HomeMy WebLinkAboutPermit Building 1995-3-23
LOCATION OF PROPOSED WORK:
X'ASSESSORS MAP: /~-r-;:<-rJ~~//
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
::P 318
.
JOB NUMBER ~5"t:::>Y7'Y
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
CK;;.Yc!)C>
~~#/~~/~.4~
::>'Y/'L,< -co'"
BLOC/<'
OWNER'
PHONF'
ADDRESS'
CITY'
DESCRIBE WORK'
NEW V REMODEL
S (I'vq(e ~~L-l..-J
,
,
STATE: (";) /2-
ZIP: q7Lf~
ADDITION
2.. "'7'to~'1 WoOt::> "'Fi-A~
DEMOLISH
OTHER
CONTRACTOR'S NAME ADDRESS
v,,1 (/tDItz5u.-. 4s,1'.. Bl9 J/
PLUMBING: ~""" P~i..,>
I
MECHANICAL: R()LF~ 1"\(5:4.-1',':"",
- I
ELECTRICAL' r::::','i-'-1 () j e......" <<=..lR ci- '
CONST.
CONTRACTOR' EXPIRES PHONE
liLL""........ Pft;c<SCMf Hdf, ofl.. 1;3c{2..1 5'/:1, 71((-odr1c.
rY.-"fl\:~ ' l ~ .qc; ~; \'\{d? )
. ~ D ~() ~ . \~ q/(J q~~l.~~
A \66 \F) rO I.':)illo lDg,~.LUz....
-7
GENERAL:
t
QUAD AREA: 4-Q.3,E=',
. OF BLDGS: \
OCCY GROUP' ~~-\- t'v\
4
'1......-
. OF STORIES:
WATER HEATER:
- OfFICE USE -
\ \ \ \
\
CONSTR. TYPE:' V A.J
H EAT SOURCE: 2::z7':?-/...... r:.4..
RANGE: _ f,
LAND USE'
· OF UNITS:
FLOOD PLAIN:
ZONING CODEA-D~
. OF BDRMS: . !\
SECONDARY HEAT:~
SQUARE FOOTAGE: VS\
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Ins pee lions requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made t~e following work day.
D Temporary Eloctrlc
~Slto Inspoctlon - To be mado
~after excavation, but prior to
setting forms. -:ie/i.';,
D Underslab Plumbing/ Electrlca"
Mechanical - Prior to cover.
d Footing - After trenches are
~xcavated.
o Masonry - Steel location, bond
.beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
~ Post and Boam - Prior to floor
~Insulatlon or decking.
rs<r"Floor Insulation - Prior to
/";"decklng.
~sanltary Sewer - PrIor 10 filling
trench.
~Slorm Sewer - Prior to fllllng
~irenCh. .
'l;:'"7( Water Line - Prior to Iilllng
i2SJ trench.. .';
i"vr"Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS
'fI\7I" Rough Mochanlcal - Prior to
J.C>.I cover. ~'S F. j4.
~ Rough Electrical - Prior to
~ cover.
l\:7t' Electrical Servlco - Must be
~ approved to obtain permanent
electrical power.
D FIreplace - Prior to facing
materials and framing Insp.
~ Fra~lng - Prior to cover.
l'YI Wail/Ceiling Insulation '- Prior to
~cover.
~ryWall - Prior to taping.
D Wood Slovo - After Installallon.
D Insert - After fireplace approval
and Installation of unit.
'f'2f Curbcut & Approach - After
~ forms are erected blll prior to
placemont of concrete.
M Sidewalk & Driveway - After
~xcavatlon Is compieto, forms
and sub-base material In place.
D Fence - When completed.
~trGet Trees - When all required
C::::5Vt-rees are planted.
R7Flnal Plumbing - When all
~ plumbing w<;>rl< Is complct.c.
f':?('Flnal Electrical - When all
~electrlcal work Is complete.
~Flnal Mcchnnlcal - When all
~ mechanIcal work Is complete.
~Flnal Building - When all
~ ~equlred Inspections have been
approved and building is
completed.
g Other C*s baJ!=,
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connectlons - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspectlons 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
ventIng have been Installed.
~
Selbacks
I PL. HSE GAR ACC I
1 N I
Is
Iw I, I . .1. ~ \ c'
'LLLLLI
Lot facos
L~P.
_ Interior
Lot sq. ftg.
Lot coverage
Corner
Topography _ _
Total height J!1 ' ----,-
< ", '\rl"l'l;-~\.l":::::, c.
.' \ ' pC.j
Panhandle
.Cul.de-sac,:,(,
",.,
BUILDING PERMIT
.ITEM so. FT.
~:;:sV"
. . t/J
Garage 4t2.t:>
'~~4 /60
X $/so. FT.
VALUE
:Sl;.. :ao:>
-'$... / ~
Ji'.-
':2jIgjo_
-
Main
~";>C.'''i
., ~zz.~:1
?~.-
l?i!.II R 'ft:>.
v~.
..!i)!.q
.. ,
/2~~~6
4C\\ .Sf)
3q5~
(A) . "-.t)3[).9>a-.
SYSTEMS DEVELOPMENT CHARGE (SDC) ,].,1
(B) ~Zo:'4-~ ffj
"
Total Value
Building Permit Fee
State Surcharge +-~
Total Fee
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
1l0() .ex)
."....
Plumbing Permit
State Surcharge t3qD
lio() .C()
(~.?D
ua.ro
Total Charge
(C)
MECHANICAL PERMIT
to.OO
4 :~)()
(CO
().
4,'50
_~ . CO
c-!Q ,00
~(o .CD
1J;('ClJ
~.06
3A.~_
Furnace
Exhaust Hood
Vont Fan NO
Wood StovellnSerl/~~~nlt )
Dryer Vent .
n(liJ ~\~ f\()
\, \
Mechanlcal,Permlt '.
Issuance
State Surcharge -t ~O'O
Total Permit (0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State surC1iar e
Sidewalk
( .
Curbcut
It
Il.ffi
\~tD
ft
Oemolillon
Slate Surcharge
Tolal Miscellaneous Permits (El
TOTAL AMOUNT DUE (exctudlng electrical) c:Q~
lA, B, C, 0, and' E' Combined) .- I
",:."
,~
I
. 'i:~ '..
.
i. IS THE PROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by lhe Historical
Coordinator prIor to permIt Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pefmlt is granted on the express condition that lhe said
construction shall, In all respects, conform 10 the Ordinance
adopted by the City.of Springfield, Including the
Devefopment Code, regulating the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation of any provisIons of said ordinances.
Plan Check Fee:'
"3/9.. $0"8
~
=3 -:? '"3"~?..5
..
Date Paid:
Receipt Numbor:--.!6. ?/?
Recelve~y: a./"_ f1
~~
Pla~ Reviewed By
--
4'/ tffi)
Systems Development Charge Is duo on all undeveloped
properlles within tho City limits which are being Improved.
AD~IONAL COMMENTS
I~~/
t~H~bCJi[lO ~U"nQ~
c ~T T: 62L\ /.l Lor)
I~ I\Q x \1\ fo ): \J,n<p.>
5;5;fAt?A7'C:
/'&;&//"1"91
~ .lJMAr;T ~r
, r .
By signature, I slato and agree, that I have carefully examined
lhe completed appltcatlon and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work porformed shall be done In accordance
with the Ordinances of the City of Sprlnglleld, and the Laws
of the Slate of Oregon pertaining to tho work described
herein, and th~t NO OCCUPANCY will be made of any
structure without permIssion of the. Building Safety Division.
I further eertHy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree 10 ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at lhe fronl
of the property, and the approved se f .~~ will remain
on the s~mes during con AI lL
Signature . ~l~
Date 3 f2,.."'/lqS
/ I
VALIDATION:
RECEIPT NUMBER
DATE'PAID
AMOUNT RECEIVED
RECEIVED BY
/7/?"'3'
7"-- :2 5' ~ 9-S-
'=3<, 5"<::::'. /'6
~~
'/
~
The following project e. submllted has the following
zoning, and doeD not require epocific land uc.
epprove!.
Z. t,... 0 f2..., ELECTRICAL PERIIIT APPLICATION
97477 onlnll
726-a.il'J'~rL('-1{ City Job Number ~~ -:go 7 Y
tJyA.
Authorized Signetu,. .... ,",vnc w.u" r "'C: SCHEDULE BELOII
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION <1/ INSTALLA~
L t::?30 ?'i?~l. er. .
LEGAL DESCRIPTION
4~ -~"'3"--// ?'~7''''O
,
~ DESCRIPTION
....,Lft~p ~A'
~~:>
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 c?~&Jf"
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name (~tV-5"1' ~~........, D.
Address 1iii'~~/ 7/L ~/c:.~
-., - '
CitY;?~~"NT~Phone ?"7/---..- ~.."
, ...~~
OIINER INSTALUrt<1'N""
The installation is being made on
property I own which is not intended
f~.u~ease or r t.
o~ature'
-j----~-----------~--------------------
DATE: . /'7 /"2. ":3 ,...'"
RECEIPT 11: . q-2s'--c;JS'...../?o
RECEIVED BY: .....-;~'
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems Cos t
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
"""""--$ 40.00 ~~
$ 55.00
$ 80.00
volts see "B" above
Branch Circuits
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE Y'~ --
5% State Surcharge ~ . ~~
3% Administrative Fee /:::? C>
TOTAL S0". ~
'1
.'
.
.
."
~
f'\' .
.. ...-~ Wi llama lane
'-tg' Park & Recreatio~ District
Job No. q~f}4
NAM
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
Q ! \J)\~'\\9itA_ PHONE:~ \ .TIm
~\ \1 \\ \~_~ )\)\ii\\ STATE: fJiLZIP Cf1t.~C:)
'.
ADDRESS:
, .
LOCATION OF PROPOSED BVILgI('lG ~}TE: '. i::t\ +-
. -Street Address if Known: . \ 0 '(.,.~C) \-\0 l\ ( k-;: JU a Q 'A ,
PI~ltName~ln~ ~\\~ ~TaxLotNumber: \~()203\ \ ()ln4{'()
1. DEVElOPMENT TYPE (Check appropriate dwellirigCsl. SDC Calculations and dwelling type
definitions are on the back.) . . .
A. Simile Familv - Detached
l Single Family home
NO OF UNITS (
Manufactured home not in a park (1)
X $400 PER UNIT .:;=" $ . 4ffi.
'.
B. Sinl1le Familv - Attached
.
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv Aoartment
NO OF UNITS
X $~77 PER UNIT =
$
D. Manufactured Home Park,
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$4tD~
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 Creditl
$
Atf). DD
\@,,!o.~~~
t.f / -:2.1i"' I ~ 5---
n~t(.lo
.
. NO. 9'503/4-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 1<.oe:.-e:.t<. W\N.I:>\-\-E:\M
LOCATION: l.o(f:'-~c ~L-I--< <;:,;,. \'iSO'2..0~ I \ - oi040D
DEVELOPMENT TYPE: L'P ~ - 'tJ.e.W c'S!=-f::-
BUILDING SIZE:
I.OT SIZE
SQ. Ft.
I. STORM DRAINAG~
IMPERVIOUS SQ. FT,
-z..~\\
X $0.209.PER SQ. FT. (4~~00
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
l'b
X $43.26 PER PFU
~ I p,~i)
'-- .-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X \ . 0 1 X $436. 19
X
X
X $436.19
X $436.19
C 44<lsi)
'-- ----
~
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S \'6 x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ ~\q4-l-
TOTAL-MWMC SDC
$ ~::, 9~
~~?4i)
--- ---
$ \9'?,"'!1.
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
~^~ L...L-
. -6 Kip Burdick
SDC Coordinator
X .05
Date: ~/z4-/'1c;
I I
TOTAL SDC
cc ~~~~
$ 2o~4- Io~
FIXTURE UN.IT S1:\lCUlA _N T ~.BlE: Number of New Fixtur.nit Equivalent =. Fixture Units
(NOTE: For remodels, calculate only th~ addItIonal f,xtures)
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
2-
2
1
2
3
G.
2
G
G
1
3
2
1/Head
2
2
1
G
4
4;
Bathtub,.... _................................................ -.............,.
Drinking Fountain.....................................................
Floor Drain........................... .....................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors'For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher...................................
Clothes washer - 3 Or More:......:...,..,...........,.............
Mobile Home Park Trap (1 Per Trailer).......:..........
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang........,....... .............,.. ... ...........,... .;.. ....
Sink: Bar, Commercial, Residential Kitchen.........,...:..........
Urinal, Stall/Wall...................... ... .......... ...... ........ :.,....
Wash Basin/Lavatory, .Single...................................
Toilet, Public Installation........................................
Toilet , Private..................................................:....
Miscellaneous:
'Z.
'Z.
"l-
'Z.
-z..
'6
TOTAL FIXTURE UNITS
=
\'6
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
19.8-3.
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
L
Credit foi'P~rcel or Land Only If Applicable
Improvement (if after annexation datel
~ . 4<.. X $ "2.4-. 2("
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
~~q4-
=
CREDIT TOTAL
. 44-
= $ <6~ -