HomeMy WebLinkAboutPermit Building 1995-05-04oLgt\P i c PAA<
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP;
LOT:
SPFlI}.GFIELD
5,7
7 .5- ,1 o) AS
7eo 30 eJOB NUMBER
225 Fif th Street
Sprlngf leld, Oregon 97477
o lher oF
oO si,o,
BLOCK:tvt .)
A
t_
2 t*zPHONE:(
STATE:CITY;
ADDRESS
OWNER:
New L// REMoDEL ADDtloN DEMoLtsH orHER
a.9 t€DESCRIBE WORK:Ho
ADDRESS EXPIRES PHON E
utu- oio
2/t 2
CONTBACTOR'S NAME
G EN EBAL:
PLUMBING:
MECHANICAL:
ELECTRICAL;
t&L
\ll
CONSI,
CONTBACTOR #
tlrt
YvlOrz-
Ab r/d
I
2
t €o
e ?-
- OFFICE USE -.
BANGE:
r OF BDRMS:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN
SECONDABY HEAT:
SQUARE FOOTAGE:
QUAD AREA:
r OF BLDGS:
OCCY GFIOUP:
I OF STORIES:
CONSTB. TYPE
HEAT SOURCE:
LAND USE:
, OF UNITS
To req
made
uest an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. Alr lnspectlons requested before 7:00 a,m, w,t bethe sante worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
lVl Temnorary Electrtc
REQUIRED INSPECTIONS
ffi nough Mechanlcat - prlor toW cover.ry
ry
ry
ry
Flnal Plumblng - When allplumblng worl< ls complete.tl Slte lnspectlon - To be madeafter excavatlon, but prlor tosettlng lorms.ry Flnal Electrlcal - When ailelectrlcal work ls complete.cover.
ry
m
Underslab Plumblng/ Electrical /Mechanical - Prlor to cover,rY Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power,
Flnal Mechanlcal - When allmechanlcal work ls cgmplete.
Footlng - After trenches are
excavated,[-l Ftreptace - prtor to factng
-
materlals and framlng lnsp.
Flnal Building - When ailrequlred lnspectlons have beenapproved and buildlng is
completed.Masonry - Steel locatlon, bond
beams, groutlng.N
ry
ry
Framlng - Prlor to cover,
m Foundatlon - After forms are
erected but prlor to concrete
placemont.
Other
Wall/Celllng lnsulatlon - prior to
cover.
Underground Plumbing - Prior
to fllllng trench.Drywall - Prlor to taplng
Underlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or decklng.
MOBILE HOME TNSPE TIONS
Wood Stovo - After lnstallatlon.
Post and Beam - Prior to floor
lnsulation or decklng.lnserl - Aftor flreplace approval
and lnstallatlon of unlt.
Blocklng and Set.Up - When ailblocklng. ls complete.
w
ry
ry
ry
Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prior toplacamcnt of concrete,
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to fllllng
trench,
Storm Sewer - Prlor to fllllng
trench,
Sidewalk & Driveway - Af ter
excavatlon ls completo, forms
and sub.base materlal ln place.
Electrical Connection - When
blocklng, set.up, and plunrbing
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Water Llne - Prlor to filling
trench.Tl Fence - When compteted.
Streel Trees - When all requlred
trees are planted,
Flnal - After all required
Inspectlons are approved andporchos, sklrtlng, decks, andventlng have been installed.
Rough Plumblng - Prlor to
cover.ry
eDr'*- - zrp, 9)97y'
?.frN d
Rough Electrlcal - prlor to
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
PLUMBING PERMIT
ITEM
Fix tu res
Resldenilal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
Lot Ty,
-- lnterlor
_- Corner
y' panhandle
-
Cul-de.sac
k IS THE PROPOSED WORK IN THE .
HISTOFIICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER? _-_
lf yes, thls applicailon must be slgnedand approved by the Historlcal
Coordinator prlor to permlt issuance.
APPROVED
a[D
3Jr
kr
qu 6)
FEE
FT.
N0 t t60 eo
lto@
FT.
FT.
Plumblng permlt
State Surcharge
Total Charge
8.qr2 + 3Z r\re.td
r 15es(c)
VALIDATION
RECEIPT N
DATE PAID
AMOUNT R
RECEIVED
UMBER
ECEIVED@2/40,2t
P.L,HSE GAR ACC
N 5,?,
S Iq
5
E 1
tL tg+ j% J-z.'{g
BUILDING PERMIT
m31aa
(A)3-1 0.q
1%
ITEM
Main
Garage
Carport
X $/SQ. FT.
563:-
SO. FT.
//3/
?ra /dro
Total Value
Building Permit Fee
State Surcharge
Total Fee
VALUE
/-vy z
Py.[qtNG VALUE, PLAN CHECKAND BUILDING PENMIf
Thls permit rs granted on the express condition that the saidconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprlngfleld, inctudtng theDevelopment code, regurating ihe Jonstruction and use ofbulldlngs, and may be suspended or revoked at any tlmeupon vlolatlon of any provisions of sald ordlnances,
Plans owed By
R 1_By:R {+:l,*=
Plan Check Fee:z.?r2-
Becelpt Numbe
Date Pald:
SYSTEMS DEVELOPMENT C
146-?
HARG E (s Dc)tt#,a'(B)
Systems Development Charge ls due on all undevelopedpropertles wlthln Ure City limits which are belng improved.
ADDITIONAL COMMENTS
I oo{
gbt)? lqbrl
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No \
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent a(&2
.'l(+ 3 %
t 5.q82
(4)\o
e.o-
&6(D)
,OulO-
Mechanlcal Permit
lssuance
State Surcharge
Total Permlt
By slgnature, I state and agree, that I have carefully examlnedthe completed appllcailon and do hereby cerilfy that alllnformatlon hereon is true and correct, and I f urther cerilfythat any and all work performed shall be done in accordancewlth the Ordinanccs of the Clty of Sprlngfield, and the Lawsof the State of Oregon pertalnlng to the work descrlbedhereln, and that NO OCCUPANCy wlil be made of anystructure wlthout permission of the Bulldlrrg Safety Dlvislon.I further certlfy that only contractors and employees whoare ln compliance wlth OFIS 70.1.055 will be used on thlsproject.
I further agree to ensure that all requlred lnspections areested at the proper ilmo, that each address ls
the street, that the permlt card ls located at
e property, and the approved set of
roqu
from
C
readable
the frontof th plans will remalnon the slte at al imes durlng const il
d- /-
Slgnatu
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut _-- ft
Demolitlon
State Surcharge
Total Mlscellaneous permlls (E)
TOTAL AMOUNT DUE (excludlng electrical)(A, B, C, D, and'E'Combtned)
BY
a
i .r;r , .j -
Ii ,.
TE--
ATTPCHMENT 81
JOB NO.15o 3oG
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAJ"1E OR COI.IPANY D uaua Kxt tGt-{ -r9
LOCATION:T C"4B A .' zt?a 3T.
DEVELOPMENT TYPE:LD g-I N ,"<
BUILDING SIZE:SI Ft
1. STORM DRAINAGF
IMPERVIOUS SQ. FT X $0.209 PER SQ. FT.
2. SANITARY SFVIFR-CiTY
NO. OF PFU'S I B X $43.26 PER PFU
(See Reverse)
3. TRANSPORTATION
.
NO OF UNITS X TRIP RATE X COST PER TRIP
X t.ot X $436.i9
x
-
x $436.i9
x
-
x $436.19
t+
$
SUBTOTAL (ADD ITEMS 1,2. & 3)$ tz13 z9
4. SANTTARY SEhIFR_|'4hlMC
NO. OF PFU'S l$$17.19 PER PFU + $10 Mt.lMC ADMIN.FEE $ atatY
(Use PFU. Total From Item 2 Above)
MhlMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
4taL
SUBTOTAL (ADD ITEMS 1.2.3 & 4)s t4tr-1
5. AI]ttTNTSTATTVF FEES
BASE CHARGE (SUBTOIAL ABOVE) X .05
SDC Coordinator
1t-
211
82. SDC
Date
TOTAI SI]C $ t51 I 5b
d;R*)-,.L z /rE /qE
--|--_-./--
148'3
FIXTURE UNIT CALCULATI - I TABLEI Number of New Fixtures
i*oii,i". remoaeis, catcuiate only tlre Nrf additional fixturesl*uao o,
FIXTURE TYPE NEW FIXTURES
L
:rit Equivalent ='Fixture Units
Bathtub-.---
Drinking Fountain-"'---
Floor Drain.
UNIT
EOUIVALENT
FIXTURE -
UNITS
4
Z
2
i
.)
J
6
2
6
6
1
3
2
1
2
lnterceptors For Grease/Oil/Solids/Etc
lnterceptors For Sand/Auto Wash/Etc
Laundry Tub/Ctotheswasher" " "'
Clotheswasher - 3 Or More
Mobile Home Park TraP (i IPer Trailer).
RecePtor For RefrigeratorAN'ater Station/Etc--.--.-.
Receptor For Commercial Si nk/Dishwasher/Etc-.
Shower, Single Stall.-...-."'ad/He
Shower, Gang.-----..-
Sink: Bar, Commercial. Residential Kitchen
Z
2
6
la
Urinal, StallMall.-.
Wash Basin/LavatorY, Single'
Toilet, Public lnstallation- """"""""""-:'
Toitet , Private
Miscellaneous:
CREDIT CALCULATION TABLE
calculate credits seParates'
Based on assessed value
Credit f.or Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
lf improvements occurred after anne
41. X$Z,I 4tqt
(Rate X Assessed Value)
X$
(Rate X Assessed Value)
CREDIT TOTAL * 4laL
z
L
TOTAL FIXTURE Uf'.!ITS
2
1
6
4
xation date in table,
Rate per $ 1,OOO
Assessed Value
Year
AnnexedYear
Annexed
Rate per $1,OOO
Assessed Value
1 985
1 986
1 987
1 9BB
1 989
i 990
1 991
1 993
$2.46
2-'14
1.77
1.37
o.97
0-61
o.44
o-15
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
3.32
3-21
3.O6
2.92
2.73
1.
,
Willamalane
Park & Recreation District
q50 ?or,
NAA4E
fob No.
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
PHONE:1?.b .LAb+
'il ,rlnfr I ' f U f=- V.l- srArE: A lZ- zrp 4t4t {ADDRESS:
LOCATTON OF FROPOSED BUILDI
Stre€t Address if Known:no+(
NC SITE: ,
Nl . Lty t*w*
1 OgVetOpfvteruf fYpf (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the baclc)
A. Single Family - Detached
II Single Famity home Manufactured home not in a park
No oF uNtrs I ' x g4oo PER UNIT -=. $
B. Sinsle Familv - Aftached
NO OF UNITS X $370 PER UNIT = ' $
tb
C. Multi-FamilyApartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
x $?77 PER UNIT =
X $280 PER UNIT =
$
$
$t0
WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worlcsheet.
3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credit)
$
Fl rta
6
$
tho
6
Platt Name , rax Lot Number: 11 t07 !/h t-+h 0('tr
CITY OT SPB OREGON
225 FfFTE STREET r ..i:,..i.:c,J
SPRINGFTELD, OREGON 974 Nnn
TNSPECTT0N REQIESTz 726-3169OFFfCE: 726-3759
1 IOCATTON OF INST,
JOB DESCRIPTION
Address
Ci ty Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
0wners Name 'r', t 'K- i5
SPF iFIELD
ELECTRICAL PERHTT APPLICATION
City Job Number
zoning, and
appfoval.not reguire specific lcnd use
Date ;lJ 4
3. COHPLETE FEE SCEEDULE BELOg
A. Nev Residential-Single orMulti-Family per dvelling unit.Service fncluded:
f tems
1000 sq. f t. or less t-
Each additional 500sq. ft or portionthereof 2-
Each Manufrd Home. or
-
Modular Dvelling
Service or Feeder
Services or FeedersInstallation, Alterationsor Relocation:
s 1s.00 ?oPo
s 40.00
s s0.00
s 60.00
s 100. 00
s130.00
s300.00s 40.00
Cos t
s 8s.00
Sum
aLe
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended ior
1.80 days.
2. COT.ITRACTOR INSTALI,ATTON ONIY
Electrical Contractor
B
c
200 amps or less
20L amps to 400 amps
-
401 amps to 600 amps
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect OnIy
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps"or less $ 4O.OO201 amps to 400 amps
-
S 55.00Over 401 to 600 amps
-
$ 8O.OOOver 600 amps or 1000-vofts see uBn affid
Address
city__.f2?)tnone 7Zb -2760
D. Branch Circuits
Nev, Alteration or Extension per panel
One Circuit
Each Additional s 3s.00
Circuit or vfth Serviceor Feeder Permit s 2.00
E
'oa
TT
OSNER TNSTALI,ATTON
The installation is being made onproperty f ovn vhich is not intendedfor sa1e, Iease or rent.
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Ou tline Lighting-
Limited Energy/Re
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Admini.strative Fee
TOTAL
s 40.00
s 40.00
$ 20.00
$ 36.00
5
DATE:
zoRECEIVED
-
h