The URL can be used to link to this page

Home My WebLink AboutPermit Building 1992-12-29ul-.j. 5755 D,'6+ INGFIELc,RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: JOB NUMBER a72 225 Fifth Street Springfield, Oregon g7 477h, JII? AJ. SELd ASSESSORS MAP:/tLOT:SUBDIVISION O rcoBLOCK: CONTRACTOR'S NAME ADDRESS HE and i tlanst. r lnr. 84353 Par['.way PieaEant Hili, 0r ?7455 Lynns Elertrir P,0. Eox A Fall tlreek 97438 Dc,n Lewi s Pl r-rmbi ng 5f-rt] Greenfield Eugene, 0r 974t)4 Plarslral I s Oi I Er Ins. 4131 ',E,,5t. Springfield, Or 97478 Brc'r-,ks Excavat i on 27681 tlrsw E:d Eugene, 0r 974tt? CONST. CONTRACTOR #EXPIRES PHONE 71158 131r)1 33t-r76, ';.371(1 55?21 0r.-/93 7t6-3838 04/93 7:6-7835 t-ra/93 688*1931 12/9?.747*7443 03/t3 345-7564 Qr.Rcl PHON E:3 8?87a6 STATE:C)r ZIP:?rcl 55 JoE- HtrurE tu C,r-i Ccrnsl P.FlrCITY: ADDRESS OWNER *=* / REM.DEL ADDrroN DEM.LT.H orHER =tr4DESCRIBE WORK: To request an inspection, you must call 726-3769. This is a24hout recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REOUIRED INSPECTIONS F xTemporary Electric Site lnspection - To be made r excavation, but prior to setting forms Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Water Line - Prior to filling trench. x B & M E Fl-Drvwatt - Prior to taping Wood Stove - After installation lnsert - After fireplace approval and installation of unit. Curbcul &Approach - After forms are erected but prior to placement of concrete. Fence - When completed. Street Trees - When all required trees are Planted. Rough Mechanical - Prior to cover. Rough Electrical - Prior to cover, Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prior to facing materials and framing lnsp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover. Final Plumbing - When all plumbing work is complete. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. K E K K/Founaation - After forms are Werected but prior to concretet placement. F g 7 P tr F F tr Final Building - When all required inspections have been approved and building is completed. Other MOBILE HOME INSPE TIONS Blocking and Set.Up - When all blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Eleclrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. ffi SiO"*"lk & Driveway - After4 excavation is complete, forms and sub-base material in Place. Rough Plumbing - Prior to cover. TAX LOT r E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR N S E J THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: 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' By: S96.-ed Receipt Numbe Plan Check Fee: Date Paid: Recei BUILDING PERMIT ITEM SQ. FT. X $/SO. FT. (A) 6/ezE?A Total Value Building Permit Fee State Surcharge Total Fee Main Garage Carport VALUEff/87 SYSTEMS DEVELOPMENT CHA (B) BFE (sDchtg # lqob29 ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE N0 /ffi J FT. FI FT. oo (c) Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent Mechanical Permit lssuance . State Surcharge Tot:LPet:*it - N0 @ i t I to)-- MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined 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 accordance 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 Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. i f urther 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 on the site at all times during construction. UL, -,\+r.J.,,it*.Signature Date MISCELLANEOUS PERMlTS Mobile Home State lssuance State SurchargL sidewark l-Tt ,, curbcut -2L) ,, Oemolition Total Miscellaneous Permits (E) urJ@ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 25/4,;r D ED BY ECE VALIDATION: RECEIPT NUMB DATE PAID AMOUNT B RECEIVED W Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ,1.q) -, JOB NO.clztlt b CITY OF SPRINGFIELD SYSTEMS DEVELOP].IENT CHARGE WORKSHEET (cor{MERcTAL & RESIDENTTAL) NAME OR COMPANY:o LOCATION DEVELOPMENT TYPE: BUILDING SIZE: o G C-o ti Loe- - NEr,nt 5F 7 I. STORM DRAINAGE IMPERVIOUS SQ. FT. NO. OF PFU'S 3 OT SIZ x $0.Ie2 PER SQ. FT. X $39.78 PER PFU . Ft. Zbto t1 (See Reverse) TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP I x /,oo9 x$401.05 X x $401.05 X x $401.05 Kip Burdick SDC Coordinator $ $ 4 SUBT0TAL (ADD ITEMS I,2, & 3)$ ((.ot* ADMINiSTRATIVE FEES BASE CHARGE (SUBTOTAL AB0VE) X .0s TOTAL-CITY SDC $ l69toJ 5. SANITARY SEt^lER-Mt^lMC N0. 0F PFU'S lg x $13.62 PER PFU + $I0 Mt'lMC ADMIN. FEE $253 t(p (Use PFU Total From Item 2 Above) Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE)?o2 TOTAL-MWMC SDC lla4gt = lz ZI ?- TOTAL SDC S I7OU22 ____-.__, 2. SANITARY SEWER-CiTY FIXTURE UNIT CALCUIA. JN TABLE: NUMbET Of NEW FIXIUTES ' For remodels, calculate only theNE additional fixtures) NUMBER OF FIXTURE TYPE NEW FI}CTURES z rit Equivalent = Fixture Units (NOTE UNIT FI)CTURE EOUIVALENT UNITS Floor Drain-. I nterceptors For Grease/Oil/Solids/Etc"" """"""' lnterceptors For Sand/Auto Wash/Etc""""""""" Laund ry Tub/Clotheswasher"""""' Clotheswasher - 3 Or More""""""""''i""" """""" Mobile Home Park Trap (1 Per Trailer)"""" ne"eptot For RefrigeratorAVater Station/Etc"""" n"""ixot For Comhercial Sink/Dishwasher/Etc" Bathtub....... Drinking Fountain.-.... Shower, Single Sta|I...""""" Shower, Gang.-...-...-- Sink, Bar, Commercial + z L 2 a /Head 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 6 4 Urinal, StallflVall.... Wash Basin/Lavatory, Single""""" Water Closet, Public lnstallation" Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) L 1,.$b x $ (Rate X Assessed Value)x$ Water Closet, Private....""' Miscellaneous: TOTAL FI}CIURE UNITS la CREDIT CALCULATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table' calculate credits (Rate X Assessed Value) CREDIT TOTAL = $Vo2 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 '1987 19BB 1989 1 990 1991 $2.16 1.90 1.60 0.25 0.87 0.50 0.16 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT ---- | lo .u c,o'q- I RUNOFF COEFFICIENTS FOR STORM DRAINAGE :;t,rttr{(;l:tr:1-rJ ,, 225 FTFTII STRIiIiT SPRINGFIELD, oREGON 97477 TNSPECTI0N REQUEST: 126_3769 oFPTCE: 72.6-3759 \>- ELBCTRICAL PERHIT APPLICATION City Job Number SCIIEDULE DELOV13 A DES Nev Residential-Single orHuIti-PamiIy per avelling unit.Service fncluded: =.lr Permi ts are non-transfe rable and ex p relf vork is not started r.,l thin 180 d aysof issuance or if vork ls suspended for180 days. 2. CO}ITRACTON INST Iilec trical Con t rac to Add cir Supervisor License Ndmber I tems Cos t $ 85.001000 sq.ft. or less Each additlonal 500sq. ft or portion tlrereof Each Manuf,d flome orHodular Dvellirig Service or Feeder $ 40.00 B Services or Feedersfnstallatlon, Alterations orRelocation: $ s0.00 $ 60.00 s100.00 $130.00 $300.00 $ 40.00 C D. Branch Circui ts Nev, Alteratlon or Extension Per Panel One Ci.rcuit S 35.00 Each Addi t ional Circui t or vi th Service or Feeder Permit $ 2.00 --s2 & @ ON l&:Q a ONLY Sum $ 1s.00 not included) 40.00 40.00 20. oo Expiration Date t s constr contr. ttumber,{ID\ 200 amps or less 20L amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- over 1000 amps/volts -Reconnect 0nly Temporary Services or Feedersfnstallatlon, Alteration or Relocation 200 amps o.r less $ 40.00 201 amps to 400 amps - $ 55.00 over /rot to 6oo amps - g Bo.oo 0ver 600 amps or 1000 volfs see rrgr ,ffi- ( Expiration Date to q3 Signature of Supervising Blectrieian Ovners Add ress Ci ty rlronc-l r OSNII.R INSTALLATION The installation is being made on property I ovn vhiclr is not intended for sale, lease or rent. 0vners Signature: DATE RIiCEIPT Hiscellaneous (Service/feeder -Each installation Pump or irrigation $ Sign/0utIine Lighting_ S Limi ted Energy/Res _ S Limited Energy/Comm S SI,BTOTAL OP ABOVB 5f State Surcharge TOTAI, E q I(IiCI.]IV[D I}Y: oo /, nrrone r)Qh-rlB%