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Home My WebLink AboutPermit Building 1995-03-20SPR!NGFIE RESIDENTIAL PERMIT APPLICATION lnspections:726-3769 Of fice: 726-3759 LOCATION OF PRO .vz JOB NUMBER 225 Fifth Street Springfleld, Oregon 97477 TAX LOT: WORK:5 (fr ASSESSOBS MAP: LOT:BLOCK:SUBDIVISION To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested belore 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS ,/z (5i:t"'"- Arter trenches are Temporary Electrlc Slte lnspectlon - To be made after excavatlon, but prior to settlng forms. Underslab Plumblng/ Electrical / Mechanlcal - Prior to cover, Masonry - Steel locatlon, bond beams, groutlng, Foundatlon - After forms are erected but prlor to concrete placement. Underground Plumblng - Prior to fllllng trench. Unde - Prior Post and Beam - Prior to floor lnsulation or decking. Sanitary Sewer - Prior to f illing trench. Water Llne - Prlor to filllng trench. Rough Mechanlcal - Prlor to1*s f ,/. ,H;*',: Flnal Plumbing - Whcn all plumbing worl( ls complete. Flnal Electrical - When all electrical work is complete. Final Mechanical - When all mechanlcal work ls complete. Flnal Building - When all requlred lnspectlons have been approved and bullding is completed, Other Electrlcal - Prlor to Electrlcal Servlce - Must be to obtaln permanent ectrlcal power. Flreplace - Prlor to faclng materlals and framlng lnsp. Framlng - Prlor to cover. Wall/Celling lnsulatlon - Prlor to cover. Drywall - Prlor to taplng. Wood Stovo - After lnstallatlon, lnsert - After flreplace approval and lnstallatlon oI unlt. Sidewalk & Drlveway - After excavatlon ls complete, forms and sub-base materlal ln place. I Treos - When all requlred aro planted. ,e X., K, E E .E B EE ,K ,B l\'l Floor lnsulatlon - Prior tolA.decKlng.fp['Curbcut & Approach - AfterR(orms are erected but prior toplacement of concrete, r'^ f'-'*(s-ztt) 15 AeeEPfED /3y ?uE, MOBILE HOME INSPECTTONS Blocking and Set.Up - When all blocklng ls complete. Plumbing Connecllons - Whenhome has been connected to water and sewer. Electrlcal Connection - When blocking, set.up, and plumbing lnspections have been approved and the home is connected to the servlce panel, Flnal - After all required lnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled. K Ki':tl,Sewer - Prior to rirrins N, K BEMODEL ADDITION DEMOLISH OTHER PHONE: /-),l?_92 ztPSTATE: 4r '2,, x-1- 7r'rzr 7d DESCRIBE WORK NEW CITY: ADDRESS: OWNEB: PHON ER4*2 -76 ADDRESS 2 c-), CONTRACTOR'S N GENEBAL: PLUMBING: MECHANICAL: ELECTRICAL: c/6 / z CONST. CONTRACTOR # 3RISz .M\\\ t - OFFICE USE - * OF UNITS: LAND USE: BANGE:WATER HEATER: r OF BDRMS: OUAD AREA: I OF BLDGS: CONSTR, TYPE: HEAT SOURCE:SECONDARY HEAT: SQUARE FOOTAGE: FLOOD PLAIN: ZONING CODE ,X-Hrl"',: Ptumbrns - Prior to @:: ^/r/u EE fl r l-l Fence - When completed. Z,< OCCY GROUP: I OF STORIES: Lot faces Lot sq. ftg. Lot coverage Topography Totat helght LLto tus2 < 2/?o l/ Lot Typx' tnterior _- Corner __ Panhandle __ Cul.de-sac I lS THE PBOPOSED WORK TN THEHISTORICAL DISTBI CT, OR ONTHE HISTORICAL REGISTER? lf yes, this appllcailon must be signedand approved by the HistoilcatCoordinator prior to permit issuance. APPROVED: PL.HSE GAR ACC N 7 S /?-/z2/ E /s X $/SQ. FT. = VALUEQ 2- C/S?/ ?, " v;;> State Surcha re" 4),4,t f /Z? 7 BUILDING PERMIT SQ. FT. Total Fee 44 /'zz(A) ,/qde ITEM Main Garage Carport Total Value Building permlt Fee ?3<> _fuz9 3272 Thls permit is granted on the express condiilon that the saidconstruction shalr, in alr respecis, """i"r,n'i" tne ordinanceadopted by the ",y ,:l spii,rsii"ij, incrudins rheDeveropment code, regurating in" Jonltrl"tton and use ofbulldlngs, and may be suspendeO o, ,"roteo at any tlmeupon violation of any provisions of ""fa orJinances. Pran check r.e, 24 5)g 9- ewed ByPlan 3 ZiZ BUILDIN G AND BUIL J,flb'Ftfihn] cHEcK Fleceived Date Pald: Recelpt Number: EMS DEVELOPMENT CHAR GE (SDC) fs a?z,t-t(B) SYST Development Charge is due on all undevelopecls within Ure City limits which are being lmproved. Systems pro pertie ITEM Flxtures Flesidenrtat Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT No /2 80(e. /72 yo FEE FI FT. FT. o.fr Plumbing permlt StateSurcharge EE* Total Charge {60 (c) Wood Stove/ lnsert/ Flreplace Unit Dryer Vent MECHANTCAL PERMIT ,3 ea state surcharge 1/fa .b7 4/,s'Total Permlt (D) 4at ,. J F,?,Ia@Mechanlcal Permlt lssuance /e:! ??z Furnace Exhaust Hood Vent Fan itu7. g; ?)o= //s,"o{2 5.7s /otu# MMENTSc const tlon. that the permlt card ls located ls readable at the front du ADDITIONAL ns are Date and approved set of plans wlll remaln lned t all rtlfy lnce .aws lbed any ;lon. who thl s Bys the , lnfor that wlth of tl here stru( lfur are I prolr lfur requ from the street, of the property, on the slte at al Xgn^ru,. MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sidewatk @2 t curbcur A/A ,, Demolitlon State Surcharge Total Miscellaneous Permlts (E) ,<40 /vl ' Ca VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVEDTOTAL AMOUNT DUE (excluding electrical) (A, B, C, 4 and'E Comblned)RECEIVED BY /Aa 6/ - -- - 2 N0 /o SPr- ,aGFIELD as submitted ha6 the iequire sPeci{ic land 225 FIFTE STREET SPRINGFIELD, OREGON INSPECTION REQTIEST: Zon }a OFFICE: 726-3759 1. LOCATION OP INSTAILATION I.,EGAL DESCRIPTION JOB DESCKTPTION 2. COMRACTOR ONLYINSTALI,ATI Electrical Contractor de> Permits are non-transferable and expire ii vottc is not started vithin 180 days of ii"u."ce or if vork is suspended for 180 days. ELECTRICAL PERHIT APPLICATION sisnature-N \* ttry ,ob Nurnber z 3. COMPIATE FEE SCEEDIILE BELOII A. Nev Residential-Single or lluf t:.-f'rri1Y Per dvelling unit' Service Included: I tems Cos t $ Bs.oo1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Manuf'd Home' or Modular Dvelling Service or Feeder s 1s.00 Dale 97 477 726rgw9z"d Sum Addres pnone ?? 7 7/7ct rvisor License Number cd Expiration Date Constr Contr. Number lotOAa Expiration Date Signature rv ing Electrician Services or Feeders InstalIation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPs - 401 amps to 600 amPs - 601 amps to.1.000 amPs over 1b00 afips/volts -Reconnect 0niY B $ 40.00 $40 pil"L"' Z/^z,r'$ s s $ 00 00 00 00 00 00 50. 60 100 130Ci ty Supe Ovners Name S3oo c.Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less - $ 40.00 20L amps to 400 amps - S 55.00 over 401 to 600 amps - $ 80.00 Over 600 amps or 1000 voT[s see I'8" y'g.oo --- aEove OSNER INSTALI.,ATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. 0rners Signature: DATE: Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Serviceor Feeder Permit s 35.00 $ 2.00 E Miscellaneous (Service/feeder not included) D. Branch Circuits SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL Address Ci ty Phone -Each installation Pump or irrigation $ Sign/outline Lighting- S Limited Energy/Res - $Limited Energy/Comm $ 40 40 20 36 00 00 00 00 oo5 RECETVED 'z ,/ zo CITY OF OREGOA', SPFlIN^TIELO 225 FIFTE STREBT SPRTNGFTELD, OREGON 974 INSPECTION REQUESTz 72 OFPICE: 726-3759 1. LOCATION OF ,ALLATION acl. I,EGAL /s,CT6n JOB DESCKTPIION //t-)na /)/irt ) 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. COI.ITRACTOR INSTALI.ATTON ONLY Electrical Contractor Phone Supervisor License Number 57) Expiration Date o -7f Constr Contr. Number 2227 Expiration Date Sigua ture of SuPervising Electrician Ovners Name s Address Ci ty-Phone OVNER INSTALI.-ATION The installation is being made on property f ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: foll tl{,e ELECTRICAL PERHIT APPLICATION City Job Number Q {a >5& 3. COHPI,ETB PEE SCMDIILE BETOV A- Nev Residential-Single or Multi-FamilY Per dvelling unit' Service Included:Items Cost i #,,',9:"#xs::f :1 ffii :ffi 3:, f;iJH Sum eddress 22/fa //' ' & Ciry .z€..---- 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 Temporary Services or Feeders Insiallation, Alteration or Relocation 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Manuf'd Home' or Modular Dvelling Sertice or Feeder B- Services or Feeders Installation, Alterations or Relocation: C r $ 1s.oo -tf s 40.00 s s $r $r 00 30. 00 00 00 00 00 00 200 amps''or less 201 amps to 400 amPs - Over 401 to 600 amPs Over 600 amps or 1000 voTI $300. $ 40. $ 40. $ ss. $ eo. s see tt 00 00 00 B" a66TE- 50. 60. D Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit s 3s.00 $ 2.00 E Miscellaneous (Service/feeder -Each installation Pump or irrigation $ sign/outline Lighting- $ Limi ted Energy/Res - S Limited Energy/Comm S not included) 40.00 40.00 20.00 6=)5 SUBTOTAL OF ABOVE 52 State Surcharge 32 Admini.strative Fee TOTALRECEIVED /oa 61) JOB NO.d o zs2- CITY OF SPRTNGFIELD SYSTEMS DEVELOPMEI. CHARGE WORKSHEET (COHMERCIAL & RESIDENTIAL) NAJ'4E OR COI'IPANY ,, LOCATiON:23ro /Y, ,^J 5/. DEVELOPHENT TYPE:5FD BUILDING SIZE: 1. STORM NRAINAGF IMPERVIOUS SQ. FT. 2. SANITARY SFWFR-CITY NO. OF PFU'S (See Reverse) TRANSPORTATTON NO OF UNITS X TRiP RATE X COST PER TRIP x /,o/ x $436-19 x - x $436.19 x -- x $436.19 SIZE. SQ. Ft. 3 2d4 X $0.209 PER SQ. FT. s lobq.64 X $43.26 PER PFU s E2/,?4 3 s /,to.f s- $ $ SUBTOTAL (ADD iTEHS i.2. & 3) SJq3?42 4. SANTTARY SFWFR-MWMC NO. OF PFU'S(Use PFU Total lF rom Item 2 Hl^lMC CREDIT IF APPLICABLE (SEE REVERSE) T0TAI -Ml.l},{C SnC SUBTOIAL (ADD ITEMS 1.2.3 & 4) 5. AI]MINiSTATIVE FFFS L2lGW BASE CI{ARGE (SUB ABOVE) X .05 s t t 3 .44 Ha 7-7s- $17.19 PER PFU + $10 Ml,'|MC AOMIN.FEE Above) s 7rG.c SDC 82. SDC i nator E Da te:3- TOTAI SI]C $ 2ZV2.r 7 /7 FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Unirs (NOTE: For remodcls, calculate onl'-- e NET additional fixturesl NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS Bathtub..... Drinking Fountain.... Ftoor 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 Refrigerator/lVater Station/Etc Beceptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Sta|I.......... Shower, Gan9........ Sink: Bar, Commercial, Residential Kitchen.. Urinal, StallAl/al!..1.... Wash BasinAavatory, Toilet, Public lnstallation. Toilet , Private....)-F- Miscellaneous:.tTl*roek *at TOTAL FIXTURE UNITS t7 I < "z 3 ead 2 1 2 J b 2 6 6 1 3 2 11H 2 2 1 6 4 1 CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, calculate credits separates. Year Annexed Rate per $ 1,OOO Assessed Value Year Annexed Rate per $1,OOO Assessed Value 1979 or before 1 980 1 981 1982 1 983 1984. 1 985 $3.46 3.38 3.32 3.21 3.O6 2.92 2.73 1985 $2.46 1986 " 2.14 1987 1.77 1988 7.37 1989 0.97 1990 0.61 1991 o.44 1993 0.1 5 Credit for Parcel or Land Only lf Applicable lmpiovemdnt (if after annexation datel x $-- (Rate X Assessed Value)x $_- (Rate X Assessed Value) CREDIT TOTAL $a I I I - 44/.--,1-r/"*," t Willamalane Park & Recreation District NAA4E SYSTEMS DEVELOPMENT CHARCE W.ORKSHEET . fob No. '160 afa n(1.4!b0 ADDRESS:fl.91, (lJ, 'D'c*srArE: 9L =,,41411 LOCATION OF FROPOSED BUILDING SITE: NI . 4TUStre€t Address if Known:Lht0 Plan Name:TVLtt- *nm Tax Lot Number:11 0'lr 0ooo ot6oo 1 B. Single Family - Attached NO OF UNITS C. Multi-Family Apartment NO OF UNTTS X $277 pER UN|T = D. Manufactured Home park NO OF UNTTS X $2S0 pER UNrT = WPRD SDC 2. sDc cREDtr (rf-applicable) sDC-payer must furnish proof of WpRD creditapproval. See SDC Credit Worksheet. $ $ $4oo,n 3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credit) DEVELOPMENTTYPE (Chect appropriate dwellingG). SDC Calculations and dwellingtype definitions are on the baclc) A. Single Farnily - Detached I Single Family home NO OF UNITS t Manufactured home not in a park X $400 PER UNIT;. ti. X $370 PER UNIT = 4u n $ $ $ $ nmmrrnitrr (,<rr\n l-)atc za .r 0n