HomeMy WebLinkAboutPermit Building 1994-5-27
RESIDENTIAL
PERMIT APPLICATION
inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:_
ASSESSORS MAP'
LOT:
.::r9
.
SPRINGFIELD
BLOCK'
OWNER: 1rIA-~ ~ _/..A/~.
ADDRESS:' fr''9 'I <_. ~ ~ ~ S"-r.
CITY' -r'p.c/7-0
,
STATE: _ ....o..b_
DESCRI8EWORK' 11....:><:"7, ""i?3C:;/'))&-A~"""'~
'NEW -f-- REMODEL ADDITION DEMOLISH
OTHER
.
(~4DS3 \
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION: '14 t/>R,I/C;;-.,u>))IA./.$
.
PHONE:
_?#L;/-L ~
ZIP' "7.L1 ~,
, ,. -
CONST.
CONTRACTOR .
iI!
'if / '79-.-
-~~j7~7
ADDRESS q17:507
GENERAL: J.lAf'7JJif" EtJj,,:z::v~.. "((".tL~~. fl~~T"
,/" 'J .eIb~l>1 ae,
PLUMBING:...4.t16EAb> VI<LU&7 - 4'~ ..... LI/'71V
..-.....~,
MECHANICAl'
ELECTRICAL: ~)J,.n €L,~-I - n~ ,~~~
, 'M4-"bPoIIJ<
CONTRACTOR'S NAME
QUAD AREA: 3~
. OF BLDGS: I
OCCY GROUP: J\~+ M
L
. OF STORIES:
WATER HEATER:
EXPIRES
?~~/"FI'
9/"<v.J<;h
PHONE
9--,> ~ :(.,L:>
ho!?3-3?.v
,
,
, . , ':t;i "Jl'7~,r
J .
~ ~.r- .:)/3 ~
REQUIRED INSPECTIONS
d Rough Mechanical - Prior to
~ cover. .
..r71" Rough Electrical - Prior to
~ cover.
r-"Yr Electrical Service - Must be
~pproved to obtain permanent
electrical power.
D FIreplace - Prior to facing
materIals and framing Insp.
~Framlng - Prior to cover.
RJ(wall/Celllng Insulation - Prior to
~ cover.
~ryWall - Prior to taping.
D Wood Stove - After Installation,
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place,
D Fence - When completed.
~treet Trees - When 'all required
~rees are planted. .
r/~/~~
FLOOD PLAIN:
ZONING CODE: ~
. OF BDRMS: .3
SECONDARY HEAT: 0'
SQUARE FOOTAGE: \ \dl!~
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.
'- OFFICE USE -
LAND USE: III I
. OF UNITS: ,.
CONSTR. TYPE:-1L.A.J
"Ii?
HEAT SOURCE: \.l.JIT
y./
RANGE:
r<v( Final Plumbing - When all
I.L:>I, plumbing work Is complet,e,
I'<v'1' Final Electrical - When all
~eJectrlcal work Is complete.
rvf Final Mechanical - When all
~mechanical work is complete.
i""'>7r Final 8ullding - When all
~requlred InspectIons have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D810cklng and Set.Up - When all
blocking Is complete,
D Plumbing Connections - When
home has been connected to
water and sewer. .
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
, . '
. ~ . .
"
D T~mporary Electric
~Slte Inspection - To be made
J6J. ~fter excavation, b~L,e[.lO! to
settlng forms. 'SC7~)
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
K:7t' Foot'lng - After trenches are
~ excavated.
D Masonry - Steel location, bond
beams, grouting.
~Foundatlon - After forms are
~rected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
"f\::7r UnderfJoor ~lumDlns.Jj1yl_eChanicW
~ - Prior to fhsulauon or decking.
K7I Post and Beam. - Prior to floor
~ Insulation or decking.
K/r Floor Insulation - Prior to
7""\ decking,
~Sanitary Sewer - Prior to filling
~ trench. .
I"CIf Storm Sewer - Prior to filling
~ trench.
~ Water Line - Prior to filOng
~ trench. -
.. ; ~. ~
~ Rou.gh"PI~mblng - Prior!"
}2SJ...cover. !
D Final - After all required
Inspections are approved and
porches, sklrtln.g, decks, a'nd
venting have been Installed.
-,liJ
Lot sq. Itg. ~O
lot coverage 25"~,
Topography L 2~
Total helgh{~1' ')
BUILDlN'G. PERMIT
'113:\_ ~~~1b = lo3LlE14
~lP,~) . ~ ~;~oql.p
Lot faces
lot Type .
X. Interior
Corner
Panhandle
Cul-de-sac
ITEM
Main
Garage
Carport
Total Val ue
Building Permit Fee
/().'p + 17,4.s:
State Surcharge
.'" . "
Total Fee' I
'-'
'.
(A)
I P.L.
IN
Is
Iw
IE
HSE
/13
91-
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N' 2- '/rd) f'C
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge 4,f>O+ ~:o-o /Z.fJ 0
Total Charge (C) /72..$0
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
'1
Wood Stove/lnsertl Fireplace Unit
Dryer Vent
Mechanical PermIt
Issuance
State Surcharge
Total Permit
.5'0 7i 1> ~
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcha~
Sidewalk r"JU It
Curbcut ~ It
Demolition
State Surcharge
/~ ~ILJ Aatt/[T,
4-~O
5,&-0
:'1'.~
/ r"" 5".0
/ c;:J ," II
/,33
'2'7.g;J
rOn~
l~qn
~.S~
Setbacks
5
,
l- 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.
.1:,..... ':_.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
constructIon shail,.ln all respects, conform to the Ordinance
adopted by the -City of Springfield, Including the
Development Code, regulating the constr.uction and use of
buildings, and may be suspended or revoked' at any time
upon violation of an~o 'si lns of p.g!d ordinances.
. . aU 22J:D.BS"
Plan Check Fee.. .1 ~"
, .' , .. '@y.- 2 ~I '
Date Paid: I '.-...t- ' ;\ . 5' !I..
Receipt Number' ~~'-). '
Recelve~)l"L-" \I\D.. )
.. /?/~, '" .:..')/5-44
'Plans Reviewed By , ,Y ~7e -' I
'Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMM~NTS
I
",lJ.,tD(\(\L ~lnOq l'nlJr,w
\ ~ T: IU()(X') Ca/i-r)
~~O~: (Clf.r,(') -'
PAn-! .1
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 01 the Building Safety Division,
I further certify that only contractors and employees who
are In compllan~e with ORS 701.055 will be used on this
project,
I further agree to ensure that all required Inspectlons 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 pi s will remain
on the site at all times dU~ con ct
. X;gnatureJ,/ pt~
Date
VALIDATION: / c::::::::
REC~IPT NUMB..E9 (I..~~)
DATE PAID tC))J r .l.f1-
AMOUNT REC~ l. 3\ \ 5 ~\l()
RECEIVED 8yl'/) IJYl J
,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcal~::l---\ \ ' a')
(A, 8, C, 0, and E Combined)
715'1{)
3f~.y:J
'2 '7.e;Z
.~,__<i'?.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) . J J"1-~,.H
,
.
o !!.'!i!I!m~!~!!t!
.
Job No. CMO~31
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: t_t\(\ 4f\o f\ r1\t). PHONE:.J44 IrfJJa(o
ADDRESS: ffi~ 0D 52t\tl ~j<KSTATE:~ZIP q'14rV)
~lVUim. fJn'LlJLJ
LOCATION OF ~ROPOSED BUIt.qI~ ~E=n
Street Address if Known: ( ) ~ r1'-1
Platt Nam~ ~(\
lot Number:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back'>
A. Sinl!le Familv - Detached
.
l Single Family home
NO OF UNITS
B. Sinl!le 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
$4t1\p0
{
X $400 PER UNIT _=
,
X $370 PER UNIT =
, $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ALD ?J
$ W
$ 40a~
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)
~ ~~-t)~i0
Community Services filision
City of Springfield
,,'l / ~'"L crt
Date
JOB NO. '1-'fOS:J/
.
.
CITY OF SPRI NGFI ELO SYSTEMS DEVELOPMENT CIlARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NME OR COMPANY: JlIVe. L &-J.4u..
. / ~
LOCATION: 3:1.'19 C-~ j)~
DEVELOPMENT TYPE: t;,t: 1)
BUILDING SIZE:
LOT S!ZE
SQ. Ft.
1. STORM DRAINAG~
IMPERV IOUS SQ. FT. 2. / 't' ~
x 50.203 PER SQ. FT. 0 ~7. yv
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See R.everse)
/l
X 542.08 PER PFU
((' "? s 7.;;'
'- .-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I
X /,0/ X 5424.31
X X 5424.31
(' -F2~,~
~
s
X
X 5424.31
s
4. $ANITARY SEWER-MWMC
NO. OF PFU'S /7 x S15.125 PER PFU + SID MWMC ADM FEE S 2 ff.<.2S-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) S 3.2./0
TOTAl-MWMC SDC ~
<........! .-/
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S /~r9.$"o
5. ADMINISTRATIVE FEES
rf 93. 9~
'-- .-/
TOTAL SDC S 1'?'73. ~r
:F~XTURE UNIT,CALCU~TION TABLE: r~IJmt'N 01 New r;x1IJ.:ii X Ullit EqIJiv;llell1 = Fix1ule Units (NOTE:
For remodels. (".1Icul~le only Ihe. "ddi:ioll;i1 Ij'l\11l"') .
. I~UI.~GEn OF l':'J1T FIXTURE
FIXTURE TYPE NEW F1.XIunES EOUI"ALEIH UNITS
-;2..
~
1-
13athlub.......................... ............... .....................
Drinking FOulllailL..................... ...................
Floor Drain.................. ... ...... .... ,..... ....... ..... ......... ......
Interceptors For Grease/Oil/Solids/Etc.................
Interceplors For Sand/Auto Wash/Elc..................
Ulunclry Tub /Dotheswasher................... ................
DOlheswaliher - J Or More.....................................
MobOe Home Park Trap (1 Per TraOer)..................
Recep!or F9r RerrigeratorfWater Slalion/Elc........
Receplor For Commercial Sink/Dishwasher/Elc..
Shower, Singl e. Stall........... ..... ....... ................. .... .....
Shower, Gang...........................................................
Sink, Bar, Commercial...:.........................................
. Urinal, Slall{lVall.......................................................
Wash BasinjUlVatory, Single..................................
Water Dose!, Public Installalion.............................
Waler Closet, Privale...............................................
Miscellaneous:
/
J
G
2
6
G
1
3
2
t /Head
2
2
1
6
4
2.
./
.2.
:2.
2.
.2.
'if
TOT.'-.L FIXTURE UNITS
=
/'1'
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation dale in lable.
calculale cred~s separates.
$3.21
3_13
3.08
2.95
2.82
2.68
2.51
Year
Annexed
1986
19B7
1988
1939
1990
1991
1992
Rate per $1,000
Assessed Value
..
r
I
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
'1985
Rale per $ 1,000
Assessed Value
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
..
Credit for Parcel or Land Only If Applicable
Improvement [rt after annexation date)
3.2/ X $ ~.~
(Rale X Assessed Value)
X $
(Rale X Assessed Value)
CREDIT TOTAL
=
3.2, /0
= ..----
= $ 3,.?,/O
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential............................. ............. .............. 0.4
CommerciaL................................................... 0.9
IndustriaL....... .............. ....... ...... ...................... 0.45
G overnmenlal...... ........... ........ ........ .... .............. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
.
The following project as submitted has the fallowing
zoning, and does nol require specific land use
225 FIFTH STREET approval. }
SPRINGFIELD, OREGON 97477 Zonino t..--D~
~~~~~~IO~2~~~~T: 7t~i03769 ~dlyJ-q4
Au;horized Signatur. '1'1.' COHPLETE FEE SCHEDULE BELOll
1, .LO!=ATION OF TN!;TALLATW~ .
~.Y'0 r:\~ci~ Y\ .D'n~""A;" A,
LEGAL DESCRIPTION
Lt'~OB DESCRIPTION
w RIiI"',"'RAI'".....G
-.-- ...
\ \d\2>t1
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 ~\\'F (\ \=IFcrk>IL
Address I d C,I i J -:2, o:! 5-\.
City l'Y\ ~t?,\."-,
Phone 41":;-JI~9
Supervisor License Number IOoIDS
Expiration Date
\ 0 -, -q",
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Constr Contr. Number f.s,?,i4S
Expiration Date q-'-i-CJ'-I
Signatu~e of S~ervising Electrician
///JI7.~_ ~_AA~
,~
Owners Name ,I,/~<?J').IIl",j 6--v'1. ~1I'c..
. " /
Address rr99 ~. .~.;l. ~ ~
Ci ty 5"r>.FL-,... Phone 744 -t.9~
.
OllNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
DATE~--------~~~ry~~-------~----
RECEIPT t: l ~ . 1ft'{ )~
RECEIVED BY: ~ 1'\\ [V lo _ ~ - ,
ELE~CAL PERMIT ~LICATION ,
City Job Number ~1'D~ 31
New Residential-Single or
Multi-Family per dwelling
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
Items
~
~
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
unit.
Cost Sum
$ 85.00 ~
$ 15.00 3D
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see nB"
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
\\~~
5.'l'5.j-3~5
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