HomeMy WebLinkAboutPermit Building 1994-06-08,s5)
"sBESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JOB NUMBER
225 Fifth Street
Spri ngfield, Oregon 97477h,
a 3tQ. cAto Sr\a-qsJL
ASSESSORS MAP:TAX LOT:
LOT:s SUBDIVISION O*U.-\-peil( ttorHn
PHoNE: 7a (o -38q 8oooo- -HE_ ANO i CONSTRUCTION,INC *7LL58
84959 Par kuray
PLEASANT HILL,OR 97455
BLOCK:
OWNE
ADDR
CITY: -
*Ew V
CONTRACTOI
GENERAL: -
PLUMBING: -
MECHANICAI
ELECTRICAL:
IE:ztP
DESCRIBE WORK:SFD
E_
q/RANGE:
OCCY GROUP:* OF BDBMS:
- OFFICE
S OF UNITS:
LAND USE:
WATER HEATEFI:
# OF STORIES
OUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
FLOOD PLAIN:
ZONING CODE
CONSTB. TYPE:
HEAT SOUFTCE:
To request an inspection, you must call 726-3769. This is a 24 hour 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 iollowing work day.
REOUIRED INSPECTIONS
Temporary Electric Yr
Y
Rough Mechanical - Prior to
cover.Y
6
F
?
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
ting - After trenches are Final Building - When all
required inspections have been
approved and building is
completed.
excavated.Fireplace - Prior to faclng
materials and framlng lnsp.
Masonry - Steel location, bond
beams, grouting.
Pp
Framing - Prior to cover.
Y
E
W
Y
(
Y
Y
?
Y
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to f illing trench.Drywall - Prior to taping
MOBILE HOME !NSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.w Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanilary Sewer - Prior to f illing
trench.p Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filllng
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completed.
Slreet Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.w
\tr:gr
tl
rE
E
r
tl
E
75{
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
L rn,"rio,
X .o,n",
-
Panhandle
-
Cul-de-sac&
Setbacks
P.L.HSE GAR ACC
N
S
E
-IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon 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 said ordinances.
PI
5ag
Dateveviewed
Plan Check Fee
Date Paid
Receipt Numbe
eived By:
x$/
.\D
VALUEffiw
5,.lat
FT.
T)€ffX
(A)
ri
4\D
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
ITEM
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limlts which are being improved.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)
f zgv.rz
ADDITIONAL COMMENTS
ITEM
trixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
](fr@
a
(c)
FT.
FT.
FT.
N0
,r\sD
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
No
a
3
a,
(D)
r.\d
MECHANICAL 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 further 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 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.
S ig natu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
:::::,:"q\,,
curbcut \1 t,
Demolition
Total Miscellaneous Permits (E)
RECEIPT NI
DATE PAID,
AMOUNT R
RECEIVED
I
UM ER
BY
VALIDATION
ECEIV
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Mechanical Permit
lssuance
State Surcharge
Total Permit
SPRINGFIELO
SiHHflilY&neg/ tqtte
225 ?I,YflE SI"sBr
SPRTNGPTBLD, oREGoN 97477
fNSPECf,fON REQUEST: 726-3769
OPPICB: 726-3759
1 TION
IJGAL DESCRIPIION
Permits are non-transferable and expire
if vork is not started vlthln 180 days
of lssuance or lf vork ls suspended for
180 days.
!
2. CONTRAC;TOR INSTALT.ATION ONLY
EIecLrlca1 Contractor BILLS
Address 3170 WEST 1 'ITH AVFNIIF
ci FIaFNF Phone 687- ins1
Supervisor Llcense Number 9BOS
Exp lration Date 70/ r/ 9s
Constr Contr. Number
,,-i
2T357
Expi ratlon Date 4/28/9t
ing Electrician
0vners I
Address
ci \_
City Job Number
3. COXPLETE PEE SCEEDIILE BELOV
A. Nev Resldentlal-Single or
HuIti-FamiIy per dvelling unit.
Service Included:
ELECTRTCAL PERXIT
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
ilodular Dvelling
Servlce or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
m
APPLICATIONq4m :,
I tems Cos t Sum
\ g Bs.oo gb
A srs.oo gD
s 40.00
B
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps
0ver 1000 amps/volts
-Reconnect 0nly
00
00
00
00
00
00
Sso
S60
00
00
00
40
4
2
3
0
0
6..00d
s100.
$130.
$300.
$ 40.
Phone
OSNER INSTALI.ATTON
The. lnstallatloir is beirig made onproperty I ovn vhich is not intendedfor sale, lease or rent.
Ocners Slgnature:
DATE:
Temporary Services or FeedersInstallation, Alteratlon or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
S 55.00
Over 401 to 600 amps
-
S 80.000ver 600 amps or 1000-voT[s see rrgrr
"[ffi-D. Branch Circuits
E
5. STIBTOTAL OP ABOVE5f State Surcharge
TOTAL
Nev, Alteration or Extension per panel
One Circuit S 35.00Each AdditionalCircuit or vith Serviceor Feeder Permit _ S 2.00
Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utIine Lighting-Limited Energy/Res
-
Llmi ted Energy./Comm
c
tu-
N*
$
s
s
$
RECEIVED
+3.+S
',
SPTTINGFIELO
0ffi ce:
INSPECTION LINE:
726-3759
7?6-3769
%
BACKFLOW PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING. SAFETY DIVISION
225 Fifth Street
Springfield, 0regon 97 477
Job Locat'ion :6
Tax Lot #:
Owner:6
Addre
City:
ss:3 7D
State , C R
Phone #: .''
ip o_, _T
Phone #:Lt4 - 7/-
?22 7q#
Backflow Permit is $15.00 + $0.75 State Surcharge 1 )t7
/a
Contractor:
Address:d
City:State:o1 zi p
,.)
Construit'ion Contractors Regi:bration #:/st Ex pires:
correct.
gna ure a
FOR OFFICE USE
By signing this perm'it/appljcation, I agrgg to call for an-'ins_pection once the
U"ac1fiow [revent!on devitb has been insla'l]ed and'is visible for. inspection
ii2O-gi6g). I also state that a'l'l information on this application/permit is
Total Amount Co'l I ected : 1 C.u;
ob #:44ot
a
Date of App'l i cat i on :.?;L
Rece'ipt il:I Issued By:
7
1 4o 7,ss
clTY 0l: PRINGFIELD sYSTEt'{s DEVEL0, , rEr{T cltAIiGE
,, o,n uoH?l [tJJ'q,EL, n,.,
NAI.IE OR COI,IPAI{Y:
LOCAT IOI'I:23?2 ,/.
DEVELOPI'ITNI TYPE:qFD
I
BUILDING SIZE:LOT SiZ
DRA I I{AG E
Il'TPERV IOUS SQ. FI.g o//, 5-x s0.203 PER SQ. FT.
?. SANITARY SE11'ER.CITY
I,IO. OF PFU'S
(See Reverse)
/Y X S42.08 PER PFU
,t
TRAt'tSP0RTAT I0tt
NO OF UI{ITS X TRIP RATE X COST PER TRIP
x f.o x s424.31
x
--
x s424.31
x x s424.31
4 . SAN I TARY S Tl{ TR - I4HI.lC
Hh't'rc CREDIT IF AppLICABLE (SEE REVERSE)
5. ADI,{INISTRATIVE FEES
S15.125 PER PFU + 510 Ml.lI4C ADI'I FEE
Above )
ABoVE) X .0s
b-tr-
TOTAL-HWMC SDC
SUBToTAL (ADD ITEHS 1,2,3 & 4)$ 2o fg.s4
Fr.
s
s zd-z. z{
TOTAL SDC 2/7,Yz-
I
s
NO. OF PFU'S
(Use PFU Tota
BASE (
I From ltem 2
o
L
r
53
7s7,
,tJi-
E.zz2
/o2,ZF
Coord i n
/
l,
;;;;;;;;. c.-rl*,riiiu' orrty tlrc l'i[: [ :rtlliiit'rrr;rl li'tltrrt':')
FtXTUnE n'['t:
tiLrr.'i[[,] L)l:
l.,tE \i', t:1.\ l uii I I _
2
L'.'r'l I'
t. OLti\'/.t I-: I Jf
,: t):l UnE
U: JI TS
8;rthtub.......
Drirtking Fe'rttrrl;irt......
Floor Dreirt.. ..'......:...."...." "'
lnlerceploru For Grease/Oil/Solids/Elc
lnl erceploru For Sand//.ul o Vr'a slr/Elc'.
L,:undry fub/Gollresrva slrer.'.......
Shorver. Singte'Stall..
Shorver, Gan9.......-...'....-.
Clothesvasl)er - 3 Or h4ore.'. -...'........."
llobile Hdrrie Park Trap (l Per Trailer)
Becep!or Fgr Befrigeralorn{at er Stat ion/El c"" " "
Hecepior For Comn'rerclal S ink/Dishr"'a sher/El c"
:l
I
i
3
6
.>
6
6
t
3
2
I
2
2
1
6
z/Head
Sink, Bar, Commercial.
' Urinal, StallfYall..-.2\Vash Basin/Levatory. Single.
\\'ater Goset, Public lnstallation.
Water Closet. Prh'ale.'......
l,{iscellaneous:
TOTi.L FlffunE Uir'lTS /3
CREDIT CALCULATION TABLE: Basej on assessed value. lf improvements occurred afier annexation date in table'
calculate cre,:'hs sePe rai es.
Ge.Cit for Parcd or L.ard Only lf Aplicable
lmprovement (rf after annexation date)
x s 6@ 3f,a7
(Rate X Assessed Val ue)
3.2 /
x s-
(Rate X Assessed Value)
CREDIT TOTAL $ 34.o.2
RUNOFF COEFFICIENTS FOR STOBM DRAINAGE
0.45
0.5
lndustrial...
Governmenta1...................
Yezr
Annexed
naie per 51,OOC
AssesseJ Value
Year
AnnexeC
Rate per 51,OO0
AssesseJ Value
i979 or before
193C
1931
1Sez
1933
1994
1W5
s3.21
3.13
3.08
2.%
2.e2
2.69
2.51
155
1 937
1993
1SE
r o11
1931
.r oc2
s 2.24
1.93
1.57
1.18
0.79
0.u
0.28
lh4PERvlous AREA = TOTAL LOT SIZE X BUt'loFF COEFFICIENT
---r-.
I
.-).l-
rftr . FiE [' I Ci-iNSN iNC PHENE No. : 5Zf 746 6787 JUrt. Zl:l 1:,!+ F-r. ,i
oA
rj{
tl
i ii: t i c{rli$ Ti?t)cTloN
\.titt)tti.it-t:-t t )
i I)AL AESCRIFT'r)N+-^-.-..-._...d
, rr7' 5 QF ATLI.iE PARI( NoRlll AS I'LA'r'rED
F,.r,c r?F(,'ol.iL>!:D JA/ tslLE 74, {'LIDES 165-167
Jt: :ii.ir L NE COUNTY PL.AT RECORDS IN
r .i,ryh L:utJNrY, oflEcoll.
.9CALt. l"-30'
2 8.1
-\, -;,1,
---4-a o,r.
-.I
l_J
(,
\
\
I
\
\
t=lt1l
+
lfi t.
l-io,o
lq
_.1-f"AUttDr\ !ldtttl
oN!-\'
t
I.ia.!-.1
l'ii'l
i
IJ4n \j
t!. --t-I
I
I
;
I:DI
I
r_la',-,lr-:l 1ij? t" i\r :i' s r
LOT COURSES
LQN.G. |HOR{.) !)_tii,
t,t il"59'57" {' 3J Zt',
N 29"50',47',' .v J5 04'.
s 88'05'.t9 W 3/ Os',
s !6"04'50" w 35.38'.
OTT O
E
Ia
trl
Lol
THIS DOES I'VOT CONSIIlUlE A DOUNDARY SURVEY AND
IS SUBJ€CT TO ANY INACCURACIES I'HAT A SUBSIOUENT
tlutJit)^rli' SURyFv MAY DtScLOrL.
I, JONAII'AN A, OAXES, ^ I?EOISTERED PI?OI:E''IONAL IAND SUIiYLYOR,
bcr lirfir,ar cERTtFy rtlAr A H1RTGAGE t o^N /NsPECToN -aF THE
,rirOI,T'OTSCNiATO PROPERTY WAS TIADE BY HE TT1I5 IOlH DAY OF
J,JiIF tgg4 AND THAT \'HE BIJILDINGS UPON SAID I.OT OO NOT
r,.,It7tIACII UIION THE $7Ri:E7S NOR UPON THF ADJOINING PROPERIY
AI.JD TI!A1 THE DI)ILDINGS UP()N TI1E ADJOINII,IG PROPLRTY DO NO
t-t'JL'ROACtl UPON SAID t Ol, {-XCEPT AS SHO}?N.
Post-lt'" hrand fax lrgnsnlitt&l memo 7671
l(LLrl5 tar(tri..J
PllOl'ESSlOt'L,n 1,
I /r\ l\lt _t \,1 1F'V !- Y I r!.
or([
J:iLY ii, 19E.1
.J0l.lATi"lnN A. (jAr l:
TluS
ttY;D SUllVI:YtN$, tNC
VF, O/?E(jON 9,/40?
DWN. BY: T-tR
# ol pages >-,%EE
"o,UcffiFt-
Fard Ii@
?EA. .ft.lll-
l-xiltlttS. DICfrnE=k I
., r'