HomeMy WebLinkAboutPermit Building 1995-05-24RES'DENTIAL
PERIIIIT APPLICATION
lnspectlons: 726.3769
0lfice:726.3759
LOCATION OF PROPOSED WORK:,=lqDai\31
h,
JoB NUMBEa ?5-a ?:
225 Fif th Street
Spring fleld, Oregon 97 477
TAX LOT:ASSESSORS MAP:
2.
LOT BLOCK:SUBDIVISION
CK 7.-S& zePHONE:
ztP 40otzCITY:€oaqJ€STATE:
2o,5 3, Se-l-Ez-aADDRESS:
OWNER:
NEW r REMoDEL ADDrroN DEMoLTSH orHER
b€ Je€/o0b5rrU?DESCRIBE WORK:DOO
MECHANICAL:
ELECTRICAL:
ADDRESS EXPIBES PHONE
8
CONTRACTOR'S NAME
PLUMBING:
GENERAL:
CONST,
CONTBACTOB ''
\\\\
v,
3tlw
3
@
- OFFICE USE -
-trtrT-
WATER HEATER:RANGE:
* OF UNITS:
LAND USE:
r OF BDRMS:
ZONING CODE:
FLOOD PLAIN
SECONDAFIY HEAT
SQUARE FOOTAGE:
CONSTFI. TYPEr
HEAT SOURCE:
OCCY GROUP:
r OF STORIES:
QUAD AREA:
# OF BLDGS
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recording. All lnspections requested before 7:00 a.m. witt be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day.
REOUIRED INSPECTIONS
Eleclrlc
Site lnspectlon - To be mado
after excavatlon, but prior to
settlng forms.
Underslab Plumbing/ Electrical /
Mechanlcal - Prior to cover,
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decking.
Posl and Beam - Prlor to lloor
lnsulatlon or decklng.
Floor lnsulallon - Prlor to
decking.
Sanitary Sewer - Prior to filllng
trench.
Storm Sewer - Prlor to filling
trench.
Waler Llne - Prlor to filllng
trench.
Rough Plumblng - Prlor to
cover.
w
N
ry
N
[Yl orywall - Prlor to taping?
Rough Mechanlcal - Prlor to
cover.
Rough Eleclrical - Prior to
cover.
Eleclrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Framlng - Prlor to cover.
Wall/Celllng tnsulatlon - Prlor to
cover.
ffi finat Plumbing - When allu/:t plumbing work is completc.t
[7] Final Electrical - When attLf'J electrical work is complete.
F7l Finat Mechanical - When att
T mecnanical work ls complete.
ffi Flnal Building - When ail
f required lnspections have been
approved and building is
completed.
tr
W
g
F
tr
m
N
w
tr
tr
tr
r
w
r
r
Wood Stove - After lnstallation
lnserl - After flreplace approvql
and lnstallation of unlt.
Curbcut & Approach - After
forms are erected but prlor to
placemont of concrete.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base material in place.
Fence - When completed.
Slreet Trees - When all requlred
trees are planted.
Other
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When all
blocklng is complete.
PJumbing 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 service panel.
Final - After all required
lnsPections are approved and
porches, skirting, decks, and
venting have been installed,
l./,, tt"-t t--
STt^io'^'Y
tl
tl
Etl
tl
Lot laces
Lot sq. ftg.
Lot coverage
ToPograPhY
Total heig
Lot TY
l/ lnterior
E'
Corner
..- Panhandle
-
Cul-de-sac
PROPO SED WORK N THE
IS THE
HISTORICAL DIST RICT,OR ON
THE HISTOBI GAL
It yes,this aPPlicatlon must be slgned
and approved by the Historlcal
Coordinator Prlor to permit issuanoe'
APPROVED:
P.L.HSE GAR
N a I
S
\G
E us
Total Value
Buildlng Permrt Fee
state surcharse 15,35 +1.5t
3,e I , ss.
@
Total Fee (A)
x $/so. FT.
,r42?
z9!o
ITEM
Main
Garage
Carport
SO. FT.
?=>
Gaq
VALUE
^72<*,' /r4a,
BUILDING VALUE, PLAN
lNil BtilLDlNG PERMIT
Thts permit is granted on the express condition that the said
construction shalt, in all respects, conform to the 0rdinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
ewed ByPI
Plan Check Fee:/*.r
Received By:
CHECK
Date Paid
SYSTEMS DEVELOPMENT CH TiliT,?p(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being impreved.
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
tt ag
tr.e-;F-
SO
FT.
FT.
'q
FT.
Plumbing Permit
State Surcharge
Total Charge
"t.s6 r [.1.1
(c)
PLUMBING PERMIT
ITEM
Fix t u res
ADDITIONAL C MMENTS
t
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
Vent Fan No \
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
rs.
C)^,3
Sla.
q.sa
nois{.
3?. s
Mechanical Permit
lssuance
State Surcharge
Total Permit
t .b.8 + .1?
(D)
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther cerilfy
that any and arr work performed shail be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Lawsof the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Building Safety Division.I further certify that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thisproject.
I further agree to ensure that all required lnspections are
requested at the proper ilme, that each address ls readable
from the street, that the permit card ls located at the front
the approved set of plans will remainof the property, a
on the sit
Slgnature
s
,L.4.
e at all mes during
Date
MISCELLANEOUS PERMITS
Mobile.Home
State lssuance
Slate Surcharge
Sidewalk t6 rt
curbcut I I rt
Demolition
Total Miscellaneous permits (E)&&t.ss
35ltet
tt P-rb.
r 5. ?lr
TOTAL AMOUNT DUE (excrudins electricat) &I3il= 33(A, B, C, Q and E Combined)RECEIVED BY
AMOUNT RECEIVED 31, 3a
DATE PAID
VALIDATION:
RECEIPT NUMBER
I
\)
BUILDING PERMIT
&q.
Receipt Number:_
s/rr /s sI olt6-
Not
- c4Ds.-
\ o. q82
N5.e
7 NO. ?So 4qn
CITY OF SPRINCFIET'D SYSTEMS DEVELOPMENT c:HAr.<;r
WORKSHEET
(c0mMERcIAL & RESIDENTIAL)
NAME 0R C0MPANY , 5r. ltx.eur DeTauu
LOCATION:255 A/. b5 7t+ cT. l10zV tbt - o />ob
DEVELOPMENT TYPE: LDR - NLN *FR
BUILDING SIZE:SIZ . Ft.
1. STORM DRAINAGE
TMPERVI0US SQ. FT. lgbs x $0-20e PER SQ. FT'
2 SAN ITARY Et,lER-C ITY
NO. OF PFU'S
(See Reverse)
X $43.26 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I x X$436.1e
rl
X
x
x $436.19
x $436.le
$
$
4. SANITARY SEl^IER-MI,/MC
NO. OF PFU'S I I X $17.19 PER PFU + $10 Ml,lMC ADM FEE $ lqao3
(Use PFU Tota'l From Item 2 Above)
MI.IMC CREDiT IF APPLICABLE (SEE REVERSE)
TOTAL-MI,IMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL ABoVE) X .0s
p Burdick
n!-
$ l4r(,?24
5
t5112
SDC Coordinator
Date:+f z+f qq
TOTAL SDC t5 t1
TJHY*:"Y$.[.":'tifi:',s
1
2
J
6
.2
6
6'
i
3
2
1
Receptor For Commercial Sink/Dishwasher/Etc"
Shower. Single Statl....-....-
Shower, Gan9......... ---......:'.""'
Sink: Bar, Commercial, Residential Kitchen.---..'..."'
: """"'
Urinal, Stall/Wall...
Toilet, Public tnstallation
eadIH
?-
ll
2
2
1
6
4 4Toilet , Private.....
Miscel{aneous
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE
calculate credits separates.
Based on assessed value. lf improvements occurred after annexation date in table.
Credit for Parcel or Land Only lf Applicabte
lmprovement (if after annexation date)
x $ lz.lL 44t
(Rate X Assessed Vatue)
X$
(Rate X Assessed Value)
-$iln9
3
CREDIT TOTAL
,l
Year
Annexed
Rate per $ 1,OOO
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
'1984
1 985
$3.46
, .>o
3-32
3-21
3.O6
2-92
2-73
1 985
1 986
1 987
1 9BB
1 989
.1990
1 991
1 993
$2.46
2-14
1.77
1-37
o.97
0.61
o-44
o.15
Units
ri
FTXTURE ''
UNITS
'L-
UNIT
EOUIVALENT
{
I
V
a,
Willamalane
Park & Recreation District
lob No.
SYSTE,V{S DEVELOPMENT CHARC E
WORKSHEET
NAME
ADDRESS:
LOCATION OF FROPOSED BUILDINC SITE:
Stred Address if Known:
Plaft Name:Tax Lot Numbec
1 DEVELOPMENT TYPE (Chect appropriate dwellingG). SDC Calculations and dwelling type
definitions are on the bacld
JT,l),nunJ,U-h ar0 PHoNE: \8tl-t8Z)
srer*W^, %UL
NO OF UNITS
B. Sinsle Familv - Attached
3. TOTAL WPRD NET eO (lf SDC reduced for Credit)
A. Single Family - Detached
It Single Family home Manufactr.rred home not in a park
L X $400 PER UNIT;.
t..
NO OF UNITS X $370 PER UNIT =
C. Multi-FamilyApartment
NO OF UNITS X $277 PER UNIT =
D. Manufactured Home Park
' NO OF UNITS X $2S0 PER UNIT =
$
-$
$
$
4m"o,
CD
WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Workheet
$
$
fama.,.nit'.r Dato
c
225 North Fifth Street
Springfield, Oregon 97477
PBNCB PBRUIT APPLICATION
CITY OF SPRINGFIELD
BUIIDING SAPBTY DIVISION
SP'TI'{GFIELO
Office:
INSPECTION LINE:
726-3759
726-3769
CITY OF OREGON
Job Location:7,-5; 0-i 3s-g of,
Assessors Map #:
Ovner:
rax Lot #: D/3D=
5^--\ vt ^c-o--\ D'AL, \
Address,;tD5 5 $er',--",-*
City: €y \ e.-L State: D {Z-
&o-,,
Phone *:ZDa
Zip:1o
1r-<)
Value of Fence:Fence Permit is $5.00
a^;-I V r.c---+ G,*- (}--, \Con t rac tor/Ins taller :
Address:Phone #:
Ci ty:State:Zipz
Construction Contractors Registration *:Ires:
By signing this permit/application, I agree to caII for an inspection once my
fence has been constructed (726-3769). I also stated that all information onthis applic
Developmen t
tion/permlt ls correct and that I vas provided wlth the Sprlngfield
<^?-%
Date
FOR OFFICE USE
de rements for fence standards.
ure
Date of Application:
Receipt f
Total Amount Collected:
JOB #:
Issued By:
Checked for Delinqueneies:Checked for Historical Status:
A,n,*'l* 4f- O yq7
rIELI,
aine following project as submitted hes the following
zonin*, end does not require specific lenC uso
appioval
?
225 rrrrg sTREET o*" Y'244m
SPRINGFIELD' OREGO!(ugl6Z
INSPE(f,ION REQUESTz 726-.
OFFICE: 726-3759
BLECTRICAL PERTIT
Ci ty Job Nunber
3. COHPLETE FEE SCEXDIILE BELOV
A. Nev- Residential-Single or
MuIti-FamiIY Per dvelling unit.
Service Included:Items Cost
3 69
1. LOCATION OP INST ON 2
ON v
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALI.,ATION ONLY
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs
-
40L amps to 600 amps
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect OnIY
_l_
_t_
\5
]b
Sum
Electri
Address
Ci ty 4l Phone
cal Contractor
)-
B
D.
s 8s.00
$ 1s.00
$ 40.00
00
s 100. 00
s130.00
$300.00
$ 40.00
50
60
$
s
00
Supervisor cense Number
Expiration Date
Constr Contr. Number N7*t)?z
Expiration Date ,t/fl / 'q(
Signature o Supe Electrician
Ovners Name
A Address
Ci ty Phone
OVNER
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
Temporary Services or Feeders
Installation, Alteration or Relocation
2oo amps"or ress t/ $ 19.99 @
over 4b1 to 6oo amps
-
$ B0.oo
Over 600 amps or 1b00 voTIs see rrBrr aEilE-
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0utIine Lighting-
Limited Energy/Res _Limited EnergY/Comm
C
T
\D..
\
S
E
$
$
$
$
00
00
00
0
40
40
20
5. SUBTOTAL OP ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
OREGONCITY OF SPR
RECEIVED B
L
SPRI 'IELD
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithj-n 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical contrac tr, 574Cil) )4P/t(
Address
ciry tEt a'Phone @7 -fiGZ O
Supervisor License Number
Expiration Date
C.
Constr Contr. Number
Expiration Date
Signature of rvising Electrician
Ovners Name
Address
225 ETFTH STREET
SPRINGFIELD, OREGON 97 477
INSPECTI0N REQUEST: 72f-3lffi6s6
OFPICE: 726-3759
1. LOCATION OF TNSTATI-ATION
Ci ty Phone
OVNER TNSTALT^ATION
The installation is being made on
property I ovn vhich is not intended
for saIe, Iease or rent.
Ovne Signature:
DATE:
a8 submltted has the
require speciflc land use
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amps/volts
Reconnect 0n1Y
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
ELECTRICAL PERHIT APPLICATION
1rJ rmber
3. COHPLETE FEE SCffiDTII;E BELOV
A. Nev Residential-Single or
MuIti-FamilY Per dvelling unit'
service rncLuded' ,a"*s cost
1000 sq.ft. or less S 85'00
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular DvelJ.ing
Service or Feeder
s 1s.00
Services or Feeders
Installation, Alterations
or Relocation:
The following Proiecl
zonlng, and doee not
apprwal.
\*
Sum
$ 40.00
s s0.00
s 60.00
$100.00
s130.00
s300.00
$ 40.00
00
-&.r,
Temporary Services or Feeders
Insiallation, Alteration or Relocation
above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Ci rcui t or vi. th Servi ce
or Feeder Permit $ 2.O0
E. Miscellaneous (Service/feeder not included)
-Each instalfation
Pump or irrigation
-
Sign/0utli.ne Lighting_
Limited Energy/Res
Limited EnergY/Comm
200 amps"or less l- $ 40.00
2oL amps to 400 amps
-
$ 55-00
over 4b1 to 600 amps
-
S 80.00
Over 600 amps or- 1000-tofts see rtB"
s 40.00
$ 40.00
$ 20.00
s 36.00
aOO
RECEIVED BY:
5
-7'ioz7 2a--'-7--7?
LEGAL DESCRIPTION/7;= z/ ?/ ot3o3