HomeMy WebLinkAboutPermit Building 1995-05-26SPllI]tGFIELE,
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PBOPOS
ASSESSORS MAP:
o rJ/ Colpr
JOB NUMBER
225 Fif th Street
Sprlngf leld, Oregon 97477
TAX LOT:
SUBDIVISION l,/t r'Jc-n:-s n'11
e
R
LOT:+BLOCK
3'r', vlnr,,*ilr J,t Qltu. Soei*rt, ur fl'l)E'i?*o*u ,,,r/',7 -,Tf; Z, A
STATE:ZIP:o&CITY:€ 0q e*/e'
ADDRESS:
OWNEB:
76* .:. -ile,*c.A
NEW t/ REMoDEL ADDtloN DEMoLtsH orHER
rL v/coD 5 r hc*r)aflDESCRIBE WORK:
ADDBESS EXPI RES PHON E
/.? 7'-scI z.r-,D;)ilt"
CONTBACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTBACTOR #
GENERAL:
PLUMBING
€,{atuL
\tu
lltl
a<
- OFFICE USE _
LAND USE:
WATEB HEATER:
FLOOD PLAIN
RANGF.:
ZONING CODE:
r OF BDRMS:
I OF UNITS:
QUAD AREA:
I OF BLDGS:
OCCY GROUP:
r OF STORIES:SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requestecJ before 7:00 a.m. wilt be
made the sante worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
E
x'
tr,
x.
X
K
X
.X
,J<"
K
x
w
tr'
l-l Temporary Electrlc
Site lnspectlon - To be madc
af ter excavatlon, but prlor to
settlng forms.
Underslab Plumblng / Electrlcal /
Mechanlcal - Prlor to cover.
Foollng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumblng - Prior
to fllllng.trench.
Underll echanlcal
- Prl or decklng
Posl and Beam'- Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon * Prlor to
deckl ng.
Sanltary Sewer - Prlor to f llllng
trench.
Water Llne - Prlor to filling
trench.
Rough Mechanlcal - Prlor to
cover.
Rough Electrical - Prior to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and f ramlng lnsp.
Framlng - Prlor to cover,
Wall/Celllng lnsulallon - Prlor to
cover.
Drywall - Prlor to taplng.
Wood Stovo - After lnstallatlon.
lnsert - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Sidewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base materlal ln place.
l\{ Final Plumblng - When aillaplumbing worl< is complete.
Flnal Electrical - When all
electrical work is complete.
Final Mecharrical - When all
mechanical worl< ls complete.
Final Building - Wherr all
requlred lnspections have been
approved and building is
completed.
Othcr
MOBILE HOME INSPE TIONS
Blocking and Sel.Up - When att
blocklng ls complete.
Plumbing Connections - When
home has been connecteci to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
lnspections have beon approved
and tl're home ls connected to
the service panel,
Final - Af ter all required
inspectlons are approved and
porchcs, sklrtlng, decl(s, and
ventlng have been lnstalleci.
X-
ldStorm Sewer - Prior ro fillingj4rench.
g
X l-l Fence - When completed,
[Vnougt Plumblng - Prlor to ffi StreetTress - When all requlred,lAcover. (!/ trees are planted.
mbln
q
r
tl
E
tl
tl
ii.
i,'i :,'
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Tyf
- t. ln,"rio,
-
Corner
-
Panhandle
-
Cul-de-sac
Se IS THE PROPOSED WORK IN THE ,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgnedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPFIOVED:
ee>
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt is granted on the express condltion that the saldconstructlon shall, in all respects, conform to the Ordlnanceadopted by the City of Springfield, includtng theDevelopment Code, regulating the oonstruction and use ofbuildlngs, and may be suspended or revoked at any tlmeupon violation of any provisions of sald ordlnances.
Plan Check Fee;
Date Paid F6o,*
Fleceipt Num
Rec ei ve
ar.fr
Revlewed
Systems Developmcnt Charge is due on all undeveloped
properties within ilre City limits which are being lmproved.
ADDITIONAL CO MENTS
?-rtk
v:
_r
P.L,HSE GAR ACC
N /2
S /./-
2G
E /*2S
/ g.3r* 2,2 /
(A)
/42_
Carport
Garage 2d
X $/SO. FT.?<
f;2 p 2,--+-/4+-/_ZL
?a,o@4e
33,'f?
Total Value
Building Permit Fee
State Surcharge
Total Fec
BUILDING PERMTT
ITEM SO. FT.
Main a
-;
= VALUE<ztr
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)<t 97
state surcha ro. y'{6 +iL? 4
FEE
A, zo//.
Plumblng Permit
?o
Total Charge (c)
FT.
FT.
No/Rcsidential Bath(s)
FT.
PLUMBING PERMIT
ITEM
Fixtures
Sanilary Sewer
Water
Storm Sewer
Mobile Home
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
Vent Fan No /
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit 2/lO,
lssuance
State Surcharge r?f *, {f
Total Permit (D)
7ao
4,{o_-7--
"/a
LO
/,zo
/ooo
@
By slgnature, I state and agree, that I have caref ully examlned
the completed appllcatlon and do hereby cerilfy that all
lnformatlon hereon is true and correct, and I f urther ceril{y
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Lawsof the State of Oregon pertalnlng to thc work descrlbed
hereln, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Building Safety Divislon.
I further certlfy that only contractors and employees who
are ln compliance with ORS 701.055 wlll be used on thls
Prolect.
I further agree to ensure that all requlred inspections are
requested at the proper tlme, that oach address ls readable
from the street, that the permit card ls located at the front
of the property, ant the approved set of plans will remaln
on the site at all times during consirucilon.'
Date 5
sr?f,,"tu ti.,4
'7-l,t--,L,1,
MISCELLANEOUS PERMITS
Total Miscellaneous Permils (E)
rge
70
s
Demolition
te Surc
Mobile,Home
State lssuance
Statc Surcharge
/a aJ/ a.Sidewal
Curbcu t
xELn
/b ,,
a ^!o
TOIAL AMOUNT DUE (exctuding etectrtcat)
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER "l { j"7-.0r
DATE PAID ZQ,)
AMOUNT RECEIVED / '/'
RECEIVED BY
/ (J-.
',, -1.:tl
3-.-
S-
B N0. 75o5oo
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0MMERCIAL & RESIDENTIAL)
NAME OR COMPANY:5r. Vt^tceNT De- ?4UL-
LOCAT ION:Z+1 r-{5 ry Cou er l1 ozz try t - o tbo*
LP? - t-ter,u Sfe-DEVELOPMENT TYPE:
BUILDING SIZE:
I STORM DRAINAGE
IMPERVIOUS SQ. FT
2. SANITARY El^lER-C I TY
5
K p Burd ck
OT SIZ
11 b x $0.209 PER SQ. FT
X $43.26 PER PFU
Ft
$
$
+q4
$t +1Ab9
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
1 x l.ol x$436.1e
X x $436.1e
x _ x $436.19
4. SANITARY SEl^lER-MWMC
NO. OF PFU'S
(Use PFU Total From Item 2 Above)
Mt.lMC CREDIT IF APPLICABLE (SEE REVERSE)
$17.19 PER PFU + $10 MI,JMC ADM FEE $l ao oa
ll-
tl
TOTAL-MI.IMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .05
+a59
SDC Coordinator
Date: 4 15
TOTAL SDC s lb52 5V
..: i., t. .
FIXTURE UNTT'CALCUTATI.oN 'TABLE: NUMbCT Of NEW FiXtUTCSO'UNit EqUiVAICNt
(NOTE: For remodels, calcutatJ only th :f additional fixturesl. NUMBER OF UNIT
FIXTURE TYPE NEW FIXTURES EOUIVALENT
:.Fixture Uoits _
FIXTURE --
UNITS
Z
Bathtub--..-2
1
2
6
2
6
6
I
2
1
2
2
1
6
4
Drinking Fountain..---.
Floor Drain-
lnterceptors For Grease/Oil/Solids/Etc-- - - - - - - - - - -- - -- -
lnterceptors'For Sand/Auto Wash/Etc. -- " " " " " " "'
Laundry Tub/Ctotheswasher- - -. - -
Clotheswasher - 3 Or More.-..-
Mobile Home Park Trap (1 Per Trailer) ----.-
Receptor For Ref rigerator/Water Station/Etc. - - - -...
Receptor For Commercial Sink/Dishwasher/Etc..
Shower. Single Statl....-....-
Shower, Gan9......... .--....'..:'.""'
Sink:Bar,Commercial.ResidentialKitchen....
Urinal, StallAl/alt...
Wash Basin/LaVatory, Single.......--
Toilet, Public lnstallation.
Toilet , Private...-.
Miscellaneous
2-
lHe ad z
t
+
TOTAL FIXTUfIE UNII:J
CREDIT CALCULATION TABLE
calculate credits separates.
Based on assessed value. lf improvements occurred af ter annexa tion date in table,
Credit for Parce[ or Land Only lf Applicable
lmprovement (if after annexation date)
XS l2.t2
(Rate X Assessed Value)
v
x $.--
+t 14
$+I cr4
(Rate X Assessed Value)
CREDIT TOTAL
Year
Annexed
tfate per $ 1,OOO
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
't9BO
1 98l
1 982
1 983
1 984
1 985
$3.46
,10
.) a.)
3.21
3.O6
2-92
2.73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$ 2.46
2-14
1 .'t7
1-3-1
o.97
0.61
o.44
o.15
I
t\
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CITY OF SPR OFEGO'V
1; ofrb
225 FIPTE STREET
SPRINGFIEID, OREGON 97
INSPECTION REQUEST: 7
oPEICE: 726-3759
ffi#q
SPRI. JIELO
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
Sertice or Feeder
The following Proiect as submitted has the folioMng
iljlritri, ,ilii?5irE'not require specilic lanrj trso
approval.
lf/49T0#
BLECTRICAL PEru{It APPLICATION
Job Nunber q m%0D
3. COHPLETE FEE SCEEDTILE BELOV
A Nev- Resident ial-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost
1 OP
t?C,+Sum
{5
IS-L
-L
$ 8s.00
40.00
55. O0
80.00
ee I'Btr aE66
JOB V^i1'/ /ryJ,U/
Supe sor License
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. CONTRACTOR INSTALI..ATION ONLY
Electrical Contractor K fl"**;
Address (o1<t "C^vt^ (,&
ci 7y/ad63wSffis
Expiration Date D
Constr Contr. Number
Expi ration Date l/rt ) q
Signa ture pervi Electrician
Ovners Name
Phone
OVNER
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vners Signature:
DATE:
s 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or I
201 amps to 4
40L amps to 6
601 amps to L 000 amps_
Over 1000 amps/volts
Reconnect Oniy
Temporary Services or Feeders
Installation, Alteration or Relocation
B
c
s s0.00
s 60.00
s100.00
s130.00
$300.00
$ 40.00
ess
00 amps
(
s,!
3r
\\
ss
\:
V
ai
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amPs
Over 600 amps or 1000 voTEs
s
s
$
s
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. 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
3Z Administrative Fee
TOTAL
Ad
Ci
sdres
vt
$ 40.00
s 40.00
$ 20.00
s 36.00
n)5
RBCETVED
P) >n>
<,
Willamalane
Park & Recreation District
$u .Dnool*D'S,*l.NAME
ADDRESS:
LOCATIO N OF FROPOSED EUILDING SITE:
Stre€t Address if Known:
Platt Name:Tax Lot Numbec
NO OF UNITS X $370 PER UNIT =
C. Multi-Famity Apa(ment
NO OF UNITS X $277 PER UNIT =
D. Manufactured Home Park
' NO OF UNITS X $2S0 PER UNIT =
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
lob No.
0 -r,, qMAL
4[0.00
PHONE:
1 oeVelOpnttrgf fype (Chect appropriate dwellingG). SDC Calculations and dwelling type
definitions are on the baclc)
A Single Family - Detached
I Singte Family homeI
Manufactured home not in a Park
NO OF UNITS
B- Sinele Familv - Attached
I x g4oo PER UNlr -=.$
- $_
$
$
00
WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worlcsh*t
3. TOTAL WPRD NEf SDC ASSESSED (lf SDC reduced for Credit)
$
fn-^.,rait r (nnrinnr Date
$
AD
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