HomeMy WebLinkAboutPermit Building 1995-01-27IELEl
R
P
ESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT
1.,
JoB NUMBER V24
225 Flfth Street
Sprlngfleld, Oregon 97472
BLOCK:
TAX LOT:
SUBDIVISION:
STATE:ZIP:
O
Z +
PHONE:6G^4.G?(i.
CITY:
ADDRESS:
OWNER:
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
REMODELNEW ,,&Z
ADDRESS EXPIRES
ELECTRICAL:
CONTRACTOB'S NAME
PHONE
MECHANICAL:
coNSt
CONTRACTOR ,
GENERAL:
PLUMBING
CONSTR. TYPE:OCCY GROUP:r OF BDBMS:
- OFFICE USE -
LAND USE:
HEAT SOURCE:
RANGE:WATER HEATER:
r OF STORIES:
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
QUAD AREA:
r OF BLDGS:
SECONDAFIY HEAT:
SQUARE FOOTAGE:
To request an lnspectlon, you must call 7 26-3769. Thls ls a 24 hovr recordlng. ell. lnsmade the same worklng day, lnspecilo ns requested after 7:00 a.m. wlll be made t
pe ctlons requested before 7:00 a.m. w lil behefollowlng work day,
$T"tPorary Electrlc
REQUIRED INSPECTTONS
lY noush Mechanlcat - prtor to---cover.X Flnal Plu mblng - When ailplumblng work ls complete.
Slte lnspectlon - To be made X:#"tl Eleclrlcat - Prlor toafter excavatlon, but prlor to ffiftnat Etectrlcat - \Mren ail.r4-.( electrlcal work ls complete.csettlng forms.
!gxg1iffi,E,::Xj:,,,
[]Jf footlng - After trenches are,-\.excavated.
flf Electrlcat Servtce - Must be/flapproved to obtaln permanent
electrlcal power.
ffi rinar Mechanlcat - When ail-- mechanlcal work ls complete.
ffiflnar Buttdlng - When a[----- requlred lnspecilons have beenapproved and bullding lscompleted.n frlasonry - Steel locatlon, bond
-
Deams, grouilng.
l-l foundation - After forms are
-
erected but prlor to concretep,acement.
Flreptace - prlor to faclngmaterlals and framlng tnspl
YFramlng - prlor to cover.
D<l waltrCeiltng tnsutatton - prtor to-- cover.fl Underground ptumblng _ prlor
to fllllng trench.
Underlloor plumblng/ Mechanlcat
- prtor to lnsulatlon or decklng.
Posl and Beam - prlor to floorlnsulatlon or decklng,
X..Drywar - prtor to taptng. ry
MOBI
Wood Stovo - Aft6r lnstallailon.
L E H o M E N SP ECr to NS
l-l lnsert - After flreplace aDprovat
ft CurUcut & Approach - Afterl-- torms are erected but prlor to .placement of concrete.
ffi SlOewalk & Drlveway - Afterr--\ excavailon ls completo, forms ..
and sub-base materlal in place.
[-l etocktng and Ser.Up _ Whep ail
-
blocklng ls complete.
Effm;t:#iua2;,"
E :;;,;ry Sewer - Prtor to rlrltns
X;:""tg.Sewer - Prtor to rttttns
|)( lljl:*rne - Prror to rrrrrns
flffi: Prumbrns - Prror to
P.lumbing Connectlons _ Whennome has been connected towater and sewgr.
Fence - When completed.
Electrlcal Conniction - When
P_'?gf,lg, ser-up, and pturpbtnslnspecilons have been approvedand the home ls connected tothe servlce panel.
fl Street Trees - When ail requtreij
-
trees are planted.
Final - After all requiredlnspecilons are approved andporc.hes, sklrilng, decks, andventlng have been lnstalled.
7-D3-3€-r'2
Lot faces
Lot sq. ftg,
Lot coverage
Topography
Total tleight
g2-f4"
<-u.
Lot Type ._
-
lnterlor
v/-
-
Panhandle
-
Cul-de-sac
nerCor
\-,s rHE PBOPOSED WOBK IN THE -
HtsroBtcAL DlsrBtcr, oR oN
THE HISTOBICAL REGISTER?
--
lf yes, thls applicatlon must bo slgned
and approved by the Hlstorlcal
Coordinator prlgr to permlt lsSuance.
APPROVED:
PL.HSE GAR ACC
N z5 z{
S 2o
/9
E ZE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfield, includlng the
Development Code, regulatlng the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordinances.
/ T i^i-
Recelpt Numbe
Plan Check Fee:
Date Paid
Received
VALUE
^c.?oa7254
"o4/./272,
(A)
41
/kq
,7<
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Galage
Carport
x $/so. FT.
2.e
Systems Developmcnt Charge ls duo on all undovoloped
properties wlthln the City llmits which are belng lmproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) t^''4'fi
PLUMBING PERMIT A TIONAL COMMENTS
ITEM
Flxturest.
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
N0
FT,
Fr. ) fo'
FT.) fo'__/5P
/5,M
&
F
3d?
FEE
4z-J@9"+
Plumblng Permlt
State. Surcharge
Total Charge
.4,5of5P / 5?'
-?.o5,2"
€;o
(c)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace .Unlt
Dryer Vent
Mechanical Permlt
lssuahce
State surcharge ,63 + '5O
Total Permit (D)
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk I t
curbcut 2 / n
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Comblned)
By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordlnances of the City of Sprlngf ield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
heroln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are In compliance with ORS 70'1.055 will be used on thls
prolect.
I further agree to ensure that all requlred lnspections are
reguested at the proper tlme, that each address ls readable
from tho street, that the Pormlt card ls located at the front
of the property, and the aP set of plans wlll remaln
on the site at all times du ng constructlon.
Si re
//.=o t-aN?oDate
2 ts
1./(
-;Z3s
42.
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
lbBl
60
/(..*
/Q,o3_
/.33
1
apploval
SPAINGFIELO
ng pr a$ cuylmitt %
ilio ianil use
97477
726-3
Dato,
e LnlL
Phone &S e )3 I
ILECTRTCAL PERHIT APPLICATION
City Jo b Nunber 24/7c,
SCMDULE BELOV
Service Included:
Nev Residential-Single or
llui, i-f"*i1y per dvelJ-ing uni t '
225 FITTII STREET l-a{>
"aa
, oREGoN
REQIIEST:
GSPRINGFIELD
INSPECTION
OFFICE: 726-3759
1. LOCATIONo A
I^EGAL DESCRIPTION
J OB DESCRIPTION
I tems
k
.L
Cos t
s Bs.oo
Sum
sy
Permits are non-transferable and expire
if vork is not started 'vithin 180 days
;; i;;;"""" ot if'vork is susPen?ed for
180 days.
2..' CONTRACTOR INSTALI,ATION ONLY
Elec t ri cal con t, ^.t o, -c(*r) lJuul /, 3 € ( rch
Addres
city€
Supervisor License Number 34Jt15
Expiration Date 5
Constr Contr Number f s?tc
Expiration Date
Signa.ture. of Supervising Electrician
,'1'
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or Less
ior "*pt to 400 amPs ---
401 amps to 600 amps
-
60L amps to 1000 amPs-
Over L000 amps/vo1ts --Reconnect OnIY
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permi t
Temporary Services or Feeders
Installation, Alteration or ReLocation
200 amps or less -t/'201 amps to 400 amps
-
Over 401 to 600 amPs
0ver 600 amps or 1000 voTEs
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Hatruf 'd Home or
Modular Dve11l'ng
Service or Feeder
$ is.oo 7-e-e
B
,q
$ 40.00
40.00
55.00
80.00
ee rBr a6Ove-
s 3s.00
$ 2.00
40.00
40.00
20,00
36.00
100
r"30
s300
(.
s
s
s
$
s
$
s
00
00
00
00
00
00
qn
60-
s40
C g
0vners Name
Address
ci ty-Phone
OSNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Ovzers Signafure:
DATD:
RECE
D. Branch Circuits
Nev, Alteration or Extension Per Panel
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
sj.gnlou tl-ine Light ing-
Limi ted Energy,/Res
Limi ted F,ne-rgy /Conm
$
s
$
$
I SUBTOTAL OF ABOVE
)/: Sl^te Sltrcharge
3.2 Admini.strative Fee't'0TAL
Z
RECETVDD I]
a .l a rr.r
Willamalane
Park & Recreation District
NAME:
ADDRESS:
LOCATTON OF FROPOSED BU
Street Address if Known:
G SITE:
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
fob No.
PHONE:
{\
STATE:gDE-Z'' qfiL
o
1
Platt Name:Tax Lot Number:
ffio:r".uappropriatedwelling(s).5DCCatculationsanddwellingtype
A Single Family - Detached
It Single Family home
NO OF UNITS
$
B. Single Family - Attached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home park
NO OF UNITS
X $370 PER UNIT =
X $277 PER UNIT =
x $280 PER UNIT =$
WPRD SDC
2- sDC cREDtr (rf appticabte) sDC-payer must furnish proof of wpRD Creditapproval. See SDC Credit Worksheet.
3. TorAl- WPRD NET sDC ASSESSED (rf sDC reduced for credit)
Manufactured home not in a park
I x $400 PER UN|T -=
$
$
$
$
$
Services
_ fi.., ^f C^.:^^fi^i,.1 on Date
%
([\R 00 +-
M
ATTACHMENT 81
B NO.7 y'tra e
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENI CI-IARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
I.IAHE OR COI-'IPAI{Y :G. S.Jor r,v
/tro /Y. tq 4
LOCATION:
DEVELOPMENT TYPE .s l,l)
BUILDING SIZE:
1. ffiqiMTffi
IMPERVIOUS SQ. FT
2. SANITARY SFWFR-CTTY
2o
2t 4 7
X /.ot Xs436.i9
x _ x s436.19
SIZ
X $0.209 PER SQ. FT
X $43.26 PER PFUNO. OF PFU'S
(See Reverse)
3.
'**SpORtaTT0N
NO OF UNITS X TRIP RATE X COST PER TRIP
-LrL
s
S
s /fil4-L
s 3 t5,r0
I
x
-
x $436.19
SUBTOTAL (ADD ITEHS 1,2. & 3)
4. SANITARY SFWFR-MWMC
NO. OF PFU.S 20 x $17.i9 PER PFU + $10 Ml^ll\4C ADI\,IIN.FEE(Use PFU Totai Frorn Item 2 Above)
Hh'I/C CREDIT IF APPLICABLE (SEE REVERSE)
iorar -ruNI- snc
SUBTOTAL (AOD ITEHS 1,2,3 & 4)
ANMTN.TSTATIVF FFFS
CI.IARGE (SUB E) X .05
H
7rrnig. P
5
G.8.f
S 2a 7/,1 z
S.z
$/os.5 7
82. SDC
Coordi nato
Date:/-+-
TOTAI SDC 2 / 7/.
FIXTURE UNIT CALCUL 'lON TABLE: Number of New Fix es X unit Equivarent = Fixrure Unirs
(NOTE: For remodels, calculate only-ihe NE-T additional fixtures)
.. NUN4BER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALEI\.IT UNITS
Bathtub I 2
Drinking Fountain....
Floor Drain
lnterceptors For Grease/Oil/Solids/Etc.................
lnterceptors For Sand/Auto Wash/Etc..........
Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More..
z
Mobile Home Park Trap (1 Per Trailer)
Receptor For RefrigeratorllVater Station/Etc
Receptor For Commercial Sink/Dishrryasher/Etc..
Shower, Single Sta!!..........
Shower, Gang........
Sink: Bar, Commercial, Residential Kitchen..
4 -T-v-Toilet , Private
Miscellaneous:,Tl,^lmPb
TOTAL FIXTURE UNITS
z
adlHe
I
?
I
1
J
6
2
6
6
1
.)
2
1
2
2
I
6
2 4
CREDIT CALCULATION TABLE: Based on assessed value lf improvements occurred after annexation date in ta ble,
calculate credits seParates.
3.6 x t /o.Gfo 3 6.7 s'
Credit for Parcet or Land Onty lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x $-
(Rate X Assessed Value)
CREDIT TOTAL = $7 .trs
Year
Annexed
Fate per $1,OO0
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984_
1 985
$3.46
zea
3.32
3.21
3.06
2.92
2.73
i 985
1 986
i 987
1 988
1 989
1 990
1 991
.t ooQ
$2.46
2.14
1.77
1.37
0.97
o.61
o.44
o.15
I
Urinal, StallAVall..:...............
Wash BasinAa vatory, d' nGD
To i I et, Pu bli c I nsta I t a tiorr
:-