HomeMy WebLinkAboutPermit Building 1994-10-24r FIELE,
B
P
ESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726.3769
Olflce:728.3759
LOCATION OF PRO
ASSESSOBS MAP:
LOT
?fr,
JOB NUMBER
225 Flfth Street
Sprl ngfleld, Oregon 97477
TAX LOT:
SUBDIVISION: _
\\\
BLOCK:
OWN
CITY:
ADD
STATEI
PHONE:
ZIP:
SH
-
OTHERoELD
AOORESS CONST.
CONTRACTOR #co N E EXPI ES
G
ELECTBI
MECHANICAL:
PLUMBING:
t t\ \
- OFFICE USE -
LAND USE:
OCCY GBOUP:
FLOOD PLAIN:
RANGE:WATER HEATER:
r OF STORIES:
ZONING CODE:
r OF BDRMS:
E OF UNITS:
QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE;
To request an lnspectlon, you must call 726.3769. Thls ls a24 hourmade the same workrng day, rnspecilons requested after 7:00 a.m.
recordlng. All lnspecilons requested before 7:00 a.m. wlll bewlll be made the followlng work day.
l_uzfTemnorary ElecIrtc
REQUIRED INSPECTIONS
Rough Mechanlcal - prlor tocover.
Rough Electrlcal - prlor tocover.
ffi Ftnat ptumbtng - When ail-f ptumblng work ls complete.
ffi ftnrt Eleclrlcat - \Mfren all--t etectrlcal work ls complete.c
F il$l#ffi"*L?,;#ffi?"ii:
ffi flnal Bulldlng - When alt-T requtred lnspecilons have beenapproved and bulldlng lscompleted.
Slte lnspectton - To be madeafter excavatlon, but prlor tosettlng forms.
l--l Undaralab ptumblng/ Etecrrlcal/lJ Mechanlcat - prloi to "orui.-"
ffi Footlng - After tfenches are
-
excavated.
W
Masonry - Stoel locauon, bond
.beamg, grouilng.
Foundallon - After forms areerected but prlor to concreteplacement.
Underground plumblng - prlor
to fllllng trench.
Underlloor plumblng/ Mechanlcal
- prtor to lnsulatlon or decklng.
Post and B6am - prlor to floorlnsulatlon or decklng.
Floor tnsulatlon - prlor todecklng.
tr
F
tr Eleclrlcal Servlce - Must beapproved to obtaln permanent
etectrlcal power.
Flreplace - prlor to faclngmaterlals and framlng lnspl
Framlng - prlor to cover.tr
ry
E
T
Other
F
m
F
ry
m
ry
ry
Sanltary Sewer - prlor to fllllngtrench.
Slorm Sewer - prlor to fllllngtrench.
Waler Llne - prtor to fllllngtrench.
Rough Plumblng - prlor to
cover.
11"-"lt -; After ftreptace approvatanct Installailon of unlt.
Curbcut & Approach - Afterrorms are erected but prlor toplacoment of concrete.
Sldewalk & Drtveway - Afterexc_availon ls complete, formsand sub.base materlal in place.
Fence - When completed.
WalllCblttng
cover.
i
lnstl latlon - prlor to
Drywall - prlor to taplng.
Wood Slove - After lnstallatlon
MOBILE HOME INSPESTIONS
[-l elocklng and Set.Up _ When ail..J blocklng ls compleie.
Plumblng Connectlons _ Whenhome has been connected towater and sewer.
Eleclrlcal Connecllon _ When
P_,9:Illp, ser-up, ano prumurnsrnspecilons have been approveda.nd the homo ls connected tothe servlce panel.
ffi Street Trees - When all reoulred.t. trees are planted.
Flnal - After all requlredrnspecilons are approved andporc.hes, sklrilng, decks, andventlng have been lnstalled.
-?B Ir"1\tr,
P.L.HSE GAR ACC'
N
S
E
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total [elght
Lot Typ
riv
A tntertor
-
Corner
-
Panhandle
-
Cul-do-sacrc'
IS THE PROPOSED WORK TN THE -
HlsroBlcAL DtsTRlgr, oR oN
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordlnator prlor tg permlt lssuance.
APPBOVED:
BUlLDtNb PERMIT
ITEM .SO. FT.
Marn l\35
Galase 4tC3
Carport
Total Value
Bulldlng Permit Fee
State Surcharge + 3%
Total Fee
X $/SO, FT.
ailr8
VALUE
w1g45\n,?.Ct
t4'to
'lo3\5
341.o PP
(A).313trr
. t528
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltlon that the sald
constructlon shall, ln all respects, conform to the Ordlnance
adopted by the Clty . of Sprlngf leld, includlng the
Development Code, regulatlng the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlme
Recelpt Number:-
Revlewed ByP
By:
s
Plan Check Fee:
Date Pald:
upon vlolation of any ordlnances.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)
{z ol7. rz
Systems Development Charge ls due on all undeveloped
propertles wlthln tho Clty limits wtiich are being lmproved.
ADDITIONAL COMMENTS
ITEM
Flxturest.
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
N0
ItoO.o'
\4 80
a
FT,
FT.
FT.
(c)112,8()
PLUMBING PERMIT
ntulOtng Permlt
State.surcharge * 3alO
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
,.-t{\uf\.
3F6-
(D)
T oN0
L
EOVent Fan
cfo
1_O
Mechanical Permlt
lssuahce
State:surcharge
Total Permit
MECHANICAL PERMIT
Furnaco
Exhaust Hood
@
By slgnature, I state and agree, that I havo caref ully examlned
the completed appllcatlon and do hereby certlfy that all
lnlormatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordlnances of the Clty of Sprlngfleld, 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 permlssion of the Bulldlng Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thls
proJect.
I further agree to ensure that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from tho street, that the permlt oard ls located at the front
of the property, and the approved set of plans wlll remaln
Date
Slgnature
on the slte at all rlng constructlon,
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Total Mlscellaneous Permits (E)
Sldewalk
Curbcut
-D ,,
,@ r,
Demolltlon
State Surch
B
DATE PAID
VALIDATION:
RECEIPT NU
AMOUNT B
RECEIVED
TOTAL AMOUNT OUE (oxcludlng electrlcal)
(A, B, C, Q and E Comblned)
W
u9 t'le I Ir=n F(rrurg Irrc.6l----?A2AbAa
Novenrber I5 , 19tJ,rr
I'u rhe Ciry ot Springticldr
ALtention I,isa,
L' kuber"r I.J. Hilr will agree to clo rrhat is requtred torelocated sewer liue -L'or l,Onnie ltar.Lingorr resiclerrCe ()11btleer, Sprirrgtield. Or.egotr. So thet construcflc]n (:atr
l0tli
c()rrLirlue at- IlJtr l0rh stl:eet,priugt ieId, 0r.egur.r
Rotrert In. Hill
b82 Sunset DrlveSprlilgtieId, 0r.trgon gl tr/ I
i- - Ll -'
/Ai/li+k_
'r ATTACHMENT BI JoB NO. 7//{/7
cIrY 0F SPRI Ntt
"'?uotilililEr?-:::PMENT
CFTARGE
'
tcouuEntr-ru
-
& RESIoENTIAL)
NAI{E 0R COHP/I\Y:4
LOCATiON
'o
DEVELOPMENT TYPE SfD.
FtSIZ
BUILDING SiZE:
i. STORI':I NRAINAGF
IMPERViOUS SQ. FT.227?50 X $0.209 PER sQ. FT'
2. .o*rronv sFwFR-CTTY
NO. OF PTU'S
(See Reverse)
r x s43.26 PtR PFU
3. TRANSPCRTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
X /,o/ X s436.19
x X 5436. i9
x _ x s436.i9
4. SA.NTTARY SfWFR-M'uJl'4C
$
S
(Use PFU Total From item 2
SUBTOTAL (ADD ITEMS 1,2. & 3) 5 / 6Og'b{
$i7.i9 PtR PFU + $1C Mi^ll'lc ADMIN.FEE s ?'/?'12
Above)
3G
MI^JMC CREDIT iF APPLICABLE (SEE REVERSE)
TOTAI -l',lhIMC SNC
SUBT0TAL (ADD ITEMS 1.2,3 & 4) s r r 1?.1 t
5. ANMTNTSTATIVF FFFS
BASE CI{ARGE (S ) x .05
/o'/z- 7*
Hary
NO. OF PFU'S r
s. P.E.
fj SDC
82. SDC
i nator
Date:
T}TA| _SD[)0 7
I
-- r--__-r{t
FIXTURE UNIT CALCULA DN TABLE: ru,-u er ot New Fixtu
{NorE: For remodels, carcurare onty tnf NEr addirional fixtures}
NUMBER OF
NEW FIXTURES
_ X Unit Equivatent : Fixrure Unirs
FIXTURE TYPE
Bathtub.........
Drinking Fountain....
Floor Drain
lnterceptors For Grease/Oil/Solids/Erc.................
lnterceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More....
Mobile Home Park Trap (1 Per Trailer)......
Receptor For RefrigeratorMater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Sta11..........
Shower, Gang........
Sink: Bar, Commercial, Besidential Kitchen..
Urinal, Stall/Wall..:
Wash Basin/Lavatory, Single.
Toilet, Public lnstallation.
Toilet , Private....
Miscellaneou's:',Ttat mp's
UNIT
EOUIVALENT
FIXTURE
UNITS
/r
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
b
4
I
I
Z
z
TOTAL FIXTURE UI'IITS
2
CREDIT CALCULATION TABLE: Based on assesse dv alue. tf improvemenis occurred after annexation date in table,
calculate credits separates.
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
9,46 x $ /T'tr?o
(Rate X Assessed Value)x$
6s.3 6
6s.sa
(Rate X Assessed Value)
CREDTT TOTAL s
Year
Annexed
Bate per $1,OOO
Assessed ValueYear
Annexed
Rate per S1,OOO
Assessed Value
1 985
1 986
1 987
lvoJ
1 989
1 990
1 991
1 002
$2.46
2.14
1.77
1.37
o.97
o.61
o.44
o.15
1979 or before
1 980
i9Bl
1 982
1 983
1 984
i 985
$3,46
3-21
5.U0
2.92
2.73
a
4
a
2_
t
2
€&#lt"emeler.g
lob No.
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
uKl-j\.
PHONE:
STATE:
ADDRESS:
LOCATION OF FROPOSED BU
Stred Address if Known:
Platt Name:
1
+V\
Tax Lot Number:
Manufacu,rred home not in a Park
3
DEVELOPMENT TYf E .
(Check
Affiitions "are o" the back')
appropriate dwell i ngG)- S DC Cal culations and dwel I i ng type
A. Single Family - Detached
-L
Single FamilY home
NO OF UNITS
B. Single Family - Auached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
X $400 PER UNIT *=$
X $370 PER UNIT =
4lDt
WPRD SDC
2. SDC CREDIT (lf applicable) sDC.-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet'
3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credi0
X $277 PER UNIT =
X $2S0 PER UNIT =
$
$-
$
$
$
$
\
\
/-:+., ^C C .,(i ^l A
Divi Date
CO
Permi ts are non-trans ferable Lre
if vork is not started vithin 1'80 days
of issuance or if vork is suspended for
days.
2.
EIe
Add
cit
INSTALI,ATION ONLY
Contractor
Supervisor License ber
SPF|INGFIELD
Services or Feeders
Installation, Alterations
or Relocation:
us€
apprwal.EI,EGTRICAL PBRHIT APPIJCATION
97477
726-31ff" lL-zt- q7 City Job Nunber
Authorized SCEEDTII,E BBIOV
A. Nev Residential-Single or
Mu1ti-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Modular Dvelling
SerVice or Feeder
$ 8s.00
$ r.s.00
Tn. toito*ing prolec't ae eubm'Itted lreg thq
ffi;;ffi ?Siiiirr iiquire sPecrric rand
225 PTrI,fl STREEf,
SPRTNGFTELD, OREGoN
INSPBCTTON REQTIEST:
OFPICE: 726-3759
1 OF\J\
Sum
$ 40.00
B
ctri
ress
v
Expi rat
Cons t r
expifat
200 amps
201 amps
401 amps
601 amps
Over 1000
Reconnec t
or less
to 400to 600to 1000
amps _
amps _I amps_
/voIts
$ s0.
s 60.
$100.
$130.
00
00
00
00
00
00
amps
0n1y
$3oo
Con t
s
Ci ty Phone
OgNER
The installation is being made on
property I ovn vhich is not intendedfor sale, lease or rent.
c Temporary Services or Feeders
Installation, Alteration or Relocation
aEove
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Cireuit $ 35.00
Eaeh AdditionalCircuit or vith Serviceor Feeder Permit $ 2.00
Miscellaneous (Service/feeder not included)
-Each i.nstallation
200 amps or less I $ 40.00
201 ambs to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 10008I'ts see rtBrf
M
ion Date
$40
$ 40.00ng- $ 40.00
s 20.00
Pump or irrigation
Sign/0utIine Lighti
Limited Energy/Res
Limi ted Energy/Comm
5. SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
E
DATE:
CITY OF OREGON
Supervising Electri
Number
igtsEruI,(JI\J ')rr(z L )RBCEIVED
36. Q0d)
Da te