HomeMy WebLinkAboutPermit Building 1994-09-02Jzl>q* fr z.o4a 5 ,A * ?y'asr
NGFIELDRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PBO
JOB NUMBER
225 Flfth Stre,
Springfleld, O
t7WORK;
ASSESSORS MAP;
LOT:BLOCK:SUBDIVISION
lL fs PHONE:
STATE:ZlPin
'*
CITY:
ADDRESS:
OWNEB:
(
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW ,T REMoDEL
ADDRESS EXPIRES
a
CONTRACTOR'S NAME PHONE
-96GENEBAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
CONST.
CONTRACTOR #
U
t
(J)CER
WATER HEATER:
HEAT SOU
BANGE:
CONSTR. TYPE:
SECONDARY HEAI
SO
FLOOD PLAIN
ZONING CODE:
,I OF BDRMS:OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
LAND USE:
#OFUNI S
OFFIC
II
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. will be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
n Temporary Electrlc tr
K
tr
Rough Mechanlcal - Prlor to
cover.
I
&Final Plumbing - When allplumblng work ls complete.
Slte lnspectlon - To be made
after excavatlon, but prlor to
settlng forms.
Rough Electrlcal - Prlor to F Flnal Eleclrlcal - \Aihen all
electrical work is complete.'cover,
Underslab Ptumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When atl
mechanlcal work ls complete.
X Footlng - After trenches are
excavated.Flnal Building - When all
requlred lnspections have been
approved and building is
completed.
Flreplace - Prlor to faclng
materlals and framlng lnsp.Masonry - Steel locatlon, bond
beams, groutlng.tr
fr
Framlng - Prlor'to cover.
K Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Walt/Celllng tnsutatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng
tr
R
k
ry
MOBILE HOME INSPE TIONSUnderlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decking.Wood Stove - After lnstallatlon
Posl and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - WheSr alt
blocklng ls complete.
Floor lnsulallon - Prlor to
decklng.rr
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prlor to fitling
trench.Electrlcal Conneclion - When
blocking, set-up, and plurgbing
inspections have been approved
and the home is connected to
the servlce panel.ff:tru,
sewer - Prlor to filllns
Sidewalk & Drlveway - After
excavation ls complete, forms
and sub.base materlal in place.
Water Llne - Prior to filling
trench.[-l fence - When completed
Slreel Trees - When all requlred
trees are planted.
Flnal - After all required
inspections are approved andporches, skirtlng, decks, and
venting have been lnstalled.
Rough Plumbing - Prior to
cover.
?lrzrc
*{
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fl
tl
E
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total [Bight
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
i - THE PROPOSED WORK rN THE -
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
E,
PL.HSE GAR ACC
N
S
E
qT'Kfs
_bp6
DStS-q
4,+h9D
| 3.Qbt AA.lo_,53lp
(A) flI g"
I
$/so. FT.
.5\o.tD
1{0-.
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
ITEM
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This 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, including the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordinances.
Plans Reviewed By
*ZH t
Date
Receipt Numbe
Date Paid:
Received By:
Plan Check Fee:oa
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Flxt#res
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
N"d
FT.
FT,
FT.
(c)I
s*+,
PLUMBING PERMIT
Plumbing Permit
State_ Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
. b3+ l.os
I
(D)
fio
No
U !r)
Vent Fan
Mechanical Permit
lssuahce
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood nature, I state and agree, that I have carefully
the completed application and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with OFIS 701.055 will be used on this
prolect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remain
7s- z/Date
By slg
on the site at all times during constructlon.
Slgnature
.' 7-2-'
MISCELLANEOUS PERMlTS
Mobile Home
State lssuance
State Surchaqe,
Srdewark -{(r,,
curbcut 3€ ,,
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Comblned)
DATE PAID
AMOUNT RECEI
RECEIVED BY
VALIDATION:
BECEIPT NUMB
t:. 1.\ i,,,i.ij?
W
q-@r;@
T=.CIw
OREGO'VCITY OF
The lollowing Pr^iact as submtttsd tnq&
'. ;..lir'.: 'inecflo bncl
225 FTFTE, STREET
zcning, and
apProval.
SPRINGFIELD OREGON 97477 Zonin
INSPECTION PAQTIEST ' 7b6;J7?/tt -u3 -l
OFFICE: 726-3759
1. LOCATION OF
DESCRI ON
JOB DESCRIPTION
B
Permits are non-transferable and expire
if vork is not started vithin 1-80 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.ATION ONLY
EIJSIRICAL PERHIT APPLICATION
city Job *u a", ?4/2SG
Ar.rhorizedsignaturo .'MEE SCmDULE BELog
A. Nev Residential-Single or
Mu1ti-FamilY Per dvelling unit'
service rncludedt ,,",n" cost sum
1OO0 sq.ft. or less 2 $ 85'OO /7O,*
Each additional 500
sq. ft or Portionthereof Z 915.00 3e
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
SPFINGFIELE,
loliowing
Ll0e
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amps
-40L amps to 600 amps _601 amps to l-000 amps_
Over l-000 amps/vo1ts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
g+i , '::
Electrical Contractor 4-/**'c
Address ,!/.2 3?F ..'z <-/r. -- ;:, .' 4'*-;?'$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
aEove-
$ 40.00
$ ss.00
$ 80.00
s see rrBrtvoTt
Ci ty Phone
Supervisor License Number ./{-71 -f
-_3
C
Constr Contr. Number : ')'7 7,;<
Expiration Date //- /3-7
Signature.ing Electrician
,//'
Ovners Name
enone lz z -276/
OVNER INSTALLATION
The installation is being made onproperty f ovn vhich is not intendedfor sale, lease or rent.
Ovners Signature:
DATE:
200 amps or l-ess
20L amps to 400 amps
Over 40L to 600 amps
Over 600 amps or 1000
Branch Circuits
@
er not included)E. Miscellaneous (Service/feed
-Each installation
Pump or irrigat j.on
Sign/Outline Lighting-
Limited Energy/Res
-
Limi ted Energy/Comm
L--
D
Address
Ci ty
Nev, Alteration or Extension per panel
One Circuit S 35.00
Each Additional
Circuit or vith Serviceor Feeder Permit $ Z.OO
$ 40.00
$ 40.00
$ 20.00
$ 36.00
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
24*/Z,e
7,zo2f7x
RECEIVED
5
Expiration Date / :"' - -'.=--..-
Willamalane
Park & Recreation District
fob No.94rasu
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
PHONE:NAM
ADDRESS:
LOCATION OF FROPOSED
Street Address if Known:
1
Services
gfield
\3e AI
srArE:W*gmg
* StrrlBSITE:
Platt Name:Lot Number:
DEVETOPMENT TypE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Single Family - Detached
single Family home Manufactured home not in a park
X $400 PER UNIT -=$
X $370 PER UNIT =$
X $277 PER UNIT =$
X $280 PER UNIT =
NO OF UNITS
B. Single Family - Attached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufuctured Home Park
NO OF UNITS
WPRD SDC
,40 @
$
$40,@
2. SDC CREDIT (lf applicable) sDC-payer must furnish proof of wPRD Credit
ippi"*L s ee sot'credit worksh)eet- $
3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credi0 $
City of
on Date
o
I
d
q .1
WM
-{=fl-
ATTACHMENT 81
r'
-18 N0.?//2SG
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI{ARGE
WORKSHEET
(COMMERCIAL & RESIDENIIAL)
NA}4E OR COMP/NY:
I-OCATION:or/c 2 2/
DEVELOPMENT TYPE:
EUILDING SIZE:
STORM DRAINAGF
IMPERVIOUS SQ. FT.
SI
zsg/
+r7f- x $0.209 PER sQ. FT.572,
Ft
I
2. SANTTARY SEWFR-CITY
NO. OF PFU'S
(See Reverse)
BASE CI.IARGE (
rni g.
SDC
X $43.26 PER PFU
tr -3/-
s ?5/.72
$ H V2.fz
s z 7 7tr.os'
zZ
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
2 X o/ X $436.19 s 77L to
x x $436.i9 s
x
-
x $436.i9 s
SUBTOTAL (ADD ITEMS 1.2. & 3) S 2129./3
4. SANTTARY SEWFR-MWMC
NO. OF PFU'S 2Z $i7.i9 PER PFU + $10 Ml,ll.lc AOMIN.FEE s 3EE./tr
(Use PFU Total From item 2 Above)
MI^IMC CREDIT IF APPLICABLE (SEE REVERSE).' TOTAI.MI^I|4C SNC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
5. ANMTNISTATIVE FFES
s 7 5.24
ABOVE) X .05 S /3C.?o
82. SDC
i nat o
Date:
TOTAI SDC s 2 8 7 f.7s'
FIXTURE UNIT CALCULAj(loN TABLE: Number or New Fixt X Unit Equivalent = Fixture Units(NOTE: For remodels, calculate only
FIXTUBE TYPE
Bathtub.....
Drinking Fountain....-..
Floor Drain
lnterceptors For Grease/Oil/Solids/Etc.................
lnterceptors For Sand/Auto Wash/Etc..........
Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More....
Mobile Home Park Trap (1 Per Trailer!......
Receptor For RefrigeratorAvater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall
Shower, Gang........
Sink: Bar, Commercial, Residential Kitchen
Urinal, StallfaVall.. l
Wash Basin/Lavatory, Single.
Toilet, Public lnstallation
Toilet , Private....
Miscellaneous: rT'Ht mP's *dk
NET addirional fixrures!
NUMBER OF
NEW FIXTURES
4L
UNIT
EOUIVALENT
FIXTURE
UNITS
-Z--I
^2
/Head
2
1
2
3
6
2
6
6
1
3
2
1
2
2
1
6
4
r L -7-
_Z
Y
2
fZ
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based
calculate credits separates.
on assessed value. lf improvements occurred after annexation date in tabte,
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Bate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
0.61
o.44
o.15
Credit. for Parcel or Land Only lf Applicable 3.1c xs
(Rate X Assessed Valuel
lmprovement (if after annexation date)x $_
(Rate X Assessed Value)
2/.7so 7s,.2 f.
$7s.zcCREDIT TOTAL
r 7