HomeMy WebLinkAboutPermit Building 1995-05-04a-'--
SPFI
EEiiB,?-Iltl,.o,'o*
lnsoections: 726'3769
of (ice: 726-3759 Qfi,
215 Fitth street
ipringtiero, oregon 97477
JOB NUMBER
/
TAX LOT:
SUBDIVISION
LOCATION OF PRO
ASSESSORS MAP:
LOT:
PO SED WOBK
J
BLOCK:
PHONE:
ztPSTATE:
7
74'/770c/
OWNER:
ADDFIESS
CITY:
./'NEW u'- REMoDEL ADDlrloN DEMoLISH orHER
.t. nDESCRIBE WORK:
PHO
C4
EESSlADDRk
5
CONST.
CONTCONTRACTOR'S NAME
G EN ERAL:
PLUMBING
MECHANICAL
ELECTRICAL:
- OFFICE USE -
OUAD ABEA:
r OF BLDGS:
h Abll-LAND USE:lill
* OF UNITS:
Rb+m VNI
I bDL
OCCY GROUP:
; OF STORIES:I L,..J +I
X
X.
tr
X,
KOrVwatl - Prlor to taptng
CONSTR. TYPE:
HEAT SOURCE;
FLOOD PLAIN:
ZONING CODE
/ OF BDRMS
SECONDABY HEAT:
SQUARE FOOTAGE:RANGF-:E
Rough Mechanical - Prlor to
cover.
Rough Electrical - Prior to
cover,
Fireplace - Prior to faclng
materials and framing Insp.
Framing - Prior to cover.
Wall/Celling Insulatlon - Prior to
cover.
WATER HEATER:L
To request an Inspection, you must call 726-3769. Thls is a24hour recordlng. All inspections requested before 7:00 a.m. wlll be
made the sanre worklng day, lnspections requested after 7:00 a.m. will be made the followlng work day.
REQUIRED INSPECTIONS
LtAb
porary Electric
Site lnspection * To be made
after excavation, but prior to
setti n g forms. €tOfi.*. S
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underl echanical
- Prior n or decking
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decki ng.
Sanitary Sewer - Prior to filling
trench-
Storm Sewer - Prior to filling
trench.
Water Line * Prlor to filling
trench.
Rough Plumbing - Prior to
cover.
]p[ finat Plumbing - When all
\OtumUIng work is complete.
pl finat Electrical - When allG\.electrical work is complete.
f-7 Electrical Servlce - Must bepupprored to obtaln permanent
blectrical power.
K
It'l rinat Buildins - When ail
flrequired inspections have been
approved and building is
completed.
Other llo
by AQ. C;t3
MOBILE HOME INSPE TIONS
[-_l Alocking and Set.Up - When ail
-
blocking ls complete.
Final Mechanical - When all
mechanical work is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved andporches, skirting, decks, andventing have been installed.
EfFooting - After trenches area excavated.
N
X
Bx
tr
,X
,X
K
Wood Stovo - After lnstallation.
lnserl - After fireplace approvql
and installatlon of unit.
Curbcut & Approach - After
forms are erected br.tt prior toplacement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Trees - When all required
s are planted
umb
4
[--l fence - When completed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ
,/._- lnteriorwo4)"
)5:
S IS THE PFIOPOSED WOHK IN THEHISTORICAL DISTRI cL oR ONTHE HISTORICAL REGISTER?--- Corner
-- Panhandle
-
Cul-de-sac
lf yes, this application must be signedand approved by the HistoiicatCoordinator prior to permit issuance.,6'
APPROVED:
PL.HSE GAR ACC
N 2D 2o
S 26
5
E 54
Total Value
Building Permit Fee
State Surcharge /$_ol + 76t.82
BUILDING PERMIT
Total Fee
&"
gB(A)
4
bb
\e
lo ,,
8s
ITEM
Main
Garage
Carport
SQ. FT. X $/SO, FT.= VALUE
6*-3;''1
7 5/o7,
SGLt
This pcrmit is granted on the express condiconstruction shall, in all respecis, ;;r;;;;adopted by rhe City of SpiingrierJ,Development Coc]e, regulating ir," ""o""t1,buildings, and may be suspended or revoupon violation of any provisions of sait o
Rcviewecl te
tion that the said
to the Ordinance
including the
ction and use of
ked at any time
,rd inances.
BUILDING
AND BUIL J,flb'FtBhfi| cHEcK
Receive
6tPlan Check Fee:
Date Paid:
Recei pt Number:
EMS DEVELOPMENT CHARGE (SDC)
s(B)'e +Ftzt
SYST Systems Development Charge is due on all undevelopedproperties within thr: City linrits which are being improvecl.
ITEM
Fixtures
Flesidentiat Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBTNG PERMIT
FEE
E?o*/,eo
FT.
FT.
FT.
Jr^ .8O(c)
,/@ G,€NoZ
/2-
Plumbing Permit
State Surcharge
Total Charge
t4b n
*
tF
00
1II
}t
ADDITIONAL COMMEN TS
MECHANTCAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No Z
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Mechanical Permit 4/l) ,
lssuance
State Surcharge ,ZS +,$
Total Permit (D)
w
2o
24,>e
oo
Z-9o
6,e
7rc-==r+
By signature, I state and agree, that I have caref ully examinedthe completed application and do hereby certify that allinformation hereon is true ancl correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Lawsof the State of Oregon pertalnlng to the work described
herein, and that NO OCCUPANCy will be made of any
structure wlthout perrnission of the Buildirrg Safety Division.
I further certlfy that only contractors and employees who
are in compliance with ORS 7O1.OS5 will be used on this
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each acJcJress is readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remain
Date
on the sit
Slgnatu re
'"ry during construction.
MISCELLAN EOUS PERMITS
Mobile Home
State lssuance
State SurLharge
Sidewalk
--
ft 7
Curbcut il ?
Demolition
State Surcharge
Total Miscellaneous PermLts (E)
2;4kI/e42/ruu ftE
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
2?#l/
'1
.4 7
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT FIECEIVED
RECEIVED BY
p
OREGO'VCITY OF SPR
225 FIFTE SI?BEf,
SPRTNGFIBLD, ORBGON
INSPECTION RBOUBST:
OFFICB: '726-3759
1
The following projsct es subrnkted has tto1
zcning, and doee rrct require epecilic
97417 apijr'ovai.
726-3769 Zorri LD(L
SPRInrGFIELO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular DveIIing
Servlce or Feeder
5. STIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
PERI{IT APPLICATION
sionature Fl#
"n" *a=ru.n,rar-Singre or
City Job Number q5m2.?
3. COHPI.ETB FBE SCMDULE BELOS
MuIti-FamiIy per dvelling unit.
Service Included:Items Cost
')
.B
\kqbB
Permits are non-transferab and expire
Address S\ZA U /1U-'
Cl ty
Supervisor License Number 5
Expiration Date \D.\
B. Services or Feeders
InstalIation, Alterations
or Relocation:
\rn Sum
0s
&
I
A
$ 8s.00
$ 1s.00
$ 40.00
s s0.00
$ 60.00
s100.00
$130.00
$300.00
$ 40.00
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
Over 1000 amps/volts
Reconnect 0nly.q.\
Constr Contr. Number
Expiration Date
s Electrician
0wners Name
Address
Ci ty Phone
OIJNER ALI.ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATB:
Temporary Services or Feeders
Installation, Alteration or Relocation
c
e_,t
200 amps or less L $ 40.00
20L amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 voTts see [8"
a
aEove
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/outline Lighting- g 40.00
Limited Energy/Res
-
$ 20.00
Limi ted Energy/Comm $ 36.00
RECEIVBD
7.?r+4^ry7'
/ 67,2n
if work is not started lrithin 180 days
of issuance or if vork ls suspended for
180 days.
2. COIITRACTOR INSTALI,ATION ONLY
Electrical contrac tor/3i //S F /e, hr.
Phonef'{-,r3)
4.q:i
,
Willamal
Park & Recreation ane
District
NAA4E
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
fob No. qdALn
PHONE:
4ao 00
ADDRESS: t1/10 h. W
LOCATTON OF FROPOSED
Stre€t Address if Known:
Platt Name:Tax Lot Numbec
LDI C
{
1
ffiaCheckappropriatedweltingG).SDCCalculationsanddwellingtype
A. Single Family - Detached
I single Famity home Manufactured home not in a park
NO OF UNITS I
-
X $4OO PER UNIT -=.
B. Single Family - Attached r . !
C Multi-FamilyApartment
NO OF UNITS
D. Manufactured Home park
NO OF UNITS
$
X $?ZI PER UNIT =
X $2BO PER UNIT =
$
$
$
$
WPRD SDC +00 @$2. SDCCREDTT (tfappticabte) SDC-oaapprovat. S *ibC Creait wo4sni[er must furnish proof of WPRD Credit
3. TOTAL WPRD NET SDC ASSESSED (rf SDC reduced for Credit)
^^.^.,.^i.r , Qa.,.i-^.
l-''t rf o
lb
s 4t0.oo
srArE: -& =,, q+l'11
L( \rt r5r, 0?rt
ATTACHMENT 81 No. .a5oU:1tB
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NA}4E OR COI"1PANY Cazt *oneg
LOCATI0N: 4oz4 l/tr<otutn St. /6oz-oEoo - oitoo F.o'
DEVELOPMENT TYPE
BUILDING SIZE:
LP R - xl ew ,FF-
. Ft.
1. ST0R|4 nRATNAGF
IMPERVIOUS SQ. FT 2b41-X $0.209 PER SQ. FT
2. SANITARY SFI,,IFR-CTTY
ISI
NO. OF PFU'S
(See Reverse)
r8
3. TRANSPORTATTON
.
NO OF UNiTS X TRiP RATE X COST PER TRIP
X l,or X$436.19
x _._- x $436.19
x _ x $436.19
SUBTOTAL (ADD ITEMS i,2, & 3)
4. SANITARY SEI^IER-MWMC
NO. OF PFU.S $17.19 PER PFU + $10 Ml^ll',lc ADMIN.FEE(Use pFU Total Fromltem 2 aOouEl
MI.IMC CREDIT IF APPLiCABLE (SEE REVERSE)
TOIAI -MI^IMC SDC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
5. ADMINiSTATTVF FFFS
BASE CHARGE (SUBTOTAL ABOVE) X .05
75
$
$
$ t-1o aZl
sb ri 4z
1 ac
$ z-ozo'A
IB'l-\ -
/,o
SDC
82. SDC
Coord i nator
Date:2
TOTAI SI'IC $21
X $43.26 PER PFU
FTXTURE UNIT CALCULATT'IN TABLE: Number of New Fixturer
(NOTE: For remodels, calculate onty the-.J additional fixtures)
. NUMBER OF
FIXTURE TYPE NEW FIXTURES
z
,nit Equivatent =' Fixture Units
Bathtub.....
UNIT
EOUIVALENT
FIXTURE -.
UNITS
2
2
1
2
5
6
2
b:
6
'-1
3
2
1/Head
2
2
1
6
4
Drinking Fountain. -..-....
Floor Drain.
lnterceptors For GreaselOit/Solids/Etc
lnterceptors For Sand/Auto Wash/Etc"" " " " " " ""
Laundry Tub/Clotheswasher" " "'
Clotheswasher - 3 Or More""""
Mobile H ome Park TraP (1 Per Trailer)
Receptor For Refrig erator/lVater StationiEtc"" " "
Receptor For Commercial Sink/Dishwasher/Etc"
Shower, Singte Stall-.""""
Shower, Gang.........
iinf.t gur, Commercial. Residential Kitchen'
Urinal, StallAl/all..r"1"']" " "" "'
Wash Basin/LavatorY, Single"'
Toitet, Public lnstallation' """"""""""':'
Toitet , Private.""
Misceltaneous
CREDIT CALCULA Tlo N TABLE: Based on assessed
calcul ate credits seParates
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
L
TOTAL FIXTURE UNITS
value. lf imProveme nts occurred
24C-o
Value)
(Rate X Assessed Value)
7-
2-
I
t8
date in table,after annexation
1 qb
CREDIT TOTAL = $1 1t
Rate Per $ 1,OOO
Assessed ValueYear
AnnexedRate Per $1,OOO
Assessed ValueYear
Annexed
1 985
1986
1 987
1 988
1 989
1990
1 991
1993
s2.46
2-14
1-77
1.37
o.97
o.61
o-44
o-15
1 979 or before
1980
1981 .
1 982
1983
'1984
1 985
s3.46
3.38
3-32
3.21
3.o6
2-92
2.73
t
: :i'z