.."..".,.,.,.....". ,
Drinking Fountain,.... ...,'.. ..,..,............",...,.,..,.','..'.."
Flc:lr Drain.. ..,........, .......,.....,..................,..,.,..,.,."""
Interceptors For Grease/Oil/Solids/Etc................,
Interceptors For Sand/Auto Wash/Etc.................,
Laundry Tub/Clotheswasher,...................... ............
Clotheswasher, 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, Commercial, Residential Kitchen........................
Urinal, Stall/Wall" :,................... ...........'....................
Wash BasinlLavatory, Single..,...............................
Toilet, Public Installation",...""".............,..,...........
Toilet , Private,.....,...."....,..""""....,........"..,.........
Miscellaneous: I TAN/rtJP',s .shVr
3
I
/
3
3
TOTAL FIXTURE UNITS
UNIT
EQUIVALENT
FIXTURE
UNITS
2
1
2
3
6
'2
6
6
1
3
2
l/Head
2
2
1
6
4
.2.
'"
:1..
2.
2.
~
I"
=
.:z7
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table.
calculate credits 'separates,
Year
Annexed
Rate per $1.000
Assessed Value
1979 or before
. .1980
1981
1982
1983
1984 "
1985
$3.46
3,38
3.32
3,21
3,06
2,92
2.73
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Rate per $1.000
Assessed Value
$2.46
2,14
1.77
1,37
0.97
0,61
0.44
0.15
Credit for Parcel or Land Only If Applicable
= _1../. -0'
Imp~ov~ment !if after annexation date)
,3.4(;;, X $ .2..2. Y 70
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
~
=
CREDIT TOTAL = $ ;ff.-;rg-
'.
..
o !!y}!I~I!!!!~.!!~
Job NO.q~~
SYSTEMS DEVELOPMENT CHARGE
l C \ '\ _ :~R.K~:EET
NAME:\ ~\ ~~~ PHONE: ...OA~.~y:/\
- I .
ADDRESS: \t'\()~ lli.0M ) \ r J STATE: ~IP a""f\6 \ '
LO~:O~~:S:~~~~~~~ BUIL~~~) ~; 3\~~~~~
PlattName:~*" \\'U.\~ ~LotNumber: \<{(mD.~\4 t)\OCD
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), SDC Calculations and dwelling type
definilions are on the back.!
Manufactured home not in a park
$ 4ti)..g)
X $400 PER UNIT .5=-,
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$~~
$lf
$ 40n .00
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~~~~~f)
r:4........( (""....~:......rl";'"'IA
4 I ~ I~
Date
.GFIELD " ,,',
,
rh~ k'I1('\Il/i'lt'l Dmiro.::t ~G 511brnttted has the following
z.,..nlll~J. t\"u"dot)!: .,VI. rvq~jjc specific land use
approva.L
Zoninp i... D L-
225 FIFTH STREET " :L.. ..-r
SPRINGFIELD, OREGON ~1?7J!:!'~~-'7~
INSPECTION REQUEST: AZ;?,lirrJ.llfiJ?gnature iJ,.....
OFFICE: 726-3759
, 1. clt~fON OFr\lNSTALLATION
L( (n ...'J.l)t ~?
~~~IO~['Qrn
non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
CONTRACTOR INSTALLATION ONLY
Elect 'cal Contractor ~
/
Address
City
Supervisor
Expiration
of Supervising
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signatu~J / ,
-1JLLA,/ ~'-
~~TE~----------------~~~-i:l')--==---
RECEI1'l ii: L D. ,l~-"'"
RECEIVED BY: l~YA ~
ELECTRICAL PERMIT APPLICATION
C~ ty Job Number q~::f1
.
3. COMPLETE FEE SCHEDULE BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dvelling
Service or Feeder
,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
Items Cost
Sum
$ 85,00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40,00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less l $ 40, 00 .1b.
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
.'
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E,
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35,00
$ 2.00
.'
no t included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
4J:\CP
~:-p~
43.~