HomeMy WebLinkAboutPermit Building 1993-6-18
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IRdslDENTIAL
'PERMIT APPLICATION
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Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT: -L Y
/7b3 ~y ~z.-
OWNER:
ADDRESS:
~ Jf HJ'/"
r(( elv I"V'
tv /f.,-k fr
/ Z,/~
?Ut
Ov
CITY'
DESC~IBE WORK'
t:-tlIH f".ul
NEW V REMODEL._ ADDITION
. ,
CONTRACTOR'S NAME
GENERAL: ,AleC/v,"" d",jul'$
PLUMBING: L""vf ~ .PI{"..~~'
MECHANIC,\L: Ro J ~s pt",.,h/'p
ELECTRICA" lJ.,.,,,,j ,c/,.C/',C,'.
QUAD ARE/\ \ R ~\ tJ
. OF BLDGS: - \
OCCY GROUP: _\o\~~-\-~
I
C(..
. OF STORIES:
WATER HEATER:
225 Fifth Street
II I Springfield, Oregon 97477
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.#"~d",, fl'. JiJ"ff, /ldr/
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TAX LOT' CCIZ-2-> '
/t"t!'/u~q?~
6 79 - 5"z,R :1
SPRINGFIELD I I. I
/'i-/,,,,,
BLOCK:
A
...
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JOB NUMBER ~::L
SUBDIVISION:
PHON~'
ZIP'
97ya--
STATF'
Nl
~~w f/~A:._,L/f7J" tr 4qff//!;
REQUIRED INSPECTIONS
r71 Rough Mechanical - Prior to
~ cover.
r7l Rough Electrical ~ Prior to
~(;over. ".
r7l Electrical Service.:.... Mllst be
~ approvod to obtain perm-anent
electrical power.
D Fireplace - Prior to facing
materials :J.nd framing Insp.
rn Framing - Prior to cover,'..
r:/l WallfCciling Insulation - Prior to
lA-l cever.
W Drywall - Prior to taping.
D Wood Stove - Arter installation.
D Insert - After fircpla~e approval
and Installation of tll~jt.
~ Curhcut & Approach - Alter
forms are erected bIll prior to
placement of concrete.
~l Sidewalk & Driveway - Alter
!AJ excavation is comple!e, forms
and sub.base mated;:;.1 ir~ pl<1ce.
D Fence - When CO~lplcted.
iXl Stroot Trees - When all required
tree~; are planted._ ,
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\ ' ,'.' ..'
PHONE
4f,f';-$"z.? -3
EXPIRES
/~kv/F.J
/ /9/9 Y Y9'Y-7YS/t:
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z.//'7'/<;'y' 9J7-2-~rr
5/~q pR--f'- 707 ~
, )
FLOOD PLAIN'
ZONING CODE:-L",\)9
. OF BDRMS: "2,
SECONDARY HEAT: ~JI+
SQUARE FOOTAGE: -:J '-Ie:, /"
To request on inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspectlons requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will bl} made the following work day.
DEMOLISH
OTHER
W Tcmporary Electric
o Sitc Inspcction - To be made
after ,}xcavalion. bul prior to
sCllln~J forms.
D
Undcr slnb Plumbing I Electricnll
Mcch.:mical - Prior to cover.
[l] Footing - After I ranches arc
cxcav.llcd.
D Masonry - Steel location, bond
beams, grouting.
[L1J Foundation - Arter forms arc
crcct(:d but prior to concrete
placement.
o Undcrground Plumbing - Prior
to filling trench.
IJl Ulldcrlloor PlumbinglMechanical
l.7"\-J - Prior to Insulation or decking.
[AJ Post and Beam - Prior to floor
Insulation or decking,
Q Floor Insulation - Prior to
decking.
[J' S<lnilary Sewer - Prior to filling
trunch. . "'. < :~.
. .
r-7l Storm Sewer - Prior: to ,O!llng
t...,t.\J trench. \
\(.if Watcr Line - Prior to filling
LA;J trench.
r7l Rough Plumbing -\Prior to
~ cover. .
CONST,
CONTRACTOR'
7;~t7Y
:f-v..- ./)-//~Qtn/' 99''' / V-
;70 f!, 4X'~6 /),..rt&- '-f;..d"J.-YCI
/YOQ Cq~#~S"(' " f??7'$ r
", . ~r71 '.
ADDRESS
/;l./~ ""r1< R $r
- OFFICE USE -.
LAND USE: l \ \ \ "
.( ,
V-!1L
I='~ Il-P
7
. OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
rV1 Final Plumbing - When all
~ plumbing worl( Is complet,e.
171 Final Electrical - Wilen all
~ electrical work is complete.
rY1 Final Mechanical - When all
!.-LV mechanical work Is complete.
r7"i Final Building - When all
J4J required inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
:=:l Blocking and Set.Up - When all
L. blocking Is complete.
'---I Plumbing Connections - Wt1en
1....-- home has been connected to
water and sewer.
n Elcctricnl Connection - Whon
-. btocl(lng, $ct.up. and plumbing
insj)l:H:tlons have bel.~n 3pprovcd
and the home is connected to
the service panel.
!.=:J Final - After all req~lred
I InspectIons are approved and
porches, sklrtlng, rjccl(s, and
venting have beer. Installed.
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Lot faces 1'L Lot Type Setbacks IS THE PROPOSED WORK IN THE
I P.L. HSEIGAR " HISTORICAL DISTRICT, OR ON
LOI sci, ltg, ~ Interior ACC
~I THE HISTORICAL REGISTER?
Lot coverage ft '~ Corner N If yes, this application must be signed
~~ S zzti>' and approved by the Hi~torical
Topography Panllandle
Total height c::::Xl-5 Iw I~( I Coordinator prior to permit issuance.
Cul-dc.sac
IE ~" I
APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/5Q, FT. VALUE
Main I,Cd- St." ::l 101,103
Garage lL,c; I Jl{L qd.(.,~
Carport
,
~~,
~?7. 75'"
22.$"1
'!~.~'t:.
SYSTEMS DEVELOPMENT CHAR9.E (SDC) If.
(B) fI "2.1".1 II:!
Total Value
Building Permit Fec.
State Surcharge
Total Fcc
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ,.z
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
~...,
Plumbing Permit
/~. <:>0
. --
1fJ.&-
/~60
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
r::..4C
'I.~
""7. &!:>
Furnace
Exhaust Hood
Vent Fan
N' ~X~
Wood Stovellnsert/Flrcplacc Unit
Dryer Vent
'3, esC>
Mechanical Permit
'"'72. ~
Issuance
/ ~ csc:.
State Surcharge
, ,/:3
.33~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk !71?' It
Curbcut ~ fl
-%~
j'i~
Demolition
State Surcharge
101al Miscellaneous Permits
/f 6&>..7.7
(E) '7iS17k:= 2,::(>b~ Ir
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condilion tllat the :.iaid
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction amJ use of
buildings, and may be suspended or revoked [It any time
upon violation of any provisions of said ordinances.
~~ <. t.L.
Dale Paid: foJ..110-:>,
,
ReCel;)! Nunlbcr:_---2-~7.
Received By: _Qp,
~e~E1~
Plan Check Fee:
~~~
Dale
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
A~e~~~JNAL COMr"IE~TS
),.,.QJI., - LJdfc. d
...Lk" e-., e TCv"f- ~ h!::!. ~O
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'"PcVttJ..1
By signature, I state and agree, that I t1avc carefull', c:x<1mincd
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 ilccord.lnce
with the Ordinances of Il1e City of Springfield, and the Law::;
of the State of Oregon pertaining to Il1e work dC:icribed
herein, and thai NO OCCUPANCY will be made of any
structure without pcrmi:>sion of the Building Safety Divi:>lon.
J further cerlify thai only contractors and employees who
are in compliance with ORS 701.055 will be used on Ihis
project.
I furl her agree to ensure that all required inspcclio~s arc
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 the site at all ti s during const~n. . _
Slgnal:.Jrr> ~~
?/ .'
Date_~/~5/fJ
VALIDATION:
9//~
b /,6,'7'3$
3~ 7"<.6 ~
RECEIPT NUMBER
DATE PAIr>
I
/
/
. !. "1,'."
.:--'
.. ..OB NO, Q'boT77-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
, WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
NAME OR COMPANY: LAtJAl/E=. Me.., (.LUf!..~
LOCATION: 12 t:j '3 I-I~NlIL:r{)^,' S-r. /70 3 ?:>4- 2- 2. ,- 00'2 zt;
DEVELOPMENT TYPE: Lpfit. - New. '$rl!:.
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUSSQ, FT.
'LOT SIZE
SQ. Ft,
?(,q'-f
X $0,192 PER SQ. FT.
G70Q1-?)
~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
I ~
X $39.78 PER PFU
c: -7/(" e'i)
--- ---
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X) .005 X $401.05
G Lf(;3~
-----
x
X $401.05
$
X
X $401.05 $ -
SUBTOTAL (ADD ITEMS 1,2, & 3) $ I $'1.~ ~
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X ,05
~ "I, "3:)
------
TOTAL-CITY SDC $ /"i,q'..l
5. SANITARY SEWER-MWMC
NO. OF PFU'S 1'1, x $13,62 PER PFU + $10 MWMC ADMIN. FEE $ 255 '~
(UsePFU Total From Item 2 Above)
k'.D~~
(j Kip Burdick
SDC Coordinator
~ /7 /93
.l ~,
$ T3-
TOTAL-MWMC SDC~;-~
\"Z.
TOTAL SDC $ '2., ~ I -
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
,
FIXTURE UNIT'CALCULA TI_ ABLE: Number of New Fixtu~es X ..ivalent ; Fixture Units (N01 e~.. \.
For remodels, calculate only the NET additional fixtures)
I
I
I
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
. ,
I
\
I
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
<I-
Balhtub, ........ ..... ..... ...... ....... ...... ......,.,........ ,........... ,..
Drinking Fountain.. ................,...... ,....,..,.,......,......,..,
Floor Drain,.. ,... ,........... ,......,..,........... ,.............., ,....,.
Interceptors For Grease/Oil/Solid~/Etc....,.......;,..,
Interceptors For Sand/Auto Wash/Etc,:........;"....;
Laund ry Tub /Clotheswasher..,.. ,.... ,....,......,.. ,....'...,
Clotheswasher - 3 Or More......,......,......,....,..........,
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorjWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower. Single Stall...............,..,...".,..,...........,..,..,..
Shower, Gang.......:........,.........,......,..,....,.,....,....,...,
Sink, Bar, CommerciaL..,....,..,........,............,.."".."
Urinal, StalljWaIL............,.,..,....,.,..,....,......,....,..,..,..
Wash Basin/Lavatory, Single,....,....,....,.,....,."",..,..
Water Closet, Public Installation.............,..,....,....,..,
Water Closet, Private.....,.....,........,..,....,....,.,..",...,..
Miscellaneous:
L
'l-
or-
2
'Z
-J,
1.
'il
TOTAL FIXTURE UNITS
;
('6
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table,
calculate credits separates,
1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2,60
2.46
2,33
1985
1986
1987
1988
1989
1990
1991
Rate per $1,000
Assessed Value
$2,16
1,90
1.60
0,25
0.87
0,50
0.16 J
<I?, ~
-
=
= $ ~!> 8;'
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Credit for Parcel or Land Only If Applicable
Improvement [If after annexation date)
z.n X $ /5,tfB
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
RUNOFF COEFFICIENTS'FOR STORM DRAINAGE
ResidentiaL....................,................................. 0.4
CommerciaL.................................................... 0.9
Industrial........................................................... 0.45
Governmental....... ...... ................ ,.. .............. ..... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
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SPRINGFIELD
.,.... ~. "....l..... ,........1....."')...... !"l..bmitt3d hanthefollowing
225 FIFTH STREET , . ...,. ...'.. " ':. .0;';0 land uC'ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9747'7'1 ,..~l.
INSPECTION REQUEST: 726-3769Zon:ng lA;)f2.-
OFFICE: 726-3759 . -\
D,to~J..'l~2 3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATIQNizCd Slgnalu'e lQ2 ,
/'2 ~ ~/.3/C ~, ' - A:-New Residential-Single or
-. . .' Hulti-Family per dwelling uni to
LEGAL DESCRIPTION Service Included:
J'?~~.-YY-;:i2'~~ ,"",P:Z:;l-:>-
. ~OJ'. DESCRIPTIO~
-W/71'q-q " .:/? .~p~~
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 1)<2."-#'~ z:.1e.JA.I~
Address/YolO> Co..",~I..h'1tt bR. RI1\
City 'L "-"] P,^, e- Phone t) RfJ - So 10
Supervisor Licen.se Number ~ 8'1 "l C;
Expiration Date ID- t - ";'
Constr Contr, Number q~ 1 3 if
"
Expiration Date_ ~ -17 - 9LJ
Signature of Supervising Electrician
\) _ -P .
. D '
Owners Name / ~~.6=' ~0 v~ .
- r" . ~ , v'
,Address /7~'f7:;rk :f> -
Ci ty--"/~~ Phone~~",,>~
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
DATE: .6'/&L-S;S
RECEIPT 11: --.::j/c~
RECEIVED BY: ././ ~
if
City Job Number q~~ 7.? 2-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dwelling
Service or Feeder
Items
/$
~
Cost
Sum
85,00
~$
15.00
12
$ 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
....--s 40. 00 ~
$ 55.00
$ 80.00
volts see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E, Hiscellaneous (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 /~ ~
5% State Surcharge ,Jl;..2,7:?
TOTAL ' /7~se:>
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