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Home My WebLink AboutPermit Building 1995-05-15SPFlII\.GFIELc, RESIDENTIAL PERM!T APPLICATION lnspections: 726-3769 Office: 726-3759 JOB NUMBER 225 Fifth Street Sprlngfield, Oregon 97 477 LOCATION OF PROPOSED WOBK;l4Jt Tart< e rlr.,^"AitJ 0L ql4-t1 ASSESSORS MAP;1--a7ar-7=d TAX LOT: LOT:BLOCK SUBDIVISION fr*z q r:9>r. n(t h ^e (l)nrC PHON E STATE ZIP: (lOWNER: ADDRESS: CITY: ADDITION(l-/DEMOLISH OTHER DESCRIBE WORK NEW- REMODEL EXPIRES PHONE 7. CONTRACTOR'S NAME ELECTRI MECHANICAL PLU MB ING: GENERA CONST. CONTRACTOR # #r5o/ _ OFFICE USE _ RANGE: OCCY GROUP: LAND USE: # OF STORIES * OF UNITS: SECONDABY HEAT: SQUARE FOOTAGE: QUAD AREA: # OF BLDGS CONSTR. TYPE HEAT SOURCE: To request an inspectlon, you must call 726'3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll bemade the sante working day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS Temporary Eleclric K Site lnspection - To be made alter excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footlng - After trenches are excavated. Foundatlon - After forms are erected but prior to concrete placement. Underlloo Ueshanjc-af - Prior to on or uecking Post and Beam - Prior to floorlnsulatlon or decking. Floor lnsulation - prior to decking. Rough Plumbing - prior to cover. 11 Rough Mechanlcat - prtor to -'l cover. X,:;*:: Erectricat - Prior to X. Final Plumbing - When allplumbing work is complete. Final Electrical - When all electrical work is complete. Final Mechanical - When allmechanical work ls complete. Final Building - When ailrequired lnspections have beenapproved and building is completed. Eleclrical Service - Must be approved to obtain permanent electrlcal power. Fireplace - Prlor to faclng materlals and framing lnsp. Framing - Prlor to cover. VJall/Ceiling lnsulation - prlor to cover. Wood Stovo - After lnstallation. lnsert - After flreplace approvql and installatlon of unlt. Curbcut & Approach - Afterforms are erected but prlor toplacement of concrete. Sidewalk & Drlveway - Afterexcavation is complete, formsand sub-base material in place. Fence - When completed. K E I X, [-l Masonry - Steel locailon, bondtJ beams, groutlng. X x., E KX X K I--| Sanitary Sewer - prior to fiilinglJ trench. ,E[-=,:"^U,.Sewer - Prior to rillins n Water Line - prior to fiiling - trench. K [-l Street Trees - When ail required - trees are olanted. Electrical Connection - Whenblocking, set.up, and plumbinglnspections have been approve,Jand the home is connected tothe service panel. Final - After all requiredinspections are approved andporches, skirting, decks, andventlng have been instarled. Underground Plumbing - prior to filllng trench.Drywall - Prlor to taplng. Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When ailblocking ls complete. Plumbing Connections - Whenhome has been connected towater and sewer. L-//' /z 1Jt" - s rt3 q1411 FLOOD PLAIN: zoNrNG coDE: -l/E!:- # OF BDRMS:_ Z(ttu) YN/ t-^r [+ WATER HEATER: r E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Tyt. _L lnterior - Corner - Panhandle - Cul-de.sac tbac IS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTOBICAL REGISTER? - lf yes, thls application must be slgnedand approved by the Historical Coordinator prior to permit issuance. APPFIOVED: E 'lt PL.HSE GAR ACC N s E BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT This permit is grantecj on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including theDevelopment CocJe, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances. VALUE 7,/, r 5,6Q 4/5Q/%P- /€91 ?ref?Plan(A){i:(' s Plan Check Fee ,/*. X $/SQ. FT. 52/ S6Y %/Si/. ewed By Date Paid Recei pt Number Received Total Value Building Permit Fee Stale Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport -7:G^Z<-- sYSr E M s D EV E Lo P r r * r, j, o *fiJr.L.,+p Systems Development Charge is due on all undeveloped properties within tlrc City limits which are being improved. ITEM Fix t u res Resldential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home ADDITIONAL COMMENTS NO F E oo6 FT. FT. f,lry4z 5aa Z(c) Fr. <fo' ? lf * z?, n+4 PLUMBING PERMIT Plumblng Permit State Surcharge Total Charge - 95,-o_bf Wood Stove/ lnsert/Flreplace Unit Dryer Vent Mechanical Permit lssuance state Surcharge'7S*' {f Total Permit (D) ./ 2o (t'. 2b ?" Vent Fan /o.qo oO MECHANICAL PERMIT Furnace Exhaust Hood Nol By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby certify that all lnformation hereon is true and correct, and I f urther cerilfy that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertainlng to thc work descrlbed herein, and that NO OCCUPANCY will be made of any structure without perrnission of the Bullding Safety Division. I further certlfy that only contractors and employees who are in compliance with ORS 701.055 will be used on thls proiect. I {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 perty, and the approved set of plans will remain #",, Date 5 of the pro all times durlng constructionon the MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Perm't'ts (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined)7zt/e DATE PAID 5V5-34- ?27,/AAMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBEB 7- ] No . 75o"2-l CITY OF SPRINGFTETD SYSTEMS DEVETOPMENT CHARGE WORKSHEET (cot'lt'IERcIAL & RESIoENTIAL) .ToNAME OR COMPANY:NI (tIT WO LFL LOCATI 0N: l4Ll ?azv-e*\1Db zrb4 - \9oo DEVELOPMENT TYPE:lp?- €e-rlnooet . BUILDING SIZE:t.t ).+ I. STORM DRAINAGE TMPERVIoUS SQ. FT.ztb t 2. SANITARY SEI,JER-CITY 1 OT SIZ x $0.209 PER SQ. FT. X $43.26 PER PFU . Ft. $ $ $ S bZZE NO. OF PFU'S (See Reverse) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x -- x $436.19 X X x $436. 19 x $436. 19 4 SANITARY SEt,lER-Mt,lMC N0. 0F PFU'S t/,A. x $17.19 pER pFU + $t0 Mt.lMC ADM FEE(Use PFU Total From Item 2 Above) Mt.lMC CREDTT rF AppLTCABLE (SEE REVERSE) TOTAL-MWMC SDC SUBToTAL (ADD ITEMS 1,2,3 & 4) ADt4INISTRATIVE FEES BASE CHARGE (SUBT0TAL ABoVE) X .05 p Burdick 5 b2a -a SDC Coordinator Date: j LI 5 TOTAL SDC s4o ,61l- FIXTURE UNIT CALCULA-r'1N TABLE: Number of New Fixturc unit Equivatent :-Fixturc Un'ts (NOTE: For remodcls.-caicutate only th*rEt additionat fixtures). NUMBER OF UNIT FTXTURE -- FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub----- Drinking Fountain. Floor Drain. lnterceptors For Grease/Oil/Solids/Etc- - - - - - - - - - - -. - - - - lnterceptors For Sand/Auto Wastr/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More..--- Mobite Home Park Trap (1 Per Traiter) --.-" Receptor For Refrigerator/lvater Station/Etc-"""' Roceptor For Commerciat Sink/Dishwasher/Etc" Shower, Single Stalt........ -- Shower, Gan9......... """"':'.""' Sink: Bar, Commercial, Residential Kitchen""""""".""""" Urinal, StallA/Vall... Wash Basin/Lavatory, Singte.. Toilet, Public lnstallation. Toitet , Private...- 2 1 2 J 6 2 6 6 I J ) 1 2 2 1 6 z ad/Fle 4 Miscellaneous: CREDIT CALCULATION TABLE:Based on assessed value' calculate credits seParates Credit for Parcel or Land Only lf Appticable lmproverhent (if after annexation datel TOTAL FIXTURE UNITS lf improvements occurred x$ (Rate X Assessed Valuex$ (Rate X Assessed Value) after annexation date in table, CREDIT TOTAL - $ Year Annexed Rate Per $1,OOO Assessed Va[ueYear Annexed Rate per $ 1,OOO Assessed Value 1 985 1 986 1 987 1 9BB 1 989 1 990 1 991 1 993 $ 2.46 2-14 1.77 1-3'I o.97 o.61 o-44 o-15 i979 or before 1 980 1 981 1 982 1 983 1984 1 985 $3.46 3.38 3.32 3.21 3.O6 1A' 2.73 1 1 CITY OF SPR'A'GFIELD, OREGO'V 225 FTTTE STREET SPRINGPTELD oREGoN 97477 Ii:, l"J :ru t3:3 :T, ?il5,?f,f;::,Ir.,"'ffi .Effiltar a;;pIoval.'6s zon*-VD D_ ci oa.u! $'h 3. col{PLRTB SPRII|GFIELO ty Job Nunber FEE SCEEDTILE BELOII PERT{IT APPLICATION -/t'h t INSPECTT0N REOIESTz 726-37 OFPICE: 726-3759 1.OF Permi s are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI,ATION'ONLY El-ectrical Contract Address Expiration Date Constr Contr. Number Expiration Date Signature of Electrician I rh Owners Address Ci ty Phone OVNER The installation is being made onproperty f ovn vhich is not intendedfor sa1e, lease or rent. Ovners Signature: DATE: srsn*ura--*;fM-Si ngre or ?5%s/ ct tvLEQ f\4.- phone 4,4%.Cq aa^ --d_ Supervisor License Number Multi-Family per dvelling unit. Service Included: I tems Cos t $ 8s.00L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Moddlar 'Dve11ing Service or Feeder $ 40.00 B.Services or FeedersInstallation, Alterationsor Relocation: 200 amps or less f20L amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- over 1000 amps/volts -Reconnect 0n1y C. Ternporary Services or FeedersInstallation, Alteration or Relocation $ s0.00 s 60.00 $100. 00 $130.00 $300.00s 40.00 g ilBr Sum a56lE D. Branch Circuits Nev, Alteration or Extension per panel one Circuit S 35.00Each AdditionalCircuit or vith Serviceor Feeder permit $ 2.OO Miqcellaneous (Service/feeder not included)-Each installation 200 amps or less $201 amps to 400 amps - $over 401 to 600 amps - $Over 600 amps or 1000ElfEs se Pump or irrigation Sign/0ut1ine Lightirg- Limi ted Energy./Re Limi ted Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 40.00 5s.00 80.00 E $ 40.00 $ 40.00 s 20.00 $ 36.00 RECETVED 5 $ 1s.00 CITY OF OFEGO'U sPrlr''^.=lELt) 225 FIFTE STREET SPRTNGFIEI,D, OREGON 97 477 INSPECTION REQUEai : 7'iB-2769---*$ In OFPICE: 726-3759 A,jrcriied Si,rnatrrra I IAGAL DESCRTPTION L1 64?r??2 l4f\ l. iri1r.,,ir)C EIJCTRICAL PERI{IT APPLICATION city Job N,^b". Cl6lUh4 Tlre {ollowino rrroiec! ss sutrmlited has thc '"iJls, j."o l, # {ara, re s ptrc r f ic i anci ,onnnb:3on! * 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. COIITRACTOR INSTALLATTON OT.ILY El-ectrical Contracto Address city- Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician COI'TPLETE FEE SCEEDTIIJ BELOV A. Nev Residential-Sing1e or Multi-Family per dvelling unit. Service Included:Items Cost L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or -Modul-ar Dvelling Sertice or Feeder s 8s.00 s i5.00 $ 40.00 B Services or Feeders fnstallation, Alterations or Relocation: Sum Temporary Services or Feedersfnstallation, Alteration or Relocation 200 anps"or less $ 40.00201 amps to 400 amps - S 55.00over 401 to 600 anps - $ 90.000ver 600 amps or 1000 voTts see ,B, a56G- D. Branch Circuits Nev, Alteration or Extension per panel 200 amps or l-ess I201 amps to 400 amps 401 amps to 600 amps -601 amps to 1000 amps- Over 1000 amps/volts - Reconnect 0n1y One Circuit Each AdditionalCircuit or vith Serviceor Feeder Permi t 4 s s0.00 s 60.00 $100. 00 s130.00 s300.00s 40.00 M c 0vners Name Address t Ci ty OVNER TNSTALLATION The installation is beproperty f ovn vhich ifor sa1e, Iease or ren 0vn6rs Signature: Phone JL6-5tr1 made onot intended 1 $ 3s.00 $ 2.oo no 40 40 20 t included) .00 .00 .00 n ingsn t. E Miscel-laneous (Service,/feeder -Each installation Pump or irrigation g Sign/Out1ine Lighting- SLimi ted Energy/Res - SLimi ted Energy/Comm S 5. SUBTOTAL OF ABOVE q1rt7" State Surchargeu'i% Adninistrative Fee TOTALBRECETYED n 1. I I / I