HomeMy WebLinkAboutPermit Building 1994-2-22
LOCATION OF PROPOSED WORK' _,994 __ k~"aA
//? -oz>'O.:or-23
.../
r
RESIDENTIAL
PF.kM'IT-APPLlCATION
Inspections: 726,3769
Office: 726,3759
ASSESSORS MAP'
LOT'
/.<:
b~ LL..I ~ ,q/'J :7<'__
ADDRESS: 2/")_~"" 779-4""R
CITY: ~..t..k<=""JT~
OWNER:
.
SPRINGFIELD
BLOCK'
'H~~"'M. '
STATE:
~
.B NUMBER -111) \ ~L
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: /100
SUBDIVISIO~.J>GW /~A-P.:s-
PHONE: _~~-~.il!i5./
ZIP'
9/4"0/
DESCRIBE WORK: /?7.44JUr-~1rt7/-'??")
NEW V REMODEL ADDITION
,L~~~". PL~;;>""?';>~J'~
CONTRACTOR'S NAME , J
GENERA" G;e~ W~LI(f
tr
PLUMBING'
It
MECHANIG^' '
~,.._P'H
DEMOLISH OTHER
ADDRESS
~~4~/.v:~u
/1
CONST.
CONTRACTOR'
,
46+7?
PHONE
726-217/
75"" 0-><) .../
/I
ELECTRICA' .
OUAD AREA. 4R.~....
. OF BLDGS: -':J k
OCCY GROUP: ~~\
\
y/
. OF STORIES:
WATER HEATER:
- OFFICE U;>i\-
LAND USE: I \ 5l )
. OF UNITS:
vtJ
HEAT SOURCE: ~ f'-",
~
CONSTR, TYPE:
RANGE:
EXPIRES
//-/.2. ...q~
/
/I
A '
~
/1
FLOOD PLAIN: ,- V
ZONING CODE: JJ 11;
?J
. OF BDRMS:
SECONDARY HEAT:
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 day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior t
'(J setting for,,'
Underslab ~ I eclnc II
Mechanical - Prior to cover.
1\:/1 Footing - After trenches are
~ excavated.
D Masonry - Steel location, bond
beams, grouti ng.
~ Foundation - After forms are
~erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decki ng.
D
Floor Insulation - Prior to
decking.
.~ Sanitary Sewer - Prior to filling
~rench.
rVr'Storm Sewer - Prior to filling
~ trench.
. ~ Water Line - Prior to filling
~ trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
r;;:/, Rough Electrical - Prior to
~cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
1;ZiFraming - Prior t<:> cover.
o Wall/Ceiling lnsula~ion - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach - After
IAJ forms are erected but' prior to
placement of concrete.
m Sidewalk & Driveway - After
~ excavation is complete, forms
and sub-base material in place.
o Fence - When completed.
'f\7T Street Trees - When all required
~ trees are planted.
(
o
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work..ls complete.
o Final Building - When all
required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
'DI Blocking and Set-Up - When all
~blOCking is complete.
f':71' Plumbing Connections - When
~ home has been connected to
water and sewer.
rv1 Electrical Connection - When
~ blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
~Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
,..~I,' ' "
I'.'
Lot faces Lot TY_ ' I, Setbacks e IS THE PROPOSED WORK'I~ ~H'E ' '.
Lot SQ, fig, .2{, Interior I P,L. HSE GAR ACC HISTORICAL DISTRICT, OR ON
IN THE HISTORtCAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is l- and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cul.dc-sac IE ]
APPROVED:
\'{)I~
f8(pg{) ~ ,8:)
~ <3.1\3
76,~3
BUILDING PERMIT
ITEM SQ, FT.
X $fSQ, FT,
Main
v
Garage
~:()
\f),\()
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VA LU ~ I'f..,
_t=)~ jllV
~'
SYSTEMS DEVELOPMENT CHARGE (SDCJ $
(B) il2tJ 5>1 1-
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT,
FT,
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surch;!]^
Sidewalk 0Y'
Curbcut ~
fI
fI
DemoUlIon
State Surcharge
FEE
(\. 'l~ CO
rDfl CO
db ,CO
nsPO
'~.r J.CS
I")B ,10
~
I f\~ CO
~!JCO
~.,0S
-1'h,Bs
/(),(rf)
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)~3
(A, B, C, 0, and E Combined) ,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thaLthe said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating (he 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:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date"
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
\ c:A-\-\ ~ \Q) V\\.o( )_
\-cAn.(\o>{ 1'010 ,) \L\ljY
By signature, I state and agree, that I have carefully examined
the completed appllcallon and do hereby certify thai 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 .Buildlng Safety Division.
I further certify that only contractors 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 at the front
of the property. and the approved set of plans will remain
on the site at all times during con ;:l:tC~
Slgnat~~ ~
Datp 2 - 2- 2.--9
I'
VALIDATION: ,,( n /\ <:::::::
RECEIPT NU~BER It:k--J
DATE PAl"":") r<J/J.L14-
AMOUNT' R~~:EI-1 Ql R2 I on . ~ ~
RECEIVED Y rfY))
'-- -
,;;;,...\. .
.
SPRINttLD
'-,
. .:....
"
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726,3753
, . FAX (503) 726.3689
...... ,....
MANUFACTURED HOME SET~IJP AGREEMENT,
.:.".
;. .
As ~.~'q~ii:e~.'by . the City.. of Springfield Developine'n t Code; i understand and agree
that vi th t.he.approval of the, attached pe&1' t~' ne pf, thefdllowing,',' . '
manufactured homes ',,;ill be placed at ~ s: _ 'JpJ);Q,(.f'L2. )' , .
Springfield, Oregon, City Job Number '+ I,
',x.
Type I Manufactured Home. A multi-sectional (double vide or vider)
unit with an enclosed tloor area of not less than i,oOO square feet,
that has.a nominal roof pitch of ,3' feet in height for.each 12 feet in
vidth, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have an exteriot thermal envelope
meet ing. performance standards vhich reduce' hea t loss to levels
equi valen t to the performance standards reqlli red of single family
dwellings constructed under the State Specialty Codes.
Type II Manufactured' Home. A unit, of not less than 12 feet in width
wi th an enclosed tloor area of not less thall 500 square feet, that has
a nominal roof pitch of 2 feet in height for each 12 feet in width and
,that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided with the
following information:
_ Manufactured Home blocking
- Water line connection
- Street tree standards
- Sanitary sewer connection
- Electrical connection
_ Minimum requirements for permanent steps
I also wldersland that if I am installing a Type I Manufactured Home, tbe home
shall be enclosed at the perimeter with stone, brick or other masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade,
_l/
~atlire
,,~.~r
-
Date
'.. . .....~,,_.;~\-.
": ~-.~~...... .
, ".,
.
. NO. '1<-1017 /
-,
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
- NAME OR COMPANY: WIL L.IANl t;' [jetTY LYNCH
- ~. ---_...-
L.OCATlON: SCf 9'-1 ::res? leA f 'i5 01- ()? -i? -- / I/)() ,
DEVELOPMENT TYP( 1..hR. - NlAr-JuFM... TUf..f.P ,l-!oivJe
;) _" -, - . t+I!...;e' .'1Z,"e CAI'-J'tr.f L..Op
, .. '1-e", '51 .>no
_ BUILDING SIZE: '2.7,,,1><13.5 1'Z.,c':>o1JN.I1- 'UfO LOT SIZE
SQ. Ft.
I. -" STORM ORA I NAG E
- - IMPERVIOUS SQ. FT.
- --- _...
''2'-'? 'f
X $0.203 PER SQ. FT.
~531~ ')
'-...... ----
'2.' SANITARY SEWER-CITY
-NO. OF PFU'S
.- (See Reverse)
3. TRANSPORTATION
!'S
X $42.08 PER PFU
(35749
, ,
; ",.'.;""'
NO OF UNITS X TRIP RATE X COST PER TRIP
X /,0 I
X
X
4. SANITARY SEWER-MWMC
f
X $424.31
X $424.31
~2-B ';5 )
'-- ----
$
X $424.31
$
NO. OF PFU'S leg x $15.125 PER PFU + $10 MWMC ADM FEE $ 'Z-'li2. -z..s
..,_ ,...," .(Use.PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ '5 i'0:.
TOTAL-MWMC SDC ~
.......... .../
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ fQ5&'!!!..
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~'" '~~J.-... 2/t1/crtf
Oki p Burdi ck /
SDC Coordinator
C q/~)
,5
TOTAL SDC $ '2-05'-1 -
''r: FIXTURE UNIT,CALCLATION 1ABLE: Number 01 New Fixt. Unit Equivalent = Fixture I).-lU;; ~NOTE:
For remodels, calculate only (h~~ additional fixtures) -, .'
_ NUMBER OF UNIT , FIXTURE
, FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
1--
2
1
2
3,
6
2,
6
6,
I'
3
2
I/Head
2
2
1
6
4
'f
Bathtub.., ...., ..,..""..""....",..,.."""".",...""",.,",....,'"
Drinking Fountain.."",.."""..""""""",.."......""""",
Roor Drain..." ...... ...."",...,......".."""..",.."",..,',..,',..
Interceptors For Grease/Oil/Sollds/Etc................,
Interceptors For Sand/Auto Wash/Etc.................,
Laundry Tub /Clotheswasher.. ....,.., ,......., ,..,..........',
" Clotheswa~er - 3 Or More..,.......,........,.......,.......,.
MobITe Hdrrie Park Trap (1 Per Trailer),...~.....:........~
c' Receptor F9r RefrigeratorjWater Station/Etc........
: Receptor For Commercial Sink/Dishwasher/Etc,._
"! Shower, Sin~le.S~alL.,.........,.,....".............,.............
Shower, Gang..:,..,:...., ........ ,..,..,.' ,... ....:........, ....:... ,.
Sink, Bar, CommerciaL,.........,."."....,......,....,.........
Urinal, StalljWall......,......,.........."....,..,...,............"...
Wash Basin/Lavatory, Single.................................,
Water Closet, Public Installation.............,...,.........,.
Water Closet,' Private..,..,......",...."....,......,...........",
. Miscellaneous:
'2.
, '2..
'2.. '
']...
'2-
go
TOTAL FIXTURE UNITS
=
(8
CREDIT CALCULATION TABLE:
calculate cred~s separates.
Ir--'~Year
I Annexed
Based on assessed value, If improvements occurred after annexation date in table,
Rate per $1,000
Assessed Value
Year.
Annexed
Rate per $1,000
Assessed Value
I
,I
1979 or before
1980
1981
1982
1983.,
1984'
1985 '
$3,21
3,13
3,08
2.96
2.82
2.68
2.51
1986
1987
1988
1989
1990
1991
1992
$ 2,24
1,93
1.57
1.18
0.79
0.44
0.28
j
Improvement (rt after annexation date)
3,1.-/ X $ {5."ib'
(Rate X Assessed Value)
X $
, (Rate X Assessed Value)
CREDIT TOTAL
=
511..~
Credtt for Parcel or Land Only If Applicable
=
= $ 5/ '2..2
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
.., ..
.'
fI\' '
~q lL'!i!I!!!!!!t\!!!
.
Job No. CN) 10 I
- -
SYSTEMS DEVELOPMENT CHARGE
~O'KSHEIT '
NAME\,\\\\(\ffi~~\-\-1 ~O\K'(\h. PHONEZ4~-~')~1
ADDRESS;(~(l~~ 'T1'Lh~. ~jY~TATE:Be.zIP Cf0401
'\J .
"- \f; 1'J'Dl1'D )
Platt Name: (iNrkn'lOn71CO Tax Lot Number: pl)~~()~?1Dl Kl)
.....
LOCATION OF PROPOSED BUILDINhSr1J:
Street Address if Known: ........ ~ L-f ~
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Familv - Detached
Single Family home
_ Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT = .
$4rD(fJ
B. Sinl!le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
$4tYJ~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit $ /'L
approval. See SDC Credit Worksheet. ILl
3. TOTAL WPRD NIT SDC ASSESSED (If SDC reduced for Credit) $ <4[)()r;J)
~~~,~~ ~. M,~
City of Springfield
WPRD SDC
.
.
Sfl'nINCFe
,..
The following project as submitted hae the f~W' '
225 ,r~t... STREET ' zoning, and does not require specHic lend u!lF'~CAL PERHIT APPLICATION
SPRINGFiELD, OREGON 974Tl'pproval, nA i \ n \
INSPECl'ION REQUEST: 726-3769 Zonino 1,["11( Ci ty Job Number ~\\t )\. I
OFFICE: 726-3759 .;;J) ItlLl
. , . Do!e _J.J~ 3. COHPLETE FEE SCHEDULE BELOV
1: ...!J)C.A:J::{OII~ O~ +t;lST~L~l'K:w.",jyed S~ature-CB, ,'"
...~V\~ ,--~,L..)l... )'Prx:..7" - ,"-- thn' n^co~,lt:mtial-Single or
, Hulti-Family per dvelling uni t.
Service Included:
\~~~~~~~ O\\(Y)
J,Q.B DESCRIPTIQf:! \ (\ P\ n D
,_\{Ie' 1111 <~. I..p\~ 0 ""t' \. V ~ I
Permits are no~'\ransferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
'2... CONTRACl'OR INSTALLATION ONLY
. .
Electrical contractor_~AE1'~~[:Le~
Address ~:f~f!t:::. '1. 'ITIt6.-VF_
Ci ty \='11 (-,~..-1\1 E-
7z...Q-l'5DO
(,W-/6dO
Cj l\C"tS
Phone
Supervisor License Number
Expiration Date
to ,.\ -9....)
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
.'
DATE: --, "n0'f:.r:/rtJ..-m------~-
RECEIPT I: .k--JJ. -:, ;;. , J " '\ { 1--0
RECEIVED BY', :1)17) f----/ .'
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd lIome or
Hodular Dwelling ~ rpf)rfJ
Service or Feeder $ 1.0.00
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
B.
Services or Feeders
Installation, Alterations
or Relocation:
C. Temporary Services or'Feeders
Constr Contr. Number ln3\?li Installation, Alteration or Relocation
Expi"ration Date 12.-2,-'1.3 200 amps or less $ 40.00
. 201 amps to 400 amps $ 55.00
Signature of Supervising Electrician Over 401 to 600 amps $ 80.00
&,k W, ~ Over 600 amps or 1000 volts see "0" above
'it Owners ~ame{ i Ji \\'\(HV\ *' &1\ tr~' D. Oranch Circui ts
'f\f'\-:l ~ '--r;::; ~'~./ ' Nev, Alteration or Extension Per Panel
Address !'II A:'...J \f\ ~ '1 J\
, city_f~~QJO~Phone{-lA?>-S:Jf)1 ~:~hC~~~~~~onal $ 35.00
(\ Circuit or vith Service
OWER INSTALLATION - or Feeder Permi t ~ $ 2,00
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
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
-!1 ,cx:J
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
.A5I,CO
<4 I ( )
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