HomeMy WebLinkAboutPermit Building 1995-6-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD "
LOCATION OF PROPOSED WORK: %~ 7_
I ~ n?~ Ob
ASSESSORS MAP:
.2,
LOT'
OWNER' "P,IZULE
ADORE'"'' /7, /4
CITY: "tUb 18\1;:'
1)~
Th-_Il I
,.12,( .
I
STATF' ZIP: q"14n4.
.
#a,uE ~FMevr / AA:bD n~
DEMOLISH OTHER
TV\{'
!/j
BLOCK'
J
LI...)
1<1-b/J17A-
DESCRIBE WORK:
;t1~AlU ':-~~A':>
NEW
REMODEL
ADDITION
.'
q5~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
()~~
~-~-U.J~
ft1DWS.
SUBDIVISION:
PHONE:
bS3S - '26 Z /
Wrl.ft
CONTRACTOR'S NAME ADDRESS
GENERAl' ~- ~(S{).J /44/ -Rw'f ~ iJ,
1'/
CONST,
CONTRACTOR'
hbi/'/7
2.0 -'Z3b tp.8 .
PHONE
669-7 )6z..
PLUMBING'
/.1
MECHANICAl'
ELECTRICAl' 'PJ.c.. 'Eu::z-.
QUAD AREA: _~ t!7f'__
· OF BLDGS: _,
12.~ -I--YY\
OCCY GROUP:
. OF STORIES:
1
~
WATER HEATER:
n
~"
'I
EXflRES
-'f 19b
',,/%
'i r /'
'\ ' ",', ,.:.,
. ., ~
- OFFICE USE -
I\S-O
· OF UNITS' I
CONSTR. TYPE:---.JL...N
fj:;
RANGE: __~
FLOOD PLAIN:
ZONING CODE: _.!:PYL
. OF BDRMS' ~ .
SECONDARY HEAT:_~' .
SQUARE FOOTAGE: ,~-J4. \ 5
"
To request an Inspection, you must call ,726.3769. ThIs Is a 24 hour recording. All Inspections requesled 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,
~~I Temporary ElectrIc
o Site Inspectlon'- To be made
after excavatlon, but prior to
setting forms. ~""'""O
~Underslab Plumblng/Ele~}~1
Mechanical - Prior to cover.
r'\,71'; Footing - After trenches are
T"/ excavated. .
o Masonry - Steel location, bond
.beams. grouting.
r:7I"'" Foundation - After forms are
L!:J erected bU~~~ c~~ .
Placement.~~_
o Underground Plumbing - Prior
to filling trench,
. 0 Underlloor PlumbIng/Mechanical
- Prior to Insulation or decking.
o Post. and Beam - Prior to tloor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
f--rsanltary Sewer - Prior 10 filling
....,..' trench.
K~;Storm Sewer - Prtor to flltlng
~;t trench.
{SlWater Line - Prior to filling,
'~I,I trench. .
<' ''''j Rough Plumbing - Prior to
....,..c cover.
LAND USE:
HEAT SOURCE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
l&-rRoU9h EI(\~~ i\ ~~
1 cover, C\f--~-
{........~"Electrlcal Service - Must be
L.'vapproved to obtain permanent
electrical power,
o Final Plumbing - When all
plumbing work Is complete.
, ,
i~nal Electrical - When all
'-tv' electrical q~
o Final Mechanical - When all
mechanical work Is complete.
~Inal Building - When all
/,..(requlred Inspe~ctlons have been
approved and bulldln I
compleled,
o Other
o Fireplace - Prior to facing
materials and framing Insp,
, ,~ran~~~~rr;
F::l Wail/Ceiling Insulation - Prior to
I.,J cover,
r~ry",all - prlorr 18PICif1
'.J f\.~\.ro\ U'\ ~~OBILE HOME INSPECTIONS
o Wood Stovo - After Installatlon. .
IV'1Slocklng and Set.Up - When all
~blocklng Is complete.
o Insert - After fireplace approvel
and Installatlon of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
.placemont of concrete.
o Sidewalk & Driveway - After
excavatIon Is completo, forms
and sub-base materIal tn place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
r\:t'"Plumblng Connections - When
~home has been connected to
water and sewer.
ljtElectrlcal Connection - When
blocking, set,up, and plumbing
Inspecllons have been approved
and the home Is connected to
the servIce panel.
m Final - Alter all required
~ Inspections are approved and
. porchos, skirting, decks, and
ventlng have been Installed.
Lot laces
Lot Type.
L Interlor
Lot sq, ltg,
Lot coverage
Corner
Topography
Total height
Panhandle
t)
BUILDING PERMIT
ITEM " sa, FT:- ,,"x
Cul-de,sac
$1 SQ, FT,
Main
~arago
5'LP
V\.\U
~,
Total Value
Building Permit Fee (~-"2_' ')
Stale Surcharge 'f?>~
Total Fee
(A)
Setbacks
I P.L. I HSE GAR' ACC I
I N I I I
I S I I I
Iw I I I I
lLLLL~ '
= 415L(fu~
" B\ ~\.lj)
~~
\rA .'::1J
F>."3f )
! \\{;)..P/J
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ts2-14-t,,'6:Z #
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s)
N'
Sanllary Sewer
Water
Stor'!'_ ~;ewer
Mobile Home
FT.
FT,
FT,
Plumbing Permit
State Surcharge
Total Charge
-\~o
(C)
MECHANICAL PERMIT
"
/\
Furnaco .
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk <~~ It
Curbcut JfL It
a..~n""'-- :YJlo on"""
State Surcharge
FEE
_8.~P()
~~~
'1~p)
it~
\/
PI
\ ()~ !X>
140.00
~.a?
\ S ,as
-.la .f"JD
.~
Total Miscellaneous Permits (El
....:.\qU~
TOTAL AMOUNT DUE (excluding electrlcall~_
(A, B, C, 0, and' E' Combined)
" ..\ ~.,::' \:"
- THE PROPOSED WORK tN THE,
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior 10 permit Issuance,
;"
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrmllls gr~nted on the express condlllon thaI the said
conslrucllon shall, In all res peels, ~6nform to the Ordinance
adopted by,lhe City ,of Springfield, Including the
Development Code. regulallng the construcllon and use of
buildings, and may be suspended or revoked at any time
upon vIolation of any provisIons of said ordinances.
Plan Check Fee:
'. ..,\,,'
Date Paid:
Receipt Number'
Received By:
,,--
Plans Reviewed 8y
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits W.hlCh are b~lng Improved.
ADDITIONAL COMMENTS
A- .f-I '. 4J, 48ao:. o.~:
/
6.n.Y11 1/ i.oHfrL drr17: tg{'(t:; (rk)
15&r12W_ 0r4LvJM;.. ,
By signature, I st~lc and agree, that I have carefully examined
the completed appllcallon and do hereby certlly that all
Information hereon Is true and correct, and I further certify' .
that any and all work perlormed shall be done In accordance
with the Ordlnanc~s 01 the City of Springfield, and the Laws
of the Slate 01 Oregon pertaining to the work described
herein, and that 'NO OCCUPANCY will be made of any
structure without permission 01 the Building Safety Division,
I further cerll fy that only co.ntractors and employees Who
are In compllanc~' with ORS 701,055 will be used on this
project.
,
"
I further agree to ensuro that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card 10 located at the front
of the P:~IY. a~d t e pproved set of ptans will remain
on t~~,e 7' all II es urlng co;str~~tlon, / /?
Slgnalure"""'" ~JAr. KJUl..{pf'
Date /6!2Vh~: . . ~
(
VALIDATION:
RECEIPT NU
DATE PAID
AMOUNT REC"(1~ \'
RECEIVED BY (}\}L{.A...--...
.
.
"!~ .,
o lL'!in~'!!t;!!~~
"
Job No. qr;;tJ(p ~ Cf.
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAIvIE:
f)e~li . BVu.Le
11)1"1 ~II.t.J ',,-c-
WYwi!B
PHONE:
{pg~ - ;{3~ ]
"
ADDRESS:
STATE: ~ ZIP 41L/Dq,
- '
,
LOCATION OF PROPOSED BUilDING SITE:
Street Address if Known: 4b?J'2.-
Platt Name: I K 6 ~ tJ to I?)
Tax lot Number: Il?jUJ 6
1. DEVELOPMENT TYPE (Check appropriate dwellirig(sl. SDC calculations and dwelling type
definitions are on the back.l ' ' , ,
A. Sinl!le Familv - Detached
, Single Family home
, NO OF UNITS
I Manufactured home not in a park
I
X $400 PER UNIT .;:,
$" l/tJ(), Q1
B. Sinl!le Familv - Attached.
.'
\
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv Aoartment ' ,
NO OF UNITS
X $777 PER UNIT =
$
D. ManufactUred Home Park
NO OF UNITS
;'-;-i
X $280 PER UNIT =
$
WPRD SDC '" $
2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit
approval. See SDC Credit Worksheet.' $
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) $
l/o(). i;~
lMtJ.uo
~C~
r.......................:..., <:"n,:r,..." n~.~i"n
/ n- / tl~ '
Y) /
n~rp
.
.B NO. Cf'SOb8eIJ
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 17t:::.-..t--l ~ 'Rt-l-oJJ..t:> />.. "'\";>\LUl-E:.
LOCATION: 4??'2- 1:-'lY -::.-r,
1<60'2..-0C;1~ -o'?"Z-OO
DEVELOPMENT TYPE: L-t:>11::... - N.E:.W MAl--tu. +-\-MAE:
~. ME:- 6A-/L 1> . W
BUILDING SIZE: U'P;.~ 21o.,iU, \z.....~ l.OT SIZE
. '
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
z.~1..-
x $0.209 PER SQ. FT. (""'2.0 q,~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
(S
X $43,26 PER PFU
GT1~";)
------ ------
3, TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $436.19
X $436. 19
G 440 ?~
------ -----
$
\.0\ X$436,19
X
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S \ '& x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ 'O\"I4"Z.
TOTAL-MWMC SDC
$ 14- ee
~
---- -----
$ "2..04-4-"2.
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~~~_ Date: '5/z:;/~5
(j Kip Burdick I 'TOTAL SDC
SDC Coordinator
C \D'2..-z?;
'-- ~
$ Z.14-Co~~
FIXTURE UI\II!:Sf\lCULA TJMI'1 T I:\BLE: Number of New Fixture_nit Equivalent = Fixture Units
(NOTE: For remodels, calculate only th~ additional flxturesl
NUMBER OF UNIT FIXTURE .'
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
'V'
2
1
2
3
6
2
6
6
1
3
2,
1/Head
2
2
1
6
4
4-
Bathtub,.......,..",.......""...,....."....."...,.",.."...........,.. .
Drinking Fountain...............u....................................
Floor Drain.,."...."""..,.."..".."""..,..."".",....,.....".,"
Interceptors For Greasc/Oil/Solids/Etc.................
Interceptors 'For Sand/Auto Wash/Etc,..................
Laundry T ub/Clotheswashcr"",.,.".",..""..",... .:"..,
Clotheswasher.. 3 Or More......,..'.....,.."..,......,......,
Mobile Home Park Trap (1 Per Trailer)............,...., '
Receptor For Refrigerator/Water Station/Etc.......,
Roceptor 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:
2-
\
'Z-
z.
'Z-
-z.
~
TOTAL FIXTUnE Ui'!1TS
\9,
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separales.
\
.1
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
liate 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
1985
1986
1987
1988
1989
1990
1991
1993
$ 2.46
2,14
1.77
1.37
0,97
0.61
0.44
0.15
\ 4- '1.'i
.-~-'-"---- -..--
Credit:foi Parcel or Land Only If Applicable ~,4'" X $ 4.7
(Rate X Assessed Value)
Improvement (it- after annexation datel X $
(Rate X Assessed Value)
CREDIT TOTAL = $ 14-~
.
SPRINttELD
The~,~ ~,
Zoning and~prO!8Cl a. sUbmittod ~
QPprov~1 oes not require ,~as lho follow'
225 FIFTH STREET ' sPec'flc lend iEt.E~CAL PERMIT ^C\LICATION
SPRING~IELD, OREGON 97471 __ 7001;019, L{)f? r!i\.\ On
INSPECTION REQUEST: 726dY;~-:?_ _ 'City Job Number aJID'\
OFFICB: 726-3759 ~ ~~
AL1horized Sl9nlllure Ai ~Il COMPLETE FEE SCHEDULE BELOII
l.W~~W 0 TION .l- u:+
~ A A. Nev lh:,,~de,ltial-Single or
Hulti-Family per dvelling unit.
Service Included:
\~Gt}r)~FTI
~ser~a ~ EAtuDOf>
Permits are ~n-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
!
2. CONTRACTOR INSTALLATION ONLY
,
Electrical Contractor
BC ELECTRIC
Address PO BOX 371
City
Phone 935-5210
ELMIRA
Supervisor License Number ~?~
Expiration Date lQLl.L95
Constr Contr. Number 66799'':
..
Expiration Date
6/4/94
Ovners
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEIPT I:
RECEIVED BY:
~.-._~-----------
l(} "( ~}~...J
~~rAD
It ems Cost Sum
1000 sq,ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or
Hodular Dvelling ~ ED
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps ' $130.00
'Over 1000 amps/volts $300.00
Reconnect Only $ 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 100u
$ 40.00
$ 55.00
$ 80.00
volts see ItD"
above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service ~
or Feeder Permit ---'- $ 2.00 ~
E.
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
40.00
40.00
20.00
36.00
not included)
5.
$
$
$
$
-&.cV
;d~.~
$.~
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL