HomeMy WebLinkAboutPermit Building 1995-04-20k1 ,-v*b
JoBNUMBEa%
225 Fifth Street
Springf leld, Oregon 97477
TAX LOT:\qD T
SPFlIt.GFIELc,
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
LOCATION OF PROPOSED WOFK:\a o7 1)-ASSESSORS MAP
LOT:BLOCK:SUBDIVISION
OWNER:PHONE
f)e$onrHrr(-
CITY:STATE
\ .rr ^ \10 \
ADDRESS:
' 3q tat
ZlPi ('l qoq
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
*ew )( REMoDEL
ADDFIESS PHONE
3
CONTBACTOR'S NAME
GENERAL:
PLUMBING:
EXPIRES
MECHANICAL:
ELECTRICAL
CONST.
CONTRACTOR #
t
?-
- OFFICE USE -
r OF BDFIMS:
WATER HEATER:
r OF UNITS:
LAND USE
SECONDARY HEAT:
SQUARE FOOTAGRANGE:
QUAD AREA:
# OF BLDGS
FLOOD PLAIN:
ZONING CODE
OCCY GROUP:
r OF STORIEST
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726'3769. Thls is a 24 hour recordlng. All inspections requested before 7:00 a.m. wlll oemade the sanle worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electric
Site lnspection - To be made
after excavation, but prior to
setting forms.
Masonry - Steel locatlon, bond
beams, groutlng.
Underground Plumbing - prior
to filling trench.
Rough Mechanlcal - Prlor to
cover.
Electrical Servlce - Must be
approved to obtain permanent
electrlcal power.
llfrinat Ptumbins - When ailrz--+plumbing work is complete.X
ffi'Foundatlon - After forms areGQ erected but prior to concrete
placement.
Final Building - When ail
required lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Final Electrical - When ailelectrical work is complete.
Final Mecharrical - When allmechanical work is complete.
Plumbing Connections - Whenhome has been connected towater and sewer.
IVI Rougfr Elecrrical - prior tol4cover.x
x'
B
[-_lUnderslabPlumbing/Electrical/ H
'J Mechanical - Prior to cover. l l
f$Footing - After trenches arerA\excavated.
p] Rost and Beam - prior to ftoor13 insulatlon or decking.
\[]zf floor lnsulation - prior to./ t decking.
ffi Sanitary Sewer - Prior to filting.R trench.
E;:t"U.Sewer - Prior to rillins
Kyg*:ine - Prror to rirrins
N1l Rougtr Ptumbing - prtor toF\cover.
n Blocking and Set.Up - When ails blocking is complete.
Final - Af ter all requiredinspections are approved andporches, sklrting, decks, andventlng have been installed.
2 | :7a-
(ln
SP-[\X-
Xygfl,tm
[-l Fireptace - Prtor to faclng
-
materlals and framlng lnsp.
fi ttu-'ng - Prlor to cover.
J!11 WatUCeiting lnsutatlon - prior to
,5*Cover.
fiotr*ull - Prior to taping'
[_J Wood Stovo - After tnstailatton.
[-l lnsert - After flreplace approval
-
and lnstallatlon of unlt.
p[ Curbcur & Approach - Afterts{ forms are erected but prior toplacement of concrete.
ffiSiO"*"lk & Drlveway - AfterF{ excavation is complete, forms
and sub-base materlal in place.
[--l fence - When compteted.
(fu,r."r rreos - when art required
\ljltrees are ptanted.
tl
n Electrical Connection - When'J blocking, set.up, and plumbing
lnspections have been approved
and the home is connected tothe service panel.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot lype Setbacks .-IS THE PFIOPOSED WOBK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
6%a r'52 lnterior
Corner
zz%
5',-
Panhandle
/ crl-d"-"""
P.L.HSE GAR ACC
N /o
S /b
E q
Garase qo ,* / /' " 2&,1,
Total Value
Building Permit Fee_
State Surcha,n" t3%)
Total Fee (A)
CD
1,
Main 24 d_24
Carporl
BUILDING PERMIT
ITEM SO. FT.X $/SO. FT. : VALUE
z?_/a."
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.
Plan Check ree: 7/2. ?a
Date Paid: -A:Z€f-
Revie
v
P
Fleceipt Numbe
Recei ve
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)4v)61&#Systems Developmcnt Charge is due on all undeveloped
properties within thc City limits which are being.improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
,AxA
Plumblng Permit
State Surcharse t3%
Total Charge (c)
FT.
FT.
FT.
PLUMBING PERMIT
,p I
).
(-
ITIONAL COMMENTSA
5
Wood Stove/ lnsert/Fireplace Unlt
Dryer Vent a
l(pstate Surchars" +3qO
Total Permit
qa CbNo4
c
(D)
MECHANICAL PERMIT
Mechanical Permit
lssuance
Fu rnace
Exhaust Hood
Vent Fan
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 certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springf ield, and the Laws
of the State of Oregon pertaining to the work described
hereln, and that NO OCCUPANCY will be made of any
structure without perrnission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance wlth ORS 701.055 will be used on this
proiect.
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 permit card ls located at the front
of the property, and the approved set of
Date 41>0/\r,x'Slgnat
plans will remain
on the s itSet atl times d'l r const ruction.
JJClwure
T--
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
sidewark SL ,,
curbcut 3 Ar,
Demolition
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Total Miscellaneous Permits (E)
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
/d'
a^ ','E/ T, I , -,, .,-
d(o.@
'roB No .15ozz5_
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0HMERCIAL & RESIDENTIAL)
C,-,r<rr9 C. flerr..t tVVNAME OR COMPANY:
LOCATION: ?91 1 5q 6r*rrH Looe t -1o zvz1 \ - t9ol
DEVELOPMENT TYPE:M>e I..ttz-r,rt I)UPLEX
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIoUS SQ. FT.
2 SAN ITARY Et.lER-C ITY
NC. OF PFU'S
(See Reverse)
SIZ
'Lo=1 x $0.20e PER SQ. FT.
. Ft.
.t-1
*coJ
S bzol9
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
L X i 'et x$436.19
X $43.26 PER PFU
TOTAL-MI^IMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
b2-
Y
X
x $436. 19
x $436. 19
$
$
V'z-$17.19 PER PFU + $10 Ml'lMC ADl.1 FEE $ ac-oo9Y
4 . SAN ITARY SEl,lER-MI,JMC
NO. OF PFU'S
(Use PFU Total From item 2 Above)
Mt,lMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADl4INI TIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .0s
K p Burdick
nL473
zozSL
;3e
SDC Coordinator
Date tr"r'
TOTAL SDC $ btbu1 4v
FIXTURE UNIT CALCULATTnN TABLE: Number of Ncw Fixtures '-'Init Equivalent :'Fixturc Uoits
(NOTE: For remodels. caliulate only ttrc _I additional fixtures) -NUMBER OF UNIT FIXTURE..
FTXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
2-Bathtub---..
4
4
6
ead
2
i
2
J
6
2
6
6
.'l
3
2
1/H
2
2
1
6
4
Drinking Fountain.---
Floor Drain
lnterceptors For Grease/OiliSotids/Etc- -...... - - - - - - - -.
lnterceptors For Sand/Auto Wastt/Etc..-. -. - - -- -- -- - ---
Laundry Tub/Clotheswasher
Clotheswasher - 3,Or More....-....
Mobile Home Park Trap (1' Per Traiter)
Receptor For RefrigeratorMater Station/Etc.----..-
Roceptor For Commercial SinklDishwasher/Etc--
Shower. Single Stall..........
Sink: Bar, Commercial. Residential Kitchen-..-
Urinal. StallMall... .-..-.---..-.-----.
Wash Easin/Lavatory, Single..
Toilet, Public lnstallation.
Toilet , Private.....
Miscellaneous
7-
L
4
TOTAL FIXTURI- Ui.]II'S -bL
CREDIT CALCULATION TABLE: Based on assessed value
catculate credits separates.
lf improvements occurred after annexation date in table.
Credit for Parcel or Land Only lf Applicabte
lmprbvement (if .after annexation date)
X$\ b.35 -' 61212 -(Rate X Assessed Value)x$
(Rate X Assessed Value)
3.+L
91
CREDIT TOTAL s56
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $ 1.OOO
Assessed Value
1979 or before
1 9BO
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
3.32
3.21
3.06
2.92
2-73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$ 2.46
2.14
1.77
1-37
o.97
o.61
o.44
o.15
+
+
-4 -
Willamalane
,
PHONE:
lob No.
Park & Recreation District
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
NAA4E
&__[y=,, qfttr
ADDRESS:
LOCATION OF FROPOSED BUI NG SITE:
Street Address if Known:"1,
Platt Name:Tax Lot Numben
1 DEVETOPMENT TYPE (Check appropriate dwellingG). SDC Calculations and dwelling type
definitions are on the baclc)
A. Sinele Familv - Detached
NO OF UNTTS X $400 PER UNIT -="
Ad\
ar'
X $370 PER UNIT =
$
'$
$
$
B. Sinsle Familv - Attached
,
NO OF UNITS
C. Multi-Familv Aoartment
D. Manufactured Home Park
.
NO OF UNITS
NO OF UNtrS X S?77 PER UNIT =
X $280 PER UNIT =
0,nWPRD SDC $
2. SDC CREDTT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. SeeSDCCreditWorlcsheeL $
3. TOTAL WPRD NEr SDC ASSESSED (lf SDC reduced for Credi0 $
;^.^.,.^?r., C r1ir l-);rtrr
2D
,d
W:@
C'TY OF OFEGO'V
225 FTFT,E STREET
SPRTNGPTEID, ORBGON 97
INSPBCIION REQUBST: 7
OPPICE: 726-3759
OP
projoct as srrbrnitlod has the
zoning and Coss nc,t requiro spocifrc land use
ar:proval.
A--lhorlzed
BLECTRICAL PERHIT APPLICATION
Ci ty Job Nunber
SCEEDULE BELOS
A. Nev Residential-Single or
HuIti-FamiIy per dwelling unit.
Service Included:
Items Cost
SPR. FIELO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Service or Feeder
STIBTOTAL OF ABOVB
5Z State Surcharge
TOTAL
c A
L
Sum
s 8s.00
s 1s.00 @
@JOB
Permi ts e non-transferable and expire
if vork is not started vithin 180 days
of lssuance or lf vork is suspended for
180 days.
2. COI|TRACTOR INSTALI.ATION ONLY
Electrical Contractor \\ eu*'S f lu,t,,.i.
Address 4 rrt
ci P,Phone 69B'3oto
Supervisor Llcense Number 39 11 S
Exp iration Date I -1
Constr Contr. Number ,113{:--
Expi rationDate 3-ll-1tt
Slgnature of Supervlsing Electrician
D- +:
0wners l
Address
Ci ty Phone
OVNER ON
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0rners Signature:
DATE:
s 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installatlon, Alteratlon or Relocation
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/volts
Reconnect 0nIy
t.loo s s0.00
s 60.00
a66tle
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one Circuit $ 35.0d
Each Additional
Circuit or vith Service
or Feeder Permi t $ 2.00
E. Hiscellaneous (Servlce/feeder not included)
2oo amps or ress t S 4o.oo
201 amps to 400 amps
-
$ 55.00
over 40L to 600 amps
-
$ 80.00
0ver 600 amps or 1000 voTts see rrBrr
0
-Each installation
Pump or irrigation
Sign/outline Lighting-
Limited Energy/Res
-Limited Energy/Comm
s
$
$
$
40.00
40.00
20.00
36.00
RBCEIVBD
5
gsq
(ro335
1.
SPNIl{OF!ELf'
I]ACKFLOW PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BI'ILDING SATETY DIVISION
225 FIFTH STREET
SPRINGFIELD OR 97477
OFFICE:
INSPECTION LINE:
726-3759
726-3769
JOB LOCATION:"Z
,( essnssoRS MAP #:
OIINER:
ADDRESS:
/ f7o
/ -zc
rAX Lor ff: D2rO 7
PIIONE #:
zrY V7//SCITY:STATE:
BACIGL0U PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + $.45 (ADUIN. FEE) = $16.20
ADDRESS:
CITY:
PHONE *:r Zzs,
STATE: AX a 7y'r1ZI?z
CONSTRUCTION CONTRACTORS REGISTRATION #:EXPIRES:
BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE
BACI(FLOII PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION
(726-3769). r ALSo STATE THAT ALL TNFoRHATIoN 0N TIIrS PERMIT/APPLTCATIoN rS
CORRECT.
4=-
FOR OFFICE USE
%T1-
DATE OF APPLICATION:
RECETPT #: / b er rssuED BY:
TOTAL AMOUNT COLLECTED:/c 7a
JOB *, 7 33-f
i - F'*o{
CONTRACTOR:
jAj -di* 7-*