HomeMy WebLinkAboutPermit Building 1992-02-03- SFHilrrGrieuo
bq4
TL A"oo
h,
tt4 t Qtanzn Lts-LOT:
TAX LOT:
SUBDIVISION
JOB NUMBEFI
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
225 Fifth Street
Spri ngf ield, Oregon 97 477
STATE:2d
PHON E:696- 743 /,
zlP"q74o5Eua7urzCITY:
ADDRESS:
OWNER:
(
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
*=* X REMoDEL
ADDRESS EXPIRES PHONE
4r(-7+3/9,zanPpu Bno 266Let
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PLUMBING:
G EN ERAL:
CONST.
CONTRACTOR #
ArdO ?-RANGE:WATER HEATER:
FLOOD PLAIN
ZONING CODE:
* OF BDRMS:
_ OFF
* OF UNITS:
LAND USE:
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
# OF BLDGS
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:OO a.m. will be made the following work day.
REOUIRED INSPECTIONS
,K
X
,X
x
K
E
E
E
X
X
X
X
K
X.
E
x
x
Temporary Electric Rough Mechanical - Prior to
cover.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
Wood Stove - After installation.
lnsert - After fireplace approval
and installation of unit.
Curbcut &Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Fence - When completed
Final Plumbing - When all
plumbing work is complete.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms. ,elL
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
- Prior to insu nor ec ng
Floor Insulation - Prior to
decki ng.
Sanitary Sewer - Prior to f illing
trench.
Slorm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
Tr.1l Final Buildino - When allJ4equired insp-ections have been
approved and building is
completed.
,ffi tt"t'ng - Prior to cover'
Xl wattlCeiling lnsulation - Prior toHcovef.
fl orVwall - Prior to taping.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocking 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 and
porches, skirting, decks, and
venting have been installed.
IYJ Post and Beam - Prior to floorlAinsulation or decking.
f*rr."t Trees - when atl required
\!/tt""" are planted.
I
E
tl
r
---_._
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type.
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setb
P.L.HSE GAR ACC
N
S
E
N'
_s THE PROPOSED WORK tN 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:
/4,1o
(A)
I rrG.'
4to,
X $/SO. FT.
3q,70
VALUE
Hgw,zo
59w,90
Total Value
Building Permit Fee
State Surcharge
Total Fee
go76s
< 7Lr
/ 8,b
3?4,eo
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
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 constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Date
C-
-25
By
Receipt Numbe
By:
2_Date Pald
Plan Check Fee:?42'45
Recei
/.?t
2/4 r'o
- 21'2.16
SYSTEMS DEVELOPMENT CHARGE (SDC)p
(B)# znta,!
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
/60.
/68r(c)
FT
FT.
FT.
N"2
Bgo
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
/-
Wood Stove/lnsert/Fireplace Unit I
Dryer Vent
64 /-r,r'-
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
g:o
3
d?
733s
ao
'/fo
/f*
/2,
No
; ODb.
q,e
MECHANICAL PERM!T
Furnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
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 compliance with ORS 701.055 will be used on this
project.
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 is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Date
(,nn.,u,"
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewark 6( t
Curbcut 2Q tt
Demolition
State Surcharge
P/*A-.' "_ -_ . ,+ill&TtzT
Total Miscellaneous Permits (E)
t .qs
2< (s
310
?.60
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
27Df2 AMouNr REcEtvED 7 84.o=
aecav,io av -1' - . ,
2^74?DATE PAID
VALIDATION:
RECEIPT NUMBER
a L
4
JoB N0. q200++
ELOPMENT CHARGE
I
AL)
CITY OF SPRINGFIELD SYSTEMS DEY
WORKSHEET
(C0HilERCIAL & RESIDENTI
NAME 0R CoMPANY: r:eieeDE\\ b<a= . Ar-r.c
LOCATION:(^q 4 \Alar>r>R-eqr DR.rv6 l-1 obZz.l lb - -L'?-OOc
DTVELOPMENT TYPE:l-oe -N\E\AJ
BUiLDING SIZE:LOT SiZ F s a. Ft.
1. STORM DRAINAGE
IMPERVIoUS SQ. FT. *,?o7 X $0.186 pER SQ. FT.$ ryTu'L
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
?.. SANiTARY SEWER-CITY
NO. OF PFU'S 2-b X 538.55 PER PFU $ all'e
5
(See Reverse To Determine Total PFU'S)
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
5 zlao+3\
x
x
X l.oo5 x s388.61
x $388.61
x s388.61t C To Determine Trip Rates)
SUBT0TAL (ADD ITEl,lS 1,2, & 3)
$-
(See Attachmen
$
s nb*9
4 ADI'IINISTRATIVI FEES
BASE CHARGE (SUBToTAL ABoVE) X .0s
SANITARY SEI.'ER-MWMC
NO. OF PFU'S
(Use PFU Total From ltem 2 Above)
Mr,rHc CREDIT IF AppLICABLE (SEE REVERSE)
K p Burdick
s '41 ql
TOTAL-CITY SDC s tb+btz
x S13.25 PER PFU + S10 l.ll,lttc AD!:IN. FEE S Z1r"i
5
$+491
TOTAL -f'lI..|I'IC SDC S 7boL1
SDC Coordinator
Zb
T0TAL sDC sTolu*
FIXTURE UNIT CALCUL-.-lON TABLE: Number of New Fixture* Urrit Equivalent = Fixture Units (NOTE
For remodels, calculate only the NEJ additional fixures)
NUMBEC OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.......
Drinking Fountain...............
Floor Drain......
I nterceptors For Grease/Oil/Solids/Etc................
I nterceptors For Sand/Auto Wash/Elc..................
Laundry Tub/Clotheswasher.............
Clotheswasher - 3 Or More..
Mobile Home Park Trap (1 Per Trailer)........
R eceptor For Ref rigeratorAVater Statiorr/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.....L
Shower, Gang....................
Sink. Bar, Commercial..2-
Urinal, StallflVall....
Wash Basin/Lavatory, Single..2-44
Water Closet, Public lnstallation..
Water Closet, Private...Z b
Miscellaneous
TOTAL FIXTURE UNITS 20
CREDIT CALCUTATTON TABLE: Based on assessed rralue. lf improvements occuffed after annexation date in table.
calculate credits separates.
Credit for Parcel or l-and Only lf Applicable
lmprovement (if after annexation date)
++l-
(Rate X Assessed Value)
2
1
?
3
6
2
6
6
1
J
2
1
2
2
1
6
4
+
t 2-
/Head
t
Z,UC X S tb17
x s--
(Rate X Assessed Value)
CREDIT TOTAL = g ,146J
Year
Annexed
Rate per S1.O0O
Assessed Value
Year
Annexed
Rate per 51,000
Assessed Value
1979 or before
1980
1981
19e2
1983
1984
sz66
2-&
2.53
2.41
,io
2.01
19&5
1986
1987
1988
I oac
1990
sl.69
1-35
1.15
0.92
0.59
0.23
RUNOFF COEFFTCIENTS FOR STORM DRAINAGE
Residential..
Commercial....
Governmental.
0.4
0.9
0.45
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
L
t
lndustrial.....
SPFI,tGFTELO
J
%
225 FI.rrA, STREET
SPRTNGFIELD, OREGON 97477
INSPECTION REQUESTI 726_3769
OFFTCE: 726-3759
1. LOCATION OF
PERHIT APPTICATION
City Job Nunber
BELOV
idential-Single or
er dvelli ng unit.
Items Cost
lO{X):L5O0sq.ft.orless I SB5.OO
Each additional 500
sq. ft or portionthereof 'L S 15.00
Each [anuf ,d Home or T-
Modular DveIIing
Service or Feeder' $ 35.00
B. Services or Feeders (10 Branch Circuitsincluded). Installation, Alterations
or Relocation:
to
? JOB DESCRTPTI9t*.,rt 7.n Lq'
Sum
te
,r2ra64?
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.A,TION ONLY
Electrical Contractor r
Address Ul5 f- b4 t[,0"t{
Ci ty t1U Phone ltf bth)f
Supervisor License Number 1tt I 7s
100 amps
101 amps
401 amps
601 amps
Over 1000
Reconnect
or less
to 400 amp s
to 600
to1
$
$
$
$
$
$
35.00
00
00
00
00
00
anps
Its
60.
80.
130.
300.
35.
Exp iration Date
Constr Contr. Number
Expiration Date /,
Signature of Supervis Electrician
TNSTALI,ATION
Name
Address
Ci ty Phone
Temporary Services or FeedersInstallation, Alteration or Relocation
-10-200 aurps or less I S -ff.00 1€),-201 amps to 400 amps
-
g 40.00
over 401 to 600 amps
-
S 8o.oo
0ver 600 amps or 1O0O Gfts see rrgrr "f,ffi
c(_-
Branch Circuits
Nev, Alteration or Extension Per panel
one dircuit
Tvo to ten Circuits
Each Addt,I ten orportion thereof $ 1s.00
Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00Sign/outline Lighting- S 36.00Signal Circuit orlimited energy panel S 36.00
SUBTOTAL OP ABOYE
5Z State Surcharge
TOTAL
s
$
00
00
35.
50.
The inst
proper tyfor sale
a1la
I nvh
ease o
is being made onich is not intendedr rent.
E
5
Ovne Signature:
DATE:
RECEI
rvice Inc e
RECEIVED BY:
OO
I