HomeMy WebLinkAboutPermit Building 1994-03-29-B',\ts E-u"*
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
\rll tlc'r*t a l-otH
SP,lINGFIELI)
JOB NUMBER
225 Fifth Street
Spri ngfield, Oregon 97 477
.}33() O..ttO
ASSESSORS MAP:TAX LOT
LOT:).BLOCK:
oooo
HE ANO i CONSTRUCTION,INC *7LL5S
84959 Parkuay
PLEASANT HTLL,OR 97455
SUBDIVISION
PHONE:
STATE:ztP
DESCRIBE WORK:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
84959 Parkway
Pleasant Hill, 0r 97455
3170 Ut llt h,
Eugene, 0r 97402
500 Greenfield
Eugene, Ar i7444
4131 "E "St .
Springfield, 0r 97478
2766L Crow Rd
Eugene, Or 97402
EXPIRES
a2/95
a4/94
a6/94
12/94
a3/94
HE and i Const,,Inc
687 - 185121351^Bills Electric
688 - 1931330760on Leulis Plumbing
7 47 -7 44"25794Harshalls OiI & Ins.
34555921Brooks Excavation
E r r---
711 58
ADDRESS
RANGE:
CONTRACIOR'S NAME
WATER HEATER:
# OF STORIES
PHONE
725-3898
SECONDARY HEAT:
SQUARE FOOTAGE:
CONST.
CONTRACTOR #
HEAT SOURC
GENERAL:
PLUMBING:-
MECHANICAL:
ELECTRICAL:
-
I
QUAD AREA: (I
s OF BLDGS:
-OCCY GROUP: I
To request an inspection, you must call 726-3769. This is a24hour 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.
REOUIRED INSPECTIONS
Final Plumbing - When allplumbing work is complete.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Final Building - When att
required inspections have been
approved and building is
completed.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - Whenblocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Final - After all required
inspections are approved andporches, skirting, decks, andventing have been installed.
Xl. remRorary Electric
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior to insulatlon or decking.
Floor lnsulation - Prior to
decki ng.
Water Line - Prior to filling
tren c h.
ffinouSh Mechanical - Prior to
-.'cover.
ffi Rough Electrical - Prior to'- cover.
K
K
K
d
8
d
K.
F
Eleclrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
fi"^-'ng - Prior to cover'
M1".."; rs"?xl,;,I,iior to froor
Lr.
Wall/Ceiling lnsulalion - Prior to
cover.
wall - Prior to taping
MOBILE HOME INSPECTIONS
f-_l Wood Stove - After instaltation
insert - Arter rireprace approvar f] 3l;:['13 TS.:,";:[- when arr
and installation of unit.
'[l Sanitary Sewer - Prior to filting
-
lrencn.
p(l Storm Sewer - Prior to fiilingu trench.
E
]!{ Sidewalk & Driveway - Afterts excavation is complete, forms
and sub-base material in place.
[--l Fence - When completed.tt
Curbcut &Approach - After
fornts are erected but prior toplacement of concrete.
Str€et Trees - When all required
trees are planted.
Rough Plumbing - Prior to
cover.
[_-l other
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type v
/ tn,urio,
-
Corner
-
Panhandle
-
Cul-de-sac
ks
P.L.HSE GAR ACC
N
S
E
VTHE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? --
lf yes, this appllcation must be signed
and approved by the Historical
Coordinator prlor to permit issuance.
APPROVED:
i
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express
construction shall, in all respects, conform to the O
adopted by the City of Spri ngfield, in
Development Code, regulating the
buildings, and may be suspended
DaPlans Reviewed By
By:
condition that the said
ng the
upon violation of anY rovts I
Plan Check Fee:
Date Paid
Becei pt
and use ofnstru
at any time
hid ordinances
(A)
I Bi\?
tpnS'
BUILDING PERMIT
Total Value
Building Permit Fee
state surcharge
Total Fee
ITEM
Main
Garage
Carport
FT. X $/SO. FT.
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)tznzt&
ADDITIONAL COMMENTS
)
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
mID
@
(c)
FT.
FT.
FT.
N0
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
Mechanical Permit
(cNTWq 6-ca
I
c
(D)
N0
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, 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 wlll be used on this
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permlt card is located at the f ront
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
curbcut 2L
Demolition
(E)Total Miscellaneous Pe
ft
ft
S Su rcha
DATE PAID
VALIDATION
RECEIPT NUM
AMOUNT REC
FIECEIVED BYTOTAL AMOUNT DUE (excludirrg electrical
(A, B, C, Q and E Combined)
5cDIt tn
3-{Li-
M
{*.}
lr/
/roB No. n4ozt4
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
I.JORKSHEET
(c0l'lt'tERCIAL & RESTDENTIAL)
NAME OR COMPANY:C
LOCATION:
DEVELOPMENT TY
BUILDING SIZE:
o o
PE: L NL W SFR
LOT SiZ . Ft.I. STORM DRAINAGE
IMPERVToUS sQ. FT.G5 x $0.203 PtR SQ. FT.
X $42.08 PER PFU
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
Z4
2 SANITARY SEWER-CiTY
NO. OF PFU'S
(See Reverse)
X t, ol x $424.31
x $424.31
x $424.31
4. SANITARY STWER-MWMC
NO. OF PFU'S
(Use PFU Total From I tem 2
5 ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL AB0VE) x .0s
Ki p Burdick
3. TRANSPORTATiON
NO OF UNITS X TRIP RATE X COST PER TRIP
\
X
x
$
$
IZ $15.125 PER pFU + $I0 MI^JMC ADM FEEAbove)zaz z5
MI.'MC CREDIT IF APPLICABLE (SEE REVERSE)b o1
bo
5oo49
151 +4
aLrS
SDC Coordinator
7 LL
TOTAL SDC Zozt*
?_4z-o
L2_
FIXTUREUNIT,CALCULAI-/NTABLE:NumberofNewFixluresX
For remodels, calcutAt'e"Jn'l;;"-G 'Taitio'ut
fixtures)
NUN4BER oF
FIKTURE TYPE NEW FIXTURES
Z
t Equivatenr = Fi(ure Units (['ICTE:
UNIT
EOUIVALENT
FIXTURE
UNITS
L
2
1
2
J
6
2
6
b
1
3
2
1l
2
2
1
6
Bathtub-.-.--.-
Drinking Fountain""
Water Closet, Private""'-""""-"'
Miscellaneous:
Shower, Gang""""""';""""-"-"
Sink. Bar, Commercet
Urinal, StatlfrVall""'
il"tn' Au.in/t-avatory Single" " " "
w;;; A;;t, Public lnstallation"'
x$o
X Assessed Val ue)
x
Head
b
_8
IB
CREDIT
calculate
CALCULATION TABLE:
credits
TOTAL FIK'URE UNITS
Based on assessed value' lf improvements occu rred after annexation date in table'
b4 o,
$3 tob*-
Credtt for Parcd or tand OnlY lt
lmprovement (rf after annexation date)
RUNOFF COEFFICI
c
R STORM DRAINAGE
ApPlicable 3
(Rate
(Rate
ENTS FO
Residential' """""""' 0'4
Commercial .-...--.--.-.3.?ttndustrial---. ................... 0.5
Governmental""""""""
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
1$,000Rateper
ueValYear
Annexed
Assessed Value
Rate Per $1,00O
Year
Annexed 1986
1987
1988
1989
1990
1991
1992
s2.24
1.93
1.57
1.18
0.79
0.44
0.28
1979 or before
1980
198'l
1982
1983
1984'1985
s.21
3.13
3.08
2.96
2.a2
2.68
2.51
OREGO'UCITY OF
5Prl!]\lGFIELD
225 FIFTE SITEBT
SPRTNGPIEID, ORBGoN 97 7
INSPBCIION BEQUEST: 72
OFFICE: '726-3759 Date
1.OF
I,EGAL DESCRIPTION
following
1.000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dwelling
Servlce or Feeder s 40.00
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 0nIy
C. Temporary Services or FeedersInstallation, Alteration or Relocation
qr
Pump or irrigation
Sign./OutIine Lighting-
Limited Energy/Res
-
Limited Energy/Comm
The following Projoc{ as eubmltled hr the
ioninb, ano?besnot require specific land u90
EIJCTTTCAL PBRI{IT APPLICATION
L City Job Nunberq-
3. COHPIATE PEE SCEEDUIA BELOV
A Nev Residential-Single or
HuIti-Family per dvelling unit.
Service Included:Items Cost
$ 8s.00U
Sumffi
&A $ 1s.00Permits are non-transferable and expire
if work is not started vithin 180 days
of issuance or lf vork is suspended for
180 days.
2 COTTIBASTOR INSTALI,ATION ONLY
Blectrical Contractor
Address 3 170 ,t/, /1 d
ci fu a-
B
$ s0.00
$ 60.00
$100.00
$ 1 30.00
$300.00
$ 40.00
Phone(/
Supervisor Lieense Number
,O;/*S4.? ^
?Fn S
Expiration Date ,l
Constr Contr. Number or
Expiration Date a
ing trician
Address 5
Ci ty Phone
OITNBR TNSTALT.ATTON
The installation is being made onproperty I ovn vhich is not intendedfor sale, lease or rent.
0cners Signature:
200 amps or less i S
201 amps to 400 amps
-
S0ver 401 to 600 anps
-
$0ver 600 amps or 1000ETfs s
Branch Circuits
40.00
55.00
80.00
0
ee ilB'' a56G-
a D
New, Alteration or Extension per panel
One Circuit S 35.00
Each AdditionalCircuit or with Serviceor Feeder permit _ $ 2.00
E. Miscellaneous (Service./feeder not included)
-Each installation
s 40.00
$ 40.00
$ 20.00
$ 36.00
5. SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
IDATB:
l\rRECBIVED
l,3sl 1q,l-
qs