HomeMy WebLinkAboutPermit Building 1992-12-14TELE}?zftar/RESID ENTIAL
PERMTT APPLICATION
lnspections: 726'3769
Office: 726-3759
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97 477
#-8_LOCATION OF PFIOPOSED WORK:--
ASSESSOBS MAP:F, lr 7-1 SLID6 7Et TAX LOT
LOT:9-g BLOCK:
RANGE:
SUBDIVISION
FLOOD PLAIN
ZONING CODE:
* OF BDRMS:
SECONDARY HEAT
SQUARE FOOTAG
_ OFFICE USE -
LAND USE:\l'\ \OUAD AREA:
# OF BLDGS
OCCY GROUP
r OF STORIES:
WATER HEATER:
tN OF UNITS:
CONSTR. TYPE
HEAT SOURCE:r
oa ?t+ttZIP:STATE:CITY:
ADDRESS:
OWNER
LDESCFIIBE WORK:
ADDITION DEMOLISH OTHERNEW ( REMODEL
CONTRACTOFI'S NAME
GENERAL: SayeAAGru6IO-
PLUMBTNG: .&aIMJD _Pll/rfu
EXPIRES
o-7
ooooc- spll?
)-(J
ADDRESS PHONE
MECHANICAL
ELECTRICAL:oA
CONST.
CONTRACTOR f
To request an lnspectlon, you must call 726'3769. Thls ls a24 hour recordlng. All lnspecilons requested before 7:00 a.m. wlll bemade the sarne worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED !NSPECTIONS
('"-o"rary Eleclrlc x
I(t nouOh Etecrrlca! - prtor to/-----\cover.
N
XSlte lnspectlon - To be madeafter excavation, but prlor tosettlng forms.
Underslab Plumblng/ Electrlcal /Mechanlcal - Prlor to cover.
Fooling - After trenches are
excavated.
Masonry - Steel locailon, bondbeams, groutlng.
Foundallon - After forms are
erected but prior to concrete
placement.
Underground Plumblng - prior
to filling trench.
Underll
- Prior n ng.
Post and Beam - Prlor to floorlnsulation or decklng.
Floor lnsulatlon - prlor to
decklng.
ffi etectrtcal Servtce - Must beJqapproved to obtain permanent
electrlcal power.
p[ Flreplace - Prtor to factngr.+ matorlals and framlng lnsp,
X
rt",,lng - Prio, to cover.
ffi WatttCelllng tnsulatlon - prtor toHcover.
X o'r"''t - Prlor to taplng.
ffi *""0 slove - After lnstallatlon.
[--l tnsert - After ftreplace approval
-
and lnstallatlon of unlt.
,E Curbcut & Approach - Afterforms are erected but prior toplacement of concrete.
fptsta"*"tk & Drlveway - AfterFl, excavatlon ls oomplete, formsand sub.base materlal ln place.
[-l Fence - When compteted.
flon"'M
MOBILE HOME INSPECTIONS
l-_] elocklng and Ser.Up - When ail.J blocklng ls compleie.
Plumblng Connections - Whenhome has been connected towater and. sewer,
Etectrical Cohnectlon - Whenblocklng, set.up, and plumblng
tnspectlons have been approvedand the home ls connected tothe servlcg panel. '
Flnal -red
Rough Mechanlcal - Prlor to
cover.
Flnal Plumblng - When allplumblng work ls complete.
Flnal Electrlcal - When alt
electrlcal work ls complete.
Final Mechanlcal - When all
mechanlcal work ls complete.
Flnal Bulldlng - When ailrequlred Inspectlons have beenapproved and buildlng is
completed.
x
,xN
,X
X
E
,K
,tr
X
,tr
Sanitary Sewer - prlor to fllllng
trench,
Slorm Sewer - prlor to fllllng
trench.
Water Llne - Prlor to fllllng
trench.
fig;y;t Prumbins - Prior to @;,y."e,"[H;flnun arr requried
tlng ed,
lumbl
OAa. r(-ss
SOUfdg16,r...1 EUtLtrelR\, pHoNE: 7q-.*C Ogth -t+ll MoD c)(
l,/l
and
and
Lot Type THE PROPOSED WORK IN THE
-AIISTORICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and apProved bY the Hlstorlcal
Coordlnator prior to permlt lssuance.
APPROVED
ADDITIONAL COMMENTS
#z
_x lnteriorLot sq. ftg.
Lot coverage
TopograPhY
Total height
e_L%LLf
Lh,
--
ibrn",
__ Panhandle
,( cut-0"-"""
P.L,HSE GAR ACC
6,5
S /o ls
E 2l
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt is granted on the express condition that the said
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Springfleld, including the
Development Code, regulating the construction and use of
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordinances'
Ptan check ,.u, _-3J16-2--
Date paid: - /4'D:2 -
ewed
v:
t',*i! ^
S v
Fleceipt Nutnbe
Recei
BUILDING PERMIT
SO. FT.
+73
/4€, rso
(A)
L47t
/4 e
ITEM
Maln
Garage
Carport
VALUE'<437o
66/,?
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
X $/SQ. FT.
5[^.e
Systems Developnrent Charge ls due on all undeveloped
properties wlthln the City limits which are being lmproved'RGE (sDc)
fi ub\z!
ANEcTHPLOMEVEDMSESYST w
(B)
ITEM
Fixtures
Flesidential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
+?2,f9
FT.
(c)/3
63Plumblng Permlt
State Surcharge
Total Gharge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
Mechanical Permlt
t3
5y',63
@4
ffo
Z
(D)
oo
s.oo
o,oo
Ltr1,\.LS
s?"
lssuance
State Surcharge
Total Permlt ''
Fu rnace
Exhaust Hood
Vent Fan
Fy slgnature, I state and agree, that I have caref ully examined
ihe completecl application and do hereby certify that all
lnformation hereon is lrue and correct' and I f urther certlly
that any and all work performed shall be done In accordance
wlththeordlnancesoftlreCltyofspr|nglleld,andtheLaws
of the State of Oregon pertalnlng to the work <Jescrlbed
hereln, and that NO OCCUPANCY wlll be made ol any
structure wltlrout permission of tlre Buildlng Safety Dlvlslon'
I lurther certify that only contractors and employees who
are ln compllance with ORS 701'055 wlll be used on thls
proiect.
I f urther agree to ensure that all required lnspections are
requested at the proper time' that each address is readable
from the street, that the permlt card ls located at the f ront
of the property, and the approved set of plans will remain
on the slte at all times durlng constructlon'
nature
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
srdewark -5b tt,
curbcut %t- t
Demolltlon
State Surcharge
(E)
(o
GO
oo
Total Mi scellaneous Permlts 5a
D
DATE PAID
RECEIVED
AMOUNT
VALIDATION:
RECEIPT NUM
TOTAL AMOUN
(A, B, C, D, and
T DUE (excludlng electrlcal)
E Comblned)
3{43v33
P4t1
N
N:-5-
FT.
/ odr?, .n
4,to
)YOF OREGO'''
:iPrraNGFrELo
(
225 FIFTB STREET
SPRTNGFTELD, oREGON 97477
INSPECf,ION REQTIBST: 726_3769
OFFICE: 726-3759
1
|'
LDR city Job Nuurber
).
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
ELBGTRICAL PERHIT APPLICATION
0b
COHPIJTB PEE SCBEDULE BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
IJGAL DESCRIPTION
Permits are non-transferable and expireif work is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACf,OR INSTALI,ATION ONLY
Electrical Contracto
0r rized Sig
A
_t_L $ 8s.oo
$ 1s.00
s 40.00
$100.
$130.
$300.
$ 40.
Sumffi
@
AddressdqgNmue
fxw.Ap=,,
Expiration Date
bupervlsor License Ntimber Jqlm
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 500 amps _
601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect 0n1y
B
Ci Phone
00
00
00
00
00
00
$so
$60
Constr Contr. Number Mrr-qb
Expiration Date \L \D -q0-
C. Temporary Services or Feeders
Installation, Alteration or Relocation
2oo amps or less I $ 40.00
201 amps to 400 amps _ $ 55.00
_fi
Signat of
0vners Name
Add ress
The installation is being made on
property I own vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEIPT
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 volts see I'8" above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit S 35.00
Each Addi t ional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscell"aneous (Service/feeder not included)
-Each installation
Ptrmp or irrigat ion
Sign/0ut1ine Light ing-
Limited Energy/Res
Linri ted Energy/Comm
trician
ci,vr-T)I{ rl-14-NlqPhone
osNE[ L]ror*rro*
$ 40.00
$ 40.00
s 20.00
$ 36.00
5
L-
-r
RECEIVED B
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
'@^5.oo
425-n7
SPRINGFIELC,
' 0ffi ce:
INSPECTION LINE:
7 26-3759
7 ?6-37 69
BACKFLOI.I PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DiVISION
225 Fifth Street
Springf ield, 0regon 97 477
CITY OF OREGO'V
Job Locati on : LZ U\,v:cl ?)7 c-t-
As s es sors 14ap #: h*^a S{xrs.e.Tax Lot #:
0wner:
Address: la l-A Ld , yr ('J ,. Phone #: ') L1+'r
State:OQ L1 p:q 1V"71C'ity :
Backflow Permjt'is $15.00 + $0.75 State Surcharge
Contractor:
Address:3.ls8r (L{-lnt^n'-.q. ?A-Phone #: 141 -94/-
City:Statet OA zi p: Q1vo3
Construction Contractors Registration #:Sll .?Ex pires:-)l tlqz
By signing this permit/application, I agree to call for an inspection once the
backfiow prevention dev'ice has been installed and is visible for inspection
(726-3769). I also state that all jnformation on this app'lication/perm'it is
correct.
Lltqlrz
na ure nate
FOR OFFICE USE
Total Amount Collected:
aDate of App'li cat'ion:b
Rece'ipt l/:fi IQG
Job #, ?)lU l-,Ll
Issued Ay: OA
\1 ]Y
Q rr.o.,ne.-
OB NO.1zr '+b+
CITY OF SPRINGFIELD ^SI:]Iif DEVELOPMENT CHARGE
WORKSHEET
(col4MERCIAL & RESIDENTIAL)
I
NAME OR COMPANY:o 2'
LOCATION:Z
DEVELOPMENT TYPE:
BUILDING SIZE:OT SI
DRAI AGE
IMPERVIOUS SQ. FT-4o8o x $0.192 PER SQ- FT.
?. SANITARY SEI.'ER-CITY
NO. OF PFU'S
(See Reverse)
X $39.78 PER PFU
TRANSPORTAT ION
NO OF UNITS X TRiP RATE X COST PER TRIP
I l.oo E x $40i.05
x $401.0s
x $401.05
sQ. Ft.
1.
3
x
x
X
$
$
4 ADM INIST TiVE F EES
BASE CHARGE (SUBTOTAL ABoVE) X '05
5. SANITARY SEWER-MWMC
NO. OF PFU'S
.l-
(Use PFU Total From Item 2
MI^IMC CREDIT IF APPLICABLE (SEE REVERSE)
Ki p Burd ick
suBTorAL (ADD ITEMS 1,2, & 3) $2ZGo9
TOTAL-CITY SDC $
$13.62 PER PFU + $10 Mt,lMC ADMIN. FEE $ ?1-1-U
Above)
TOTAL-MWMC SDC
bbb
\or,'l*
ob
oZ
SDC Coordinator
o
TOTAL SDC S Z1b\29
,ON 6or
DL -^/
FIXTURE UNIT CALCULATIOil TABLE: t'tumoer of New Fixtures
For remodels, calculate only the NET additional fixtures)
NUMBER OF
FIXTURE TYPE NEW FIXTURES
t,
X Lrrnr-Equivalent = Fixture Units (NOTE:
UNIT FIXTURE
EQUIVALENT UNITS
Bathtub-..-.-.
Drinking Fountain""'
2
2
t+9
deaH
t
2
1
2
3
6
2
6
6
1
a
2
1/
2
2
1
6
4
Floor Drain-
i nierceptots For G rease/Oil/Solids/Etc""""""""'
lnterceptors For Sand/Auto Wash/Etc"""""""""
Laund ry Tub/Clotheswasher"""
Clotheswasher - 3 Or More"""" ""':""."""""""" "'
HlloUif" Home Park Trap (1 Per Trailer)""'*"""""
Receptor For RefrigeratorAVater Station/Ltc""""
n"""'p,ot For Commercial Sink/Dishwasher/Etc"
Shower, Single Sta||..."""""
Shower, Gang--.--.--.--
Sink, Bar, Commercial
Urinal, StallflVall.>(,
------f-Wash Basin/Lavatory, Single"""-'
Water Closet, Public lnstallation"
Water Closet, Private.."'
Ir,4iscellaneous:
TOTAL FIr|URE UNITS 21
CREDIT CALCULATToN TABLE: Based on assessed vatue. lf improvements occurred after annexation date in table'
calc ulate credits seParates-
L
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x$
(Rate X Assessed Value)x$
(Rate X Assessed
CREDIT
Value)
TOTAL =$N A.
Year
Annexed
Rate per $1,000
Assessed ValueYear
Annexed
Rate per $1,000
Assessed Value
1985
1986
1 987
1988
1989
1 990
1991
$2.1 6
1.90
1.60
o.25
0.87
0.50
0.16
1979 or before
1980
1981
1 982
1983
1984
$2.83
2.76
2.7'l
2.60
2.46
2.33
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT
9