HomeMy WebLinkAboutPermit Building 1992-11-20f5
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LOCATION OF PROPOSED WORK: -'1'
LOT:
TAX LOT:
RESIDENT'AL
PERMIT APPTICAT'ON
lnspections: 726.3769
0llice:726-3759
JoB NUMBER ,%/U26
225 Flfth Street
Sprlngfleld, Oregon 97477
SUBDIVISION:
2
PHONE:
ZlPtSTATE:
92 c/
OWNER:
ADDRESS:
CITY:
,&ptxz /
DESCRIBE WORK:
-X- DEMoLIsH orHER
NEW
---
REMODEL ADDITION
PHONEEXPIRES
ADDRESS
_a
ELECTRICAL
33N?Io"'o*'
CONTRACTOR'S NAME
GENERAL: * 2w*4-
PLUMBING: - -
MECHANICAL:
SOUARE FOOTAGE:
tg SECONDARY HEAT:./.
OFFIC ffi-
WATER HEATER:
OUAD AREA:ZONING CODE:
# OF BDRMS
FLOOD PLAIN:
RANGE:
, OF BLDGS: -..
OCCY GROUP:
, OF STORIES:
# oF UNITS,
-1CONSTFI. TYPE:
HEAT SOURCE:
LAND USE
To request an lnsPect lon, You must call 726'3769' Thls ls a 24 hou r recordlng. All lnsPe
wlll be made the fol
ctions requested before 7:00 a'm' wlll be
made the same workl ng daY, lnsPect lons reqttested after 7:OO a'm lowlng work daY'
REQUIRED INSPECTIONS 6 Slliul"T;.lfl ," #,li?"*l
w 5i::i,fl:i$L?, " #,lii"ill
[__l TemPorary Electrlc w Bough Mechanlcal - Prlor to
cover.
cover.
E
Site lnspectlon - To be made
IiiJt'"i6rr.tlon, but Prior to
settlng forms'
ttnderslab Plumbing I Electrlcal'
tnectrantcat - Prlor to cover'
Footlng - After trenches are
excavated.
Masonry - Steel locatlon' bond
beams, groutlng'
m 5,""11*'t'.1, ;' #i?l i:'#:"ff "
Placement'
w
m
E yJfli,i:fi,:iiJ:-'rns - Prior W
a Rough Electrical - Prlor to
Electrlcal Servlce - Must be
;ffi;;;a to obtain Permanent
electrlcal Power'
Flreplace - Prlor to faclng
."i6ir"r" and framlng lnsP'
Framlng - Prlor to cover'
Flnal Mechanlcal - When all
i"eJitiniC"t work ls comPlete'
Flnal Bulldlng - When all
i.,iiituo in"Pictlons have been
.plioveA and bullding ts
completed.
4
w
Other
q
E
w
Underltoor Plumblng I Mechanlcal
l'iii"t-t" lnsulatlon or decklng'
Post and Beam - Prlor to floor
lnsulatlon or deckln0'
Floor lnsulallon - Prior to
decklng.
Sanltary Sewer - Prlor to filling
Wood Stove - After lnstallatlon'
lnserl - After flrePlace aPProval
"n-O
ln"t"tt"tlon of unlt'
Curbcut & APProach - After
i"i." "t. er6iteo but Prlor to
placement of concrete'
Sidewalk & DrivewaY .- Af ter
I"ilr"tion ls comPlete, torms
l^i-"r6'ou.e materlal in Place'
Fence - When comPleted'
Stre€t Trees - When all requlied
trees are Planted'
Electrlcal Connectlon - When
Ei""i.'r"s, set'uP, and Plumblng .
i,il"irijiio^" navi been aPproved
;;;th; home ls connected to
the servlce Panel'
WalllCelllng lnsulatlon - Prlor to
cover.
Drywall - Prlor to taPlng'
MOBILE HOME INSPEGTIONS
Blocklng and Set'UP - When all
blocklng ls comPlete'
Plumblng Connectlons - When
i,fil" 6"1 been connected to
water and sewer'
trench
Storm Sewer - Prior to filllng
trench.
Waler Llne - Prlor to tllllng
trench.
lnstall
l-I-l Rough Plumblng - Prlor to
I,AJ cover.
12 -4aa
r
n
E
tl
Lot taces
Lot sq. ftg.
Lot coverage
Topography
Total height
tu?Zfuazbw'
,4 tnterior
-
c'6rner
Lo\
_- Panhandle
-- Cul-de-sac
S THE PROPOSEO WORK IN THE
THE HISTOFIICAL REGISTER?
--_It yes, this application must be signedand approved by the Historlcal
Coordrnator prior to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT,VALUE
--2e
_7---,/ 7-
(A)
-#,za 27e"a
Total Value
Bulldlng Permit Fee
State Surcharge
Total Fee
Main
Garage
CarportA-n
zv8-
//.
ewe d
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condiilon that the saidconstruction shall, in all respects, conform to Ure Ordinanceadopted by the City of Springfield, inctuding theDevelopnrent Code, regulating the construction and Lse ofbulldlngs, arrd may be suspencJecl or revol<ed at any tirneupon violation of any provisions of said ordinances.
//-R-:7-
Datez-:o2i\
Plan Check Fce:>,/
Date Paid
Receipt Nutrrber:
Flec By:
SYSTEMS DEVELOPMEN r CHARGE (sDcl +p(B) fu$':Systems Developrnent Charge is due on all undeveloped
properties within ilre City linrits which are being improvecJ.
ITEM
Fix t u res
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEEy'1/a
N0
/a.d
FT.
FT.
(Je
' =rr.-
(c)
,2 ,o
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace l_-
Exlraust Hood
Vent Fan No ?Y 7
Wood Stove/ lnsert / Flreplace Unlt
Dryer Vent4=,Azz
,Q---t@_:_
4nC
,za.
//2_a
(D)
OD- e+\
-r
Mechanical Permit
lssuance
State Surcharge
Total Permit
By signature, I state and agree, that I have carefully examinedthe completecl application and do hereby certify that allinformatlon hereon is true and correct, and I f urther certifythat any and all work performed shall be done in accordancewlth the Ordinances of the City of Springfield, and the Lawsof the State of Oregon pertaining to the work describedhereln, and that NO OCCUPANCY wlll be made of anystructure wlthout perrrrission of the Builcling Safety Division.I further certify that only conlractors and employees whoare ln compliance with OFIS 7O.|.O5S will be used on thisproject.
I further agree to ensure that all required inspections arerequested at the proper time, that each address is readabrefrom the street, that the permrt card rs rocated at the frontof the property, arrcJ the approved set of prans wlrl renrainon the site at all times durlng construcilon.
D
Signatu re
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk --- ft
Curbcut _.._- ft
Demolition
State Surcharge
Total Miscellaneous permits (E)
l/1r1*-.
TOTA L A M O U N T D U E (exc I u d I n g et ect ri c a D :,t ;1t,. 27. E(A, B, C, Q and E Comblned)
l( -ZtDATE PAID
AMOUNT FIECEIVED
RECEIVED BY
,-1 2-
VALIDATION:
RECEIPT NUMBER
P.L,HSE GAR ACCa
S ,/o ;/
7r(,,al
E ar,,3 i
FT.
N ry
225 rlnfi STIU,JIiT
SPIuLIGFI ELD, lRIlG)N g 7 /,77INSPBCTTON REQUTIST:
S l.r r rrvq1,1r. a,,
PUIII'IT ATPLTCATION
City Job Number ?.t 32
3 COHPLETE TIBB SCNEDULE BELOU
1-Singl eor
ling uni t.
Items Cost
Hul t i-F am per dwelService fncluded:
726-37OFPICE:726-37se I
1. LoCATI0N or INSTALId
LEGAL DESCRII"TTON
JOB DESCRTPTION
Addr:ess
Ci ty Phone
Supervisor License Ndmber
lixpiration Date
Constr Contr. Number
Ii>:piration Date
Signature of Supcrvising Blectrician
0wners Name
Arld ress
City Phone
OVNEN INSTALLATION
The installation is being made on
property I own vhich is not intended
for saIe, Iease or rent.
Ovn rs Signattr
1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf ,d llome or
-Modular Dr.relling
Service or Feeder
Services or Feedersfnstallatlon, Alterations or
RcLocation:
D. Branch Circuits
-Each installation
Ptrmp or irrigation
Sign/Ou tline Liglt t ing-
Limi ted Energy/Res
Limited tnerly/comm
-SIIBTOTAL OF ABOVB
5I State Surcharge
TOTNl,
0ver 1000 amps/volts $300.
Reconneet 0n1y $ 40.
Temporary Services or Feeders
Installatlon, Alteration or Relocation
200 amps or less
201 anrps to 400 .rps
-401 amps to 600 amps
-601 amps to 1000 amps
200 amps or Jess $
201 amps to /r00 amps _ $
0ver 401. to 600 amps _ $
0ver 600 amps or 1000 volts se
ffi
Sum
a
$ 8s.00
$ 1s.00
s 40.00
.00
.00
.00
rBil above
Pcrnri ts are non-transferable ancl expireif vork is nor srarted vlthin 180 d;ysof issuance or if vork ls suspended for180 days.
2. CO}.NRACf,OR INSTALIJTION ONLY
Iilcr:trical Con trac tor
B
$
$
$1
$1
00
00
00
00
00
00
50
60
00
30
40
55
BO
e
C
#m*rz 8a4w
New, Alteratlon or Extension Per Panel
onecircuir / $35.oo ?fnEach Addi t ional
Circuit or vith service ,
or Feeder Permi t € $ 2.oo 4r.Q
I'liscellaneous (Service/feeder not included)
$ 40.00
$ 40.00
s 20.00
$ 36.00
DITE:\\-4t-
RECF,I
-F---F---
!l"n-9al(li(:lilVIll) IIY:
E
5
ce
d
JOB [,^2t 5 zb
CITY OF SPRINGFIELD SYSIEMS- DEYELOPMEI{T CHARGEWORKSHEET
(C,MilERCIAL & RESIDEflIIAT)
UCTH 6a*uevNAME OR COMPANY:
L0CATI0N: zbb qN t lTr{ Sf 1obzG I ooO1
DEVELOPMENT TYPE: Lvg_ _&epr rr
BUILDING SIZE: ?1t?a ?oae Agel OT SIZ
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2. SANITARY SEt^/ER-CITY
NO. OF PFU'S
3
(See Reverse)
TRANSPORTAT ION
NO OF UNITS X TRIP RATE X COST PER TRIP
x - x $401.0s
X x $401 .05
x _ x $401.05
ADMINISTRATiVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .os
5. SANITARY SEhlER-t',ll^lMC
F sq. Ft.
bo x $0.192 PER SQ. FT
1 X $39.78 PER PFU
$
$
SUBToTAL (ADD iTEMS I,2, & 3)s 4z*?-
4
$ t+.{16:
$13.62 PER PFU + $10 MI,{MC ADMIN. FEE
Above)
NO. OF PFU'S
(Use PFU Total From Item 2
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
,L t(
Kip Burdick
SDC Coordinator
TOTAL-MWMC SDC
TOTAL SDC
$
+-
.l L $ +41b2
1
I
TOTAL-CITY SDC
X Unit Equivalent = Fixture Units (NOTE:
FIXTURE UNIT CAL-UIATIONTABLE: Number ot Neu' - tures
For remodels, calcutate onry tn" NE additional fixtures)
NUMBER OF
FIXTURE TYPE NEW FIXTURES
\
UNIT
EOUIVALENT
FIKI'URE
UNITS
FIoor Drain.
i ni"i""ptot" For Grease/Oil /Solid s/Etc" " " " " " " "'
i ni"r""ptor. For Sand/Auto Wash/Etc" " """ """"
Laundry Tub/Clotheswasher" """"'
Clotheswasher - 3 Or More""""""""''."""'
Mobile Home Park Trap (1 Per Trailer)"""""""""
R eceptor For RefrigeratorAVater Station/Etc" " " "
Receptor For Commercial Sink/Dishwasher/Etc"
Bathtub......-
Drinking Fountain"""
Shower, Single Stall..-..........
Shower, Ganq......-....
Sink, Bar, Commercial
Urinal, StallflVall....
Wash Basin/Lavatory, Single..."""'
Water Closet, Public lnstallation"
Water Closet, Private....-....
Miscellaneous:
CREDIT CALCULATION TABLE
calculate credits separates.
TOTAL FIKI-URE UNITS
Based on assessed value. lf improvements occurred after annexation date in table'
x$
L2
1
2
o
o
2
6
6
1
.)
2
1 /Head
2
2
1
6
4 T-
1
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)X$
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential.. .............. 0.4Commercial .............. 0.9lndustrial..... .............. 0.45Governmental................. ..............0.5
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
1985
1 986
1 987
19BB
1989
1 990
1 991
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
I
I
t
I
I
I
I
I
lMPERVlous AREA = TorAL LoT srzE x RUNOFF coEFFrcrENT
(Rate X Assessed Value)
CREDIT TOTAL = g