HomeMy WebLinkAboutPermit Building 1995-02-28RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3169
Office; 726-3759
LOCATION OF PBO D WOBK:
ASSESSORS MAP:
LOT:
LD
JOB NUMBER 5
225 Fitlh Street
Sprl ngf leld, Oregon gl 417
TAX LOT:
BLOCK:SUBDIVISI
OWNE
ADDB
CITY:STATE:
PHONE:
ZIP:
ADDITION H-- OTHEB
DESCBIBE WORK:
NEW l--- REMoDEL
NAME ADDRESS EXPIRES PHONE
CONST.
\
B#
PLUMBING
CONT
GEN
MECHANICAi
ELECTRICAL:
e-
l ltl
14B UlU
l(
- OFFICE USE -
RANGE:WATER HEATER:
* OF UNITS:
LAND USE:
ZONING CODE:
* OF BDRMS;
SECONDABY HEAT:
SQUARE FOOTAGE;
CONSTR. TYPE:
HEAT SOURCE:
FLOOD PLAIN:
OCCY GROUP:
* OF STORIES;
QUAD AREA:
* OF BLDGS:
To request an rnspecflon, you must calr 726-3769. Thrs rs a 24 rmade the same worklng day, inspections requestecl after 7:00
hour recording. Ail inspections requested before 7:00 a.m. wilr bet a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
E*"t: Mechanicar - Prior to ETil;1.?l,r"tri?p,;#,ffii"ill
Temporary Electric
Site lnspection - To be madeafter excavation, but prior tosetting forms.
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
fl,.footng - After trenches are
-
excavateo.
Masonry - Steel location, bond
beams, grouting,
Underground Plunnbing - Prior'
to filling trench,
llFoundation - After forms arelJ erected but prior to cgncrete
placement.fJwalllCelling lnsulation - Prior tolJ cover.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When att
blocklng ls complete.
Plumblng Connections - When
home has been connected to
water and sewer,
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
lnspectlgns are approved and
porches, skirting, decks, and
ventlng have been lnstalled.
E|-Aough Electrical - prior to
-
cover.f-ftfhd Electrtcat - When ail
-
electrlcal work ls complete.
f-lfElectrical Service - Must be
-
approved to obtaln permanent
electrlcal power.
l-J-+inat Mechanlcat - When alt'J mechanlcal work ls complete.
[l flreplace - Prior to factngu materlals and framlng lnsp,
f-ftfinat Butlding - When ail
'J requlred lnspections have been
approved and building is
completed.
l-J-Eraming - Prior to cover.
l-il-Underrloor Plumbing / Mechanical
Prior to lnsulatlon or decking.
[-}+ost and Beam - Prior to floorr lnsulatlon or decking.
l--lJloor lnsulation - Prlor tot.gdecking.
f-l-€anit'ary Sewer - Prior to fillinglJ trench.
lf-€torm Sewer - Prior to fillingE trench.
lll-Water Line - Prior to fillingu trench.
ffifiougtt Plumblng - Prior toH cover,
l-l|-€urbcut & Approach - AftertJ forms are erected but prior to
placement of concrete.
f/siaewalk & Driveway - After
'J excavatlon ls complete, forms
and sub-base materlal ln place.
- Prlor to taping.
Wood Stove - After lnstallation.
lnsert - After fireplace approval
and lnstallatlon of unit.
Fence - When completed.
Str€et Tress - When all required
trees are planted.
fl
\[D0
F.
\
t-lIr
T
E
tl
M
E
Lot faces
Lot sq. ftg
Lot coverage
TopograPhY
Total helght
Lot TYPt
y' lnlerior
-
Corner
-
Panhandle
-
Cul'de'sac
. IS THE PBOPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON h
TH E H |STORICAL REG ISTERq-II-D-
lf yes, this appllcatlon must be slgned
and aPProved bY the Hlstorlcal
Coordinator prlor to permit issuance'
APPROVED:
PL.HSE GAB ACC
N tD5
S 5
4D 4D
E h ))o
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condltlon that the sald
consiruction shall, in all respects, conform to the Ordlnance
"A.pi"O by the City of Sprlngfleld' lncluding the
O"r"top."nt Code' rejutating the construction and use of
["iiai^i", and may be suspended or revoked at any tlme
upon viotation of any provisions of said ordinances'
Dateins Reviewed v
Plan Check Fee:
Date Paid:
Recelpt Numbe
Received BY:
BUILDING PERMIT x s/so. FT.
-aoloState Surcharge I r
Total Fee (A)
5\\e LD
\\.\C)oc
\\1lD
$gpc)
.Al qL
3!]p se
ITEM
Maln
Garage
Carport
VALUE
u3rfi+
18qb
Total Value
Bulldlng Permit Fee
SO. FT.\\i3
Systems Development Charge ls due on all undeveloped
properties within the City limits which are belng lmproved'SYSTEMS DEVELOPMENT lss,ffi"
ADDITIONAL COMMENTS
ITEM
Flxtures
Resldentlal Bath(s)
SanltarY Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
t 3o/o
(,
FT.
FT.
(c)
Plumbing Permlt
State Surcharge
Total Charge
NFO
\ A?N
\10. 80
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MECHANICAL PERMIT
\D DT)
t33
A? a3
4
&
(D)
\\o .5C
N0
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do hereby certify that all
lnformation hereon is true and correct, and I further certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springf ield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure without permission of the Buildlng Safety Divlslon.
I further certify that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required lnspections 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
Slgnatu re
Date
on the site at all es during
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharoe
srdewark 1'l- ,,
curbcut LV ,,
Demolltlon
Total Mlscellaneous Permi ts (E)
Su arge
TOTAL AMOUNT DUE (excluding electrlcal)
(A, B, C, D, and E Combined)
lnAD bq
VALIDATION:
REoETPT NUMBER %^
.Z
AMOUNT RECEIVED
RECEIVED BY
DATE PAID
N"&
FT.
qn
3
q rd)
z5r-
CITY OF OFEGO'V
SPRI]TIGFIELD
225 FIFTH STREET
1. LOCATION OF
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALT.ATION ONLY B
Electrical Contrae tor trUnO trL>c.*p.l<
Address
ihe iclloi..'ing prcjee.{ as submiitsd hao the
zonirig-r, nnd cic'es lrol re<luiro speciiic land
apDroi,a!.
- )_)
.:,.-.', l-?L BLECTRICAL PERHIT APPTICATION
SPRINGFIELD, OREGON 97477 .. o;)l -c; (
INSPECTION REOUEST: 726-3769 ' z-' {-A) t -'
OFFICE: 726-3759 ... :
qSDl 1qCi ty Job Number
J. ' UUHTIJIE T.El;SCEBDIILE BELOS
Nev Resi.dential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
A
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dv611ing
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPS _
601 arnps to 1000 amps-
Over 1000 amps/vo1ts
Reconnect Only
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000 voTEs
SUBTOTAL OF ABOVE
5Z State Surcharge
3% Administrative Fee
TOTAL
s 8s.00
$ 1s.00
$ 40.00
40. 00
55.00
80.00
ee uB* aEove
no\
w
&
p $ s0.00
$ 60.00
s100.00
$130. 00
$300. 00
s 40.00
$
$
$
s
Ciq ryrttu>il5 Phone l+)r 37
Supervisor License Number /0OCS
Expiration Date /c _t _ff
constr conrr. Nr^u", 6 f, 7/J-
Temporary Servi,ces or Feeders
Installation, Alteration or Rel-oeation
C
Expiration Date
Si ture of SuPerv ing Electrician
Ovners
Address
Ci ty Phone
OVNER TION
The install-ation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Mlsceflaneous (Service/feeder not included)
-Each installation
Pump or irrigation S
Sign/OutIine Lightittg- $
t imited EnergY/Res $
Limited Energy/Comm $
40
40
20
00
00
00
5
RECETVED
ATTACHMENI BI
crry 0F
''R'ITGFIELD
sysrEr'rs DEVEL,pr.{r*-,:t# *7'
I{ORKSHEET
(COHMERCIAL & RESIDENTIAL)
NAJ'II OR COHPA},IY:
"/LOCATION , 7/ t S .,,
DEVELOPMENT TYPE:
BUILDiNG SIZE
Ft1. .STORI,I I''RAINAGF
iI',IPERVIOUS SQ. FT.X SO.2O9 PER SQ. FT
2. SANITARY SF|IJFR.CTTY
NO. OF PFU'S
(See Reverse)
tY X $43.26 PER PFU
TRI.NSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x /,o/ x s436.i9
x _ x s435.19
4. SANIIARY SFI^JFR-HI1,MC
NO. OF PFU'S t'$17.19 PER PFU + SiO MlttHC ADMIN.FEE
Above)
3
i9. P
s
s
SUBTOTAL (P.DD iTEHS 1,2. & 3)s / z/7.2 3
5\g kt"lrcfrs4rtl,I5
s 3/?./ 2
2c 3
$/ ,ftz. / Z
(Use PFU Total F rom item 2
Ml.lHC CREDIT iF APPLICABLE (SEE REVERSE)
TOTAI -I"II.IMC SNC
SUBTOTAL (ADD ITEHS 1.2,3 & 4)
5. AI'IMINISTATTVE FFFS
E(ABoVE) X .05
2 -zz-? 5-
.f-cz
82. SDC
rdi nator
Date:
TOTAI SDC S/
\brrt38
LOT SIZE' en
-
FlxruRE UNIT CALcuLryTloN TABLE: Numucr or New Fixr"res X Unit Equivalcnt = Fixtu'c units
(NOTE: For remodcl'' cotc'tor" ontr ^ :. NEI oddirional lixturcsl
NUMBER oF uNlT FlxTUnE
NEW FIXTUNES EOUIVALENT UNITS
FIXTURE TYPE
4
Bathtub....
Drinking Fountain""
Floor
rs For Grease/Oil/Solids /EtclntercePto
lnterceP For Sand/Auto Wash/Etc"" " """"" "tors
Laundry Tub/Clotheswasher
Clotheswasher
Mobile Home Park TraP (1 Per Trailerl
RecePtor For Refrigerator Affater Station/Etc
RecePtor For Commercial Sink/Dishwasher/Etc"
Shower, Single Stall""""""
Shower, Gang"""""'
Sink: Bar, Commercial'Residential Kitchen" "'
Urinal, StallNVall" l"'
Wash Basin/LavatorY , Single
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4Toilet, Public lnstallation'
Toilet , Private.."
lvliscettaneous:. tT'*t rocl gtlk
CREDIT CALCULA Tlo N TABLE: Based on ass
c alculate credits seParates'
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
essed value. lf imProvem
.7',46
(Bate X Assessed Value)xs
(Rate X Assessed Value)
2
TOTAL FIXTURE UNITS
ents occurred after
x$7.58o 26.2>
.1.
-
annexation date in table'
CBEDTTTOTAL =s26'29
Year
Annexed
Rate per S1,OOO
Assessed ValueRate Per $1,OOO
Assessed ValueYear
Annexed
1 985
1 986
1 987
1 988
1 989
1 990
1991
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
1sp4
1 985
s3.46
3.38
3.32
3.21
3.06
2.92
2.73
J
z-
I