HomeMy WebLinkAboutPermit Building 1994-5-27
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. .
RESIDENTIAL
PER'MIT APPLICATION
,
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: _.
ASSESSORS MAP'
LOT' :5f("
OWNER:
IIA Y7'l ;",v
.
'F('.;'9
EA/T. :2: -V"t'",
~_ ~!.l. -..I sr:
ADDR~"'"
CITY'
.,;-, ~L'))
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('1."..,>>..;-7".
DESCRIBE WORK'
NEW '/... REMODEL
~.
BLOCK'
STATE:"_..?J~ .
~ 1;: ~ I 2J Ji: .A ./,..-13
ADDITION
DEMOLISH
OTHER
~ '- .,..
~i
..- )
,
JOB NUMBER
""7" ~
'~4()~~ _
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION: ~~6../ t-; oIP-".-I/<;;
PHONE:
7,#-f/-{.7~
ZIP' '77'-~?
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR #
GENERAL: ;/,A~L>~_ (.0/ .,.wI, 3)~',.Q):"),~";..., ~?gr
PLUMBING: EM ~ LJI-,. J/A/lA.. - S#.o SO-.-""~ S"P.I':b. iltr" '7 I :7
/
MECHANICA' .
ELECTRICAL: ~ I 'pl.8,.f - /2. ~ LV .lIP s"T _ At/>> 1'4 "
EXPIRES
.,h~/<;~
91/~/9.u
PHONE
1'43 -Lc.~:>
t.?3 ..O/~
,,-.L ~ 74r "1,4.1.<;"(
~ >.r- .21.7,7
- OFFICE USE -
QUAD AREA: s'\<?J0 ./ LAND USE: \ \ \ \ FLOOD PLAIN:
# OF 8LDGS: \ # OF UNITS' " ZONING CODE: / Lf)(2/
OCCY GROUP: ~8-\N\ CONSTR. TYPE: VtJ # OF BDRMS: ~
# OF STORIES: ~ HEAT SOURCE: WH 1. SECONDARY HEAT: g
WATER HEATER' 'U RANGE: y, SQUARE FOOTAGE: \ r:\?J)
To request an Inspectton, you must call 726.3769. This Is a 24 hour recordIng. Alllnspectlons 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 to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
~ Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams; grouting.
~Foundatlon - After forms are
~~rected but prior to concrete
placeme~t.
o Underground Plumbing - Prior
to filling trench.
-r7f underfloot"Piumbinj[J:Mechanlc!i>
25::J- _ Prior ~-suration ~'r 'oeCKlng.
~Post and Beam - Prior to floor
~Insulatlon or decking.
f"'\::A Floor Insulation - Prior to
~ecklng,
rvr Sanitary Sewer - Prior to filling
~ trench.
f\:7r Storm Sewer - Prior to filling
~rench. .
roo< Water Line - Prior to filling
~rench.
~ough Plumbing - Prior to
~over.
L
~
REQUIRED INSPECTIONS
r\:?I"" Rough Mechanical - Prior to
~cover. '.
t""f\::/r Rough Electrical - Prior to
~cover.
1C71' Electrical Service - Must be
~approved to obtain permanent
electrical power.. .
o Fireplace - PrIor to facing
materials and framing Insp. .
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation ~ Prior to
~over.
~DryWall - Prior to tapl.ng,
o Wood Stove - After l~starrat'lon.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
o SIdewalk & Driveway - After
excavation Is complete, forms
and 5:ub-base material In place.
o Fence - When completed.
~treet Trees - When -all required
~ees are planted.. .
.0. Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical - When all
J6l electrical work is complete.
I'\7f Final Mechanical - When all
~ mechanical work Is complete.
~ Final Building - When all
k:::S...requlred 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, skirting, decks, and
ventlng have been Installed.
..
- ~ ,'.....
\
l" _HE PROPOSED WORK' IN THE
'Lot Type Setbacks
I P.L I I I I HISTORICAL DISTRICT, OR ON .
Interior HSE GAR ACC
Z IN ;'J I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Panhandle Is 34- I and approved by the Historical
Iw .1 Coordinator prior to permit Issuance.
Cul-de-sac -;l:r ~. ~
IE S 5 I APPROVED:
,..
~-
- ,
~
Lot sq, ftg, ~
Lot coverage ~
Topography L. 2po
Total height ti
( en"=!:-')
, .
BUILDING PERMIT
SQ, FT.
~Jf
Lot faces
X $fSQ. FT, ~ I ~ALU~
aO-~{) L02.\'-ti .
\~ .\0 t::)(
I
ITEM
Main
Garage
Carport
\.o~ ,5?'A
Building Permit Fee ~~ OC
(/.:9,20'1'/7,6-0 ~7t-&P
3(b.~
SYSTEMS DEVELOPMENT CHARGE (SDC)
$/'/ s8'. .92.,
Total Val ue
'State Surcharge
Total.Fee.
. (f')'.
. '.
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' "2
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
/ (LX) 6<l
Plumbing Permit
State Surcharge
4,$4 +-8,00
(C)
/2.S0
/77. ~ t)
Total Charge
MECHANICAL PERMIT
Furnace
4So
9,&0
Exhaust Hood
Vent Fan
N'
.s
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
3. c:ro
Mechanical Permit
/~ ,sz,
/D.e~
1..5 J
;:z. 7, 'ib:J
",
Issuance
State Surcharge
Total Permit
.~:> +,!;"o
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk \ c:x:J ft
Curbcut .d.i.c2. ft
Demolition
c9.5~
I.~~
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcal~t)I&16
(A, B, C, 0, and E Combined)
~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
"
This permit Is granted on the express condition that the saId
constr~ctlon shall, In all respects, co~f.orm' to t'he 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 tlme
upon violation of a'l\~OVISiO)bOf said ordinances.
Plan Check Fee: r,j _ \ 0
Date Paid: q - ~, ,44.
Receipt Number:-J,Jj, -.:\q{~')
Received By: '6\~
'''~~ !:""h.V""7'
.~lanS-Reviewed By t!f/~} 7(
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
~ ~1tJ(l d' t _011 Q u......Yl QLLJ
\ ~+ T: _ \O,OCO LU\t ')
, d\l\ MlLJJO t 0) ~ \q l t20
Ab'A7tJa5.\ ,ff"A-IPt (/~ 1. J
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 certlfy
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 Salety 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 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 PlanSZ11I r In
, on the site at all t es durln/?truc~ , _
/Cgnature (~. AA~ ,'7)
Date
VALIDATION: 111 TV'') n
RECEIPT NUMBER ~ /
DATE PAIl" <-5 -c<:1').Lf7 ~ ,
AMOUNT RECf.W.ei :'.l.{)~ ,t-;5
RECEIVED BX:'XlLn _ ) ,
""""
,
.
JOB NO. '1-16S3<
...
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI/^RGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NANE OR COI1PANY: J/,u,L f-...7.', ~,
. . / '
LOCATION: ~:25"5"" t-~ j)./?
DEVELOPNENT TYPE: 5PR
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $424.31
~"f~li',~
~
,$
S
I
X /,0 I X $424.31
X X $424.31
4. SANITARY SEWER-MWMC
NO. OF PFU'S IX x S15.125 PER PFU + SID MWMC ADM FEE S 27.<,zs-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) s 3.:2,/6
TOTAL-MWMe SDe ~
'- .-/
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S /8"s,~~
5. ADMINISTRATIVE FEES
8ASEZ~A(;;a,El X.OS
./ ill' .1uhliE:rb
/' SD~oordinator
~?3,2?)
'- ...-/
TOTAL SDe S / '?~-8, '? 2
FIXTURE UNIT,CALCU~ION TABLE: Nlllllt'N 01 Ncw fj'1. Unil Equi\':llcllt = Fi\1Ule Units (NOIE:
For remodels, c.,lcul!Jte only Ihe""ddi;i"n:llli\lIl1l"')
I-IUI.\GEII OF l':,lrrIXIURE
FIXTURE n'PE NEW F1X'lUf1ES EOL'I\'i,I.EIH U:"TS
Oalhlub.............. ..... ..................... .... ................
Drinking Founlain.......................... ..........................
Floor Drain.... ........................... \................................
Interceptors For Grease/Oil/SoJids/EIC.................
Interceptors For Sand/Auto Wash/Elc..................
Laundry Tub/Oolheswasher...................................
OOlheswa~~er . 3 Or More.....................................
Mobne Hdme Park Trap (1 Per Trailer)..................
Recep)or F9r Refrigerator/Waler Station/Etc........
Receptor For Commercial Sink/Dishwasher/Elc..
Shower, Single.Stall.................................................
Shower, Gang...........................................................
Sink, Bar, CommerciaL....................................:......
. Urinal, Slall!\Vall.......................................................
Wash Basin/Lavatory, Single..................................
Water Oosel, Public Installation.............................
Water Ooset, Private...............................................
Miscellaneous:
.2
.,
1-
..
.\
J
3
G
2
G
6
1
3
2
I/Head
2
2
1
6
4
2.
:z
z
~
2
8'
TOT,'.L FIXTURE UNITS
=
If"
CREDIT CALCULATION TABLE:
Flate crOOhs;:s.
1979 or before
1980
1981
1982
1983
1984
'1985
Based on assessed value. If improvements occurred after annexation date in lable,
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
L
$3.21
3.13
3.06
2.95
2.B2
2.66
2.51
1986
19B7
1968
1989
1990
1991
1992
S 2.24
1.93
1.57
1.18
0.79
0.44
0.28
Credit for Parcel or Land Only If Applicable
3..21 X $ /", 0'lJ"V
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
=
:?.2.r'O
Improvement (rt after annexation date)
=
....--
= $ J..2JCJ
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R esidenlial........................... .................. ........... 0.4
Commercial...................................................... 0.9
Industrial.................... ........................ ............... 0.45
Governmental................................................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
01\ Enb. PHONE: f)44-I~w(O
B q bn ~'Lrd ~\ ~ STATE:(QLIP Q~400
(;ClJ\r\t Xl \J xi ~ ~ .J
Tax Lot Numbe~ fkn Gr\ n r\.u16
) -
.
fi 1!.'!ill.!!!!!!~.!!!!
NAME: t
ADDRESS:
LOCATION OF IilROPOSED BUILDING SITE:
. O"'r'-'r-
Street Address If Known: I J C'"lIl \, ,
Plan Name:
..
Job No, ~4{\~?JL
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back'>
A. Simile Familv - Detached
-L Single Family home
NO OF UNITS l
B. Simile Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
$ 4{)f)~
X $400 PER UNIT _=
,
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$4\)[)PO
$ 0
$400~
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)
~~;~;~
City of Springfield
fu{)? lo/f
Date
------
~.
.
SPRINGFIELD
~.~~!~~~"~~d dO~S' not require specific land uso
225 FIFTH STREET Cppr(;/D'~cnina L.'[)(2.. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ")-cn...tjU rrAnc::..'1/'1
INSPECTION REQUEST: 726D37('~ .'. \. '^ ^ City Job Number ~ ,LY L-
OFFICE: ~6-3759~..... . H'~c:):ledf.ll'li>\Ur. I" r v ' .
. ~~ Cl/~L/~. 3. COMPLETE FEE SCHEDULE BELOV
1, LOCATI OF INS ALLATION
1,,-1 :< <7 - W.A+;j)~ ~#h~ A. New Residential-Single or
Multi~Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
JOB DESCRIPTION II c:..fy......r5
$K-.J.fJ ~.<;'?'j)>>"'j~ ~
,
Permits are non-traftsferable 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 t\\\SI'\ ~\td:Rl'r,
Address lci. SId ~~ ~-I-.
City_M;:.-.\I?/<.<'"
Phone LJ15-::2IM-
Supervisor Licen;;e Number I Ol'Xo:)
Expiration Date
1 n-I-q.;-
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Constr Contr. Number (o~l'-l~
Expiration Date q -1./- Clt.j
.
Signature of Supervising Electrician
, ~_____ ~,.,... A~/
Owners Namepf"n~.I\ l5"""/~;:Z::-~
Address 1rq-q Ss::>. 3::1-ud1%
City .<~"}-.,
Phone )~L.I-~94;;
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
------------ ,,-
DATE: ....c:::s.o)-,
RECEIPT I: 'Ff\b'\-~
RECEIVED BY: ~ J( A.
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
-'-
d
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
Cost Sum
$ 85.00 f!n
$ 15.00 0()
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see "8" above
New, 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 with Service
or Feeder Permit
E,
5,.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
1~~T_345
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