HomeMy WebLinkAboutPermit Mechanical 1998-9-29
,
SQP-Ol-9B OB'~
RESIDENTIAL
PERMIT APPLICATION
Il'laP9cUons: 726-3769
Ollie.: '726.3759
.-
'.. .
, .
LOCATION OF PROPOSED WORK: _.!L~-?.9 -1I..1)1/Y
ASSESSORS MAP:...J5i.JI A. 0..'5 Z-I _.-__
LM.
BLOCK: .
OWNER:__i2e.nl~p fA Jash,'njil1o
ADDRESS' __..'1~ I-InILy gf: , ..
CITY. ;"in....., 'n, ~ ..! f rJ . _ STATE' i'JR
DESCRIBE WORK:.... Jaffa II.....;?'\ ;;-;-'/l... /1 /{'~
NEW -X- REMODEl. _. ADDITION _ DEMOl.ISH __.
.
P.Oz
q'i W~~
JOO NU""'RM./<t&
225 Flllh S"~ClI
Sprlr,gll..-lrJ, Oregon 97477
TAX LOT:
o U!:JK>
SUOt)IVISION: _.
PHDNE.J:..lf(- 7'1.&-/</&..
ZIP:
'q7l/7~~
OHI~~___._..
CONST.
CONTRACTOR'S NAM:a.oLVI'B ctYMiL,u:.. HEATINt'N.Q~'( C.
GENERAL: -.. JU;fU \NOLING .. ,.- ".. ..
PLU~Nt:1.
( ~lCHANI~ 2305 r~bLJ'.. Ru: ,:)~ 1/(;"'__._ fs'lityF CR.~-=-,
ELECTRICAL: ~ V".II'/lSU'" ,D3-:35L-DK'/9
o -'Z
o ~ 0 - OUAO AREA:..,..
=>"<00_0)>
3 Q> 0 )> :3; ~ ~ OF tlLCGS:
",=:' :D!;l:Em".
en ::J ~ (C e: ... Z~c:v GIlOup;
_....cccU1Oc:-l,
\,J - - N:J CD OF SIDRIE9:
~Q~36_(J)n .
- - 0 P> 0 m Pl ~TER HEATl:R:
~;:rCD'<""":Jc.."
_.CD::SOI_OV
en 0 - C" 8: CD '0 avo rcquCSI an Inape-OUon, you mU:H COlli 726.3715!). thIs Is 0 24 hour rer.onJlng, Alllnspc:!,:llo/lS reqUC:llod bclor~ ";00 Ll,m.
~ = ~ 6i -. ~ m ranad~ Iho S.ClrtlO workIng dl'Y. InspeCllon:l rOl1u....t~a nfter 7:00 8.m. will bt' m...tI", tho fOllowlnll ......ork day.
CD'~":""::'O"""ClO .
:3 '0 ~:i ;:; s: 5' =- REQUIRED INSPECTIONS
w ::l St..g a ~ '< ~o Tompo,nry I!lllctrlc 0 Rough Mechllnlcal _ PrlC)r to
"., C CD -. C < t:c.>Yer.
--:::!:"CDtO~CD~
f}>=-en c: CD
I\) -< =r =r CD .cD su. Inepocllon _ To ba mlll:lo
c.> Z CD 2. 0 en CD c: "rt., e,l(cavlltlon. bUI prior 10
t CD - )> Q;l to::;;' ..,lIIng '()1'lns.
;-g..mffi:DCi) 0 m
::::!:l"C CO en :J ~ Undoralab Plult1blnglEloclrlclIlI
o ::r 2 0'1 CD 0 MechanIcal _ Prior 10 cover.
DlO;;:I\)_ c:
-::l..... I -
c5" CD en 8 0' - C[] Footing - Alter trenches llre
::l C" ...... ;:1 OXCGv.lIlad.
'<.::T
- OFF"CE USE _
LAND USE: _..
/I OF UNITS:
CONSTn, TVPE:
HEAY SOURCE: _
RANQF.; __. .
RxrlllES ...
~9c;
rHON~
FLOOD PLAIN:
ZONING CODE: _....
" Of OORM~:
SECONDARY HeAT: _ _
SCUM-iF. FOOTAGE: ..__,_.
D Meunry - Sleel IOClltlon, bend
beam., grouting.
o piI'oundat'Dn - AflQr forms ant
erecled but prior 10 concrele
placamonl.
:t> C'l )> ...... :z o Undlrground Plumbh1g - Prior
~ 0 C :J:
~ s: ...... en 0 10 (1Il1ng lrench.
s: :J: " -f
.", 0 (') o Underllool PlumblnO/Mer:hanlcul
C-, IT! ::0 m - Prior 10 InsulatiOn or deck.lng.
-. ::0
::J <- hi I'T1
'" C'l s:
< m =i o Poe' and Seam - Prior to fI"or
CJ 0 InlJultltlon or dDcklng.
'0 0 C fJ)
." ::0 Z :J: o Floor InsulaUon - Prior 10
:0 0 :I>
<5 en r- tJOl;ldng.
m r-
:::l :I> ::0 m o San1tM)' S.wcr - Prior 10 flJllnq
~ ~ X Ireneh, .
"
Z en :D D SIDrrn S._r - Prim :0 IiIU"!l
0
0 " m hunch,
Z m "ii
m ::0 o Wale' Llno - Prior 10 fIIllll!'J .
0 s: ~ trench.
es =i m
en ~ o Rough Plumbing - Prior lel
::0 cover,
2:
0 ::0
...... ^
o Rough Elcctrlc.l - Prior 10
cover.
o Eloctrica' S....lc. - MU:l1 Dc
approvld to Clbt.oin pe,man"nt
Oloclrloal poWl::r.
o Fhoploco - Prior to facing
malerlala ""1'1CI 'ramlng lnsp.
o FraminG - PriOr t~ c.:~vcr.
o W~IICcnrno '"cUI.tlcn - Prior 10
c.:ovcr.
o OrywnU - PT~Qr 10 taping.
o Wood Stovo - After In~IIlUalltln,
o Inaoll - Allor rr'II~IMCe ApprOVe'
ana Inslallllllol1 01 unit,
D Curbcul & Approach - After
f",'mll ere erucled bul prl"" In
pl3CtllTlOllt of r:oncrele
D Side-walk & Otlvow:aV - Aller
~xcavlltlon 18 complete. fOIlIl:>
and aub'~a'lu milled,,! II'I ploco
o Faneo - Whon r.o"1(1lelr,(1.
o ~lr..t rr... - Whon ell rCtQulrltd
trees aro planlod.
will hp.
o FInal. PlumbinG - Wilen .!Ill
plulJlbing work Is ~omplelc.
D rlrlo.l Eh:glrle..I._ WnCrl all
eleclrlclIr wurk IS complcl".
~"I Mcch.3nlo.1 - When 0.1/
HlIlr:hanIcal wo,k 1:- r.ornptete.
o Final buildIng - WhOll all
required InGpec.:lIons hQve blttm
IBpprOv(ld IIrtd bulldll'Q Is
e()fnpl~ltfd.
OOth",.
MOBILE HOME INSPECTIONS
o BlockIng IInd Set.Up - Whe" ArI
- l)rockln~ Is COrnplCle.
I:::J Plumbing ConnQctlon. - When
. h()me 110l~ boon eonnaclccr 10
w.IIler :'Inti SOwur.
o EI~ctrlc.' Connection - 'Nhen
blocklo!J. ""I.up. 3nd pJul'I'btno
In1'.pl!r.lll)nO h;.wC! bllf'" A...rHI)Vn(1
ant.! 1I11t tlornl! ill> conncctlld 10
lIu'! ,;enllt:e panel.
O Fin...1 - Aft!}r all rcqLtI(~"
lnepcclIOr'l:lllro appmv~ lInd
porches, Skirting. doe"", oIIn<l
vOntlntl hn",,, been 1"IOI01/lotJ..
, .
S.p-Ol-9a
oa,.
,.
''-~ . '.1
LoI fllt.os
Lot "ype
lol sq, fig.
Lot cavarao"
Imerlof
Corner
TOpoor.:aphy
TOlal htlght
Panh:!ndro
Cul'do'~::lC
BUILDING PERMIT
ITEM sa. F'l. )( s/sa. FT.
Moln
GIU.lI.l.lU
C<i'I1(,lrl
101.:11 Vo1rUQ
OulhJing Pe"nil Foa
Sl31e SurcharQc
'Iul.l Fuv
(A)
....il:\.;;:..,:
.
P.03
Setback:.
~'"~~: =1
E I
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FllllurGS
R~~PCIcmlial Bathls) !'!'
Sdnilllry S~wcr
t:T:..
f\
EI~. _
Wator
S/orm Sewer
. MOblh: Home
PlumbIng Pormtl
Slate Surchargo
101al Cl'Ulrgu
lei
MECHANICAL PERMIT
Furnaco
Exhaust HO<JQ
Vent Fan
~~. .
IIJQod Stove/lnserl/F1rop'ar;tI Unil
0,,., VWnl.y fA/.
1I1"i?~ /Wn.p 7iff'm
Mech.:lnlc.l:ll POtrlll1 .
FEE
/c;; u:E.
~Hal. Surcn3rgu
"iO
LQ-=:-
o.'1~O. 7~
~Q
Issuance
TOlill Permit
ID)
MISCELLANEOUS PERMITS
MobilCl Homp
Slalc taaU3.nce
S'.IIl" Surcharge
Sldi';lw41lk
"
CUlbeul
"
Oemollllon
Slal.5urChargo
To/III Miec:aJlaneous. PormilS (I!.)
TO"AL AMOUNT DUe (CllCludi.,g CICt;I,'c;Jtr)
(A.' a. C. 0, and E COl11blned)
,- ~..-
'S THl:. PHOPOSED WORK IN THE.
. l-II~ lOAlCAL DISTRICT. OR ON
THE HISlORlCAL REGISTER?__
II Ylls. lhla .ppllcatlon must be signed
.:IlId OlpprO\letl by Il1e HistOrical
CoordlnOltor prlo, 10 permit Issuanco.
APPROVED: _. _
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permif I~ gri:lnllHl on the 1J1lpro~s eonrJlUun thallhe ,old
constructlun .liih~II, in .all rClipCCIS, conrorm to U"e Ordinance
adopted by the City ",f Spring1lold, InCluding the
DOvQlolmlenl Code, rcgulaOrlU {lOlC construction a"'<l vile 01
Oulldlngs, and may h~ sU"'lJetlded or rovok$d ..I any timo
upon vlo,.,Uon 01 MY provl!llonll '01 said oRllnOlnces,
PIon Check Foo:
DUllI Paid:
RO.COIIJI Nurnbor:_.
Atll:~Jveu By:
Pians-ncvlc...;mJ~iY.
DBIO
Syet"ms Ocvoleprllonr C"arge Is due on all undO\loloPCd
propc'liet: within tlu; City limll:> whlel, ,,-re being Improved.
ADDITIONAL COMMENTS
Byalgllalure, J SI.1I1l ~')(,I Hu'ee, thai' have C;u.refully oxamlneCl
Itl., comploted alJ~lication IiIn" CIa hereby certify thilll all
I"tormlltlon hor..on is true .mCl Corrwcl, Wld J !urlher cenlly
Ihat.1ny .1od all work performc'>d l;h;11l be cooo in aeeor(l.anc:e
wllh Ihe OrC1inolllCu:> 01 the Cily of $pnngllofcf. and the I.aw.
of thO SUlIe 01 O:c:gon pertaining to Iho Work de~crlbud
herein. Dnd that NO OCCUPANCY wHl be made of any
.lruchJ... wlthoul ~Jimnil6ion ~f the Building S.'e'y Dlvlaton,
I further ClIrlily In:l.I Ollly contrlllctors .r"J employ.e~ who
aro In Compliance with OAS 701.0~~ will be uSlIcf on this
project.
I funhor agn:e 10 on:JUHl 111.1.1 all rOQulred InsPOctlona are
rlaue.led al the propor Um., It..leach acJdr... ,. rNclabl.
from IhO &lreel, HHiI the permit card 1& lacato(J at Iho fronl
ollho prOpOrly. .1nd tho approvO(l sel 01 plans will remain
on the silo at all limes during construction.
Slgnalu.. ~" ~ ,1.1 ~&.&...c-
Oat8_. U
VALIDATION:
RECEIPT NUMBER '.. ,;31'5 7C?
DATE PAID Q-:,cJ..1- 1'f
AMOUNT ReCEIVF.D --JI. d),(" cro .
.~~~CEIVED BY _ ~
.
\~P\I01J~
JOB DESCRIPTION ATTENTION:Oregon law reqll:i.~OWC;>ft. or less
"'TD" ~ If' "'IT'" follow rules adopted by the Orl!ileH 41ijid\i tional 500
Notification ljemer. I hose rules %f~.SEl!lo~1jI portion
permi t s are non- trans fltr~9aM~~1Q,through OI1ffi~~~l9P1-
if \lork is not startedaOOt/:1:\t\)ulrtltly~ncopiesOElhfurl.H\1mll'f'd Home, or
of issuance or if \lork i~a1l~,;,..t.,l..&p~Note: the tiMollbllin'D\lelling
180 days. number for the Oregon Utility ~iziUi@j'l or Feeder
Center is 1-800-332-2344).
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
Installation, Alterations
or Relocation:
ZOning.\.d 11'_,." .
Da~ ~~-<Z\ ~
Aulh_ $ignaIwu...J;"\ ""^. _..;_
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
4439 HOLLY STREET
Electrical Contractor "'RT f'T"'V InEe.. CO.
,
, -B=:CTRICAL PERMIT APPLICATION
City Job Number, Q~\\~Lo
3. COMPLETE FEE SCHEDULE BELOY
A.
Ne\l Residential-Single or
Multi-Family per d\lelling unit.
Service Included:
Items
Cost
Sum
$ 85.00
$ 15.00
. $ 40.00
AddressP. O. BOX #68797J1ie._ 200 amps~~:{ess $ 50.00
. . '~.i I tCE. 201 amps to. 400 amps $ 60.00
Ci tY_MILW~KTF: Phone ('in1 )F;qCl'i.tR'~22: 401 amps to 600 amps $100.00
, AI' '>''1MI''' 601 amps to 1000 amps $130.00
Supervi~or License Number 2405S Jrfl()~j~" SH/fl!(ef:,200~ amps/volts $300.00
lJU1i1Mfi, ''''7D/jNrJ;.e~1. Only $ 40.00
Expiration Date lO/Ol/Cl8 .4"'- ~/G~D ~R'TJ.JI t:rJtEw
., ItjO fJ C'J.f:/ l!Je'iJ~~~;f1I!R&.er"lralfrr or Feeders
Constr ContI'. Number 3-214(' 4'fP~RlnDI~'S'tIltt!1latl~r\(SM:>t.eration or Relocation
ulVED FOr> r
Expiration Date 10/01/98 200 amps' 'or "less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Signature of Supervising Electrician .
~ ~A"'4~
V
O\lners Name DENISE WASHINGTON
. .
Addres~ 4439 HOLLY STREET
City SPjHllilFIELD PhOne)'i41 1'74fi-1488
.f.'
OJ/NER INSTALLATION
,
The installation is being made on
property I o\ln \lhich is"not intended
for sale, lease or rent.
Owners Signature:
,l~
DATE~=--------~----~~~~-~J'--
RECEIPT II: U-H\,\;'J \~I -
RECEIVED BY: 0'--T;"JW0 LJ\~
D.
Branch Circuits
.'
Ne\l, Alteration or Extension Per Panel
$ 35.00 3S: () tJ
/
One Circuit
Each Additional
Circuit or \lith Service
or Feeder Permit
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation'
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not' included)
, '
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL .
3....-.60
J. "7~-
J, 1:)-
,. J. '? W-
JOB NO. q \ \ 6 \ ~
CITY' S"NGFIELD SYSTEMS DEY,E_MEt CHARGE
WORKSHEET II
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: c.A:p'?"'\o\..lE: \-\ot-\'C-S. T\..l<.. . 01"- ,O~of..\
LOCATION: <+4?;,q l--kt.-t.-Y ?". 1<(,0"2- oS-:2--1 - 0/000
DEVELOPMENT TYPE: l,ne..-Nf:1N
.BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 2-'2::.>110 X $0.186 PER SQ. FT. ~ 4-~o74
(See Reverse For Runoff Coefficients If Actual Imperv. Area'Is Unknown)
LOT SIZE
SQ. Ft.
2: SANITARY SEWER-CITY
NO_ OF PFU'S ~~ X 538.55' PER PFU
(See Reverse To Determine Total PFU'S)
5 BB<,,"'2...
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
\
X \ .<:>oS X $388.61
,S;~C>~
X
X 5388.61
s
H X X 5388.61 S
(See Attachment C To Oetennine Trip Rates)
SUBTOTAL (ADO ITEMS 1,2, & 3) S; \lol~ '
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
s ~.,,~
TOTAL-C TY SDC S 11",\,,:>:.--1
5. SANITARY SEWER-MWMC
NO. OF PFU'S
'2-?
x S13.25 PER PFU + SIO I1wr.1C A!)~:IN. fEE S ~\~lS
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
V'_~~~L~
~ Kip Burdick:
SOC Coordinator
\ - '7:, -"1"2-
S '?\ 'i2.
TOTAL-MW~lC SDC S 2..e-:,'Z-8
TOTAL SDC S '2.011, '-~
FIXTURE UNIT CALCU~IO.ABLE: Number of New Fixtur.Unit eivalent = Fi).1ure Units (NOTE
For remodels, calculate only the NET additional fixtures) .
NUMBER' ~F UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
'?
2
t
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
'-I
Bathtub......................................................................
Drinking Fountain................,.............,......................
Floor Drain.......................................:.....................:..
Interceptors For Grease/OU/Sofids/Etc.................
Interceptors For Sand/Auto Wash/Etc....:.............
Laundry T ub/Clotheswasher...................................
Clotheswasher . 3 Or More............:........................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator fWater Statiorr/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang..........................................................
Sink, Bar, Commercia!.............................................
Urinal, StallfWal!.......................................................
Wash Basin/Lavatory. Single............................._....
Water Closet, Public lnstallation........................_....
Water Closet, Private.....................................--..-..
Miscellaneous:
?~
'2.-
'2-
'?
"'"
\'2-
TOTAL FIXTURE UNITS
=
2::.
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table.
calculate credits separates.
52.66
2.64
2.53
2.41
2.i9
2.04
Year
Annexed
1985
1986
1987
, .
1986
1989
1990
Rate per S1,OOO
Assessed Value
I
L
Year
Annexed
1979 or before
1980
1981
'; 1982
1983
1984
Rate Per S1,ooo
Assessed Value
S1.69
1.35
1.15
0.92
0.59
0.23
I
i
_I
Credit for Parcel or Land Only If Applicable '2- . (,. c.. X S I I . S ~ ~ l 'B-
(Rate X Assessed Value)
Improvement (If after annexation date) X S
(Rate X Assessed Value)
CREDIT TOTAL = s ":Z,\ '-1-1
RUNOFF COEFFICIENTS FOR STORM DRAtNAGE
Residentia!......... ....... ........................................ 0.4
CommerciaL................................................... 0.9
I ndustrial............ ....... ........... ........... .:...... .......... 0,45
GovernmentaL................................................ 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT