HomeMy WebLinkAboutPermit Building 1995-05-08IELEI
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:4
JOB NUMBER ?fo7z2
225 Fifth Street
Spri ngf leld, Oregon 97 477
TAX LOT:/a2-
t;,,hlto* 1Z-Poz|l
ASSESSORS MAP:12 *7*-1i-2<2-
LOT:
-
BLOCK:SUBDIVISION:
STATE:ZIPaz7 9>q.>8CITY:4,zx
PHONE: ^26-464: /OWNER:
ADDRESS:?
LD.
ruew ,,1' REMoDEL ADDrrloN DEMoLISH orHER
DESCRIBE WORK:
PLUMBING:
ADDRESS EXPIRES PHON ECONTBACTOR'S NAME
GENERAL:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
.{R,DIr)
3
,il l:
- OFFICE USE -
OCCY GROUP:
LAND USE:
. u OF BDRMS:
WATER HEATER:
. I OF STORIES:
RANGE:
ZONING CODE:
FLOOD PLAIN:
A OF UNITS:
SECONDARY HEAT:
, SOUARE FOOTAGE:
QUAD AREA:
r OF BLDGS:
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 following work day.
REQUIRED INSPECTIONS
l-l Temporary Electric
ll
Rough Mechanlcal - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspectlon - To be made
after excavation, but Prior to
setting forms.
X.Rough Electrical - Prior to l\7 Flnal Electrical - When alllA(electrlcal work is complete.cover.
Underslab Plumblng/ Electrical/
Mechanlcal - Prior to cover.
'Vf Electrlcal Servlce - Must be
frpproved to obtaln Permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
,X Footlng - After trenches are
excavated,Flreplace - Prlor to faclng
materlals and framlng lnsP.
X Flnal Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.X Framlno - Prlor to cover.
(wruoocu51
WalllCelllng lnsulatlon - Prlor to
cover.
r Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to filllng trench.l-_l Drywall - Prlor to taolng
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prior to insulation or decklng.Wood Stove - After lnstallation
{-n Post and Beam - Prlor to floor
.A{.lnsulation or decklng.
]Vf Floot lnsulation 4 Prlor to
]a\decxlng'
lnsert - After flrePlace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Curbcut & APProach - After
forms are erected but Prior to
placemcnt of concrete.
P.lumbing Connectlons - When
home has been connected to
water and sewer.
X.
B
E
Sanilary Sewer - Prlor to filling
trench.Sidewalk & Drlveway - After
excavation ls comPlete, forms
and sub-base material ln Place.
Electrical Connection - When
blocking, set-uP, and Plumbing
lnspections have been approved
and the home ls connected to
the service panel.
Storm Sewer - Prlor to filling
trench.
Waler Llne - Prlor to filling
trench.m
E
Fence - When comPleted
Street Trees - When all requlred
trees are Planted.
Final - After all required
lnspections are approved and
porchcs, sklrting, decks, and
venting have been lnstalled.Rough Plumblng - Prlor to
cover.
I l)
-IDrF-
tl
[--l otner
E
E
D
E
't.
Lot {aces
Lot sq. ftg.
Lot coverage
Topography
Total height
Z2TA
Wb,,
Lot Tyt-
Y/ lnterio,
-
Corner
-
Panhandle
-
Cul-de-sac
backs IS THE PROPOSED WORK I.N THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgnedand approved by the Historlcal
Coordinator prior to permit lssuance.
APPROVED:
4n1
PL.HSE GAR ACC
N 5
S
Zb
E 2o
3f
/+@
1b1
so.FT.X $FT.so.LU E
BUILDING PERMIT
ITEM
Main
4? > f ?.."d
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
G arage
Carport
-2%f
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granted on the express conditlon that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, includlng theDevelopment Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
eviewedP q#
e /.e>
Receipt Numbc
Date Paid
Received
Plan Check Fee:
SYSTEMS DEVELOPMENT CHA
(B)
RG
+
E(S Systems Development Charge is due on all undeveloped
properties within the City limlts which are being lmproved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
25-
FT, Z SO,
FT. Z
FEE
No
FT. Z 50'
5,rc
^t
oo(c)
@
oo
?t -t tl'72.
Plumbing Permit
State Surcharge b
Total Charge
ADDITIONAL COMMENTS
o
o
MECHANICAL PERMIT
Fu rnace
Exhaust l-lood
Vent Fan No
Wood Stove/ lnsert / Fireplace Unit
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
/VA,O rlXg( f AVe/6
By slgnature, I state and agree, that I have careru
the completed application and rtn s^- .
I further agree to ensure that all required inspections arorequested at the proper ilme, that each address ls
from the street, that the permlt card ls located atof the property, and the approved set of plans wl
Date 6-&-?r
z6r
{oobSYr
o,
5
da-
/oo,oo
3*
oO'ob
readable
the front
ll remainon the site at all times du ructlon.
s,;#
project.
lly examined
rtlfy that all
rther certlly
accordance
rd the Laws
i descrlbed
ade of any
ty Divislon.
oyees who
ed on this
lnformatlon h-
that any and a
with the Ordir
of the State (
herein, and il
structure withc
I f urther certif,
are ln complia
MISCELLANEOUS PERMITS
Mobile.Homi
State lssuance
State Surcharge
Sidewalk -.-.- ft
Curbcut ---.-- ft
Demolition
Total Miscellaneous permits (E)
-?-G
State Surcharge
ToTAL AMOUNT DUE (exctuding elecrrica|, ./6A(A, B, q D, and E Combined)
Z
€.{-DATE PAID
AMOUNT RECEIVED
BECEIVED BY
VALIDATION:
RECEIPT NUMBER
/^
.ZS*
JB N0. n6o+21
CITY OT SPRINGFIELD SYSTEMS DEVEI,OPMENT CHARGE
WORKSHEET
(coMt'IERcIAL & RESIDENTIAL)
NAME OR COMPANY: JN O E P<r+ U E
LOCATION l5zo t-t t-ft. *1 101zb4z - looz-
LDE- - t-t tr--W SFB-DEVELOPMENT TYPE:
BUILDING SIZE:OT SIZ
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.l,t-o x $0.209 PER SQ. FT
NO. OF PFU'S
(See Reverse)
t{X $43.26 PER PFU
TRANSPORTAT I ON
NO OF UNITS X TRIP RATE X COST PER TRIP
( X (,ot X$436.19
X x $436.19
X x $436.19
SANITARY SEl^lER-Ml^lMC
NO. OF PFU'S I I $17.19 PER PFU + $IO Mt,lMC ADM FEE $ t13
(Use PFU Total From Item 2 Above)
Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE)Q{'
TOTAL-Ml^iMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)$ L3q1 *
5 ADt'4INISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X .os
K p Burdick
a. Ft.
3
$
$
4
oa
bzGo!
44-b*
\bc>91
SDC Coordinator
Date:4 o 1b
TOTAL SDC $ $1a13
2. SANITARY SEWER-CITY
FIXTURE UNIT CALCULA-r'ON TABLE: Number of New Fixtur
(NOTE: For remodeii, iatcutate onty tt._ IET additional fixturesl
. NUMBER OF
FI1TURE TYPE NEW FIXTURES
Unit Equivalent :' Fixture Units
UNII FIXTURE -.
EOUIVALENT UNITS
2
1
2
a
6
2
6
t)
1
2
2
1
.)
2
1
6
4
zBathtub---..
Drinking Fountain....
Floor Drain-
tnterceptors For Grease/Oil/Sotids/Etc. -.. - - - - -. - - - - - -.
lnterceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More-----
Mobite Home Park Trap ('l Per Traiter) ----------.----...
Receptor For Refrigerator/vvater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc-.
Shower. Single Stall..--......
Sink: Bar, Commercial. Residential Kitchen-.--
Urinal, StaltAl/all
Wash Basin/Lavatory. Single.
Toilet, Pubtic lnstallation.
Toilet, Private.....-..-
Miscellaneous
ad/He z
t
+
TOTAL FIXTURE UI.JIIS
CREDIT CALCULATION TABLE: Based on assessed value-
calculate credits separates.
lf improvements occurred after annexation date in table,
Creditifor parcet or Land Only lf Applicabte
lmprOv€nrept (if after annexation date)
7,+U x $
(Rate X Assessed Value)
lz.G,+b1'L
x $_
(Rate X Assessed Vatue)
CREDIT TOTAL -$+r;9
Year
Annexed
Rate per $1.OOO
Assessed Va{ue
Year
Annexed
Rate per $ 1,OOO
Assessed Value
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
s 2.46
2.14
1.77
1.37
o.97
o.61
o-44
o.15
1979 or before
1 9BO
1981
1 982
1 983
1984
1 985
$3.46
,ao
.) a.',
3-21
3-O6
2.92
2--t3
tr
t
z
I
r:
1,
Willamalane
Park & Recreation District
Iob No.
q
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
PHONE:1NAA4E
ADDRESS:
LOCATION OF FROPOSED BUILDING SITE:
Street Address if Known:
Plaft Name:
1
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home Park
srArE:&.,, qHS
?=Tax Lot Numbec
DEVELOPMENT TYPE (Chec* appropriate dwellingG). SDC Calculations and dwelling type
definitions are on the baclc)
A. Single Family - Detached
t Single Famity home Manufactured home not in a Park
NO OF UNITS
(X $400 PER UNIT -=..$
B. Sinsle Familv - Attached
NO OF UNITS X $370 PER UNIT =$
X $277 PER UNIT =
NO OF UNTTS X $280 PER UNIT =
$
$
0
WPRD SDC $
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. SeeSoCCreditworksheeL $
3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credi0 $
d
fn-^i,.^it r (nr,ni n Date
a
t$Nr
\
4fnd
ma
SPRINGFIELD
m
225 PTYTB SMgEf,
SPRINGPTELD, oRBGoN 97477
INSPECTION RE0t EsTr 726-3769
OPPICE: 726-3759
1.\"sry.t\'.'
permits are non-transferable and expire
if vork is not started vithln 180 days
of lssuance or lf vork ls suspended for
180 days.,
2. COIITRACTOR INSTALI.ATION O}ILY
Elecrrlcal Contractor RoSE C0RP
Address 89976 DAY LAN
.'.ffi-,::"qSAt
3. COHPLETE PEE SCEEDT'LE BELOII
Nev Resldentlal-Single or
HuIti-FamiIy per dvelling unit.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
-Hodular Dvelling
Servlce or Feeder
$ 8s.00
$ 1s.00
$ 40.00
B. Services or FeedersInstallation, Alterations
or Reloeation:
A
D.
Sum
FIIGFI\IF Phone 6RA-ogoq
Supervisor Llcense Number 15685
Explration Date r0/t/e5
Constr Contr. Number
.,-i
5443i'
ExP i'ratlon Date 9/30/95
Slgnature Electrician
0vners Name
Address L
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps
Over 1000 amps/volts
-Reconnect Only -T-
200 amps or less
201 arnps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000ETts
Branch Circuits
Temporary Services or'Feeders
Installation, Alteratlon or Relocation
E $ s0.00
s 60.00
s100.00
$130.00
s300.00
s 40.00
ci
akF
s 40.00
$ ss.oo
s 80.00
see ,Bt' a66F
c
o
ci Phone
OIINER IN ALI^ATION
The. installatioir is beirig made on
property I own vhich is not intendedfor sale, lease or rent.
Osners Signature:
DATE:
Nev, Alteration or Extension Per Panel
One Circuiq $ SS.OO
Each Atdi tional
Circui t or r,ri th Service
or Feeder Permit $ 2.00
E. Hiscellaneous (Service/fe,eder not included)
-Each installation
Pump or irrigation
Sign/0utline Lighti
Limited Energy/Res
Llmited Energy/Comm
SIIBTOTAL OP ABOVB5f State Surclrarge
iPorrtb *T:k;-Q*
ng_s
s
S
s
00
00
00
00
40.
40.
20.
36.
I I 0f
RECEIVgD
5
(D
.CITY
l,
t
OCCUPAI.ICY INSPECTION APPLICATION
CITY OF SPRINGPIEU)BUII.DING DI\TTSION
DATE: S- a/€, -
ADDRESS OF INSPECTION:
OIflNER:
JoB NUMBER, ?50{a7
f/,,aeB
l7-03->t *Va-
Jada-?mnL PHoNE NUMBER: %qacgbo/
lo0 .>-
OLINER,S ADDRESS 3b a
@
APPLICANT SqTN.P-, AS CL\O/<,
7
:::=::::::=::=::::]l]]===]]:::::::=:u=*=,=,=^--,=:,\1
APPLICANT'S ADDRESS:
PROPOSED USE:
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIINER OF THE PROPERTY TO BE
INSPECTED.
rOR OFFICE USE ONLY
DATE PAID:vza^?f
DATE OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
RECEIPT NUMBER:
DATE OF REPORT:
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INSPECTIONS 726-3769
OLD ADDRESS
t fo Dor, > E"(AL
es pt on
- CITY OF SPRINGFIELD
225 North 5th Street
BUILDING MOVING PERMIT/BUILDING DIVISION
BUSlNESS 726-3753
NEI'I ADDRESS (Furnished by Buil ng Div
ry
Legal Descr p
7eV-><./z
Building Owner Address Phone
(.x 'Co'n C
rm
/
V ress
? f;- w 2'7 d'3,tLl-g?7t
L s Exp.e
Cl'',r'l S.lo,^
Descript
Bra Mou <l
on ntende Use
Route
CITY DESIGNATED JOB NLIT{BER,r-?talz
scr].'
Fr,
pt
ln
10n o
6l cn v-,oo d o^ Sr.p*trrr:efi tr to &,tlxr,i<l toto Toncrr
/A <f, Fo (,
Description of Building
.Square Footage
Number 0f Sections Being l"loved
Moving Leng th3Ll Moving width Z9'lO"H"ight on Do1l
Of Construct ion /aaa l-._r^r,dilll,UATION
t7
I
NOTIFICATION 0F I{OVE: The 1
will route copies of this application to all
appropriate divisions, departments and Agen-
cies. HOYJEVER, the appticant must contact
property owners if trees are involved in the
proposed move. IN ADDITI0N, the applicant
must secure the approval of all appropriate
municipal, county and state authorities
should the move originate or terminate out-
side the City of Springfield.
ng Division PLANS, FEES, AND CFIARGES:or to receiv-
ing a perrnit to nove a building to property
within the City, the applicant or his/her
authorized representative must :
1. Submit 2 copies of site or plot plan
for new site.
2. Submit 2 copies of foundation plan for
the relocated building.
3. 0btain a permit covering the new founda-
tion, as well as all plumbing/mechanical
and electrical work relating to the re-
located building.
4. Pay Systerns Development Charge if appli-
cabIe.
SEIVER CAP : Bui 1 ngs mov
City limits shal1 have the sewer capped at
the property line and inspected one working
day prior to the move. If the inspection
indicates that the sewer has not been prop-
erly capped, the moving permit will be
revoked.
owner sha1l have all sludge from the septic
tank, seepage pit or cesspool removed by a
person holding a sewage dispoal service li-
cense, and shal1 fill same with clean bar-
run gravel or other material approved by the
Director or his authorized entative.
nat
on ion. I
ED BEFORE 5 I{ORKING DAYS
lderts Board is in fu1l
if exempt the basis is
wi in the SEPTIC TANK I Prior to mov f,8,
I CERTIFY THAT the above information is true and correct, that all ed contac
olc ockebeen
on
d a-uthorizations obtained, that the move will begi't S- and will be completed by / L'.oo orclock
t tno anges n the route will be made without contacting Bui
also certify that I have been informed that N0 PER.I4IT WILL BE ISSU
HAVE ELASPED. I further certify that my registration with the Bui
force and effect as required by ORS 701.055 and 70L.070, and that
noted hereon. Basis for Builderrs Board Exemption:
NAME car SIGNATURE
FOR OFFICE USE ONLY
Zorr"[.fft e of Construction OccupancyFlood Plain Typ
Stories Living Units Square Footage VALUE
Application fee $18.00 -- Date Paid
Permit fee $6 0.00 -- Date Paid
Number of Blocks over 6 @ .60+
Sewer Cap $10.00 + 4% State Surcharge -- Date Paid
lCe rtment amalane Park
Receipt Number
Receipt Nurnber
/? ?/?7
Amoun OD
creat SU
Fire Department
Northwest Gas -Pagi+i.e+*F#1\)tlv0g$e
-Lane Transit District
Group W Cable
0THER -- spe cify
_LaneCountyA&T
,SW,\A
have
t
\
cro"p R3
Appl
A.
B.
C.
D.
E.
F.
G.
H.
I.
I
BUILDING MoV IN(^_ -RMIT
'icant to furnish (except as ind'icated)
0ld address for building
Lega'l Descri pti on
New address for building
(Build'ing D'iv. will furn'ish)
Legal Description
Name, etc. of building owner
Name, etc. of moving firm
A description of intended use
A description of proPosed route
A descri pt'ion of the bui 1d'ing
Applicant to contact property owners if trees
involved, and secure authorizations from
other jurisdictions as necessary.
A s'ite or plot p1an, and foundation plan must
be submitted for the new site (2 sets)
Plans must also be subm'itted for any other
work relating to the relocated build'ing.
Fees & Charges:A. Application fee due and payable at time
of appl icationB. Moving permit fees due and payable upon
permi t i ssuanceC. FEES & CHARGES TO BE CALCULATED BY
BUILDING DIVISION STAFF
FOR OFFICE USE ONLYA. Plan check data collectedB. Copies of appf ication to appropriate
divis'ions, departments and agencies
- PERMIT VALIDATION
PERMIT CLERK
II.
III.
IV.
V.
VI.
)
BUILDI DI ISION REPORT:
TRAFFIC DIVISION REPORT:4 e PP /C E.+sr ktr c.t-()vLR.z OeEa,^J5
Sfrfe ltu^,1 De/f oe0 +2.2-
5
/Lr 7b
SI re sa 6< F_uZz_,
flou
ENG I NEERI G DIVISION REPORT:
DS Da
?P"tvA{e oTL PUBLIL PEoPEETg.
ADDITIONAL PROJECT INFORMATION :
By Da te
i5Bt nfulli>let Date
Llr
!)l*'AL ULL utrJJo_U'
.=a
AV
t{,SI
s
F
U>
IF-N
F-aEl-
->-n
(r
L!,FG,
(-)
)
N
': ,: ''
I :-=r: I
CENTTENN!AL
/PABXEA-gI_
:EF
SI
. 3/,
:.i,'r. :.
Brattail,l i
T
o n0LAN0
WY
T.|-@
/l'
'r,.' ;l
F.))
'F
ar,
Y,,.,
Fa
:EF@
:cf:
U)
Oogon o€ryln,ont ol TtfiWttd*n
HIGHWAY DIVISION VF PERMIT NO.S :CIAL TRANSPORTATION P-qMIT
FOR HOUSE MOVES (101414
Chri s Schoap Bu'i I di ng Mover s03 ) 344-8833 Same
I E LhPHONE
()
AIJIJHISS
755 U 27th
AI]I]HESS
CIIY, S IAIE, IIP
Eugene, 0R 97405
oilY,stAtt,ztP
tsUILIJLH HEGIS I HAI ION NUMBER
32039
UAIE
s/18/esPIRMIT INSPECTION DEPOSII CHIUK NUMAEH PEHMII FEE
8.00 7767
COMTilODITY
l,Jood Frame
NO. OF SECTIONS
LENGTH *,
34',
vvrurH *'
32',
HLTGHT*.
17',
OVERALL LENGTH
64',
1
2
3
1
2
3
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2
3
1
2
3
PILO I VEH]CLt
REOUIREMENTS 2 LANE:
4 LANE:
fl NoNE
D ttorur
ffirnour
ffirnorur
[l nenn
E neen
BTGINNING AUUHESS
99 & Roosevelt
DESTINATION ADDRESS
Hwy ?28 onto Centennial
YEAIT ANU MAKt OF LUUIPMIN I
1967 FL.ID
IU NU
N1 7606
PUU NO.
YCPJ631
LICENSE NO.coMP. NO.
ROUTE
121.14
123.18
1. 40
Chambers & 6th
Hi gh
Hwy 15
Centenni al
122.48
123.99
0 - 1.63
0.62
vel t
TYPE OF
PAVEMENT
WIDTH OF
PAVEMENT USABLE ROADWAY
Off Highway by B:00
HAULINLi HUUHS Hts I HIU ItU IU
a. m.Sunday (5-21-95)
HAULING DAYS RESTRICTED TO
5/31/95-
Cross Hwy 99 @ Roor
Enter 7th @ Chambe
0nto 99 0 Broadway
Onto 228 (Spfld
HIGHWAY LOWEST
OVERHEAD STRUCTURE
*sgg REzERIE stDE oF THts pERMt FoR spEctAL paovtstoNs *
i.
THE PERMITTEE SHALL NOTIFY THE DISTRICT MANAGER, OR THEIR REPRESENTATIVE, OF THE MOVE AT LEAST 24
734-2006 7-9O)
MOVE.HOURS PRIOR TO COMMEN