HomeMy WebLinkAboutPermit Building 1992-04-10SPRINGFTELD
SED
BLOCK:
\A
Zfr,
SUBDIVISION
IAX LOT:
Sprirr0 f iel<!, Oregon 97 4 /7
Rtr,SIDENTIAL
PERM!T APPLICATION
Irrspr:ctions: 7 26-37 69
Oilir,e: 7'l{J.'311,9
---5!!.5r!rt-
JOB NUMBER -_-_
225 Fif th Slreet
LOCN ION OF PNO
A:]SJESSORS MAP:
LOT: --..--. ,
ZIP:STATE:CITY:
ADDRESS:
()WNER
EXPIRES PHONENAMEADDNESS
U)LA
S-
DESC B WORK:
REMODEL
-
A
CONTRACTO
C tr N F,RAL
t,t.LJMfllNCi
l:LLCI RICAt-
Mf:CFlANl
NEW DITION DEMOLISH OTHER
CONST.
CONTRACTOR #
- \rrGq5 3 \\ qo
qL
OUAD AREA:
I OF BLDGS: .
OCCY GROUP:
* OF STORIES:
\
I
4J4LY}SOUARE FOOTAGWATER HEATER
HEAT SOURCE:
RANGE:
FLOOD PLAIN: .
ZONING CODE:
CONSTR. TYPE:
* OF UNITS: - .-
-oF
LAND USE:
Y OF BDRMS: -
SECONDARY HEAT:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:o0 a.m. will be
made the same working day, inspections reciuested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Eleclric 4
q4
Rough Mechanical - Prior to
cover.B Final Plumbing - When all
plurnbing work is complete.
Site lnspection - To be made
after excavation, but Prior to
setting lorms.
Rough Electrical - Prior to fd rinat Electrical - When alllr4l electrical work is contplete.cover
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.a Electrical Service - Must be
approved to obtain Pertnanent
electrical power.
w Final Mechanical - When all
mechanical worl( is com[)lete.
m Footing - Af ter trenches are
excavated.Fireplace - Prior to facing
materials and framing lns1r.w Final Building - When all
required inspections have been
approved and brrilding is
cornpleted.Masonry - Stecl location, bond
beaftrs, grouting.K
w
Framing - Prior to cover,
OtherwFoundation - After forms are
erectecl but prior to concrele
placement.Wall/Ceiling lrrsulation - Prlor to
cover.
E
w
W
w
w
w
rx
B
Underground Plumbing - Prior
to filling trench.fl] Drywatl - Prior to taoing
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Slove - After installation
Post and Beam - Prior to floor
insulation or decking.lnserl - After firePlace aPProval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.w Curbcut & Approach - A(ter
forms are erected but Prior to
placement of concrete.
Plunrbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to lilling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Slorm Sewer - Prior to lilling
trench.
Sidewalk & DrivewaY - After
excavation is comPlete, forms
and sub-base' ntaterial in Place,
Water Line - P(io( to filling
trench.
[-l Fence - When comoleted
Street Trees - When all required
trees are planted.
Final - After all recluirecl
inspections are approved and
porches, skirting, decks, and
venting have been installed.Rough Plumbing - Prior to
cover.w
PHONE:
E
r tl
Lot faces Lot Type
IJ
Setbacks IS THE PROPOSED WORK IN THE
- HlsToFilcAL DlsTRlcT, oR oN
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved bY the Historical
CoorrJinator prior to pcrmit issuance.
APPROVED:
Lot sq. ftg. 2W?
-
lnterior
Lot coverage ZA -X- co'n"'
Topography Q€a =- Panhandle
Total height €2'
-
cul-de-sac
Wza Fs Fz*qfrZZo4.sP fuar
GAR ACCPL.HSE
N /do
J 72t"
?rrtE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condrtion that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating lhe construction and use of
buildings, and may be suspended or revol<ed at any time
upon violation of any provisions of said ordinances.
Ptan check r"", --%-eA--
BUILDING PERMIT
VALUE
/4/o
/-24ry.*
_z_#72
"€
Fst
(A)
4?.?6
Date Paid
Flecei
ITEM
Main
Garage
Carport
Total Value
BuilcJing Permit Fee
State Surcharge
Total Fce
/A-zs
_?a,-16-
{1?_._Z_
Fleceipt Number:--
X $/SQ. FT.SQ. FT.
z7a6-
Systems Developtnerrt Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS D EV ELo P * r *r,"1, ^TffH#
TONAL COMMENTSA
ITEM
Fix t u res
Residential Bath(s)
Sanitary Sewer
Water
Storrn Sewer
Mobile Home
PLUMBING PERMIT
FEE
N'%./60_22.?
FT.
FT.
FT.
?%--r(c)
42A-#
/LPlumbing Permit
State Surcharge
Tolal Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer vent ZX7
(D)
66
4!'e,
3a-=f,
7ao
N0
?.aa
MECHANICAL PERMIT
7)(% 5a
/.7f
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
o-e
By signature, I state and agree, that I have caref ully 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 worl< performed shall be done in accordance
with the Ordinances of the City of Springfield, arrd thc Laws
of the State of Orcgorr pertaining to lhe work dcscribed
herein, and that NO OCCUPANCY will be made of any
structure without pernrission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 70'1.055 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 tlte approved set of plans wlll remain
Signatu re
loDate
on the site at all titnes during construction.
I
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
curbcut VO tt
Demolition
State Surcharge
Total Miscellaneous Permits (E)
iE
r\DATE PAID
RECEIPT NUMBER.
VALIDATION
AMOUNT RECEIVED
RECEIVED BY
TOTAL AMOUNT DUE (excluding
(A, B, C, D, and E Combined)ry'4f,
electrical
e1
I%
'bE.
1
2
lssued Date
OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILIT!ES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under ORS 701.010(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
I own, reside in, or will reside in the completed structure.
I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
A My general contractor is
Contractor registration num
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
3.8 I will be my own general contractor.
lf I hire subcontractors, lwill hire only subcontractors registered with the Construc-
tion Contractors Board. lf I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the office issuing this building permit of the name of
the contractor.
I hereby certify that the above inlormation is correct and that I have read and understand
the lnlormation Notice to Property Owners about Construction Responsibilities on the
reverse side of this lorm.
alrh=
S nature cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
3
OR
t
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
Permit No: ?za /=^
Address: //r-F'; +rxz<#
aCITY OF
5r.l ilN(lrrLLt)
225 FIFTE STREET
SPRTNGFIELD, oREGoN
INSPECTION REQTIEST:
OPFTCE: 726-3759
97477
726-3769
J
Permi ts re non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. collTRACf,oR ONLY
Electrical Contractor
Address
Ci ty Phone
Supervisor e Ndmber
Expiration Date
Constr Contr. Number ()40-Qb
Expiration Date rAl qA
Signat o ct
0vners Name
Address
Ci ty Phone
OVNER
The installation is being made on
property I own which is not intendedfor sa1e, Iease or rent.
Ovners Sitnature:
DATE:
PT
ELECTRICAL PERH
,,-ir, ., ,.; , ,, ,i r:ir Aity Tob Number
0b
IT APPLICATI
Items Cost Sum
2 $ 85.00 /7_
L g 1s.oo Q
$ 40.00
lE lobrrcquh6t
1
;--COHPLETE FEE SCEEDULE BEL0V
Nev Residential-Single or
Servi
.fgmily per dvelling unit.
ce fncluded:
B
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Hone or
Hodular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations or
Relocat i on :
0nb Ci.rcui t
Each Addi tional
Circuit or vith Service
or Feeder Permit
STIBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
200 amps or less S
201 amps to 4OO amps
-
$
401 amps to 600 amps
-
$
601 amps to 1000 amps_ $
Over 1000 amps/volts $
Reconnect Only $
00
00
00
00
00
00
50.
60.
100.
130.
300.
40.
s 2.00
above
4-Cr
c Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less ''- S 40.00
201 amps to 400 amps
-
S 55.00
Over 40L to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see "Brl
rd
an
D Branch Circui ts
Nev, Alteratlon or Extension Per Panel
s 3s.00
ON
E. Hiscellaneous (Service/feeder not included)
-Each ins taIIat ion
Pump or irrigation
Sign/outline Lighting-
Limi ted Energy/Res
Limi ted Energy/Comm
.$ 40. 00
$ 40.00
s 20.00
s 36.00
5
RECEIVED BY://eFEF
JOB NO. ?7o4q7
CITY OF SI-XiNGFiELD SYSIEMS OEVELOPME.. CHARGE
WORKSHEET ,
. (c0t{l{ERclAL & RESIDENIIAL)
NAl.lE 0R C0MPANY: 5f, Vtttcettr De ?*uu
LOCAT ION:l.toz 1 t,+os r..1. 5 a sr. /7o>Lb*+ - oo4oo
BUILDING SIZE:LOI SIZ
1. STORM DRAINAGE
IMPERVT0USSQ. W- ?47o x $0.186 PER SQ- FT.
(See Reverse For Runoff Coefficients I f Actual Imperv- Area Is Un )
?. SANITARY SEI.IER-CITY
NO. OF PFU'S X 538.55 PER PFU s l?st 83
3
(See Reverse To Deteroine Total PFU'S)
TRANSPORTATIO.N
NO OF UNITS X TRIP RAIE X COST PER TRIP
7 X l, oo 5_ X 5388-61
x $388.61
x s388.61
L
.5
s4b lo
s **o13
a- Ft.
x
x
(Seq Attachment C To Deteraine Trip Rates
SUBTOTAL
)
(AoD ITEl,lS 1,2, & 3)' Sz0t+79
4. ADI'IINISTRATIVE FEES
'BASE.
CHARGE (SUBTOTAL nS0tr) X .0s s 14013
TOTAL-CITY SDC SZb55*
5. SANITARY SEIIER-HI.,HC
NO. OF PFU'S gL x 513.25 PER PFU + S!0 Hlll'tC A0l,iIN- FEE
(Use PFU Total From Item 2 Above)
r.rt.lHc CREDIT IF APPLICABLE (SEE REVERSE)
s +87e
Kip Burdick
SDC Coordinator
TOTAL-HWMC SDC
TOTAL SDC
lo
3 )t L
s ?zqSqj
DEVEL0PI'IENT TYPE: H LoB - NeW Duet-e'l . ,
FIXTURE UNIT CALCULA-,ON TABLE:
Fo, ,enlodels. calculale only lhe NEI'*rditional fixrures)
FIKTURE TYPE
Bathlub..-...-
Drinking Fountain""""""""""""'
Shower. Single
Floor D rain--.--------:.""""
ini"i""ptor" For Grease/Oil/Solids/Etc""""""""''..
intet""ptots For Sand/Auto Wash/Etc
Laund ry Tub/Clothes:washer"""
Gotheswasher - 3 Or More"-""""
Mobne Home Park Trap (1 Per Trailer)"-' -
n"""p,o, For Ref rlgerator^Vater Station/Erc--' --'
il"""i o, For Commercial Sink/Distrwasher/Etc':
Number of Nert, F.-fluresX I ln
NUMBEF OF
NEW FIKTURES
*
?-
UNIT
EOUIVALENT
FIXTURE
UNITS
occurred after annexation date in 'taHe'
4u9
ir Equivalerrt = Fixlute Units (trJOi E
2
1
2
3
6
2
6
6
1
J
2
t/Head
2
2
1
6
4
Shower. Gang-----------
SinK Bar. Commercial---"':'-"""'
Urinal.
Wash
Water
Water Ooset Private-""'
Miscellaneous.
CREDIT
calcdate crcdits
2.b6 X 5 17'77
-- (R"t X Assessed Value)xs
(Rate X Assessed Value)
CREDIT TOTAL
TOTALFXruRE UNTTS
CALCUTATTONTABLE:Basedonassessedvaluelf'lmprorements
Credtt for Parcet or l-and Orrly lf Apflicable
lmproremerf fif after anneDcatk)n date)
=S 4u'9
Year
Ann€D(ed Assbssed Value
Rate Per 51.O0O
Year
Anno<6d Assessed Value
Rate PerS1.0OO
1985
1985
1987
1988
1989
1990
sl.@
1.35'1-15
o-92
o.59
o-23
1979 or before
1980
1981
1982
1983
1984
sz66z&
253
241
z^19
LM
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential- """'-""'
Commerctal'-"""
lndustrial-----
GovernmenEt""" """'--'
0.4
0.9
0.45
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
1l/ao I=E,9|L/EI\ I IAL - tvlJl- ll - lEl=l..rlltL
SIDEIUAK / CUREC/.JT
APPLtCATrOr.,l / PEt flT
SPFlINGFIELE,
225 NORTH FIFTI{ STREET
5FRrl.GFlEL9, ORE60hl 314'1'1
E\I3INEERhG DlVlSIOtlo*tcE No. 17b-1191
IN9PECTIO| I LINE,'T26'3'163
JOO ADDRESS: IAOS l4oS [\cE*I * *a%
A99E590R9 tlAP NO.*.4,,-)TAX LOT NO.,2
gr,lBDtYtgtohl. -
OIINER €r.rr-
ADDRE99: *?C,S S. S€s.e.r.A
D*r.-
c]m ?+:atnt-
STATE: C)Z ZIF: t?Aoz PHoNE No..1.tS-<:_StS.
gIDAT'ALI< X CURB SIDE
-
5ETBACK
-CURB-C{JT: RE9IDENTIA
-
CoMHERICAL
-9ECOhID DRI\EIUAY ( gEE TRAFFIC )
REaUIR=9 AFFLlcATlar.l FoR A SEcohlD DRI\€[UAY(T-4.1a)
OR A C,o.JNTY APPLICATION rcR FACILITY PER!-1IT (C %.2O3)
IF IN Tl{E UG.E.
DATE 4 APPLICATIOT.{
RECETFT No; b\)"t
cA5l.l
cH=cK { # +zS
* -/'
CltECi<ED FOR DEL NaLEllClEg
SIGNED:Enrir,n
DAiTz
'11. 9.qz-,
cq1134gron* :f. U , v.. . ,o *\
COI,ITRACTOR
=o,ar*a,^ *o.*EXPIRE9:
ADDRE99 P|-{ONE:
FFOCEDUFE FoR INgFECTlct l REGIIE9T:
CAIL 12b-31bA (re,CO@ER ) gTATE YOIJR CITY DE9I6NATED JOB NU|13=R, JOB ADDEgS,TYPE OF
IN9F,ECTIOT.I REAUEgTED AJ.ID II}4EN YOU II,IILL BE READY rcR NSFECTIO?.I. CO}.{TRACIOR3 OR OIJ'.IERg N4J.1E AID
l3l-]ohtE NTJIIBER REaLIE9TS RECEIVED BEFoRE 1,oo Nl u,lLL BE HADE Tl{E 9A1E DAY, FEaJEgrg r'FTER 1,@@
AH IUILL BE I1ADE THE }.{EXT IIJORKING DAY
EXISTI}.]G tsTIILDI}.IG FERj.1IT NO. ( tF APFLICABLE )
**CgEE Eo,OK
REaUFED tNgPECTlctlg 9IDEIUALK / DRI\GIUAYrcR ALL CONCRETE PAVING U,IITHIN
THE gTREET RIGI]T OF I].JAY, TO BE
F1ADE AFTER AL EXCAVATINa
15 COF1PLETE AI.ID FOF!-1 TIJORK
AID gJts-BA9E HATERIAL 19
IN PLACE
CU@ / APPROACI-{ APRO'|{,
AFTER FO315 Are ERECJED
BUT FRIOR TO POJRII.IG
C,oNCRETE.
FEE9' giDEtUALKg
TOTAL PER|IIT FEE:
rlo.oo + to.lb/LF.( X )
OF UJALK
IIAOO +tA)9/LF.(X)
CO\.II.IERICAL DRI\€UJAYg gi-iALL
HAVE 5' TO A'FLAIRS
3'- @'STADARD
CURB-CUT UJALK X,
t+9-*)
1
I i-]A\E CAREFULLY EXA1INED TI-.IE CO|.IPLETED APPLICATIOI{ FOR PEEiIT, ,l}.lD DO I-.{EFEBY CERTIFY THAT ALL
ll.FORllATlOhl HEREON l9 TBIE Ar{D CORRECT, p*.lD I RJRTIIER CERTIFY TtiAT ANY AND ALL u.OR< PERFOSIED
9|..IALL 3E DONE IN ACCORDANCE IIJITH TI{E ORDINANCES OF TI.]E CITY C SPRNG# IELD, A\D -!= LATi,Ig G TI-{EgTATE G OREGON PERTAINING TO TI]E IIJOR< DEgCRI3ED IIER=IN, A\D Ti]AT NO OCC,UFA\CY UILL 3E I.1AD=4 A}.iY STRJCTURE I.UITI-{Oi,JT PEFTIgSIAN OF THE BUILDINC DIVI9IOII I FURTI]ER CERTIFY'ii.JAT O\LY CONTR.ACTORS/.ND EF1PLOYEE9 UJ{-IO ARE IN CO|.IPLIANCE IIJITI{ OR1 \OIO'9 IUILL BE USED ON TI]I5 PROJECT.
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