HomeMy WebLinkAboutPermit Building 1994-5-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
51'" '3tq
JOB NUMBER
Q4{X:01
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' ;;" X' s: t/
ASSESSOljl\' MAP' (~A nAt1.~
LOT' r',) \. . BLOC~'
--( .
J e.SS IfYA- 'Dr,
. TAX LOT: np/JOIJ
SUBDIVISION:,rr:utt11iPjij\ )
OWNER:
ADDRESS:
f! IL.ds /) rfi1.-
ol/ d-; .5:
CITY'
11/ f>~uJ
DESCRIBE WOR~'
NEW vREMODEL
ADDITION
70 PC--
STAT'"
S-Ff;J,
DEMOLISH
OTHER
. PHON'"
ZIP:
~
CON ST.
CONTRACTOR'S NAME ADDRESS /) _ CONTRACTOR #
GENERA" t.oP, l.1 /4'2S..6Q aJ~ .f3~9L/7
PLUMBING: t.J; da.h #~,.vl"y()wq~04 (1 [g3Ldf3S
MECHANICAL: /)/1 R ;::~ fa 1)8-60:? ' <;,~''l
ELECTRICAL: p_ii/s \..~/!)[)LV U J F~ -:c-913~1'
QUAD AREA: ~
# OF BLDGS: l
OCCY GROUP~ Q'T M
# OF STORIES: ,.Q
-v
WATER HEATER'
'';'" OFFICE USE -
LAND USE: _I \ I I
1
CONSTR. TYPE: V Ai
HEAT SOURCE: Fu
'f..-
# OF UNITf"
RANGE:
I oYOCH-. rWl.10Bl(2f
In.sqq. l4b.q~l
(0 ,1().94-'f4.1.~
4~lfUr2)" r6)1'
FLOOD PLAIN'
ZONING CODE: LJ )IL
# OF BDRMS: ' ~ '" /
k?
SECONDARY HEAT:
SQUARE FOOTAG E: _ A(~ /) AI.
- .
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. .
D Temporary Electric
'tv'r Site Inspection - To be made
~after excavation, but prior to
setting forms. -:;11 It.-
o Underslab Plumbing/Electrlcal/
Me~hanicaJ - Prior to cover.
'1\:'"AFooting - After trenches are
JA..lexcavated.
D Masonry - Steel location, bond
beams, grouting.
i"'Vl, F Foundation - After forms are
~rected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
p<;;fJ Rough Mechanical - Prior to
~ove~ .
.F;?1' Rough Electrical - Prior to
~cover.
f'Jr Electrical Service - Must be
~pproved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing ~nsp.
~ramln.g - PrIor to cover.
~ Wail/CeIlIng Insulation'- Prior to
J...6..lcover. .
~ryWall - Prior to taping,
'1C/l' Underjlo~umblna~chanic0 '
~ -,Prior to ,rl~U'cld()n"'t.~-ut:(;~mg. 0 Wood Stove - After Installation.
rc:;;{ Post and Beam - Prior to floor
~insulation or decking.
r\:71' Floor Insulation - Prior to
~decklng.
'("/'f-Sanitary Sewer - Prior to filling
~ trench.
I\7f Storm Sewer - Prior to filling
~ trench. .
!'VI Water Line - Prior to filling
, ~trench,
rVI Rough Plumbing - Prior to
~cove~ '
o Insert - After fireplace approval
and Installation of unit. ,
I\7T Curbcut & Approach - After
~ forms are erected but" prior to
placement of concrete.
~ Sidewalk & Driveway - After
...1CS""excavatlon Is complete, forms
and s:ub-base material in place.
D Fence - When completed. "; ~,;.
~treet Trees - When all reqUired:'
'~ees are planted. . .
~ Final Plumbing - When all
~ plumbing work Is complete.
r'Vt Final Electrical - When all
~electrlcal work Is complete.
~Final Mechanical - When all
~ mechanical work is complete.
1C/l' 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
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 ,servl?e panel.
I
o Final - After all required
Inspections are 'approved and
" porches, sklrtln'g, decks, ,i'nd
venting have been Installed:
Lot faces ~
.~30
Lot sq, ltg, . ~
Lot coverage 10ft>
Topography 1!20 +-
Total height ,~ I
\104"')
BUILDING PERMIT
ITEM sa, FT.
B~'cl
-(~()
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
LfY'ype .
6, Interior
Corner
Panhandle
Cul.de.sac
I
L.....HE PROPOSED WORK IN THE
"I'!rsTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
I P.L
IN
Is
Iw
IE
Setbacks
HSE GAR ACC I
I
37' 3'1' I
201 I
, S', I
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
x .!ip~ff) = \rA~.ffG2..
l:Lill- -.!] I' 1~1- .
(A)
N' ;:<;
FT.
FT,
FT,
S.78+,/,&"
(C)
Dryer Vent
Wood Stove/lnserlfFlreplace Unit
N'
~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(J.n -1-1.'2.&
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~/" ft
, ,
Curbcut ~ L It
Demolition
StR Surcharge i __
t N \f\ \\ \\ r .cWiJL...
;otal Miscellaneous per~J
FEE
c:::>--?S.::J
J/~,
-:2.1:)'7.1',-
- . '-<-
...6.0-0
~S-O
/;:2. .(1 &>
/10-
-?c, So
....
J D,DO
'2. ." 5
2,7.S-.r
-2! .~i9
l~f;O
\
4,DpQJ
(E)
TOTAL AMOUNT DUE (excluding electrical) ~s. '76
(A, B, C, D, and E Combined)
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.
::t~ :::~k Fe..~~ 9J / ~,
Receipt Number: . \ ~t ~
Re~ J.J,\ s;0er
PlanS- Reviewed By ~ate .
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~ I)() Jll.O . , <;\W \ ()n~ .
, 1~\'0" I~ 0 f'-p q:..l{)\~
\ ~TI OIGU\t O( l
~l'Q): \CA.\)<6
~1;(lL
0HJ\bf.:\.((1Q ,~n Q II niU--->
"
.,
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 Ordlnanc~s 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 Dlvis!on.
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 tlme~ 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 wll.1 remain
on the site at all...-~e~)rlng construction.
:::""" ~/;Zif
VALIDATION: \ n f51@ n
RECEIPT NUMBER ~mJ .
DATE PAID 1..~.,{20 .9Lf
AMOUNTRE~. ,~(, 2--9. I~
RECEIVED B '.!..~_ )
f,r \
")"[.-11 e &~
+/43 ~ ;
'--
.
.
o !!!i!IJ:!!!!!!~!!!!
JObNO'~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: .tht~0Q {tl
AODRESS0!f1 tQ.~S0() PN~'I ~
PHONE: ~
STATE:OC-ZIP ~7
.
LOCATION OF I'ROPOSED ~UIL.R!NG ~ITE: \ ^
Street Address if Known: t D K S <-t ~ ul\l f'f)
)
Platt Name~ 111l-h PltJI cy Tax Lot Number: J2(J 8DtJ.;)..\~ff)oc)
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
NO OF UNITS I
Manufactured home not in a park C() .
X $400 PER UNIT _= $ 4rf), - .
B. Sim~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 =
$
$ 4ff)~
$kJcr)
$4CO.
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Cledit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
k&,~~~)
City of Springfield
/l /J).O /31-
Date
.
.
SPRINGFIELD
225 r H u. STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: . 726-3759 ,
~. LOO~J!~ O~ f8~Fb _ ) A.
lP1f)rIJ!:!)''i~J~DB1d)
S~~~S~rl\(f'l fMo_~2f
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
Electrical Contractor E/ il", f:/f' cft.t'C
Address3/?!.? 1.41 t'/7,t
City EttcEllIe Phone~-SY<17
Supervisor License Number 9(1(0 S
Expiration Date l (). \ ~
,
Constr Contr. Number ~ f) g 1/ cA~c::...J
Expiration Date 4. ~B.q1-
S~} f :1er;:~ Ele/i~ )
io O::ers ;a,~ffi( _ ~J:L/
Address IlJfJc; ~{
City~ . Phone
~~ALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------------~-~W '~1;: "'> 5.
:g:~~D I~~'f -\..." ·
3.
ELECTRICAL PERKIT ~.ON ,
City Job Number -In ^- l .J \
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less -L $ 85.00 B~
Each additional 500
sq. ft or portion '"~. 4s
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps or less 1 $ 40.00 40
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see nB" above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
\ f)'D ~
XJ~~i-.s'(D
J!'
.
.B NO. q';Of,D"}
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 1-1 U f) S P &- -(1-'
LOCATION: C, r5 '-I S'e<7S/CA PIa...
DEVELOPMENT TYPE: LOK. - A1~w ~~Ji?,.
18o'2-07.-].~ .. O?7l:iO
BUILDING SIZE:
LOT SI7F
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. --Z/U:> ? X $0.203 PER SQ. FT. r;-o.f6q ~l)
'-- ,./'
2. SANITARY SEWER-CITY
NO. OF PFU'S 'Z-'? X $42.08 PER PFU (q("7B:!)
(See Reverse) '--- ..........
3. TRANS PORT A TI ON
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $424.31
~'l.~-~)
------ --------
$
$
1
X 1.01 X $424.31
X X $424.31
4. SANITARY SEWER-MWMC
$ 2. L: 7 i'].
NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE ~~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 70 't!.
TOTAL-MWMC SDC ~
'--- ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ Z/<f2,~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~~Lcl... '-f /2D IN
~ Kip Burdick I I
SDC Coordinator
rs--- /D7 '0
'-- /
~2.
TOTAL SDC $ 2-"2--60 --
~ ---
.."",....
~
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4-
2.
Bathtub...........
Drinking Fountain..... . .................
Floor Drain...............................
Interceptors For Grease/Oil/Sollds/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub /OotheSWasher............................ .......
Ootheswa~her - 3 Or More....................................'..
Mobile Home Park Trap (1 Per Trailer)..................:
Receptor F9r Refrigerator jWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single.StaIL..............................................
Shower, Gang.....................................................'.....
Sink, Bar, CommerciaL..,........,................................
Urinal, StalljWaIL.....................................................
Wash Basin/Lavatory, Single..................................
Water Ooset, Public Installation.............................
Water Ooset, Private...............................................
Miscellaneous:
2-
I
1.
7,
~
_11.
CREDIT CALCUU\.TION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
TOTAL FIXTURE UNITS
'U:>
I'
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
:1
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
]
Credit for Parcel or Land Only If Applicable -z,."2.--1 X $ 1.-1. "I~ to '!!
(Rate X Assessed Value)
Improvement (If after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = $ If) .;q
---
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL...................................,.................. 0.4
CommerciaL................................................... 0.9
I nd ustriaL............................. ........... ................ 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT