HomeMy WebLinkAboutPermit Building 1995-04-07RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP;
LOT:
SP'lIAIGFIELE)
tl€Co', TA {
JOB NUMBER
225 Fitth Street
Sprlngf leld, Oregon 97477
y'ir qra r'4 3{
I
+
BLOCK:
TAX LOT:
SUBDIVISION:
-OWN
ADDR
CITY:
PHON
STATE:ztP
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW y' REMoDEL
ADDRESS ACTOR #EXPIRES PHONE
CONST.
GENERA
CONTRACTOR'S NAME
PLUMBING:
MECHANICAL:
ELECTRICAL:
...'1Rso-
t V +
€,
a,u
- OFFICE USE -
RANGE:WATER HEATER:
FLOOD PLAIN:
ZONING CODE:
r OF BDRMS:
r OF UNITS:
LAND USE:QUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc
Slte lnspectlon - To be made
after excavatlon, but Prior to
setting forms.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but Prlor to concrete
placement.
Underground Plumblng - Prlor
to fllllng trench.
Underltoor Plumblngl Mechanlcal
- Prior to lnsulatlon or decklng.
Post and Beam - Prlor to lloor
lnsulatlon or decklng.
Water Llne - Prlor to filling
lrench.
V Rough Mechanlcal - Prlor to/a{ cover.
-Ef Rough Electricat - Prior tojl\eover.
Flnal Plumbing - When all
plumblng work is complete.
F7 Flnal Electrlcal - When all
IAJ electrical work is comptete.
ls7[ Flnal Mechanlcal - When all
.lA{ mecnanical work Is complete.
Vl Plnal Buildlng - When allJA{ requlred lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocklng and Set'UP - When all
blocklng ls comPlete.
Ptumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set'uP, and Plumblng
lnspections have been approved
and the home ls connected to
the servlce Panel.
Flnal - After all required
lnsoectlons are aPProved and
porches, sklrtlng, decks' and
ventlng have been lnstalled.
F
E6xg1?gry,:'::Y;'"" X
TX Footlng - After trenches area\xcavated.
E
IVf Floor lnsulallon - Prior to
Adecrlng.
X Sanllary Sewer - Prlor to fllllng
trench.
F(TStorm Sewer - Prlor to fllllng
,lAtrench.
K
V[ nough Plumbing - Prlor to
A{ cover.
Electrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framlng lnsP.
Framlng - Prlor to cover,
Wall/Celting lnsulatlon - Prlor to
cover.
Drywall - Prlor to taplng.
Wood Stove - After lnstallatlon
lnsert - After flrePlace aPProval
and lnstallatlon of unlt.
Curbcut & APProach - After
forms are erected but Prior lo
placement of concrete.
Sldewalk & DrlvewaY - After
excavatlon ls comPlete, forms
and sub-base materlal ln Place'
l_l fence - When comoleted
reet Trees - When all requlred
are planted
X X
E.
X
tl
E
E
tl
E
tl
tl
.t-. :
Lot faces
Lot sg. ftg.
Lot coverage
TopograPhY
Total helgh
Lot Typ€ _
-
lnterior
!
"orn",
-
Panhandle
-
Cul-de-sac
_4?,
IS THE PROPOSED WORK TN THE -
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
It yes, this application must be slgned
and aPProved bY the Historical
Coordinator prior to permit issuance'
APPROVED:
1-D"tg
P,L.HSE GAR ACC'
N b3
S /q
W q I
E tb
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
consiruction shall, in all respects, conform to the Ordlnance
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 tlme
uoon violation of any provisions of said ordinances'
ptan cnecx ,"", de8'? [P
PI
Receipt Numbe
Date Paid
Beceived
BUTLDING PERMIT x $/so.
\
+€/o
(A)
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) #lorzL-N
ITEM
Fixtures
Besldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
+9o
(c)
FT.
FT,
FT.
No
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
State surcharge +3Ob
(D)Total Permit
@
V
l,-o
l0-N0Vent Fan
Mechanical Permit
lssuance
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
lnformatlon 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 Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
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 compllance with ORS 701.O55 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address is readable
from the street, that the permlt card ls located at the front
son the site at all times du constructlon,
Date
set of plans will remalnof the property, and the ap
X
Signature
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
sidewark t8 ,,
curbcut M,- ,,
Demolltion
(E)Total Mlscellaneous Permits
,/
Surc e
ffi-
TOTAL AMOUNT DUE (excluding electricat
(A, B, C, D, and E Combined)
R
VALIDATION
RECEIPT NU
DATE PAID
AMOUNT RECE
RECEIVED BY
. . i :lr1
I
/ il:7 pate
VALUE
9\n,\pD1
1lnt4.5AD
t+\
B NO.6
CITYoTSPRINGFIEIJDSYSTET{SDEVELOPMENTCIIARGEWORKSHEET
(C0I'IHERCIAL & RESIDENTIAL)
NAME OR COMPANY Mp=r*un wvL
LOCATION:g t -\\o
?&vl ou*>'( ,"7
b\oz
FtLX-
DEVELOPMENT TYPE:e Yr1O DY
BUILDING SIZE:SIZ
I. STORM DRAINAGE
IMPERVI0US SQ. FI. ??$\-tooo'?Z* x $0.209 PER SQ. FT-
c-ger2tr \Aoo +a'-€t.
2. SANITARY SEI,IER-CITY
NO. OF PFU'S ZZ- t\ ),tl x $43.26 PER PFU
(See Reverse) c-?<aefi rl PFo'5
3. TRANSPORTATION
cfls911 tREglDeilftr\L
NO OF UNITS X TRIP RATE X COST PER TRIP
(z-) x l.ot x$436.1e
x $436.19
x $436. 19
4 SAN ITARY EI.IER-MhIMC
N0. 0F PFU'S 2L-11 $17.19 PER PFU + $IO MhlMC ADM FEE
(Use PFU Total From Item 2 Above )
MI,,MC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MI,JMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .05
Kip Burdick
SDC Coordinator
X
X
. Ft.
$
$
6tw
s a<oz2
5
41 '1-1
TOTAL SDC $ t6v4
$ lq9 0:
Date: e /zz /qq----7-------l-------
F'XTURE UNTT CALCULATIqN TABLE: NUMbCT Of NCW FiXIUTC(NOfE: For remodels, calcutate onty th. J additional fixtures)
TOTAL FIXTURE UNITS
'Jnit Equiwalent --- Fixturc lJr.its
UNIT FIXTURE -.
EOUTVALENT UNITS
2z
FIXTURE TYPE
Eathtub----.
Drinking Fountain....
Floor Drain..-.-...
lnterceptors For Grease/Oil/Sotids/Etc.
lnterceptors For Sand/Auto Wash/Etc.
Laundry Tub/Clotheswasher......
Clotheswasher - 3 Or More-.-.-.i---------.-.:r
Mobile Home Park Trap (1 Per Traitcr].
Receptor For Ref rigerator/Vvater Stiitio
Roceptor For Commercial Sink/Dishwasher/Etc..
Shower. Single Sta1t..........
Shower, Gang......... ..........:.-.....
Sink: Bar. Commercial, Residential Kitchen....
Urinal, StatlAVall..- ....................
Wash Basin/Lavatory, Singte..
Toilet, Public lnstallation.
Toilet , Private
Miscellaneous:
n/Etc..-....-
NUMBER OF
NEW FIXTURES
2
Z
2-
4
z
ad
2
1
2
6'2
6
6
,1"3
2
1/He
2
2
1
6
4
CREDIT CALCULATION TABLE: Based on assessed value-
calculate credits separates.
Credit for.Parcel or Land Only lf Applicabte
lmprov'ement (if after annexation date)
lf improvemerits occurred after anne xation date in table,
*,t-aa.+u x $44.81 (51
(Rate X Assessed Value)
(Rate X Assessed Value)
CREDIT TOTAL _ $tbtz9
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $ 1.OOO
Assessed Value
1979 or before
1 9BO
198'l
1 982
1.983
1 984
1 985
$3.46
.a 1a
3.32
3.21
3.O6
2-92
2-73
.1985
'1986
'1987
1 9BB
1 989
1 990
1 991
'1993
$2.46
2.14
1.77
1.31
o.97
0.61
o-44
o-15
Z
---E-
.)
, * Nurno\rrtrrod ss- )l,otfunne-{c Oc0Dtxl.r,c} d.l-Q-ry
Willamalane
,
Park & Recreation District
Platt Name:
C Multi-FamilyApartment
D. Manufaoured Home park
NO OF UNITS
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
PHONE:
Iob No.
'$
$
$
ADDRESS:.QQIrM 6o ",( hlo r-fl Up , srArE:l!$ =*{*41r.
I
LOCATION OF FROPOSED BUILDINC SITE:
]u* Address if Known:.\.
Tax Lot Numbec
X $370 PER UNIT =
X $280 PER UNIT =
ffiJfl*nappropriatedwetting(s).SDCCalculationsanddweltingtype
,A" Single Family - Detached
NO OF UNTTS X g4OO pER UNIT _=.
B. Single Family - Attached i r .
$
NO OF UNITS T *.3 @
WPRD SDC
2- sDc cREDrr (rf appricabrd sDC-payer must furnish proof of wpRD creditapproval. Sx SDCCredit worl<shit
3. ToTAt wpRD NET sDc AssEssED (rf sDc reduced for credi0
$
o4?O.@d$
$
Sr. , (n..^. f.\ir Oeta
r')
b1ao0
-I )C'TY OF SPRINGFIELD,ON
,/
The.foll"owing proioct ae submltted has the
iljl:i'i5;15"-d i'tot require specif ic land
aooroval.\^^' Zoning W''-
3} CIFIELD
u58
EECTRICAL PERHIT APPLICATIO,N225'BIiTH STREBT
SPRINGPTEIJ, OREGON 97477
INSPBCTIoN REQUEST:'726-$469
OFPICB: 726-3759
Authorlzed Sig
1.
JOB PTION g
Permi ts a t'e non-transferable and expireif vork i s not started vithin 180 daysof is suance or if vork is sus pended for
1.80 days
2. COI{TRACTOR INSTALI.ATTON ONLY
Electrical Contractor r
Address
phone 6d,- OSAS
Supervisor License Number I 5 6es
Expiration Date
City Job Nunber
SCMDIIIJ BELOII
Nev Residential-Single or
Mu1ti-Family per dvelling unit.
Service Included:
ftems Cost
/\q(q5
A
Sum
1000 sq.ft. or Less
Each additional 500sq. ft or portion
thereof
Each Manufrd Home or
-Modular Dvelling
Service or Feeder
Services or Feedersfnstallation, Alterationsor Relocation:
{
d
s 8s.00
s 1s.00
$ 40.00
o,-a
?^Lo
t1cn
*roa)
B
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-60L amps to 1000 amps-0ver 1000 amps/vo1t
Reconnect 0n1y
-C. Temporary Services or Feedersg fnstallation, Alteration or Relocation
;3? :ili: :; o'ffi"",," + g IB.BB 4c
0ver 401 to 600 amps ]- $ gO.O0
-
0ver 600 amps or fOOOToEs """ ,'[r.affi
D. Branch Circuits
$ s0.00
s 60.00
$100.00
s130.00
s300.00
$ 40.00I
Constr Contr. Nu
Expiration Date
Signature
0vners N,
Address
Ci
mber
TALI,ATTON
o
o 5
ising Electrician
Phone
0
The installation is being made onproperty f ovn vhich is not intendedfor sale, lease or rent.
Ovners Signature:
Nev, Alteration or Extension per paneL
One Circuit $ 35.00Each AdditionalCircuit or vith Serviceor Feeder permit _ $ 2.OO
Miscellaneous (Service/feeder not included)-Each instalLation
IYrp.9. irrigation S 40.00
ligtlolrline Lishting- i +o.ooilll::q Energy/Res
-
S 20.00
SUBTOTAL OF ABOVE5Z State Surcharge
3Z Administrative Fee
TOTAL
u
E
OC)5DATE:
BRECETVED
J
s:
2-g,7 ra
city 6,g.O(
I