HomeMy WebLinkAboutPermit Building 1994-04-14SP'rINGFIELD
a35L{
JOB NUMBER
225 Fifth Street
Spri ngf leld, Oregon 97 477
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Olfice: 726-3759 @,
r4ao O#o
ASSESSORS MAP:
LOCATION OF PROPOSED WORK:
LOT -7
OWNER:
ADDRES
CITY:
-
CttLl-q- Pqru( thcrq
PHONE:7aG 3 898oo,fltoo*, i coNsrRUcTroN,rNc *7LL5B
84959 Par kuray
PLEASANT HILL,OR 97455
TAX LOT:
SUBDIVISIONBLOCK
ztP
To request an inspection, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested atlerT:OO a.m. rvlll be made the followlng work day.
REQUIRED INSPECTIONS
EE ,"-oorary Electric
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrlcal /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel locatlon, bond
ms, grouting
Foundation - After forms are
rected but prior to concrete
placement
Underground Plumbing - Prlor
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
Post and Beam - Prlor to floor
insulation or decking.
Floor lnsulation - Prior to
decklng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filllng
trench.
Water Line - Prlor to fllllng
trench.
Rm"'r:
Mechanlcal - Prlor to k-
{*;1:
Elecrrrcat - Prror to K
l4erc"tical Service - Must be.lAt
"pprored to obtain permanent\electrlcal power.
Final Plumbing - When all
plumbing work is complete.
Final Electrlcal - When all
electrical work is complete.
Final Mechanical - When all
hanlcal work ls complete.
Final Building - When all
required lnspectlons have been
approved and buildlng is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocklng ls complete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and p!umbing
inspections have been appro,red
and the home is connected to
the servlce panel.
,6
4
K
K
4
X
6
,g
N
Xory*"rl - Prior to taplng.
d
fr
Fireplace - Prlor to faclng
materlals and framlng lnsp.
Framing - Prlor to cover.
Wall/Ceiling lnsulation - Prior to
cover,
Wood Stove - After installation.
lnsert - After flreplace approval
and lnstallation of unlt.
Curbcut & Approach - After
forms are erected but prlor to
piacement of concrete.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base material ln place.
Street Trees - When all requlred
trees are planted.
Final - After all required
lnspectlons are.approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
NEW } REMODEL ADDITION DEMOLISH OTHER
5trbDESCRIBE WOFIK
CONTRA TOR'S NAME
GENERAL: HE and i Const
PLUMBING:
MECHANI.AL: _ Bills fllect ric
ELECTRICAL:
-
84959 Parkray ZIISB
Pleasant HilI, 0r 92455
3170 td llth, 21351
Eugene, 0r 97402
500 Greenfield 33026
Eugene, 0r 97404
4131 "E "51 . 25790
Springfield, 0r g7478
2766L Crow Rd 55921
Eugene, 0r 974A2
EXPIRESADDRESS
, Inc.a2/95 7?6-3898
a4/94 687-1851
06/94 688*1931
llarshalls OiI & Ins "7 47 -7 445L2/94
Brooks Excavation a3/9s 345-7564
r-lr:nl gVVr
RANGE:
PHONE
I
€
Don Leulis Plumbing
SQUAFIE TOOTACC/L)]CT--WATER HEATER:
* OF STORIES:
CONST.
CONTRACTOR #
OUAD AREAd-
# OF BLDGS:
-OCCY GROUP: \
Rough Plumbing - Prior to
cover.@
E
tl
E
E
Fence - When completed.
L]
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total hel
Lotlype v
X lnterior
-
Gorner
-
Panhandle
-
Cul-de'sac
tbacks
P.L.HSE GAR Acc
N
S
W
E
iYrsE PBoPoSED woRK lN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL BEGISTER?
ll yes, this appllcatlon m slgned
and approved bY the i s torl cal
Coordinator prior to permlt issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condi
construction shall, in all respects, con{orm
adopted bY the CitY of SPringfiel
Pla
By:
tion that the said
to Ordinance
Development Code, regulatlng the co
Re
bulldings, and maY be susPend
stof any
Date Pald
Beceipt N
tion and use ol
revoked at any tlme
d ordinances.upon vlolation o
Plan Check Fee:
ncluding the
BUTLDING PERMIT
Exso.so. FT.
/5ia<j53
-)
(A)
ITEM
Main
Garage
Carport
Total Value
Bulldlng Permit Fee
State Surcharge
Total Fee
Systems Development Charge ls due on all undeveloped
properties withln the City limits which are being improved'SYSTEMS DEVELOPMENT CHA.B
(B) k #GE
7t
ADDITIONAL COMMENTS
{lc,ro )'
^rilI
C
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
FT.
FT.
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
No 3
t(D)
/.r
Mechanical Permit
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
I
By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformation hereon ls true and correct, and I lurther certlly
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the City of Sprlngfield, and the Lawg
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure wlthout permisslon of the Buildlng Safety Dlvlslon'
I further certify that only contractors and employees rvho
are ln compliance wlth ORS 701.055 wlll be used on thls
project.
I further agree to ensure that all requlred inspections are
requested at th€ proper time, that each address is readable
lrom the street, that the permlt card ls located at the front
of the property, and the approved set ol plans will remain
te at all times during constructlon
l- 4-?v
1>
on the si
Ju, **)L4 t'tSignature
Date
MTSCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge\EISldewalk \ I tt
curbcut ldt ,,
Oemoliiiorl
Total Mlscellaneous Permlts (E)
I
t
DATE PAID
VALIDATION:
RECEIPT NUMB
AMOUN'T REC
RECEIVED BY
TOTAL AMOUNT DUE (excluding electrical)r
(A, B, C, Q and E Comblned)
#34
,n n0.I(
CD
JoB No. 140 471
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
I.IORKSHEET
(C0HMERCTAL & RESTDENTTAL)
NAME OR COMPANY:
LOCATION: 24ZO OT TO
DEVELOPMENT TYPE : LDR. - t'/EN aFR
BUILDING SIZE:OT SIZ F SQ. Ft
1. STORM DRAINAGE
IHPERVIoUS SQ. FT.2-0oo x $0.203 PER SQ. FT.
2. SANITARY Et,JER_CITY
NO. OF PFU'S /r X $42.08 PER PFU
3
(See Reverse)
TRANS PORTAT ION
NO OF UNITS X TRIP RATE X COST PER TRIP
x /,ol x $424.31
x $424.31X
x _ x $424.3i
4, SANITARY SEWER-MWMC
N0.0F PFU'S x $15.125 PER pFU + $10 Mt,lMC ADM FEE(Use PFU Total From ltem 2 Above)
Mt.lMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATTVE FEES
BASE CHARGE (SUBTOTAL ABoVE) X .0s
$
?.6
$282
3+o2
q,Ioo
5
Kip Burdick
SDC Coordinator
5ag'9
-7s1 4!
s*2
TOTAL SDC s Zt oza!
I
2-
$
'it Equivalent : Fixture Units (NOTE
FIXTURF.UNItr,CALCU LA )N TABLE: Number of Nerv Fixlures ' -ioi r..noo"rs, catcuiaie onty the ttlil i-ooltional fixtures)
NUN4BER OF
FIXTURE TYPE NEW FIXTURES
2-
Bathtub-.-....-
Drinking Fountain"""
Floor Drain--
lnterceptoo For Grease/Oil/Solld s/Etc" "" "" "" "'
lnterceptors For Sand/Auto Wash/Etc" " " " " " """
UNIT
EOUIVALENT
FIXIURE
UNITS
I
?_
1
?_
J
6
2
6
6
1
2
1/Head
2
2
1
6
4
'?-
7-
2
a
lg
Clotheswalher - 3 Or More"""""'
Mobile Hdnie Park Trap (1 Per Trailer)"" -"""""'
Receptor For Ref rigeratorAVate r-Station / ttc" " " "
n"""p,ot, For Commercial Sink/Dishwasher/Etc"
L-aundry Tub/Clotheswasher" " " "
Shower, Single'Stall--
Shower. Gang-.-------..
Sink. Bar, Commercial
Urinal, StallflVall.-.-
Wash Basinflavatory, Single"""
Water Closet Public lnstallation'
2
?
TOTAL FIXTURE UNITS
.71 xs O,L
(Rate X As sessed Value)
Water Closet, Private.---.-
Miscellaneous:
CREDIT CALCULATION TABLE: Based on assessed value
calculate credits seParates.
lf improvements occurred after annexation date in table'
Credit for Parcd or t'and Only lf ApplicaHe
lmprovement (if after annexation date)
3
xs
74'3
=$7 4oa(Rate X
c
Assessed Value)
REDIT TOTAL
RUNOFF COEFFICIENTS FOR STORM D RAINAGE
0.4
0.9
0.45
0.5
Year
Annexed
Rate Per $1,O00
Assessed ValueYear
Annexed
Rate Per $1,0O0
Assessed Value
1986
1 987
19BB
1989
1990
1991
1992
$ 2.24
1.93
1.57
1.18
0.79
o.44
0.28
1979 or before
1980
1981
1982
1983
1984
1985
s.21
3.13
3.08
2.96
2.82
2.68
2.51
IMPERVIOUSAREA=ToTALLoTSIZEXRUNOFFCOEFFICIENT
I
225 FTTf! SIT,EEf,
SPRn|GPIBLD, ORBGON 91477
INSPBCTION RE0UBST: 726-3769
OPPICE: '726-3759
SPRIt{GFIELO
as subrnltted hag
require specific
L 0-EI.A TRICAL PBRHIT
u"2r:-lSlt{City Job Nunber
Arfrhoci.sd signduib. COHPLATE FEE SCEEDTII.,E BELOg
The lollowlng Proloc,t
zoning, and does not
approval.
1.OF
IJGAL DBSCRIPTION
permits are non-transferable and expire
if work is not started vithin 180 days
of lssuance or lf vork is suspended for
180 days.
2. COI|TRACTOR INSTALI^ATION ONLY
Erectricar contrac o, Et/ ', t'futfr r:
Address s/71 tll //u-
ci puon"W.?
Supervi License Number Qto s
Expiration Date /e)q5
Constr Con tr. Numbe, Qe g / c
Expiration Dat
o trician
s
Add
Ci ty Phone
OgNER INSTALI.ATION
The installation is belrig made on
property I ovn r,rhich is not intended
for sale, Iease or rent.
0sners Signature:
DATE:
A. Nev Residential-Single or
HuIti-FamiIY Per dvelling unit.
Service Included:Items Cost
r,r 1000 so.ft. or less I S 85.00tr nach additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular DveIIing
Service or Feeder
B. Services or Feeders
Insta1lation, Alterations
or Relocation:
Sum
3 $ 1s.00
$ 40.00
s s0.00
s 60.00
$100.00
$130.00
$300.00
$ 40.00
%5
a D.
c.
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
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less S 40.00
201 amps to 400 amps
-
$ 55.00
Over 4b1 to 600 ambs
-
$ 80.00
0ver 600 amps or 1000 voTts see uBu aE6F
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permi t $ 2.00
E Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $Sign/Outline Lighting- SLimited Energy/Res $Limited Energy/Comm $
not included)
40.00
40.00
20.00
36.00
SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
OREGO'UCITY OF SPF
RECEIVED
5
q)
,l
i0