HomeMy WebLinkAboutPermit Building 1995-03-21/-
SPRIhlGFIELO
RESIDENTIAL
PERMIT APPLICATION
inspections: 726-3769
Cffice: 726-3759
LOCATION OF PROPOSED WOHK:
a fozzzJOB NUMBER
225 Fif th Street
Spring{leld, Oregon 97477
tlltt N, t,\t S,{/LoA flerl(
ASSESSOBS MAP;5o* ro, C ^9d
t,BLOCK:^r SUBDIVISION
OWNEB;/f). I f/l^, {L,," l. ,d L|4"un PHONE:7c? - 7/L7
c^a+<- 74Cr-766?
ADDRESS:44loc Po"l--*n* P.!
01.o,^^l il:/l 7
CITY:STATE:OK
I/.nC 5&<c
ZIP:
7
5
DESCBIBE WORK:6 o"^o.Connr"s,t^ fb /,',
NEW- BEMODEL K
J
ADDITION X DEMOLISH
J
OTHEFI
CONTRACTOR'S NAME
CONST.
CONTBACTOR #EXPI RES PHON E
GENERAL:s.ll ADDRESS
3 u,n-ct4 <bor.
PLUMBING:
MECHANICAL;s,l{1l
ELECTRICAL:s.lt
_ OFFICE USE _
QUAD AREA:LAND USE:
# OF UNITS
FLOOD PLAIN
r OF BLDGS:ZONING C
OCCY GBOUP:CONSTR. TYPEr
HEAT SOUBCE:
Y OF BDRMS:
'' OF STOBIES SECONDABY HEAT:
SOUARE FOOTAGE:WATER HEATER
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recor<Jlng. All lnspections requested before 7:00 a.m. wlll be
made the sarne wgrklng day, lnspections requested after 7:00 a.m. will be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumbing - When all
plumblng worl< ls complete.
E
m
E
E
E
E
l
:l
l
l
Slte lnspection - To be made
after excavatlon, but prior to
settlng forms.
Underslab Plumbing/ Electrical /
Mechanlcal - Prior to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng,
Foundatlon - After forms are
erected but prlor to concrete
placemont.
Underlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllling
trench.
Storm Sewer - Prior to filling
trench.
Waler Llne - Prlor to filling
trench.
Rough Plumblng - Prlor to
cover.
Rough Electrlcal - Prlor to
cover
Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
Flreplaco - Prlor to facing
materlals and framlng lnsp.
Framlng - Prlor to cover.
Wall/Colling lnsulatlon - Prlor to
cover.
Drywall - Prlor to taplng
Wood Stovo - After lnstallation
lnsert - After f lreplace approvql
and lnstallatlon of unlt.
Curbcut & Approaclr - After
forms are erected but prior to
placoment of concrete,
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base materlal in place.
Fencs - When completed.
Slr€€t Trees - When all requlred
trees are Planted.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work ls complete.
ry
T
v
F
tr
ry
ry Flnal Building - When all
requlred lnspectlons have been
approved and building is
completed.
Othor
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspections are approved and
porches, skirtlng, decks, and
ventlng have been lnstalled.
l./'at^ aor I
lt )l
.. :
{QIVI ,\\\t
Underground Plumbing - Prior
to fllllng trench.
E
tl
tf
tl
E
E
E tl
Lot {aces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Tyl
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
Se IS THE PROPOSED WORK TN THE .HtsroRtcAL DtsTFilCI, OR ONTHE HISTORICAL REGISTER?
-
lf yes, thls applicailon must be slgnedand approved by the Historlcal
Coordinator prlor to permlt issuance.
APPROVED:
AD ITIONAL COMMENTS
\*)
VALUE
ruz€
3,rs+t't /.gs
s/^*C
sG
BUILDING PERMIT
,6rr*t4f z Zzff i zZa-
Total Value
Building Permit Fee
State Surcharge
Total Fee
SO. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
2%-d4/s rq
Py.[qtNG VALUE, PLAN CHECKAND BUILDING PCNMIT
Thls permlt is granted on the express condltlon
. of Sprlngfield, lncludlng thelatlng the constructlon and use of
< ,i:
, Datev
v
gu
that the satdconstruction shall, in all res pects, conform to the Ordinanceadopted by the Cit
Development Code, re
buildings, and may bes uspended or revoked at any tlmeupon violation of any p rovislons of sald ordlnan ces.
Plan Check Fee:
Date Pald:
Recelpt Number:
Received By:
SYSTEMS DEVELOPMENT CHARGE
b1s(B)
(s Dc)Systems Development Charge is due on all undevelopedproperties within tl.re City limits which are being lmproved.
ITEM
Fix t u res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
No
FI
FT.
(c)
Plumblng Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanlcal permit
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
By slgnature, r state and agree, that r have carefuily examrnedthe completed application and do hereby cerilfy that alllnformatlon hereon ls true and correct, and I f urther certlfythat any and all work performed shall be done in accordancewlth the Ordinances of the Clty of Sprlngfield, and the Lawsof the state of oregon pertarnrng to the work descrrbedhereln, and that NO OCCUPANCy will be made of anystructure wlthout permission of the Bulldlng Safety Dlvlslon.I further certify that only contractors anOlmptoyees whoare ln compllance wlth ORS 7O1.O5S wlll be used on thlsproject,
I further agree to ensure that all required lnsrequested at the proper ilme, that each add
from the street, that the permlt card ls
of the property, and the approved set
7
pectlons are
ress ls readable
located at the front
of plans wlll remalnon the slte at all durlng c tlon.
J- a /-
Slgnatu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut tt
Demoliilon
State Surcharge
(E)
Total Miscellaneous Permits
VALIDATION;
RECEIPT NUMBER
DATE PAID
t_{_s=ea AMOUNT BECEIVED
TOTAL_AMOUNT DUE (ex,(A, B, q e and'E Combtn
cluding electrical)
red)9b RECEIVED BY
{3 ffi eg
(A)
FT-
t
RESIDENTIAL
PERMIT APPLICATTON
lnspections: 726.3769
Office: 726-3159
LOCATION OF PROPOSED WOFIK:
ASSESSORS MAP:
SPrIIh.GFIELE,
LOI: BLoCK:
TAX LOT:O 2
SUBDIVtStON: --..-
.7
*?
PHONE:
ztP
OWNER
ADDR
CITY:
NEW
-
BEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS EXPIRES PHONE
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST,
CONTRACTOR #
GENERAL:
PLUMBING
_ OFFICE USE -
WATER HEATEB:
FLOOD PLAIN
ZONING CODE:
LAND USE:QUAD AFIEA:
* OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS:
--
RANGE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS: -.--
To request an inspection
made the same working ' you must call 726'3769. Thls ls a24hour recordlng. All inspections requested before 7:00 a.m. will beday, lnspections requested after 7:00 a.m. wiil be made the foilowing work day.
REQUIRED INSPECTIONS
[_-l Temporary Electric w Rough Mechanical - prior to
ff)a"* 4zr.Rough Electrical - prior to
COVEI,
ll Finat ptumbins - When ail'J plumbing worl< is complete.
Site lnspection - To be madeafter excavation, but prior tosetting iorms.
Final Electrical - When allelectrical work is complete.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must beapproved to obtalrr permanent
electrical power.
Final Mechanical - When all
'HDryZt *YtDSmPrete'
?,m",,m(nf,nu^,,.
required lnspections have beenapproved and building is
completed.
Footlng - After trenches are
excavated.
Masonry - Steel location, boncl
beams, grouting,
Fireplace - Prior to faclng
materlals and framing lnsp.
Framing - Prior to cover.
Foundatlon - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - prior to
cover.
Underground Plumbing - prior
to filling trench.|.--l Drywall - prior to taping
Underlloor Plumbing/ Mechanical
- Prior to lnsulation or decking.
MOBILE HOME INSPE TIONS
I-l Wood Stova - After instailation.
Post and Beam - Prior to lloor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set.Up - When ailblocking is complete.
Floor lnsulation - Prior to
decking.Curbcut & AJ:prroaclr - After
forms are erected but prior toplacemcnt of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.
Slorm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, {orms
and sub-base malerial in place.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Waler Line - Prior to filling
trench.I-_l Fence - When compteted.
Rough Plumbing - Prior to
cover.
{itreel Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirting, decks, andventing have been installed.
JOB NUMBEA ?-+AZ=P
225 Fifth Street
Springfietd, Oregon 97 4ll
SrArE: . 4T _
E Other
-
fl
E
E tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type t
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setb \ lS THE PROPOSED WORK tN THE
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
l{ yes, this applicatlon must be signed
arrd approved bY the Historical
Coordinator prior to permit issuance.
APPROVED:
ACCP.L.HSE GAR
N
S
E
VALUE
(A)
X $/SO. FT.
Main
Carport
Garage
Total Value
Building Permit Fee
State Surcharge
Total Fec
BUILDING PERMIT
ITEM SO. FT.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed t3y Date
Receipt Numbe
Plan Check Fee
Date Paid:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accorrJance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Buildirrg Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 7Ol.O55 will be used on this
Proiect.
I further 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 the approved set of plans will remain
s duri ng constructlpn.br,fu*-
Date
on the site
Signatu
'a4L//- { - ?c
MECHANICAL PERMITFurnace Z 2m
Exhaust Hood
Wood Stove/ lnsert/ Fireplace Unit
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut _ ft
Demolition
State Surcharge
Total Miscellaneous permi ls
ryzeE
-2i'6.2a
(E)
Dryer nt
N0Vent Fan
@
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (exctuding etecrricat)(A, B, C, D, and E Combined)
/,/" Z/^%
<v
DATE PAID
-2eAMOUNT RECEIVED
RECEIVED BY
VALIDATION:
FIECEIPT NUMBER
7?:6
ATTACHMENT Bi
-,J NO.a5oz z.b
CiTY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NA}.l[ OR COHPANY M -(+oN\
LOCATION:\ 64c)\tn Tr{-1 0221-bl - oTqao
DEVELOPI'IENT TYPE LD 12-REjAoDgL
BUILDING SIZE: 12*7-1 LOT SI
STORI'I NRAINAGF
IMPERVIOUS SQ. FT.b+b X $0.209 PER SQ. FT
X $43.26 PER PFU
. Ft.
1
2. SANITARY SFI,,IFR-CITY
3
NO. OF PFU'S
(See Reverse)
TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
x _-. x$436.i9
x
-
x $436.19
x $436.19
$
X $
SUBTOTAL (ADD ITEMS 1,2, & 3)$ 1213
4. SANITARY SEI.IER-I'1WI',1C
NO. OF PFU'S $17.19 PER PFU + $10 Mhll'4c ADMIN.FEE s
(Use PFU Total From Item 2 Above)
l4t.ll.4c CREDiT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
5. AOMINISTATTVE FFES
BASE CHARGE (SUBTOTAL ABOVE) X .05
$1L 19
tJ
SDC Coordinator
82. SDC
Date:b
TOTAI SDC s 1to z1
i
b''L
FIXTURE UNIT CALCULA-ION TABLE: Number of New Fixtt
(NOTE: For remodetd, caiculate only i- - NET additional fixtures)
NUMBER OF
FI1TURE TYPE NEW FIXTURES
X Unit Equivalent : Fixture Units
Bathtub-....
Drinking Fountain....
Floor Drain-
lnterceptors For Grease/Oit/Solids/Etc-
lnterceptors For Sand/Auto Wash/Etc-. -. - - - -. - - -. - -. - -
Clotheswasher - 3 Or More..-.-....----.--.----
Mobile Home Park Trap ('l Per Trailer)
Receptor For Refrigerator/Water Station/Etc
Roceptor For Commercial Sink/Dishwasher/Etc-.
Shower, Single Statl..........
Shower, Gang.........
Sink: Bar, Commercial. Residential Kitchen...-
Wash Basin/Lavatory, Single
Toilet, Public lnstallation..
Toilet, Private..... .------..-.-..'"
Miscellaneous:
2
i
2
J
6
)
6
6
1
J
)
/Head1
2
')
1
6
4
a
TOTAL FIXTUi]E UNITS
CREDIT CALCULATION TABLE: Based on assessed value.
calculate credits separates.
lf improvements occurred after annexation date in table,
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
X$
(Rate X Assessed Value)xs
(Rate X Assessed Value)
CREDITTOTAL = $-
Year
Annexed
Rate per $i,OOO
Assessed Value
Year
Annexed
Rate per $ i,OOO
Assessed Value
1979 or before
1 980
198't
1 982
1 983
1 984
1 985
$3.46
3.38
3-32
3.21
3.O6
2.92
2.73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o-97
0.6i
o.44
o-15
UNIT FIXTURE -.
EOUIVALENT UNITS
Permits are non*transferabl-e and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
COMRACTOR INSTALI.ATTON ONLY
EIec cal Contractor
ress
ty
rvisor License ber
use
ELECTRICAL PERUTT APPLICATTON
3. COHPI^ETE TEE SCMDIILE BELOV
Nev Residential-Sing1e or
Multi-Family per dvelling unit.
Service fncLuded:
I tems Cos t
1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf'd Home. or
-Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterationsor Relocation:
200 amps or l-ess /201 amps to 400 amps
-
401 amps to 600 amps
-601 amps to,1000 amps-
Over 1000 amps/volts
Reconnect 0n1y
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps"or less $ 40.00
201 amps to 400 amps
-
S 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 1000-tofTs see rrB'r aSotE-
D. Branch Circuits
approval.
225 FTTTE STREET
SPRINGTTELD, oREGON 974
INSPECTION REQ{IEST: 72
OFPICE: 726-3759 Aulhorlzod
1. LOCATION OP INSTALLATTON
f/,
SP ;FIEL')
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
t'fha foltorlng prolect m submlttod h8? try
iljiii'd,-#i iff' nort require speci{ic land
Uibw Ci Job Nu.mb er 75pZZf
I A
B
C
Sum
J
<J
S
S so.
S oo.
S1oo.
s130.
r00
o0
00
00
00
00
s300
s40
Expi ra t
Cons tr
Expira t
a
]/L.^^ I t// op
rs Name
Address egTo t O-.l,n , ls
ion Dat
Con Number
Da te
ure of Supervising Electrician
Nev, Alteration or Extension Per Panel
.2r!E. Misce]laneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Ou tline Lighting-
Limi ted Energy/Res
-Limited Energy/Comm
#-oO
One Circui t
Each AdditionalCircuit or with Serviceor Feeder Permit '
ity
DATE:
-
Phone 7q7-7/6 ?
s 3s.00
s 2.00OSNER INSTALI^ATION
instaLlati.on is being made on
roperty I ovn vhich is not intended
or saIe, lease or rent.
0nners
s 40.00
s 40.00
$ 20.00
$ 36.00
RECETVED B
re:
c
5
5v,l