HomeMy WebLinkAboutPermit Building 1994-3-21
LOCATION OF PROPOSED WORK: ~9"''2
ASSESSORS MAP' { P-,O ~ () c7\~ ' d--
~
OWNER: PD ? (>Of'."( ('ASc-
ADDRESS~n \r~,\s ~~D ~rL. ..!:JU\QQ J- .
CITL~\ \ \f\F:\*O Q 0l STATE: (\ h_ 0 6"\ oY\.
A/uJ
"'RESI[JENTIAL
PERMIT APPLICATION
~
Inspections: 726.3769
Office: 726,3759
LOT:
/1
DESCRIBE WORK:
NEW
REMODEL
SPRINGFIELD
BLOCK:
,.,. ,
S.F. D,
ADDITION
DEMOLISH,
OTHER
----" "'"
..,--'
-'..
'SF" z.. 70
,
"
JOB NUMBER
7Y~ :;?t::::7S-
225 Fifth Street
Springfield, Oregon 97477
TAX LOe ('A(:::::(Ii )
SUBDIVISION: q----~~ /;:$/"
, PHON"'-
ZIP:
C{~
, .
CONTRACTOR'S NAME ADDRESS
(lo :I. fA t-Itn.r,,.., S'
- ,
#u ,t/ LA ...Il/
MA-.t..sA.d s
# /.
CONST
3;.~~T~ACTO\ ~ \DE~E.s 141~~7ot
6 B::J \l)''b___ "l<'1bC\CW
~~I)YO \fl.~ '147m.,;
f5tACn hfJ():Yi' --
GENERAl'
PLUMBING:
MECHANICA' .
ELECTRICAL:
____A
QUAD AREA: '4~~
l
OCCY GROUP: K;:)-;- ^'~
'.11
. OF STORIES: ~
7/
. OF BLDGS:
WATER HEATER:
/' -
. -~
- OFFICE USE -
\\ \ \
LAND USE:
'1
CONSTR. TYPE: V N
HEAT SOURCE: /"""""~ F~
5"L,'~/. ',T'.I>
RANGF' ___ r "-
C _
. OF UNITS'
FLOOD PLAIN'
ZONING CODE:-Lf)V
. OF BDRMS: '- ~
SECONDARY HEAT: ~j/
SQUARE FOOTAGE: rQ4~
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.
o Temporary Ele'ctrlc
'N1' Site Inspection - To be made
~ after excavation, but prior to
setting forms, -SOIt.~,
o Underslab Plumbing/Electrical/
Mechanical - PrIor to cover.
'1V1" Footing - After trenches are
~ excavated,
D Masonry - Steer locatIon, bond
beams, grouting.
'C7f Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
1C71" Underfloor Plumbing/Mechanical
~ - Prior to Insulation or decking,
~ Post and Beam - Prior to froor
~Insulation or decking. ._
~Floor Insulation - Prior to
~decking,
~Sanitary Sewer - Prior to filling
J.L::S....trench,
~torm Sewer - Prior to flll1ng
~trench, .
~ Water Line - Prior to filling
~ trench.
~ Rough Plumbing - Prior to
~ cover,
REQUIRED INSPECTIONS
~ough Mechanical - Prior to
~ove~ . .
~Rough Electrical - Prior to
)2S-J-cover,
~Iectrlcal Service - M~~t be
~pproved to obtain permanent
electrical power,
D Fireplace - Prior to facl'ng
materials and framing In~p,
~ Framln~ - Prior to c~ve~~. ,
. .ol'
". \ '
l5<r'WaIl/C"eillng Insulation - ~Jprlor to
...over,
.... '\.
~ Drywall - Prior to ta~i,ng::
D Wood Stove - After I~stallatlon,
D Insert - After fireplace approval
.... and Installation of unit.
~Curbcut & Approach -- After
~forms are erected but prior to
placement of concrete,
'R:7fSidewalk & Driveway - After
~cavation is complete, forms
and sub-base material In place.
D Fence - When co_mpleted:
~ '
@}reet Trees -~Wh:e~~al,l [,eq~.lred
tf. es are planted: . ,....... ..
.,~ .... . - .
~Inal Plumbing - When all
~lumbJng work Is complet.e,
...c""7f Final Electrical - When all
~ electrical work is complete,
~Flnal Mechanical - When all
~mechanical work Is complete,
M Final Building - When all
, ..:;quJred Inspections have been
approved and building Is
completed,
.,~
,
~ Other ~A-7) LIIJe.
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.
,
D 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
venting have been Installed,
Lot faces ~ 2e. Setbacks \ .HE PROPOSED WORK IN THC:
1:4- I P,l, HSE GAR ACC I ......HiSTORiCAL DISTRICT, OR ON o- j"
lot Sq, ftg, ; . Interior 1t/t I THE HISTORICAL REGISTER? l
Lot coverage ~ Corner N If yes, this application must be signed
~ Panhandle S la' t and approved by the Historical
Topography I.w 7!,~d I Coordinator prior to permit issuance, I
Total height ~/\ Cul-de.sac tOE IJt!.~-, I I ' ,,, I
r APPROVED:
'---
BUILOING PER~!T
SQ. FT.
/~~
~t?
'x $/S.o. FT. = VALUE
~..::?-,.I!):l/~~
--- '
N- /Z> &'!j/./P. -= .
ITEM
Main
Garage
Carport
///:/9'?~
,.-
fKJfO
~ tJ-O
4$3,D"fJ
SYSTEMS DEVELOPMENT CHARGE (SDC)
. JI. ll'>
(B) 1!>"Z:Z,<;>S-
Total Vaiue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' -::<;
Sanitary Sewer FT,
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan N' 4
-r Wood Stove/lnse~I~~
Dryer Vent
-t~ L;15,!
Mechanical Permit
Issuance
State Surcharge
Total Permit (D)
FEE
I 'J'5l !>"o
Cl.63
'202 (3
1090
4. 5'"10
/'2. 0 0
J s. tr<J
,
~oo
~? tH>
~7-?()
/,0.00
'2/~
$1,63
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
.22.7S
/5/0
Sidewalk
~<::; It
~4- It
Curbcut
Demolition
State Surcharge
~W .A7iV/M
"'2.Q'J 6'0
q3~ 65
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electricaI)833z;.'~i
(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
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 said ordinances,
Plan Check Fee: ;;;Z 99. ~
Date Paid:
ReceIpt Number
.'
.:? 1;//94
/~k/'
Pia
Systems Development Ch~rge Is due on all undeveloped
properties within the City limits which are being improved,
~ ~~~, 'L ..._
ADDITIONAL COMMENTS
e:;u:P~ 6JpZ- ~/ J
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,<it-T: &l.lqLQC)
L(2\f\rNX tlfL"\Q; \C\tr,{)
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011 n X\,\l,(lQJ ~JtA 0 LC"'dJr'
;?If#~ fZhv pp;~ ~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 certify
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 Safety Division,
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on t.hls
project.
I further agree to ensure that all required Inspections a-re
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 plans will remain
on t~e site at ~~m~rlng constructlon,
Signature ~
Date
VALIDATION: 1 0 c/
RECEIPT NUMBER ~o 0
/2.,/1\. ,/
DATE PAID l' Ji;SL} -
AMOUNT REC~I ?+_.,\\~) Ut/ I
RECEIVED BY ~ ,[)()J ,
.
o !!.'!i!I.f!!!!:!!~!!!!
.
JObNO.~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: FrL ~ (l()r(')!.. (It} liJ -"'
ADDRESS:0(() I A 'IS ffi "{l~ S)
" J
PHONE: 14fJ-R1N
- ,
STATE: !!JtZIP !32111
LOCATION OF PROPOSED B0q~G ~E: /' I?\ ^.. ". D. f\ 0 ,(),
Street Address if Known: ~d (1- ( II '1 0 A ') UI 11 J'C.J
Platt Name: (1fJJY'n dfl, !hJJfT;w Lot Number: jPf){iYl fJ/l ('friO
/81- '~ .'
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), SDC Calculations and dwelling type
definitions are on the back,)
A. Sim!le Familv - Detached
Single Family home
NO OF UNITS
B, SinQle 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 cff)
X $400 PER UNIT = $ 4ff),
X $370 PER UNIT =
$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4mr;D
$0
$4mCfJ
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)
cl~~L;~~~\ .~
City of Springfield
l~ /
~Gq4
Date
.
.
_OB NO. 440'].05
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ED 4 LD/{OL- QA7t
LOCATION: (;''152 ~'-A uER-;
/ ~ 0 1.-0'2. '2,:2, - 04-000
DEVELOPMENT TYPE: L17r< - Nf:J1\! Sf'~
BUILDING SIZE: LOT SIZF SQ. Ft.
l. STORM DRAINAGE
IMPERVIOUS SQ. FT. '~ ~'6 er X $0.203 PER SQ, FT. ~b'-l &7~
'- ./
2. ,~ANITARY SEWER-CITY ", .
NO. OF PFU'S 'Z-"? X $42,08 PER PFU c;q~7gh
(See Reverse) ~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $424.31
{" '-f-'U3 ;5~
......... ,./
$
$
/
X 1,01 X $424.31
X X .$424.31
4. SANITARY SEWER-MWMC
NO. OF PFU'S 'Z? x $15.125 PER PFU + $10 MWMC ADM FEE $ 36,5;2-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ 1 () 1!..
TOTAL-MWMC SDC ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ '2/'-/- 'i'':t!:..-
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
V"-~L'~ -z./1.S/"It
lJ Kip Burd i ck I f
SDC Coordinator
(IOl"~
~'"
TOTAL SDC $ 'l1.-5 ':) -
FIXTURE UNIT CALCU~ON TABLE: Numb~r of New Fixture.nit Equivaient = Fixture Units~NOTE:
For remodels. calcul1iie only'the NET additional fIXtures) ',- .-
NUMBER OF UNIT FIXTURE
FIXTURE TYpE NEW FIXTURES EQUIVALENT UNITS
Bathtub..,........,......,..., --,....,.',...,.".' --.".....,., --,.,."... --'
Drinking Fountain__... ,....,...,.....,... --"",.,.,.', --,...".,.....
Roor Drain,........... ..,............ ...,...,.,.,........'".....,..'..."
Interceptors For GreasejOiIjSolldsjEtc........,........
Interceptors For SandjAuto Wash/Etc.....,...,....,...
Laundry Tub/Ootheswasher,nnm ."" '00"""'''''''' ..,.,
Ootheswa~er - 3 Or More.....".....nn"....n..."........
MobUe H6me Park Trap (1 Per Trailerl"...n""n,,,,,
Receptor F9r RefrigeratorjWater Station/Etcn..""
Receptor For Commercial SinkjDishwasher jEtc..
Shower, Single .StaIL"...",,,,,...,,.,, ...,.... ..,..." ,...' 00'"
Shower, Gang.. ..""000000'...""'...'00"'.' 0000"...00...''''"...,
Sink. Bar, COmmerciaL....".."n"..nn,.......".....,.....,
Urinal. StalljWall.............."...n""...."nn"..,.....n.."nn
Wash BasinjLavaiory. Single..,n"m"",........",nn""
Water Ooset, Public Installation,m...,...."n,n..."n...
Water Ooset, Private""nn:""...n"..nn""n..............,
Miscellaneous:
z
2
1
2
3
6,
2
6,
6'
1
3'
2:
l/Head
2
2.-
1
6'
4'
(
1
?,
~
TOTAL FIXTURE UNITS
..j
z
'2.
'b
1'2-
23>
Based on assessed value. If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credns separates,
I
Rate per $1.000
Assessed Value
Year
Annexed
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
1985
$3.21
3,13
3,08
2,96
2.82
2,68
2,51
1986
1987
1988
1989
1990
1991
1992
Rate 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 ~, 1--1 X $ 1--1, q t. 70'1:1
(Rate X Assessed Valuel
Improvement (If after annexation datel X $ =
(Rate X Assessed Valuel
CREDIT TOTAL = $ 76 '1-'1
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential.....""...,,,,,.....n............,,,........,n....., 0.4
CommerciaL...""""...,..."..."...".."......."........ 0.9
Industrial...".""""'''"...."..."""n....""""....,,n... 0.45
Governmental........"""",...."".....,,,.........,,n...., 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
.
~
. . .'
a oJ/owing pr J ,.
Zoning, and doa~ act as submitted h
apprc.vel. ~ not require Spec 11' 9S the fo .
..IIIC 1Qndr:<<
;~i:r~~~:~~:iaON 97471 ZOning 1_W E~CAL PERKIT ~n~~
INSPECTION REQUEST: 726-37(9)~' - City Job Number ''--''l:'\..1CII-)
OFFICE: . 726-3759 Authorized <" \-
, "'9nelurG~ COMPLETE FEE SCHEDULE BELOV
1. r~~Ir;^t(\T~~) A.
~~~rY(r()4Doo
~O~ES~rRf cl Q/l('or04/F')
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 B.
Electrical Contractor~j~~ ~~~~J
Address ,,:/ /?IJ w. / / lh
Ci ty tuB...hv11 Phone 9. cr Lf-5tJ3 l
supe~icen.se Number q t'() S
Expiration Date
New Residential-Single or
Multi~Family per dwelling unit.
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
~
~~,
Cost Sum
$ 85.00 ~
$ 15.00 1-5
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or'Feeders
:::::,::,~,:"...,nT MV !:- ;;";;;;';;";;;:::::""~ "' ;";;:;;"10
?~(V1ff 7?P~ ng Ele~cian Over 401 to 600 amps $ 80.00
lJ:) , C V. / / / Over 600 amps or 1000 volts see "B" above
io (\J/ \./. C ~ L 11 { Il'l' ^ rD. Branch Circui ts
o'wners Name r r f"'-l ( ~ 1) (~
Address C]() If) 1~ "\ ill, l!irY New, Alteration or Extension Per Panel
~ T One Circuit $ 35,00
City _' t::\\ Pho.n~ Each Addi t ional
~ Circuit or with Service
o STALLATION or Feeder Permit $ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~----- I~-;Q I ,qCj=---,---:---;---
RECEIPT I: _Jr-..J..'.l _ {~:H'JJ t
RECEIVED BY: ~(_LA.-
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
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
E.
5..
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL .
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
~1~ciJ
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