HomeMy WebLinkAboutPermit Building 1994-10-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORt<'
18 02 05 1 2
ASSESSORS MAP'
98
LOT'
.
SPRINGFIELD ,',
4548 Glacier Street
TL 4000"
.,!
BLOCK'
OWNER'
ADDRESS'
P.O. Box 22636
Capstone Homes, Inc. of Oreqon
CITY:
Eugene, OR 97402
STATF' '
DESCRIBE WORK'
Single Family Residence
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
DEMOLISH
OTHER
.
qL\ ~.Cfl)
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
SP 95
TAX LOT'
SUBDIVISION:
Lucerne Meadows
PHONF' 689-5567
ZIP:
ADDRESS'
CONST.
CONTRACTOR'
- OFFICE USE -
\ t\ \
\V. I
CONSTR. TYP'" IV
HEAT SOURCE: ~(...,
'c:/l
LAND USE:
. OF UNITS'
RANGE:
REQUIRED INSPECTIONS
.kR~U9h Mechanical - Prior to
~ cover.
~ROUghElectrlcal - Prlor'to
cover.
d"Electrfcal Service - Must be
~ ~pproved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
l8J Framing - Prior to cover.
rvf Wail/Ceiling Insulation - Prior to
Q"J cover.
Ji:! Orywefl .,.. Prl,or to tapl ng,
D Wood Stove - After I~stallatlon.
D Insert - After fireplace approv.1
and Installation of unit. '
~curbcut & Approach .,..After
arms Bre erected but. 'prior to
placement of concret,e.
ItTl Sidewalk & Orlvewey - After
~ exc':lvatlon Is complete. forms
and sub-base material In place.
D Fen~e - When completed.
o Street Trees - When all required
trees are planted.
GENERA" CaDstone Homes, Inc. of OR P.D.B. 22636 Euq..OR 97402 62018
PLUMBING' Fridlund Plumbinq 85628 Di11e~ Lane Euq"OR 97405 51835
MECHANICAl' Garibay Heating 4207 W. 5th Ave. Eug.,OR 97402 70545
ELECTRICA" Hauck/Hammer Elect. 353 S. 68th Pl. Spfld.,OR 97478 89423
EXPIRES PHONE
10-16-94 689-5567
12-14-94 746-9433
, i'
12-21-94 344-2481
3-5-96 744-1165
./'
QUAD AREA: \.. ~Q..~ .-'
. OF BLDGS' _ \ _
OCCY GROUP: V\0tV\
. OF STORIES: .!..\
(~
WATER HEATER: =\
FLOOD PLAIN: ID -
ZONING CODE: ' _~
. OF BDRMS: ::::, p
SECONDARY HEAT: -~'
SQUARE FOOTAGEQ):) 14:-.-
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,
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Undersleb Plumblng/Electrlcal/
Mechanical - Prior to cover.
JFOOtlng - After trenches are
'b(J ~xcavated. .
D Masonry - Steel location, bond
,beams. grouting.
dFoundatlon - Atter forms are
~ ~rected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
r't>r"'Underfloor Plumbing/Mechanical
~ - Prior to Insulation or decking,
r\:::I- Post and Beam - Prior to floor
~ Insulation or decking.
rn Floor Insulation - PrIor to
"""" deckl ng,
rxf"Senltary Sewer - Prior to filling
~ trench.
~Storm Sewer - Prior to tillIng
~ trench. .
..vweler Line - Prior to filling
lL1"irench.
~' , : i-j '-:r..'i?7;,..'
Rough Plumblng:- .Prlor:to
cover.
, M Final Plumbing - When all
rPIUmblng Work Is complet,e.
~ Final Electrical - When all
~eJectrlcal work Is complete.
~Jnal Mechanical - When all
r /meChanlC81 work Is complete.
~Inal Building - When all
equlred Inspections have been
approved and building Is,
completed.
D'O,lher
MOBILE HOME INSPECTIONS
D Blocking end 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 Final - After all required
Inspectl_ons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
,.
-' !'
{'.~' ;..
,,"i,,^ ..,'.'i,,',,;. "~"
" 'I;}\ "C;:l ~"t'{li-->''; t~'~'-A':.;~ ...tc~:
'"./~i\L \:\::'~.> ":-. .:,"". ;;~'t""rt~t:l},"'~ ,t.:;,
Lot sq. Itg.
Lot TYpe.
..x Interior
Corner
Lot coverage
Topography
- 7'JZL"
Total height q.{,)
ITEM
Main
Garage .
Carport
Total Value
Building Permit Fee
State Surcha~ge
'.,.
Total Fee
.... THEPROPOSED 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.
" '"~.
Setbacks .
HSE GAR ACC
Panhandla
Cul.de.sac
..fp.L.
. "'1
.' N'
Is
Iw
IE
BUILDING. PERMIT
\~?,S X $/~Q. FT'=\C03V7
,C={)G1_ ~'.~4~
'.~
13.5"3~2.i.S5~tCr6
. (A).' + e/'i O~ .
SYSTEMS DEVELOPMENT CHARGE (SDC)
. ., :: '. . " .. - .. - ,'(B) ... f.21'9,';'2.
PLUMBING PERMIT
ITEM
tq9,"~
o,l'iS ;-Cua '~:'1 I
. (C) ~(jJ.q I
. l() (JJ
4'3)
1\ cO
\ rlI .
(\ 71.0-/
~.CO
.~(P
Lt~~
\ tJ .fXJ
.3.lo5
5~.ify
Fixtures
; Residential Bath(s) N' .~
Sanitary Sewer FT.
Water' FT.
Storm, Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stova"lnsert~e~laca unf)
~i\tA '-B"
Me anlcal pe~~~ \ '-'.. .'
Issuance
:"\.
FEE
\C\9~)
~ .~6+ I.?>')
State Surcharge
Total Permit .'
"
MISCELLANEOUS PERMITS
.(0)
Mobile Home
State Issuance
Stata Surcharge
Slde~ai~ :P-fJ It
Curbcul .w It
Demolition
l
sr\~ ~urchar~ - . llt0
\ . vuJ\ ~() ~l
c9Q~
. / \ '7:f....)
\\..
\\,\.LU
. ' .
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
. (A, B, C, D, and E Combined) .
APPROVED' .
--I f
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the 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 time
upon violation of any provisions of sald- ordinances.
Plan Che9~. Fee'
Date Paid:
)
f\:'=~ B~
~~e~lewed By
~
,
/33oQ1
Date
Systel)1.s Development Charge Is due. on all undeveloped
. properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
w\+l: ~ (/loO
00\ tr r nrO ): \ qr 1~
- . ^
l'uJ\bLWio ~
.'11' .
.-r VL/
By signature, I stale and agree, that I have carefully examined
tha completed application and. do hereby certify that all
Info'rmatlon 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 Springfield, and the Laws
oftha'State of Oregon pertaining to the work described
heraln, 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 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 time; that each address Is readable
froin the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site atJJ2s during construction.
SlgnaturD a~~C?r~~
Date l! -,:;;J., Lf - q L/.
VALIDATION: ~~
RECEIPT NUMBER W M
DATE PAID I D;,.~ _1- .
AMOUNT RECEJ!j ~:40~1~f15
RECEIVED BY Li) I!\f) )
j
.
.
fi !J.I!i!I'!~i!!t\!!~
~
Job No.
Cf\ Vt qO
NAME:
ADDRESS:~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
~Q,\~U
~ 1113lo, h)~
G\~
l PJ O~D9 ~ O'\QX)
PHONE: \Oq.,,~ . Q7J\!l
ctftOz....
STATE: ~IP
LOCATION OF li'ROPOSED BUI)H~G~IJffi
. ~~~~ro 'T~
Platt Nam' . ~ Tax Lot Number:
-/
1. .DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Sin!1le Family - Detached
\ Single Family home
NO OF UNITS \
B. Sinl!le Family - Attached
NO OF UNITS
C. Multi-Family Aoartmen~
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park /\ f\(\ (J)'
X $400 PER UNIT _= $ \\A)., '
.
X $370 PER UNIT =
, $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4\)0 ~
g
$-
$4GO~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDE SESSED (If SDC reduced for Credit)
\D I \0
Date
I q+
..
...--..--..-.-.-.
. ATTACHMENT Bl .
NO. q ~/2. 7tJ
CITY OF SPRINGFIELD SYSTEMS' DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
. ,
NAME OR COMPANY: ~.JA">'f..-L // ..'.. ~
LOCATION: /f5"-4'g a~ 5--1
DEVELOPMENT TYPE: 5r/)
BUILDING SIZE:
1. SIQBM nRATN~
IMPERV IOUS SQ. FT. ;2.:2. 1- 3
I OT SI7F'
SQ. Ft.
X $0.209 PER SQ. FT. ~S;00
2, SANTTARY SFWFR-CTTY
NO. OF PFU'S
(See Reverse)
3. TRANSPORT(illill!
NO OF UNITS X TRIP RATE X COST PER TRIP
24
X $43.26 PER PFU
'cC03_~'0
X
X $436.19
CM.~~)
$
$,
SUBTOTAL (ADD ITEMS 1.2. & 3) $ /t'5"$. 8'S-
/
X 1,01 X $436.19
X X $436.19
4. SANlIARY SFWFR-MWMr.
NO. OF PFU'S ~' x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ ,;f.22.5"~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $_?A. 7""';.
IQIAI -MWMC SDC (,$ 3 9~, 7')
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 2:5 S'/, b~
5. ~nMTNTSTaLTVF FFFS
Blf5HARGE ~S'TO~ ABOVE) X .05
~ df . Date: ?-/3-7~
~ ~arY}HDrnig~
ShV'Coordinator
C! J/7'~
TOTAl SOC
0fG?.2Y
B2.S0C .
FIXTURE UNIT CALCULAaN T~.BLE: Number of New FixtU. Unit Equivalent c Fixture Units
(NOTE: For remodels, calculate only th~ additional fixtures) .' .,
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTl,IRES EOUIVALENT UNITS
Bathtub.,....,....................."...,..."......,...,..."......,....,.. .
Drinking Fountain... ..,............,..,......,....,...................
Floor Drain..................,....,......,........,.."...."....",.......
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.................."... ............,
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Waler St.ation/Etc........
Receptor For Commerciai 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: ,TANI1C~S SoI"'~
/
z.
2
1
2
3
6
2
6
6
1
3
2
lIHead
2
2
1
6'
4
..l
/2
I
;2..
/
z.
I
z.
"3
~,
~
TOTAL FIXTURE UNITS
2.4
=
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
1979 or before
1980
1981
1982
1983
1984
1985 .
$3.46
3,38
3,32
3.21
3.06
2.92
2.73
Year
Annexed
Rate per $1,000
Assessed Value
1985
.J986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1,77
1,37
0.97
0.61
0.44
. .
0.15
$.1(;, X $ 1i~o
(Rate X Assessed Valuel
X $
(Rate X Assessed Value)
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
.2-<1.77
----
=
=
CREDIT TOTAL = $;2?, 77'
.\
.
.
The following project as submitted has tho follo''i!illl_
zoning. and do.. not require speciHc land BLECTlUCAL PERMIT APPLICATIO
97477apprcvol, /J t:lA\lIn
726-3769 Zonlnp \....V'll--- City Job Number '-'ti 'l.X\
Ollie (,'j)-IJ-'iL.{ 3. COHPLETE PEE SCHEDULE BELOV
1. ~T~~F 6iB"t{t~~dSignaIU;e~
~.'i<~~
1:-~~ ~wr~~ &3\~
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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 INST~TION ONLY),.\.. _... _ .B~
Electrical contrac~o~~ _~. V\11ill'1\Q.Y
Address..3~ ~ n LoR'"' Q..R -
City ~_ Phone '):\4. n\r5
SuPervisor\iicense Number ~lf{) ~
\(). \ .Q.5
e,q~2.. ~
o.~.c\s
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
, ~ d. .-"
Owners Nr\e ~
Addres~}J.\l. ~_1l0'?W
City rnC:e 00-... Phone\.Q~.~fo7
OVNER I~TALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------------------7~--~~~ 5.
DATE: ~ In.w'
RECEIPT j1: ...f' . ,
RECEIVED BY: ')JI"., -'
. '-
L'tl;::W AIC:.:l~J'Cu...:.al-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home' or
Modular Dwelling
Service or Feeder
I
3
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
unit.
Cost
Sum
55
~
$ 85.00
$ 15.00
$ 40.00
$ 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-vorts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightinp: '..'
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5% State Surcharge
3%.Administrative Fee
'TOTAL' -- . .. ..
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
\mp6
\~.:::u
'.~r)~
~