HomeMy WebLinkAboutPermit Building 1992-5-26
LOCATION OF PROPOSED WORK: ?l~
, Bo~ ()L.j 7'-4
'-.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT:
10
OWNER'
'7O\)^,o~
W1l1\E.b~JZ.€. T.
ADDRESS' ?.n"'?-' ,.., I .'1 "^ \lIe.....
CITY' ~ r.JbF I e-.o
.
SPRINGFIELD
, k.~LW\ \A.
L."-'
BLOCK'
ST.
STATF'
o~.
OESCRIBE WORK' ?1-re.WD~ ... t:a-v.srevcnoJ0 -:fOi2...
NEW)C REMODEL ADDITION DEMOLISH
.
0) -;} 07 ~~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' ('"JZ.qOO
SUBDIVISION: ~-:lI.J ~
PHONF.' /44 - 2..0)'7~
ZIP:
q'l4I1
W\I"tN V ~""'-"'L) ta.eb fulME:.
OTHER v1-\.I-I. PU'lLGtt.\6\Jr.
CONST.
CONTRACTOR'S NAME ADDRESS tJ CONTRACTOR'
GENERAL:.:kfi'W-tlllfZt'J":oI\J &A~. ~~y ~ 6b441
PLUMBING:~Oe>J .1JAli.J~"J ~T. . ~~'t ;';~L '2.0' Z3c.. ?5.
MECHANICAl'
ELECTRICAL: ~
~.
P/"h W.
""U6eve::
2-4 ;",
a74d?
EXPIRES PHONE
&; /7 Jq~ ~-1JI77bZ-
11I~1C)2. ux>'-I"1l-,Z-
20- 2Po c.
I zJqz.
3l/<I-lsoo
- OFFICE USE -
QUAD AREA: 2., R. ~ c.... LAND USE: 1JJ2f) FLOOD PLAIN:
# OF BLDGS: I # OF UNITS: \. J ZONING CODE: <ll )\ C-..-/
OCCY GROUP' 1;) .~ CONSTR. TYPE: 'V(V. # OF BDRMS' :,
. OF STORIES:_ I HEAT SOURCE: ~'7.. SECONDARY HEAT:
WATER HEATER: '7 RANGF' '7 SQUARE FOOTAGE: 1:5-' '2-
To request an inspection, you must call 726-3769. Tills is a 24 hour recording. ^lIln~pl1ctions requested before 1;00 3.'''''. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
00 Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
lZl Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
I"'Vl Sanitary Sewer - Prior to filling
~ trench.
rV"l Storm Sewer - Prior to filling
L...A-J trench.
[]] Water Lino - Prior to filling
trench.
D Rough Plumbil,lg - Prior to
cover. .
REQUIRED INSPECTIONS
"
o Rough Mechanical~ P!ior 'to
cove~ '
IV1 Rough Electrical - Prior to
Lp...J cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - Atter Installation.
. '
o Insert - After fireplace approval
d Installation of unll. -
urbcut & Approach":' After
forms are erected. but prior to
lacement of c:~n~rcte..
idewalk & Driveway - After
excavation, is complete, forms
and sub-base malerial in place.
D Fence - When completed.
~ '-. l :"-... ....\:.
D Street Trees - When all required
trees are planted:' . -. .
D Final Plumbing - When all
plumbing work is complcl.e.
l2?J Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is, complete.
[K] Final Building - When all
required inspections have been
approved and building is
compieted.
DOther
MOBILE HOME INSPECTIONS
~BIOCking and Set.Up - When all
blocking is complete:
rYl Plumbing Connections - When
~ home has been connected to
water and sewer...
~Eleclrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
126' Final - After all required
inspectlons are approved and
porches, skirting, decks, and
venting have been installed.
Lot Type. ./ .
Lot facos -&:L Setbacks 4It THE PROPOSED WORK IN THE
Lot sq, ltg, +-- Interior I P.L. HSE GAR I ACC I ~ISTORICAL DISTRtCT, OR ON
IN ~ I I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
5 .-, el_ and approved by the Historical
Topography Panhandle Coordinator prior to permit issuance.
Total height Cul-de-sac W Mt/fi
IE V' : I APPROVED:
BUILDING PERMIT
ITEM SO, FT,
Main .~Ll J-J- :
Garalle ';}4~;).11 5'"2(,,_
X $/50. FT.
VALUE
1Y. II)
3S.CQQ
_~JA.I ~
Cmpoll
~~~
1-1.0(')0
Q.J ') I (,()
-9'~. s-.::>
-,-~~~
/b3. '1"3
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
, fl., 't?
. (B) fl":>'2.-
Total Value
Building Permit Fec
Slate Sllrchar~_lc...'
Tolar Fcc
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtules
Rcsidcnlial Balh(s)
N'
Sanitary Sewer
FT. _-:2S
FT, "7 e;-
FT. '2<""
~
'lS~~- .-
(3/]5~':' .r--
(C) f)815~~ ~"-
Water
Storm Sewer
Mobile Horne
Plumbing Permit
Stale SUfchar{l(J
Tolal Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
Wood Stove/lnsertl Fireplace Unit
Dryer Vent
Mechanical Pennit
Issuance'
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
- ~..
_107> .
-.--2C>. ~
--~Q'
"23. $e::>
_L '3.60
Mobile Horne
Stale Issuance
Stale Surchar{le
Sidewalk _~~ It
Curbcul 7.~ It
Demolition
State Surchmu~
'\) g r /V'VJ *"zA) ~ p u,)
...18.n-:....,
:f.~ -~
~e;l.Ob
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition (hat the said
construclion shall, in all respects, conform 10 the Ordinance
adoptc9 by Ihe City of Springfield, including tile
Development Code, reoulating the construction an<lusc 01
build/nus, <1n(1 rn;Jy be suspended or revoked.ill any lillH)
upon violatio.n 01 <lny provisions of said OIuinnncc5.
Plan Clleck Fee: ( .. Lj . () 0
Date Paid:
Receipt Number'
Received By: c::
/'7 ,~...;s,;..,
/ .(' ~~_ ;.;;;r---- _-'/
IPWlI'levicwed 61' ./
':) --::? / .q? .::z..
Datc
Systems Development Charge is due on all undeveloped
properties within the Cily limits which are being improved.
ADDITIONAL COMMENTS
.ldh"JK -
A~-r
CLv, /r, <::. ; dL
\~. q;:y.,
\ C1iCl
~^^nPL..
I By signature, I stale 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 Sprlngfield, and the Laws
of the State of Oregon pertaining to the wOIk 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 Wll0
are in compliance with ORS 701.055 will be used on 0115
project.
I furlher agree 10 ensure Ihat all required inspections arc
requested at the proper lime, that each address is readable
from the slreet, Ihal the permit card is located al the fronl
of Ihe property, and the approved set of plan:; will remain
on lhe site at all times during construction.
SignaIUre_~~ J. 14
Dalp
$? / Ie>! cyz..
VALIDATION: A 1).11 &;::...
RECEIPT NUMBER -r "J
DATE PAID .r:::., Olio .Cf~
AMOUNT REdiilltbh " ;{31'f'-8.::LL
RECEIVED ~~ ./
<.-.-'" '.
.
DEVELOPMENT SERVICES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD. OR 97477
(503) 726-3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield Development Code, I understand and agree
that with the approval of the attached peyj...tMn:5J;..hl1 following
manufac tured homes will be placed a t.......' I ( , J m \ t'\ )
Springfield, Oregon, City Job Number L{ ~(_ I -. --
'X _
Type I Manufactured Home. A multi-sectional (double wide or wider)
unit with an enclosed floor area of not less than 1,000 square feet,
that has a nominal roof pitch of 3 feet in height for each 12 feet in
width, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have an exterior thermal envelope
meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family
dwellings constructed under the State Specialty Codes.
-
-
Type II Manufactured Home. A unit of not less than 12 feet in width
with an enclosed floor area of not less than 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
- IJater line connection
- Street tree standards
- Sanitary sewer connection
- Electrical connection
- Minimum requirements for permanent steps
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the perimeter with stone, brick or other masonry materials,
and wi,th no more than 12 inches of the enclosing ma terial exposed above grade.
4 j AvulJ
Signature .
~/Z.6 /C)L
Date
CITY OF
JOB 110. 91-0/'?"2-
SJtINGFIELO SYSTEMS OEVELOPM~ CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.,-
NN1EOR COI'lPANY: t-I\A:\Z;&M?;e.i '?OlltJDS
lOCATION: S'1B'4 ,KI'I-LMI.... <LAtJ~
,<1.0'1-0'-+1'-1- - (j'Z..GlOC
DEVELOP~lENT TYPE: \"-\)E- - ,,\e.w MA/o.lUF-""--"'ll~l> {....k,l.i\,,=-
H-DM'" &...~. p.w .
BUILDING SIZE: '71."-"1-1, 1.",.,."'/-1.. ,Il,.,CZA- lOT SIZE
SQ. Ft.
II
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. 2<:'-''1.. X $0.186 PER SQ. FT. b'-l-/5?~
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S I B X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
Is "'''i~ 9~ I
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X l. DOS X 5388.61
X' X 5388.61
Is ?q 0 ~
$
X X' 5388.61 $
(See Attachment C To Determine Trip Rates)
SUBTOTAl'(ADD ITEMS 1,2, & 3) S I'S"-z.~
4. ADMINISTRATIVE FEES
'BASE CHARGE (SUBTOTAl ABOVE) X ~05
Is Ii 1+ I
TOTAL-CITY socsl {.,,+o :!.
5. SANITARY SEWER-MWMC
NO. OF PFU'S '18
x $13.25 PER PFU + $!OMWHC ADMIN. FEE S 2&.{6<;c
(Use PFU Total From Item 2 Above)
\G"_b~L..J.:.
. -a Kip Burdick
SOC Coordinator
S /,9 jcj'l-
's ?'1o.z
TOTAL -Mlo/MC SDC Is 1. I' of].. I
TOTAL SOC S \<6SZ'l-S
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCULA. N TABLE: r,umber 01 New Fi'1ures x,ai; EQu~'alenl = F;'1ure Un;;s (I~OTE:
For remodels. calculate only the NET 2ddi';01l21 li'1ure,) , ·
NUMBEf' OF UNIT FIXTURE
fiXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
-1-
2
1
2
3
G
2
5
5
1
3
2
l/Head
2
2
1
6
4
Bathtub.................................................,............,.......
Drinking Fountain..:...:................................,.............
Roor Drain....... ....:........:.......................... ......... ........
Interceptors For Grease/Qi1jSolids/Etc.................
Interceptors For'Sand/Auto Wash/Etc..........:.......
Laundry Tub/Qotheswasher..................................,
Qotheswasher - 3 Or More.....................................
Mobne Home Park Trap (1 Per Traner)..................
Receptor For RefrigeratorjWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc.:
Shower. Single Stall..................................................
Shower. Gang.....'..:..................................................
Sink. Bar, COmmerciaL......................_..................
Urinal. StalljWalL......_.....................-.........._...........
Wash Basinflavatory, Single._..___......_...............
Water Qosel. Public Installation.........-..................
Water Qosel. Private_......................---.-..
Miscellaneous:.
\
1--
1-
TOTAL FlXfURE UNITS
+
'1-
'2-
z.
B
..-IPJ
Based on ,assess'ld value. If .Improvements occurred after annexation date in ,table,
CREDIT CALCULATION TABLE:
calculate credits separates.
I
I
Year
Annexed
1985
1986
1987
1988
1989
1990
Rate per $1.000
Assessed Value
$2.66
2.64
2.53
2.41
2.19
2.04
Year
Annexed
I,
1979 or before
1980
1981
1982
1983
1984'
'?/O.2.
'l,,,-,,- X5\~'''\'''
(Rate X Assessed Value)
X 5
(Rate X Assessed Value)
CREDIT TOTAL
= s :z."o~
Credit for Parcel or Land Only Ii Applicable
Improvement (d after annexation date) ,
Rate per 51.000,
Assessed Value
Sl.69
1.35
1.15
0.92
0.59
0.23
-
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resid enti2.L.. ........................... ......... ..........-.... 0.4
COmmerci:=I....................-................................ 0.9
I nd uS1ria1....... ................................. ........ ........... 0.45
Government.2I.,................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
SPIIINGFIl:.LO
" t4);
225 FIITH STREET Tho. foliowing proj3<,1 os "ub",a;,.!! ha, the !El:BeutICAL P'ERHIT APPLICATION ~
lOnlng, and dCC3 not rV<I'<) s"e";i'c '-nd
SPRINGFIELD, OREGON 974T~pproval. ~ ...., ,., "sa '
INSPECTION REQUEST: 726-3769 Z '. (f\ Ci ty Job Number q A TJ7 <3
Olllno \ 1 )
OFFICE: 726-3759 5 (fl.-fA?
Oota '- . L-V...r-l(....3.
1. ,l\~~~~~~etN".
-. .
tcg~m~lf n~Cf C()
~::~~::::-~b: :.d .",,,
if work is not starte~~hin 180 days
of issuance or if work is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Heritaoe Elect
Address 855 West 24th Avenue
City
Euoene
Phone 344-1500
/
Supervisor License Number 9455
Expiration Date
10/1/
COMPLETE FEE SCHEDULE BELOV
~l,;w Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
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
fA $ 40.00 8l)
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number 63137,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
~ tV. ~~~ r!~~)-S D Branch Circuits
Owners N~~ f'\\.. .\{)~HI' _14-\ .
^Of"r::J /\1 -, New, Alteration or Extension Per Panel
Addres!Q( I,} (\.)\ 11 cf:i"
~ rlJ - (\, One Circui t
Ci ty " 1 l.Y ~ Phone ri Each Addi tional
I Circuit or with Service/
OVNER iNSTALLATION or Feeder Permit --L $
Expiration Date
12/27/
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------71'-----tt-:T------
DATE: _ _ S-c;7-\.f7' q 'crA.L::)....:t _
RECEIPT If: "/ - "r/TD-
RECEIVED BY: ,Cil/.I R ~
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
E.
5.
SUBTOTAL OF ABOVE
,5% State Surcharge
TOTAL
volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
$ 35.00
2: 00 d
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
BJ.~
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