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Home My WebLink AboutPermit Building 1994-03-29SPRIF'GFIELI) JoB NUMBE^ adzr*a 225 Fifth Street Spri ngfield, Orcgon 97477 RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOCATION OF PROPOSED WORK:ab76 O**o \t ASS LOT: ESSOBS ,{ MAP:TAX LOT: BLOCK:SUBDIVISION OWNER: ADDREST CITY: - oooo HE AND i COHSTRUCTION,INC *7LL58 84959 Parkuay PLIASANT HILL,OR 97455 PHON E ZIP: DESCRIBE WORK:SFD NEW * REMoDEL ADDtloN DEMoLTsH orHER CONTRACTOR'S NAME GENERAL: - PLUMBING: HE and i Const.,Inc. MECHANICI ELEcTRtcAL BiIIs Electric 84959 Parkway 71158 Pleasant HiII, 0r 97455 3170 tll llth, 21351 Eugene, 0r 97442 500 Greenfield 33076 Eugene, 0r 97444 4131"E"5t. 25794 Springfield, Or 97478 2766L Crow Rd 5592L Eugene, Or 97402 ADDRESS EXPI RES PHONE 7?6-3898a2/95 687- 1851a4/94 68B-193106/94Don Letlis Plumbing 7 47 -7 445L2/94llarshalls OiI & Ins. 345-756403/94Brooks Excavation RANGE:SQUARE FOOTAGE:C:-ER: CONST. CONTRACTOR # --T7 QUAD ABEA # OF BLDGS OCCY GROTJ # OF STORIE WATER HEAT Site lnspection - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. 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, lnspections requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Electric gh Mechanical - Prior to cover. K K x K X E K ry ry tr K fr # tr .K x Rough Electrical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prior to facing materials and framlng lnsp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover, Drywall - Prior to taping. Wood Stove - After installation. lnsert - After fireplace approval and lnstallation of unit. Curbcul &Approach - After fornrs are erected but prior to placement of concrete. Fence - When completed Slreet Trees - When all required trees are planted. Final Plumbing - When all plumbing work is complete. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. Final Building - When all required inspections have been approved and building is completed. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundalion - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam' - Prior to floor insulation or decking. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Slorm Sewer - Prior to filling trench. er Line - Prior to filling t renc h. Rough Plumbing - Prior to cover. I U Side*atk & Driveway - AfterHexcavation is compiete, forms and sub-base material in place. Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When all blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. k!((- d35{ Loct\ E E E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type X tnt"rio,, - Corner - Panhandle - Cul-de-sac\!j Se P.L.HSE GAR ACC N S E HE PROPOSED WORK IN THE H-ISToRICAL DISTRICT, OR ON THE HISTORICAL REGISTER? -.-lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED:) 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 $Kq DatePBy ceived By: aid rdinances Plan Check Fee: Date Paid Receipt Number: X (A) BUILDING PERMIT Total Value Buildlng Permit Fee State Surcharge Total Fee ITEM Main Garage Carport Systems Development Charge ls due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT C (B) ,^T:l?l?e ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE oo (c) FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent t^ tD +&-qm @ q (D) N0 ) Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood 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 pertalning 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 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 ls located at the front of the property, and the approved set of plans will remain on the site at all times during construction. lzlesDate Sig natu re MISCELLANEOUS PERMITS Mobile Home State lssuance ) Jtr -f,) Cu rbcut State Surc Sidewalk Demolition Surch Total Miscellaneous Permits (E) ft ft DATE PAID AMOUNT FIECE RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electric (A, B, C, D, and E Combined) OZ (. \ JOB NO.q+ovbo CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE }IORKSHEET (cot'['tERcIAL & RESIDENTIAL) NAME OR COMPANY: LoCATION : a-b1 to O-T To C-o*rgrr. DEVELOPMENT TYPE: LVZ -- NEt^{ 9(* BUILDING SIZE: 1. STORM DRAINAGE IMPERVIOUS SQ. FT. .L bl 2. SANITARY SEl.JER-CITY x $0.203 PER SQ. FT. X $42.08 PER PFU siz F S a. Ft. NO. OF PFU'S (See Reverse) (s 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X l.ot 4. SANITARY SEWER-MWMC NO. OF PFU'S (Use PFU Total From Item 2 Above) Ml'lMC CREDIT IF APPLICABLE (SEE REVERSE) ADMiNISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) X .05 \<.B-^--LJ- 1:lL"A4$ Tit Burdick SDC Coordinator s $ $15.125 PER PFU + $10 Ml.lMC ADM FEE $ZbZLz X X x $424.31 x $424.31 x $424.31 o7 TOTAL-MI,IMC SDC SUBToTAL (ADD ITEMS 1,2,3 & 4)$ Zor*q 5 '18bbo 15 ,+t Z+bZ3 ooD TOTAL SDC --t"J- $ Z\ \5 '--) \ FIXTURE UNIT,CALCUI-I - ON TABLE: NUMbET O{ NEW FIXIUTES For remodels, calculAie only the NET additional fixtures) NUtT4BER oF FIXTURE TYPE NEW FIXTURES rt Equivalent = Fixture Units (NUTE: UNIT EOUIVALENT FIXTUBE UNITS + lnterceptors For Grease/Oil /S ol id s/Elc" " " " " " " "' lnterceptors For Sand/Aurto Wash/Etc" " "' - " " " " " 8athtub...........----- Drinking Fountain..---.- Floor Drain-- t-aundry Tub/Ctotheswasher- - - Clotheswalher - 3 Or More.--.-. Mobile Hdnie Park TraP (1 Per .L ,?- a- TOTAL FIXTURE UNITS v.2-t X $o.6 2 1 2 J 6 2 6 6 1 3 2 1 2 2 1 L Trailer)............ -.... Receptor For R efrigeratorAVater Station/ Etc" " " " Receptor For Commerclal Sink/Dishwasher/Etc-' Shower, Single'Stall.. Shower. Gang.......-..- Sink, Bar, Commercial Urinal, StallflVall.... Wash Basin/Lavatory, Single----"' Water Closet Public lnstallation'- Water Closet, Private.....- Miscellaneous: /Head 6 4 -7' L -_.-::-a CREDIT CALCULATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table' calculate credhs seParates- Credit for Parcd or t-and Only lf Applicable lmprovement (if after annexation date) (Rate X Assessed Value) b+o2 $ 7,402 t x$ (Rate X Assessed Value) CREDIT TOTAL RUNOFF COEFFTCIENTS FOR STORM DRAINAGE Residential. """"""" 0'4 Commercial-.----..--."""" """"""" 0'9 lndustriat..-- """"'--"' 0'45 Governmental...----..-.----. """"""" 0'5 tMpERvtous AREA = TOTAL LOT SIZE X RUNOF"F COEFFICIENT Year Annexed Rate per $1,0OO Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 1985 s.21 3.13 3.08 2.96 2.82 2.@ 2.51 1986 1987 19BB 1989 1990 1991 19S2 $ 2.24 1.93 1.57 1.18 0.79 0.44 0.28 OFEGO'UC'TY OF SPF SPRINGFIELO 22s PrFrE $nBEf, I:l::Ji1II;Xt3g?S'iffi.,?I$*If;"I,s iinrncrrgl.D, oRBGoN 97477approvai' , .- / INSPECIION nrOUgSt: 726-3769 Tanins l-l)v OPFICE: '726-3759 1.OF c IJGAL DESCRIPTION Permits are non-transferable and expire if work is not started vithin 180 days of lssuance or if vork ls suspended for 180 days. 2. CONTRACTOR INSTALI.ATION ONLY Electricar contrac r* fi).4 /zrrzliiz" Address ,?/7/13. //& 7 u8A-BIACTRICAL PERI{IT APPLICATION City Job Nunber o^tu32.3A! 3. coHPLETB FBB scEEDuLE BBLou Slgnatur€A.Nev Residential-Sing1e or HuIti-FamiIy per dvelling unit. Service Included:Items Cost r? 1000 sq.ft. or less I $ 85.00Lt Each additional 500 sq. ft -or portion athereof _) $ 15.00 Each Manuf'd Home or Modular Dvelling Service or Feeder $ 40.00 Sum& 15 Phone rv]' Expiration Date tD,\"9: Constr Contr. Number Expiration Date 4q4 Superv Electrician s Address Ci ty D.Nut Phone DATE: Services or Feeders InstaIIation, 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 Oniy Temporary Services or Feeders Installation, Alteration or Relocation B Ct ty Supe 00 00 00 00 00 00 $300 $ $so $60 $100 $r30 40 c 200 amps or less 201 amirs to 400 amps -0ver 401 to 600 amps 0ver 600 amps or 1000 voTt s see .00 6- .00 .00trgtt .ffiff $ $ $ 40 55 80 t D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Service or Feeder Permit - $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0ut1ine Lighting- Limited Energy/Res Limited Energy/Comm -SUBTOTAL OF ABOVB 5Z State Surcharge TOTAL O9NER INSTALI,ATION The installation is beirig made on property I ovn vhich is not intended for sale, lease or rent. 0mers Signature: $ 40.00 $ 40.00 $ 20.00 $ 36.00 )(1 RECEIVBD 5 oo License Number I nt S C;ITY OF SPR OREGO'U SPPTXGFIELD I,IOOD STOVE/INSERT INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth StreetSpringfield, Oregon 9147? Job Location: 0ffice: INSPECTION LINE: 726-375e 726-3769 Asses Ovner Addre Ci ty: sors Ha p *: ss: Tax Lot *: Phone *: State:Zipz ++rs Value of llood Stov t Stov (please clrcle appliance) Preriminary rnspection is $15.00 (prior to instarration of insert) IJood Stove/Pellet/Insert Permi s .00 + S10.00 Issuance + $.15 state surcharge, Type of Inspecti.Reques ted Contractor: Address:Phone *: Ci ty:State:Zipz Construction Contractors Registration *:_Expires: By signing this permit/applieation, I agree to call for an inspection(s) as required (726-3769). I state that all information on this application/permit is correct and that I vas provided vith the llood Stove Safety in formation for vood burning appliances and preliminary inspection standards.I further state that the aPPliance I am installing meets smoke emission standards as set by the 0regon DePartment of Environmental Quality or the Pederal Environmental Protection AgencY and I agree to p rovide the testing approval number to the inspector at the time of insPection. I nsert, l6Cf) that if I am requesting a prelirninary inspection, the vall covering be 7- 3? also may be s tand uired ture Date FOR OFFICE USE REQUIRED INSPECTION(S) :PELLET PRELIHINARY Date of Application:Job *: Total Amount Collecte Receipt *:Issued BY: l3rt,-ffi Checked for Delinquenciesz-Checked for Histor ical Status: P-,