HomeMy WebLinkAboutPermit Building 1994-12-06RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
q4t LZ
PrlINGFIET.D
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97 4ll
ll ?"h'// #r.n-y'
ASSESSORS MAP:
LOT:
-
BLOCK:
3 -32 TAX LoT: / / f, -
SUBDIVISION:
OWNER:
ADDRESS
CITY:
PHONE:
STATT]:ZlPi
.{
NEW- REMODEL
DESCRIBE WOR
ADDITION DEMOLISI-I OTHER
'S NAME ADDRESS EXPIRES PHONE
MECHANICAL:
ELECTRICAL:
PLUMBING;
GENERAL:
CONT CONST.
CONTRACTOR #
\QSr),rr
\
_ OFFICE USE -
, OF BDRMS
ZONING CODE:
LAND USE:
* OF UNITS:
QUAD AREA:
/ OF BLDGS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
BANGE:
\.
FLOOD PLAIN:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon,
made the sanre worklng ,
,you must call 726-3769. Thls ls a24hour recordlng. All lnspections requeslecl before 7:0o a.m. wlll beday, lnspections requested after 7:00 a.nr. wlll be made the foltowlng work day.
REQUIRED INSPECTTONS
[--l Temporary Etectrtc Rough Mechanlcal - prior to ffirlnal plumbing - when ail
flplumblng worl< ls complete.
pfrinat Etectricat - When ail.F\electrical work is complete.
cover.
Slte lnspectlon - To be made
after excavatlon, but prior to
settlng forms._x Rough Electrical - prior to
cover.
Underslab Plumblng/ Electrical/
Mechanlcal - Prlor to cover.Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Flnal Mechanical - When allmechanical work is complete.
Foollng - After trenches are
excavated.l-l Fireptace - prlor to facing
-
materlals and frarrring lnsp.
l!l Framlng - prlor to cover.
-'q-
ffiWatltCelling lnsuiauon - prlor to
flcover.
Final Building - When allrequlred lnspections have beenEMasonry - Steel locatlon, bond
beams, groutlng.
pproved and building is
completed
Foundallon - After forms are
erected but prlor to concrete
placement.
Other
Underground Plumblng - prior
to fllllng trench.Drywall - Prior t,) taping.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
MOBILE HOME INSPECTIONS
l-_l Wood Stove - Airer lnstailation.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flrt:place approval
and lnstallatlon ot unlt.
Blocking and Set.Up - Wh.en allblocklng ls compleie. . '
i
Plumbing Conneclions - When
home has been connected to
water and sewer.
Floor lnsulatlon - Prior to
decklng.Curbcut & Appro;rch - After
forms are erectecj but prior toplacemcnt of corr,;rete.Sanitary Sewer - Prlor to tilling
trench.
Slorm Sewer - Prlor to fllling
trench.
Sidewalk & Driveu,ay - After
excavation is cor,rlrlete, forms
and sub-base maicrial in place.
Eleclrical Connection - Whenblocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Water Llne - Prlor to filling
trench.l--l Fence - When compteted
Stresl Trees - Vlllsn all requlred
trees are planted.
Final - After all required
inspections are approved andporches, sklrting, decks, and'ventlng have been installed.X Rough Plumbing - Prior to
cover.
WATER HEATEFI:
-
n
tl
tl
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
W
E
IS THE PROPOSED WORK IN THE -- HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcatlon must be slgned
and approved by the Historical
Coordinator prlor to permit issuance,
APPROVED:
Total Value
, Bullding Permit Fee
i ,,r," s-ur.n.rs" /b?t * /o't4
| ,o,u, ,uu (A)
X S/SQ. FT,
?3be"
-4-2217-AI-+
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
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
t>/r,/r4
Plans ewed By
Receipt Num
' Date
Plan Check Fee
Date Paid:
Received
upon violation of any ordinances.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)
/ 2a.rr
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
o
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work described
hereln, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Bullditrg Safety Division,
I further certify that only contractors and employees who
are ln compliance with ORS 701.05S wlll be used on this
project.
I further agree to ensure that all required lnspections are
reguested at the proper time, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remain
GDate
on the site at all times durl ng constructlon
Inn",,
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
4G 7, A7
RECEIVED BY
--*
o'?AMOUNT RECEIVED
DATE PAID
VALIDATION:
BECEIPT NUMBER
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
ldoblle Home
No
Plumblng Permlt
State Surcharge
Total Charge
.7f *,4{
FEE
. FT.
r%J,
/trto
/ 70
(c)
FT,
FT.
, '-O
SPHTNGFIELr)
IH,L"J:s[%B:??"j'
approval'
isxPl$""lfi3iiffi ilr""n Zfr,
225 FIFTB STRXET
SPRINGFIELD, 0REGON 9747,ft,:
a
EI-ECTRICAL PERHIT APPLICATION
City Job Nun.ber z
3. COHPLETE FEE SCBEDTILE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof S 15.00
Each Manuf'd Home. or
-Modular Dvelling
SerVice or Feeder $ 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or Less
201 amps to 400 amps _40i- amps to 600 amps _601 amps tori.000 amps_
Over 1000 amps/vo1ts
Reconnect 0n1y
C. Temporary Services or Feeders
Installation, Alteration or Relocation
INSPECTION REQTEST:. 726-3769 .
OFPICE: 726-3759 t ""' ''''
1 TION OF ,TION
I.EGAL DESCRIPTION7o3 3t 3 z D,//O L
JOB DESCRTPTION(' aL') ar)za<tzr- '
200 amps''or L
201 amps to 4
Over 401 to 6
Over 600 amps or1
Lps
000-voI-[s
Sum
s 40.00
$ ss.00
s 80.00
see ItBtt a6ove
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.,ATION ONLY
Electrical Contractor
Addr
Ci ty
Supe
Expiration Date to -t
ess
Phone
rv sor cense Number
-,Jtr4 bSb
3l rlES
-q5
s s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
Constr Contr. Number
Expiration Date
Signature of Supervi Electrician
ses
0o
00
amps
am
0vners Name
Address
Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit I $ 3s.oo .:5.90
Each Additional
Circuit or vith Service
or Feeder Permit--- -k- $ 2.00 I?,OO
Miscellaneous (Service/feeder not included)
Ci Phone
OVNER INSTALLATTON
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
Ovners Signature:
DATE:
E
-Each installation
Pump or irrigation
-
S
Sign/outline l,ighting- S
l,imi ted Energy/Res
-
S
40.00
40.00
20.00
36.00
5 SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAIPSCEIVED B
a
,
AilALnmLiil ril
NA,I.4E OR COMPANY
LOCATION:
DEVELOPMENT TYPE
BUILDING SIZE: I OT SI
JOB NO ail722
CITY OF SPRINT,TIELD SYSTEMS DEVELOPMENT . ARGE
I^lORKS
(COt.4l'4ERC
Ft
1. ., SIORF] NRAINAGF
iMPERVIOUS SQ. FT
2. SANTTARY SFWFR-CTTY
NO. OF PFU'S
(See Reverse)
X $0.209 PER SQ. FT
X $43.26 PER PFU s tr6,62
s
s
SUBTOTAL (ADD ITEMS 1,2, & 3)s tr6,5 ?
S K€t?opEL
2
3. TRANSPORTATTON
NO OF UNITS X TRiP RATE X COST PER TRIP
x _ x $436.19
x _ x s436.i9
x
--
x s436.19
4. SANTTARY SIUIER-MI^IMC
NO. OF PFU'S
(Use PFU Total From Item 2
$i7.19 PER PFU + $10 I'4I^JHC ADMIN.FEE
Above)
Ml^]l'4C CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MI^IMC SDC
SUBTOTAL (ADD iTEMS 1.2,3 & 4)
5. ANMTNiSTATIVE FFFS
sd_-.-T--___
s fe-sz
(AL ) x .05
6-
s a.33
ni g, P.
IDENT
82. SDC
Coord'inator
Date:
TOTAI SDC s ?o,6s
$^A-/L€
BAShCHPRGE
Bathtub.....
Drinking Fountain....
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc.
lnterceptors For Sand/Auto WashiEtc.
Mobile Home Park Trap (1 Per Traiter)-.....
Receptor For Refrigerator/lvater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc"
Shower, Single Stall..........
Shower, Gang.........
Sink: Bar, Commercial, Residential Kitchen....
Urinal, StatlMall..l
Wash Basin/LavatorY, Single.
Toilet, Public lnstallation.
Miscellaneous: tT'il Pal g,tk
FTXTURE UNIT CALCULATION TABLE: Number or New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the NET addirional fixturesl*ra*
O, UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
d/Hea
2
1
2
J
6
2
6
6
1
J
2
1
2
2
1
6
4
?
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value' I f improvements occurred after annexation date in table,
calculate credits seParates.
Year
Annexed
Rate per $1,O0O
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
i 979 or before
1 980
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
0.61
o.44
0.15
Credit for Parcel or Land Only lf Applicable
lmprovement (if sfter annexation date)
x$
(Rate X Assessed Value)7(6poDEAx $-
(Rate X Assessed Value)
CREDIT TOTAL $
Z