HomeMy WebLinkAboutPermit Building 1993-06-22tA {12
RESIDENTIAL
PEBMIT APPLICATION
inspections: 726-37G9
Of fice: 726-3/59
LOCATION C)F PROPOSED WORK: -
ASSESSORS; MAP:
SPNII\lGFIELE,
Electrical Service - [\1'"tst be
approved to obtain permanent
electrical power.
l:ireplace - Prior to facing
rnaterials and framing lnsP.
Framing - Prior to cover.
Wall/Ceiling lnsulation - Pricr to
cover
225 Fifth Street
Springfield, Oregon 97 477
TAX LOT:ZDZ
?torsa
h,
72 l
BLOCK SUBDIVISION
To request an inspection, you must call 726-3769. This is a24 hour recording. All inspections requested be.fore 7:00 a.m. will be
made the s;rme working ciay, inspections requested after 7:00 a.m. will be made the following vr'ork day.
* REOUIRED INSPECTIONS
s
rcr:2_7?-?-/228
ffi '"tootarY
Electric
Site lrrspection - Tb be made
af ter '-'xcavation, bul prior to
setting forms.
Underslab Plumbing/ Electrical/
Mechcnical - Prior to cover.
Footirrg - After trenches are
excavated.
Masonry - Steel location, bond
beam:;, grouting.
Founclation - Af ter forms are
erectc.d but prior to concrete
placernent.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumbing / Mechanical
- Prior to insulation or deching.
Post and Beam - Prior to floor
insulzrtion or decking.
Floor lnsulation - Prior to
deckirrg.
Sanitary Sewer - Prior to f illing
trencll.
Storm Sewer - Prior to filling
trenclr.
Water Line - Prior to iilling
trcnclr.
Rouglr Plumbing -- Prior to
J--ll Rough Mechanical - Pr;or touJ cover-
l--7 Rouoh Electrical - Prior tr,$p
"ouJ'..
xr
Final Plumbing - When all
plumbing work is cornplete.
Final Electrical - When all
electrical lvo'l< is complete.
Vl
w)
w
WE
w
E
m
w
B
m
h
w
V)
@ o'r*^tl - Prior to taning
Wood Slove - After lnstallation
lnsert - After f irenlace aPProval
ernd installation of unit.
Curbcul & Approach - After
forms are erecl.rd but Ptior to
g:lacement of cc)nctete.
Sidewalk & Driveway - After
excavation is contplete, forrns
and sub-base nrateri;:l in Place.
Fence -. When coml-rleted
l;treet Trees - When erll rcquired
t re er; Art) plantecf .
Final Building - When all
required inspections have been
approveC and buildirrg is
complete d.
Other
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When all
blocking is cornplete.
Plumbing Connections - When
home has been connected to
water and sewer.
[--l Electrical Connection - WhenLl blocking, set-up, and plumbing
inspections have been approved
ano the home is connected to
the service panel.
Final - Aiter all required
inspections are approved and
porclres, sl(irting, dccks, and
venting have been irtstalled.
P tl C) t.l E:
4t't11ZiP:STATECITY:
-----
OWNER: .
ADDRESS:.
v OTHER
)
ION --- DEMOLISH
DESCRIBE \VORK:
NEW REMODEL AD
(I 'n
PHONEADDBESSE
ELECTRICA
CON-IRACTOR'S NAME
C EN ERAL:
PLUMBI
lvl EC t{A N
CONST.
CONTRACTOR l'
# OF UNII'S
OUAD AREA:
RANGE:
OT- BDiIMS
_ OFFICE USE -
LAND USE
WATER HEATER
ZONING CODE:
FLOOD PLAIN
mr-fL SECONDARY HEAT:
SOUARE FOOTAGE:
CONSTR. TYPEI
HFAT SOURCE:
r OF BLDG:]: _
OCCY GROUP:
a OF STORIES:
v
cover.trl
JOB NUMBER
1-t- - *1o-t
trt
?,
ri
[]
tJ
Final Mechanical - When all
mechanical work is cornplete.
!
HSE GAR ACCP.L.
N tl'g',',.
la/S
nd I%
E lzt
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Totai height
Lot Type
Y lnt.rio,
-
Corner
-
Panhandle
-
Cul-de-sac
Setb
ffia%
d_:Po\5
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL RE,GISTER? .--
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SQ. FT.
Main FZZ
X $/SQ. FT.= VALUE
6a2*,56.?o
Garage
Carport
a./,A t/./a
Total Value
Building Permit Fee
State Surcharge
Total Fee
22,9444aa
4a
(A)z4-@
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition tlrat the said
construction shall, in all resl-,ects' conform to the Ordinance
adopted by the Citl'of Springfield, including the
Development Code, regulating the conslruction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of saic.l ordinances.
Prarr check ree, 7, VE-5{-
Date Paid:
Receipt Nunrbe
f,>:22
7
Recei By:z/6qe
-7 o-"IJ--
SYSTEMS DEVELOPMENT C
(B)
HARGE (S
#tqr
DC) B
oe9
Systems Developntcnt Charge is due 6n all undeveloped
properties within the City lirnits which are being improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
No2 /6a -
FT.
FT.
FT.
Plumbing Permit
State Surcharge
Total Charge
^:'B.*
a5
(c)
AD IONAL COMMENTS
I
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
z z2lDA.
Vent Fan No2
{-s>
6.e
Wood Stove/ Insert/ Fireplace Unit
Dryer Vent -4*
Mechanical Permit
lssuance
State Surcharge
Total Permit
--/?'6d
/D-E
73
(D)zo.t/3
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information lrereon is true and correct, and I f urther certif y
that any and all work performed shall be done in :rccordance
witlr the Ordinances of the City of Springf ield, 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 permit;siorr of the Building Safety Division.
I f urther certify that only contractors and ernployees who
are in compliance with OHS 701.055 will be used on this
proiect.
I furthcr agree to ensure that all required inspcctiorls are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the f ront
of the property, and thr: approved set of plans will remain
on thc site at s durt truction
Signat
b 2L- q3Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
sidewark Nf t //r///e/VA2l@
curbcut /y'A t, ,77?€
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER q tbt
DATE PAID 6 t-t-
AMO(JNT RECEIVED *
\jAlt\A-RECEIVED BY (TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
zlzaz
JoB No. _13ol5z
NAME OR COMPANY:0
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0MMERCIAL & RESIDENTIAL)
c t/.v rvtE,Z
LOCATION:lq LZ
^1
. l'7 rt sr laot"52+ -'ltoo
DEVELOPMENT TYPE:LoE- - xlE 9FR
BUILDING SIZE:OT SIZ
1. STORM DRAiNAGE
IMPERVToUS SQ. FT.75 lD x $o.lez PER sQ. FT.
2. SANITARY SEI,JER-CITY
No. oF PFU'I lg x $39.78 PER PFU
(See Reverse)
3. TRANSPO RTAT I ON
NO OF UNITS X TRIP RATE X COST PER TRIP
I x l,oo, x $401.05
S a. Ft.
X
X
x $401.05
x $401.05
$
4 ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .0s
5. SANITARY SEWER-MWMC
NO. OF PFU'S g
(Use PFU Total From Item 2 Above)
MI,IMC CREDIT IF APPLICABLE (SEE REVERSE)
La
Kip Burdick
SDC Coordinator
c0
SUBT0TAL (ADD ITEMS i,2, & 3)s tbot*
TOTAL-CITY SDC S ltog I oJ
$13.62 PER PFU + $10 Mt.lMC ADMIN. FEE $ ?-EEt9
L'l
tooL
TOTAL SDC s llloss
a. ti
FIXTURE UNIT CALCUIATIt N TABLE: r.lumuer of New Fixtures X urm Equivalent = Fixture Units (NorE:
For remodels, calculate only theNEJ additional fixtures)
FIXTURE TYPE
Bathtub.......
Drinking Fountain.....
Floor Drain..
lnterceptors For Grease/Oil/Solids/Etc...-.....--'--...
I nterceptors For Sand/Auto Wash/Etc-.-...--.....---..
Laundry Tub/Clotheswasher.-..--
Clotheswasher - 3 Or More.........-......-.
lVobile Home Park Trap (1 Per Trailer).
NUMBER OF
NEW FIXTURES
.)-
.?
TOTAL FIXTURE UNITS
Receptor For RefrigeratorAVater Station/Etc-....--.
Receptor For Commercial Sink/Dishwasher/Etc'.
Shower, Single Sta||.............
Shower, Gang...........
UNIT
EQUIVALENT
FIXTURE
UNITS
2
L
z
7
--3-
tg
2
1
2
o
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
Sink, Bar, Commercial.
Urinal, StallflVall....
Wash Basin/Lavatory, Single..
Water Closet, Public lnstallation..
Water Closet, Private.....
Miscellaneous
CREDIT CALCULATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits separates.
7,89 x $ol,o 1 25b3Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x $_
(Rate X Assessed Value)
CREDIT TOTAL _ $25 b1
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
1986
't987
1988
1989
1990
1991
$2.16
1.90
1.60
0,25
0.87'0.50
0.'16
RUNOFF COEFFTCIENTS FOR STORM DRAINAGE
Residential..
Commercial
o.4
0.9
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
,
{
I
t
5a.ttlNul:lr:Lu
2fr,c1 as subn
rot require225 I]II."TII STRI|I.:T
sl,tuNGIrIt:LI), 0RI':G0l'l 97 471
INSPIICTION REQUTIST 2 72.6_3769
0FPICF,: 72.6-3759
ILECTRICAL PBRHIT APPLICATI ON
City Job Number
3. COHPLBTE t'BB SCNEDULB BBLOS
A Nev Residential-Single or
HuIti-FamilY Per dwelling unit.
Service Included:
o
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
tlrereo f
Each Manuf 'd llome or
Hodular DveIIing
Service or Feeder
Items Cost Sum
$ Bs.oo
$ 1s.00
$ 40.00
B Services or Feeders
Installatlon, Alterations or
Relocation:
(Z-
ul>>lav
qs 75,\
1 or ON
Pcrnri t re non-transf ble and explre
it vork is not started vlthin 180 days
of issuance or if vork ls suspended for
180 days.
2. CO}rIRACf,OR INSTALI.ATION ONLY
Iil cr: t rir:al Cot) t rac tol.'
Ad d r:css 3 o
Ci ty fit o (A(_ r'rro,ru 3 t/3 1353
A
ffi
gD
200 amps or less $
201 anrps to 400 amps
-
$
401 amps to 6oo amps
-
$1
601 amps to 1000 arps- $1
over 1bo0 amps/vorts
-
$3--T---
Supervisor License Ndmber "to 4 Q
Expiration Date /o- I -?3
Constr Contr. Number -?/.3,5)
?
50.00
60.00
00.00
30.00
00.00
40.00
I
a56F
$ 40.00
$ ss.00
s 80.00
see rtBrl
Expiration Date
Signature oa
Ouners Name
Arld rcss
cit
0vN
Temporary Services or Feeders
Installatlon, Alteration or Relocation
200 amps or less I
201 amps to 400 amps
-0ver 401 to 600 amps
-
0ver 600 amps or 1000 voltsSupervsEIec t ri cian
I'lron<:
ALLATION
D
C.
Tlre installation is being made on
property I oun which is not intended
for sa1e, lease or rent.
Ovncrs Signaturc:
DATE: ' L, ' LL -1 b
RECEIPf #: c,l l,€l
Branch Circults
Nev, Alteratlon or Extenslon Per Panel
One Ci,rcu i t
Each Addi tional
Circui t or vi th Service
or Feeder Permi t
s 3s.00
$ 2.00
E l'liscellaneous (Service/feeder not included)
-Each installation
Ptrmp or i rriga t ion
Sign/0u tline Ligh t ing-
Limi ted EnergY/Res
-
Limi ted EnergY/Comm
$
$
s
s
0.00
0
4
4
20
36
00
00
00
STJDTOTAL OT ABOVB
5f State Surcharge
TOTAI,
I(liCI'lIVID l]Y: &r^^,--s-
5
.af*%ffi,