HomeMy WebLinkAboutPermit Building 1994-11-28t'
ELl)
RESID ENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce: 726-3759
JOB NUMBER
225 Fltth Street
Sprlngfleld, Oregon 97477
TAX LOT
LOCATION OF PRO K:
\ASS
LOT
ESSORS MAP:
"3'7 BLOCK:SUBDIVISIO
LOWN
ADDR
CITY:STATE:
NE:
ZlPi
OTHERDHY-DESCRIBE WORK:
NEW REMODEL
NAM AODRESS NEtEXPIRESqco
GEN
MECHAN
?WATER HEATER:
r OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN:
ZONING CODE:
, OF BDRMS
- OFFICE
LAND USE:\\
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
QUAD AREA:
r OF BLDGS:
To reqqest an lnspectlon, you
made ihe Samo worklng day,
must call 726'3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlil belnspectlons requested after 7:0p a.m. wllr be mado tho foilowrng work day.
REOUIBED INSPECTIONS
[--l temporary Etecrrlc I Rough Mechanlcal - prlor to
cover.ffi ftnat ptumblng - When ail
-_-plumblng
work ls complet€.
fl Slte lnspoctlon - To be madoafter oxcavatlon, but prlor tosettlng forms.x Rough Eloctrlcal - prlor to
covor.E.Flnal Electrlcal - Whon allelectrlcal work ls complote,
1-lUnderstabPlumbtnglEloctrlcat/ rsrtu Mochanlcal - prlor to cover. I xL Elsctrlqat Servlce - Must beapproved to obtaln perman€nt
electrlcal powor.
B Flnal Mochanlcal - When allmechanlcal work ls complele.
[Vl Foottng - After trenches are..F excavated.[l Ftroptace - prlor to factng
-
matorlals and lramlng lnsp.
|7f-5'lnat Bultdtng - When ail4 foqulrod lnspoctlons have beenapproved and bulldlng ls
completed.l-l Masonry - Stoel locatlon, bondH beams, groutlng.
EX
B
Framlng - Prlor to cover.B Foundatlon - Aftdr forms are
erocted but.prlor to concreteplacomont.
Othor
WallrCblllno lneulatton - prlor to
cover.
[-l Underground ptumbtng - prtor
-
to fllllng trench.ffif_ovwatt - prlor to raptng.
f] Wood Stovs - Aftor lnstailarlon.
l-l lnsert - After flreplaco approval
-
and lnstallailon of unlt.
ffi Curbcut & Approach - After.a forms are erected but prlor toplacemont of concrete.
B
E
K
R
tr
Undorlloor Plumblngl Mechanlcal
- Prlor to lnsulatlon or docklng.
MOBILE HOME INSPESNONS
Posl and Beam - prlor to floorlnsulatlon or decklng.[-l etocklng and Set.Up - When ail
-
blocklng ls complete.
Floor lnsulatlon - prlor to
decklng,Plumblng Connectlons - Whenhomo has been connected towater and sewer.Sanltary Sewer - Prlor to fllllng
tronch.
Slorm Sewor - Prlor to fllllng
tronch.
&Sldewalk & Drlveway - Afterexcavatlon l9 completo, formsand sub-baso materlal ln place.
Electrlcal Connectlon - Whenblocklng, set.up, and plumblngtnspoctlons havo been approvedand the home ls connecied tothe servlce panol.
lljl:rn.a,"" - Prtor to filnns l--l rence - When compteted.
Rough Plumblng - Prlor to
cover.
Flnal - After all requlredlnepecllons are approvod andporchos, sklrtlng, decks, andventlng have been lnstalted.
xI.
E E Slreet Treoo - When all requlredtreos aro planted.
PLUMBING:
\
.' ' 1,' r'':l{,
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total holght
Lot Tvoe
&''n*rd,
X
"o,nr.
-
Panhandle
-
Cul-de.sacE
1. ..rS THE PROPOSED WORK rN ThE -
HlsroBlcAL DtsTRlcfr, oR oN
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slg;edand approv€d by the Hlstorlcal
Coordlnator prlor to permlt lssuance.
APPROVED:
P.L.HSE GAR ACC'
N
S
W
E
BUILDING PERMIT
l0*7+
*(A)
ITEM
Maln
Garage
Carport
Total Value
Bulldlng Permlt Fee
State Surcharge
Total Feo
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMTT
Thls permlt ls granted on th€ express condltlon that the sald
constructlon shall, ln all respects, conform to the Ordlnanceadopted by the Clty .of Sprlngfleld, lncludlng the
Development Code, regulaflng the construcilon and use ofbulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances.
I
') B-%Rovl
Plan Check Fee:
Date Pald:
Recelpt Num
Recelved By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /2o:t.r/
Systems Oevelopment Charge ls due on all undeveloped
propertles wlthln the Clty llmlts whlch are belng lmproved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle HomE
FEE
Nq+
FT.
FT,
FT.
(c)
4.8C +
PLUMBING PERMIT
Plumblng Permlt
Stato Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert / Flreplace Unlt
Dryer Vent 3.oo
SOt
(D)
No
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMTT
Furnaco
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlned
the completed appllcaUon and do horeby cerilly that all
lnformatlon hereon ls true and correct, and I further csrtlfy
that any and all work performed shall be done ln accordance
wlth tho Ordlnances of the Clty of Sprlngfleld, and the Laws
of the Stato o[ Oregon pertalnlng to tho work descrlbed
horoln, and that NO OCCUPANCy wlll be made of any
structure wlthout permisslon of the Bulldlng Safety Dlvlslon.
I further certlfy that,only contractors and employees who
aro ln compllance wlth OFIS 7O1.OSS wlll bo used on thls
prolect.
I further agreo to ensure that all requlred lnspectlons are
requested at the proper tlme, that each address
from tho streot, that the permlt card ls located
o
Date
ls readable
the front
at all mes durln
set ofof the property, and the a I remaln
MISCELLANEOUS PERMITS
Total Mlscellaneous Pormlts (E)
s
Demolltlon
Surch
MobllE Home
State issuance
State Surcharge
Sldewall
Curbcut
ke55,rslr,,
rt
TOTAL AMOUNT DUE (excludlng electrtcat
(A, B, C, Q and E Gomblned)
VALIDATION:
RECEIPT NUM
DATE PAID
AMOUNT RECE
RECEIVED BY
3l
I r': "r'
ffiffiw
I
AllACLII"IENT 81
JOB NO.71rvl7
CITY OF SPRINGFIELD SYSTEMS DEVELOPI..,IENT CHARGE
t^lORKSHEET
(COMMERCIAL & RESIDENTIAL)
NA},IE OR COHPANY
LOCATION:tr,b 5 i2
DEVELOPI,IENT TYPE 5FD
BUILDING SIZE OT SIZ Fr.
1 . STORM NRAI NAGF
IMPERVICUS SQ. FT 23 68 X $0.209 PER SQ T
2. SANITARY SFlrJFR-CITY
Y X $43.26 PER PFU
3 . TR.ANSPORTATl ON
NO OF UNITS X TRIP RATE X COST PER TRIP
x /,0/ x $436.19
x
-
x s436.i9
o.
x _ x s436.19 c
D
SUBTOTAL (ADD ITEMS 1,2. & 3)$
1. SANTTARY SFHFR-I'4I/JMC
I,JO. OF PFU'S r $17.19 PER PFU + S10 }4t^lt'lc ADi'ilN.FtE s "/7. /2(Use PFU Total From item 2 Above)
HI,IMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL.I'1I^IMC SDC
6A
SUBTOTAL (ADD ITEMS 1.2.3 & 4) S /42r,76
5. ADl',lINISTATIVF FFFS
BASE CIIARGE (SUB A\ABOVE) X .05
Date: Z/e
ary
SDC Coordi
NO. OF PFU'S
(See Reverse)
$
i9
82. SDC
8.ct
TOTAI SDC $ 2 ofF.77
/n/
/
FTXTURE UNIT CALCULP-
(NOTE: For remodels, calculate only the
FIXTUBE TYPE
3N TABLE: NumUer of New Fixrr, X Unit Equivalent = Fixture units
NEI additional fixturesl
NUMBER OF
NEW FIXTURES
L
UNIT
EOUIVALENT
FIXTURE
UNITS
4
Z
-
--'.)c
.)a-
v
Bathtub
/Head
2
1
2
3
6
2
6
6
1
3
2
1
2
2
1
6
4
I
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)"""
n"*p,"t For RefrigeratorMater Station/Etc
n"""p,ot For Commercial Sink/Dishwasher/Etc"
Shower, Single Stall"""""
Shower, Gang'......'
iinf.t gut, Commercial, Residential Kitchen""
Urinal, StallflVall..l
Wash Basin/LavatorY, Single"'
Toilet, Public lnstallation'
Toilet , Private....
Miscellaneous: ,T' Nt toR's s/Hk
TOTAL FIXTURE UNITS
CREDIT CALCULATION TAB LE: Based o n assessed value. lf improvements occurred after annexation date in table,
calcul ate credits seParates.
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
3,f6 x $/ D. cra-a 3y'.60
(Rate X Assessed V alue)x$
(Rate X Assessed V alue)
CREDIT TOTAL - $Jl.6a
Year
Annexed
Rate per $1,OOO
Assessed ValueYear
Annexed
Rate Per $1,OOO
Assessed Value
i 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
0.61
o.44
0.15
1979 or bef ore
1 9BO
1 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
?
2
OREGOA'c,'TY OF SPR"t'G
approval.
225 FIWfl STREBT
SPRINGFIEI.D, OREGON 974
INSPECTION REQUBST | 72641@tzed
OFFICE: 726-3759
1 LOCATION OF
JOB DESCRTPTION,{/,h))) ,i Z
Permits are non-transferable and exy'lrreif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CO}IIRACTOR INSTALLATTON ONLY
Electrical Contractor
Address A ad S*p:e
Ci ty /nJp Phone [,-lf,--Jt.1?
Supervisor Lieense Number ICC:S
Expiration Dare lD- t_q
Expiration Date L]-{ -q5
Signature of Superv lsL ng Electrician
0vners Name
Address
Ci ty Phone Z4q- 6gd<_
OgNER TNSTALLATION
The installation is being made onproperty f ovn vhich is not intendedfor sale, Iease or rent.
0vners Signature:
DATE:
roquire land use
1000 sq.ft. or Iess
Each additional 500sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or FeedersInstallation, Alterationsor Relocation:
c
D.
E
SPIII,{G..ELrl
BLB TRICAL PERilIT APPLICATIONq4\%1
3.
A
)
City Job Number
New Residential-Single or
MuIti-Family per dvelling unir.
Service Included:
f tems
-L
2-
%
*o
Cos t
$ 8s.00
$ ls.00
$ 40.00
Sum
/s,f.m
77r
B
r.)200 amps or less
201- amps to 400 amps
40L amps to 600 amps
-601 amps to 1000 amps-over 1000 amps/volts
-Reconnect 0n1y
$ s0.00
s 60.00
$100. 00
$130.00
s300. 00
$ 40.00
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps or less $ 4O.OO201 amps to 400 amps
-
$ 55.000ver 40L to 600 amps
-
$ 90.000ver 600 amps or 1000-6T[s see rrgrr
"ffi
Branch Circuits
Nev, Alteration or Extension per panel
One Circuit $ 35.00Each AdditionalCircuit or vith Serviceor Feeder permit _ $ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting-Limited Energy/Res
-
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Admlnistrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
s 36.00
5
RECXTyED *af
4b7,4"
SCBBDTILE BELOV
Constr Contr. Number lrRl