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HomeMy WebLinkAboutPermit Building 1995-05-03t/ RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office:726-3759 ASSESSOBS MAP: SPrlIr.lGFIELE, Lof LNE " ,ou NUMBER 7ft YzS 225 Fif th Street LOT: - BLOCK: _ rlngf leld, Oregon 97477 ,ry77.-*"EZ IAX LOT: SUBDIVISION: A,74 t STATE:ZIP:/q>/>> N E: OWNER: ADDRESS: CITY; ADDITION DEMOLISH OTHER DESCRIBE WORK NEW X REMODEL PHONE ELECTRICAL: CONTBACTOB'S NAME EXPI RES ?^ MECHANICAL; PLUMBING: GENERAL: CONST. CONTRACTOR , L. l-qL l.26{ t za€F- u)fl, I /^J ,t( - OFFICE USE - r OF BDFIMS: BANGE:WATER HEATEB LAND USE: SECONDARY HEAT: SQUARE FOOTAGE: QUAD AFIEA: E OF BLDGS: FLOOO PLAIN: ZONING CODE: CONSTB, TYPE: HEAT SOURCE: # OF UNITS To request an lnspecilon made the sanre worklng , you must call 726-376g. Thls ls a 24 hour recordlng. Allday, lnspections requested after 7:00 a.m, will be made lnspections requested before 7;00 a.mthe following work day, wlll be Sile lnspectlon - To be madeaner excavatlon, but prior tosetUng forms, U.nderslab plumblng/ Electrical /Mechanlcal - prloi to cover. X!f:*"- Arter trenches are [-l ruasonry - steel tocatlon, bond.J beams, grouting, X:,"":l*'t* ; #l:: J:[;,?" Underground plumblng _ priorto fllllng trench, una".lto@vMechanrcal - pilor to lnsulatlon or c,ecklng. Posl. and Beam - prior to floorrnsutailon or decklng. Floor lnsulailon - prior tooecKt ng. Sanltary Sewer - prior to flillngtrench. Storm Sewer - prior to fllllngtrench. Water Llno - prlor to filllngtrench. Rough plumblng - prlor tocover. REOUIRED INSPECTIONS ,X.lf"';r Mechantcat - Prior to Xi;;"t: Electrtcat - Prror to X "'r,",xJ: fl .:";rij ; #;:," ff ,olectrlcal power. F,lreplace - prlor to faclngmaterlals and framlng lnsf Framtng - prlor to cover, Final Plumbing - When ailprumbtng work ls complete. F.lnal Eleclrlcal _ When allerectrlcal work ls complete. flla] rUgchanicat _ When ailmecnanical work ls complete. Flnal Building _ When ailrequlred.lnspecilons have beenapproved and bulldinq iscompleted. "x X K X x E K {all/Celllng lnsulatlon _ prtor tocover. Drywall - prlor to taplng K X X X X K R' l-l Wood Stovo - After lnstailation lnsert - After flreplace approvaland lnstallailon of unlt. Curbcut & Approach _ Afterrorms are erected but prior topracomcnt ol concrete. Sldewalk & Drtveway _ Afterexc.avauon lg completo, formsano sub.base materlal in place. Fence - When completed, MOBILE HOME INSPECTIONS I Blocking and Ser.Up _ When ail< blocklng ls compleie. lqTUinS Connecrtons - Whennome has been connected towater and sewer. Eleclrical Connection _ When P^l:gftig, ser_up, and ptumbin-srnsp€cilons have been approvedand the horne ls connected tothe service panel. @x;;t [";F,"Yhen arr requrred Flnal - After ail requiredtn-spections are appioved andg-oj9,nosl sklrilng, decks, andvenilng have been lnstalled. LOCATION OF PBOPOSED WOFK: ,€-2 I I lllr OCCY GROUP: E OF STOFIIES: fr"^o"rarv Erecrrtc [-l ourer Lot faces Lot sq. ftg. Lot coverage Topography Total helght a/24 42% Lot Typ. -y' ,n,J,,o, -- Corner _- Panhandle - Cul.de-sac P.L,HSE GAR ACC N n S q /5 /S E 25 IS THE PROPOSED WORK TN THE. HISTOFIICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls appllcailon must be slgnedand approved by the Historlcal Coordinator prlor to permlt issuance. APPROVED: /ez. /4 . ', z:Vza >z state surcharse 11O,9Sa1P,t/ BUILDING PERMiT VALUE Total Fee (A) 6?fr>,/ 6Fv-x-la X $/SO. FT.ITEM Main Garage Carport SO, FT, /D22 Total Value, Building Permit Fee 2Aado -,JrsL-+' -.%21vaz?a BUILDING VALUE, PLAN CHECKAND BUILDING PERMTT Thls petmlt ls granted on the express condltion that the saidconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Springfleld, includlng theDevelopment Code, regulatlng the constructlon and use ofbulldlngs, and may be suspended or revoked at any tlmeupon vlolation of any provislons of sald ordlnances. Recelpt Nu^be,,fu a -/*9r- v: 4-- $r DatePewe Date Pald Recel Plan Check Fee: SYSTEMS DEVELOPMENT C (B) HARGE (SDC) +i fl zto+'9tP Systems Development Charge ls due on all undeveloped propertles wlthln tlre City limits which are being lmproved, o- ITIONAL COMMENTS a c0 ITEM Flx tu res Besldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE ./bo.oo / ZpobY *4,8o 17"2:(c) FT. FT. FT. No 2- PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unlt Oryer Vent 4,* 3,Oo 7tt2,/ 5,oo ./o.a o zo/ -t,r 20.2.(c). Vent Fan Mechanlcal Permlt I ssu an ce State Surcharge Total Permlt ,?f r,4-f (D) MECHANICAL PERMIT Furnace Exhaust Hood No'e By slgnature, I state and agree, that I have caref ully examlned the completed applicatlon and do hereby certlfy that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordlnanccs of the Clty of Sprlngfield, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCY wlll be made of any structure wlthout permission of the Buildlrrg Safety Dlvislon. I further certlfy that only contractors and employees who are ln compllance wlth OBS 701.055 wlll be used on thls prolect. I further agree to ensure that all requlred inspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the f ront of the property, and the approved set of plans wlll remaln on the slte at all tlmes durlng constructlon.x,/ Slgnature Date ftr" A;r.^l* s- ] - ?< M ISCELLAN EOUS PERM ITS Moblle Home State lssuance State Surcharge Sldewalk - tt -Curbcul - ft Demolitlon State Surcharge Total Mlscellaneous Permlts (E) VALIDATION: HECEIPT NUMBER DATE PAID ,h- AMOUNT RECEIVED TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, D, and'E Comblned) %?]z RECEIVEO BY qa 5z 2 CITY OF SPR OFEGO'V oFPrcE: 726-3759 Ar a":itJ siSnatu'a--'['l 3- aoHPLEfE Jl:,1o_,lo-yi1 g, p:.oiact as $L, bm [roo has rhe f oi ! :. vringzonrng, and Coes not requit.e si,eLlfic lano iiseaprproval. zo,,ins LDfu--*-*.- BLECtRTcaL pgRt{rr AppLrcATroN225 FTFTE SIREET 1.ON INST I^EGAL I fae JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI.,AITION ONLY B. ELectrical Contractor Address Ci ty hl ehone 724 45ZO Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signa 0vne SPFlI}tG.FIELO ty Job Nunber FEE SCffiDTIIJ BETOV A- Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost Sum Address / Og 4D 5t ciry 1aft pno"" 7y'422? OIJNER INSTALI,ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: C. Temporary Services or Feeders Installation, Alteration or Relocat 200 amps"or less / z. $ 40.00 201 amps to 400 amps ----- $ 55.00 0ver 401 to 600 amps - $ 80.00 Over 600 amps or i000 volTs see "B" D. Branch Cireuits -Each installation Pump or irrigation S Sign/Outline Lighting- $ Limited Energy/Res $ Limited Energy/Comm $ Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E Miscellaneous (Service/feeder not included) L000 sq.ft. or less Sach additional 500 sq. ft or portion thereof Each Manuf'd Home, or -Modular Dvelling Sertice or Feeder Services or Feeders InstalIation, Alterations or Relocation: 200 amps or less 20i. amps to 400 amps _ 401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/vo1ts Reconnect 0n1y SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.strative Fee TOTAL s 8s.00 $ 1s.00 $ 40.00 s s0.00 s 60.00 s100.00 s130. 00 s300.00 s 40.00 10n #3 o a6oiil r e 40.00 40.00 20.00 36.00--> 6O RECEIVED B 5 OO r B NO.150*zq LL CITY OF SPRINGFIEI,D SYSTEMS DEVEI,OPMENT CHARGE WORKSHEET (C0MHERCIAL & RESIDENTIAL) NAME OR COMPANY:n 6Ru TON - /45oo LOCATION:ods DEVELOPMENT TYPE:LDP il e*v 9FP Ft BUILDING SIZE: 1. STOBM DRAINAGE IMPERVI0US SQ. FT. SIZ 54o x $0.209 PER SQ. FT-Z 2 SANIT ARY SEt,lER -C ITY NO. OF PFU'S (See Reverse) I X $43.26 PER PFU 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X A X t.x $436.19 x $436. 19 x $436. 19 $ 4. SANIT ARY SEI,IER -Ml,jMC NO. OF PFU'S 18 X $17.19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL (ADD ITEMS 1,2,3 & 4) ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL ABoVE) X .05 4z $3tq 79 t5Zoo 5 Burdick Coordi nator obZ6 K Date: TOTAL SDC $ ZI O+VL I $ +/a, FIXTURE uruIr }ALCTLATTON TABLE: Number or Ncw Fixturc (NOTE: For remodet., tuttltut. only 1 .ET additionat fixrures). NUMBER OF FIXTURE TYPE NEW FIXTURES 'Unit Equivalent :-Fixture Units UNIT FIXTURE -. EOUIVALENT UNITS z- Bathtub-.-.-2 Drinking Fountain..-.1 2 6 2 6 6 .I 3 2 1 2 ') 1 o 4 I I Floor Drain. lnterceptors For Grease/Oil/Solids/Etc_ - -... - _ - - - - - -.. - lnterceptors'For Sand/Auto Wash/Etc... -. -... -,... -..- Laundry Tub/Clotheswasher....'-...-..... -'. - --,.. - -..- - ----:.',. Clotheswasher - 3 Or More..-.. Mobite Home Park Trap it p"r trailer) Receptor For Refrigerator/lvater Station/Etc Roceptor For Commercial Sink/Dishwasher/Etc.. Shower. Single Stall....-...-. Shower, Gan9......... ................ , Sink: Bar, Commercial. Residential Kitchen Urinal, StallflVatl... Wash Basin/Lavatory, Single.?-2- Toilet, Public lnstallation.-E-Toilet , Private Miscellaneous: L TOTAL FIXTURL UNITS l8 CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, calculate credits separates. 4- -----:-- b lHead Year Annexed Rate per $1,OOO Assessed Value Year Annexed Rate per $ 1,OOO Assessed Value 1979 or before 1 9BO 1 981 1 982 i 983 1 eB4 1 985 $3-46,)ro .) a.) 3.2.t 3.O6 2-92 2.73 1 985 1 986 't 987 1 9BB 1 989 1 990 1991 1 993 s2.46 2.14 1.-17 1-37 o.97 0.61 o-44 o-15 Lfu- x $I 9.s3_b179Credit for Parcel or Land Only lf Appticabte lmproVement (if after annexation date) (Rate X Assessed Vatue)x $_ (Rate X Assessed Value) CREDTT TOTAL _ $b5y Willamalane Park & Recreation District l}gtl, 'D' "fr fob No. qtkt' nAq SYSTEMS DEVELOPMENT CHARGE WORKSHEET , PHONE:NAA4E ADDRESS: LO-CATION OF FROPOSED Stre€t Address if Known: 1 BUILDI Plaft Name: NO OF UNIrS I B. Single Family - Attached *) Tax Lot Number: Manufactured home not in a Park X $400 PER UNIT -=. tr. $ $ srArE: @. =r, q1 441 $ \tn.a0 $ $ $ ,00 DEVETOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back-) A Single Family - Detached I Single Family home NO OF UNITS X $370 PER UNIT = C. Multi-FamilyApartment NO OF UNITS X $?77 PER UNlr = D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = WPRD SDC 2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet 3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credit) , '^it r (nn rirnr Datc $ Llw"ta stuw illd0 AJ-r6 CITY OF SPRINGFIELD.OREGO'V 225 FIVTE SItsEEf, SPRINGSIELD, OREGON INSPECTTON REQIIEST: oFFICE: 726-3759 SPFTTTIGFIELD The lollowing project as submltlecl has the follolving zoning, and does not roquiro rpecilic latrci use BIJCTRICAL pERl{IT A3pIJCATION sTrfr^t'v72 City Job Nunber aotu ?9- 4(3. COHPI,ETE FEE SCEEDTILE BELOIIp A. Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost 1. \rz?ry:"nOF Sum 3_gu tf)0 o Permits are non-transferable and expire if vork is not started vithin L80 days of issuance or if work is-suspended for 180 days. Signature trician s Name Addre Ci ty 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Eome or Modufar Dvelling Service or Feeder B. Services or Feeders Ins tallation, Alterations or Relocation: t--- $ eS. OO. ES z s 1s.00 \o $ 80.00 see rrBfr aE6lE $ 40.00 2. COI{TRACf,OR INSTALI,ATTON ONLI Electrical contractor (i ,il fkdn- Address P0 0r>r t0lo1 ci rl Phone U" -1 03 Supervisor License Number Lbl l5 Expiration Date io l,lqr-, constr contr. Number b5b6l Temporary Services or Feeders Installation, Alteration or Relocation c Expiration Date zlzx lqb 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect 0n1y 200 amps or less 201 amps to 400 amps -Over 401 to 600 amps 0ver 600 amps or 1000Tofts Branch Circuits 00 00 00 00 00 00 50 60 100 130 300 40 s $ $ $ s $ $ 40.00 $ ss.00 */ttdrCqt4tua, D INST The installation is being made on property f ovn which is not intended for sale, Iease or rent. Omers Signature: ' 'T1n-, tsna*- Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Misce.llaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0ut1ine Light ing- Limited Bnergy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL oo ne $ 40.00 $ 40.00 $ 20.00 $ 36.00 5qDATE: LO