HomeMy WebLinkAboutPermit Building 1992-06-12SP]IING'.TELO
Tzoz/a
LOCATION ()l lrl-lol'OSi:D Wol.ll(
AS:iESSol{:; r.'lnP: /7A-73-1/
BLOCK:LOT:
h,Springfield, Oregon 97 477
SUBDIVISI()N:
--
RESIDENTIAL
PERMII At'PLICATION
lnspections:,' 26'3709
Ollice: 726-3i'.,9
uOll NUMBEI] .
225 Fi{th Street
rAx Lor: -ea/l<
57/5 &azsrea-fu-
OWNER: --
ADDRESS:
CITY: ----
PHONE -Z%==?52
STAI'E:,,r,-2228
/a|rzg
DEMOLISH OTHER
DESCRIAE W()RK: * -
NEW -REMODEL
-
- ADDITION
FIACTOR #ADDRI SSCONI RACI( rr. Sl NAML
GENERAL
CONST.
,)L tJMulN(
MF:Ct'lANl()Al : , ---
LANt) USE:
/ OF tJNlTfl:
_ OFFICE
Lt{
USE
t_
f- I Tc'nr1,o, .,t y Electr i,;IJ
Site lrrspection - To be rrlade
af ter rtxr:avation, but Pri()I to
settin(.) lorms.
Undr:rsl ab Plurnltirrg/ Electrical /
Meclrarrical - ['t1,..,I to c()ver.
Footing - After lrenches .lre
excavJ l |d.
Masorrry - Slr,'r:l locatiorl, bottcl
buarrni,,lroutitrg.
Foutr<llrlion - nll(ir folltrs are
erectc(l l)ut prlor lo conorcte
placun t, 'n [.
Undcrgrottnd t)lttnrblng - l)rior
to liilirr,t trencll.
Undet I Ioor Plunrbing/ Mechanical
- [)r ior ttr insul;rtton or tlecl<irtg.
Posl anrt Beant - Prior to floor
insulalion or de()l\lrlg.
coNl; rR. l Yl'l
HEAt SOUnCI'
RANC:E: -
l---.] Rough Mechatrical - Prior toU cover.
tx Rough Elct' trical - Prior to
COVET.
Etectrical Service - Mr.rst be
alrl)rovecl to obtain perrrlanent
electrical power.
Fileplace - frrior to facino
rn;rterlals :rtr<l lr;rtttlng ltrsp.
lX fro*in9 - Prior to c()ver'
l-71 walllCeiling lnsulation - Prior to14 cover.
[Xl Drywall - Prior to taoins.
l-_l Wooa Stove - After installation.
lnserl - n fter fireplace approval
anci installation of unit.
Curbcul & ApProach - After
lortns at'c (iructe(, but l)rlor to
Jrlacement of cottcrete.
Siclewalk & DrivewaY - After
excavatiort is conlPlete, forms
ancl sub-base tttalerial in place.
Ferrce -- When comPleted.
Streel Trces -- When all required
lrecs are platlted.
FLOOD PLAINI:
ZONING CODI-
, OI= EIDRMS:
SECONDARY IIEAT:
SQUARE FOOTAGE: -
Firral Eleclrical - Wlrerl all
t-'lectrical work is coltll,l(.rle.
Final Mechanical _ Wlrcn ;rll
rnechanicitl work is t;<,rtttlrlett:.
Final Building - Wlrt:rr all
required inspections ll;rvtl bt:r'tt
rrpproved ;rtrtl bttiltlirr,l r:;
cornpleted.
VN
To rc(fuest ar, rrrspecriorr, you rnust call 126-3769. This ls a24hour recording. All inspections requested l.rr:fore 7:00,i.m. will tre
made tlre:i.ilr,e worl(irrg day, inspeclions requestecl after 7:0O a.nr- will be made the followin0 work day'
REGUIRED !NSPECTIONS
Final Plumbing - Wttr,'n all
plumbing worli is cotltplr'lte.
ii tx
w
l- I other -- -
Sarritary Sewer - Prior tr-i fillirrq
trent: lt.
Slorm Sewer - l)rior to f illing
trench.
Water Line - Prior ttrfillitrg
trencll.
MOBILE HOME INSPECTIONS
Blocking and Set'Up - Wlri-'rr i.rll
blocking is comPletc.
Plumbing Connectiotts - Wltrltt
home has ttec'n conttrl<:tcd lt.t
water and sewer.
Electrical Connectiorr - Wltrrtt
blocking, set-up, atrtl plumbtrrtl
anspections lt:rve bcr:tt .tpprov(i(l
and the hotne is corrr)(-'cted t()
the service panel.
Final - Af ter all recltriretl
inspections are aPProvcd an(l
porches, skirting, <let:ks, antl
venting have been ittstirlled.Rouglt l)lumbing - Prior to
cover.
tl
ouADon,^€RJ\-D-
, or RLn(,'; -^ !-
oc(.Y (;tr()il !\3
,/ (-)t Slotill : t
WAIER H[ /rl t R:
--
\4s
fl
w
n
L,ff
fl
fl
w
w
tJ
tl
E
tl
tl
tl
Floor lnsulalion -- Prior to
decktrt.l
tl
t_l
tl
N
S
HSE
Lot faces
Lot s(1. ftg.
Lol r:overage
lbpollraPltY
Total height
PL.
Setbacl<s
GAR 49c
{E I'I]OPOSiED WORI( IN THE.-I{TSTORICAL DISTRICT, Ofl ON
l'[-lE HlStORlcn L HEGISI't:rl'1
lf yes, this application tntrlit l)o signed
;rrrrl ;rpproverl by the l-l istorical
()r:lotdirr;tlor prit,r to l)eIlllil i[;:]Ltancc.
lY
E APPFIOVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pernlit is glranted on tlle express conditiorr l|1at the said
construction shall, in atl respects, conforrn to tll{l Oldinance
aclopted by the City of Springfield, irrt;ltrr-ling the
Developtrent Code, regulatirrg the constructi<'rr ar'rd use of
buildings, and may be suspended or rcvokecj at any tirne
u pon violation of any lrrovisions of saicj otditt;trrt;es.
['lan Chcck r.u, -J6-=7=-
Datc
4-le*=
z_Date Paicl
t'leceipt Numbet:--
flecei
VALUE
/qD
(A)
3?.?_
BUILDING PERMIT
lirt;rl Value
lJuilriirrg Pct rrri t Fec-
.'i I ;r tr: Stt t t;lt;rr<;r-'
Tol;rl l:ee
66_,{az-*5
52.27
SO. FT. X $/SO. FTITEM
M:ritr
Garage
Carl:r:rt
Systems Developmerrt Charllc is duc on all trrrclcvcloped
properties witlrirr tlrc City lirnits wl'rir;h are berrrrl itnl:rovecl.
SYSTEMS DEVELOPMENT CHARGE (SDC)&(B) b-6 (2
ADDITIONAL COMMENTS
ITEM
I:ixlutes
Flcsicjential uath(s)
S:rrril;rry Sewr:r
Wiltcr
Stor rrr Scwcr
Molrile l-lotttr:
PLUMBING PERMIT
FEE
(c)
NO
FT.
FT.
FT.
Plunrbing Permit
St;rtr.'Sutcttarge
Tot;rl Ch;rrge
Woorl Stovc/lnsert/Fircplace Unit
Dtyor Vctrt
MECHANICAL PERMIT
(D)
No
Mcr;lranical Permit
lssu ance
State Surcharge
-Iotal Permit
Furnace
E.xh;rrrst Hoocl
Vcnt Fan
tly signatLrre, lslate;ttrt.l agrer:, thal I have carof rtlly examined
thc corrrpleted ;rpplir:;rtion ;tncl do l-rereby 6t'r liIy that all
information hereon is true attd correct, and I f trrtlrt:t certify
that any and all worl< pcrfortrretl shall be clone itr ;tr:cor(lance
with the Ordinan<;es of tl-re City of Sprinrlf iel<l,.rrttl lltc [.;rws
ol lhe Slale of Orc<lorl p(,'rlaininq lo tile wt,rk rlr:scrit;r:d
Itcrein, ;rncl llral NO OCCLII']ANCY will b(: t,r;ttlt) of ;rny
structure wi tlrou t pcrtrrissiotr of the Builcling S;ifr;[1' Divisiotl.
I f urther ccrti{y lhat t>nly conllactors and enrltlo'y'ees who
are in cornpliance with ORS 701.055 will be rrsed on this
proiect.
I further agree lo etlsure that all required inspr.:<:tions are
requested at the proper tinre, that each addres,r is readable
from the street, that the pe'rrnit card is locate(l at the front
of the property,;rnd tlrr: apl.rroved sr:t of plan'; will rctnai n
on the site at all titnes during con:itruction.
Signature -,
[)a I
q Za/t
$J,rfu&
MISCELLANEOUS PERMITS
Mol;ile Home
Statc lssuance
State Surch;rrge
Sirlr:vv;tlk - -* ft
Crrrlrr:tlt - -- ft
Dcnrolitiort
Slato Sutcllargc
Tot;rl Misccllaneous Permits (E)
VALIDATION:
TIECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEI)
SuYau l)-q2,-
3,1_4_y-
TOTA L AMOUNT DUE (excluding clectric;tl)
(A, tl, C, D, and E Cornbined)
2{#
RECEIVED U'--__ &
Lot Type \zv
-
lnterior
-
Corner
-* ,. Par'lhan(lle
-
Cul-de-sac
225 FIFTTI STREEf,
SPRTNGFIELD, oREGoN 97477
INSPECTION REQUESTT 726-3769
0FFICE: 726-3759
1 LOCATTON OP TNSTALIJTI ON
IAGAL DESCRIPTION
JOB
2. CONTRACf,OR INSTALI.ATION ONLY
Electrical Contractor
Address
cit Phone
Supervisor License Ntimber
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name
Address
Ci ty Phone
OgNER INSTALI.ATION
The installation is being made on
property f own which is not intended
for sale, Iease or rent.
Ovners Signature:rlrrure z4/rffi
DATE:
RECEIPT
ELECTRICAL PERHIT APPLICATION
Ci ty Job Number QZ,o
Nev Residential-Sing1e or
MuIti-FamiIy per dvelling unit.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
t hereo f
Each Manuf 'd tlome or
-Modular DweIIing
Service or Feeder
$ 8s.00
$ 1s.00
s 40.00
Services or Feeders
fnstallation, Alterations or
Relocation:
Zfi,
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
STIBTOTAL OTI ABOVE
5f State Surcharge
TOTAL
K'
3
A
Sum
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
B
s s0.00
s 60.00
s100.00
$130.00
s300. 00
$ 40.00
c Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps or less $ 40.00
0ver 401 to 600 amps _ S 80.00
Over 600 amps or 1000 volts see I'B'r above
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
one ci rcui r / S 35.00 ,z C*
Each Additional
Circuit or vith Service
or Feeder Permi t / $ 2.00 :?
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation S
Sign/0utIine Ligtrting- S
Limi ted Energy/Res
-
S
Limi ted Energy/Comm S
E
5
not included)
40.00
40. oo
20.00
RECEIVED BY:
?>e
COHPLETE FEE SCIIEDULE BELOV
/7 -az -=.-z^ , aa//=
a-3 / D\4-d\
ceE #
*c
Jog no . 3U:tA
CITY OF SPITINGFIELD SYSTEMS DEVELOPMLIiI CIIAtlcE
WORKSHEET
(C0HHERCIAL & RESIDENTiAL)
Dou G GE>*NAI.IE OR COI'IPANY:
LOCAT ION:5 t5 oz bl - ooil
LD Aopr <rnr.lDTVELOPI'IENT TYPE:
t;lCLOVeg a, H.'S
BUILDiNG SIZE:\o f tO
1. STORM DRAINAGE
?. SANITA RY SEI.IER -CITY
4
NO. OF PFU'S
TMPERVT0US SQ. l- lbo x
(See Reverse For Runoff Coefficients If
LOT SI
50-186 PER SQ- FT.
Actual ImPerv- Are
S a. Ft.
a Is Unknown)
NO. OF PFU'S
(See Reverse To Oetermine Tota
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x
--
x s3B8-61
x
ADI'IiNiSTRATiVE FEES
BASE CHARGE (SUBToTAL ABoVE) X .05
5. SANITARY SEI.IER-HI,IMC
x
--
x s38s-61
isee Attach-menT c To Deteraine r.!g-Bl!:s),-^^
sUgroraL-'(ADD ITEI'ts 1,2, & 3)
X 538.55 PER PFU
PFU'S )
s
t
3
s
S
48sb+
sI Q 1
(Use PFU Total From Item 2 Above)
r'1r^['1c cREDIT iF APPLICABLE (SEE REVERSE)
t5
S
TOTAL-HWMC SDC s+
x
TOTAL-CiTY SDC sb+
513-25 PER PFU + S!0 Ht.lI'IC AITHIN' FEE
-LG
Ki p Burdick
SDC Coordinator
{a
7
TOTAI
rq
s
x s388-61
{ cnY oF
225 FIFTB SI?BET
SPRINGFIELD oREGoN 97477
INSPECTION REQT'EST.. 726-37
5r.t rrN(;t- tLLL,
&J
3 COHPLETE FBE SCBEDULE BBLOV
-Single or
MuIti-FamiIy per dvelling unit.
Service fneluded:
Items Cost
The.lollowln0 Brojectz.'nr,"tg, End doeg not
69
i}:t,,
OPPICE: 726-3759
1 LOCATION OT INSTALLATIOI*ili.,1''r',ir
IJGAL DESCRIPTION
JOB DESCN PTION
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACf,OR INSTALI,ATION ONLY
Electrical Contractor DLda)'&.
Address
Ci ty Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Nanie fuzn 4ar,q
Address
Ci ty Phone
OVNER INSTALI.ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
B. Services or Feeders
Installation, 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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Panel
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
One Ci rcui t
Each Addi tiona]
Circui t or vi th Service
or Feeder Permi t
200 amps or less $ 40.00
201 amps to 400 amps
-
g 55.00
Over 600 amps or 1000 volts see "8" above
Sum
s s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 8s.00
s 1s.00
$ 40.00
s 3s.00
$ 2.00
5a
E. Miscellaneous (Service/feeder not included)
-Each ins tallat ion
Prrmp or irrigation
Sign/0utIine Ligtrt ing-
Limi ted Energy/Res
Limited Energy/Comm
5. SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
s 40.00
$ 40.00
s 20.00
s 36.00
{oe
-t €o
-52.yRECEIVED BY:
L
'' oz .\? '/ or n
PERHIT APPLICATION
Ci ty Job Number Qzo