HomeMy WebLinkAboutPermit Building 1995-05-24RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED K:
ASSESSORS MAP:
LOT I
SPRII\rGFIELD
BLOCK:
.JOB
NUMBER
2fr,
225 Fif th Street
Springfleld, Oregon 97 477
TAX LOT:
a
SUBDIVISION
ztP:oASTATE:
PHONE:8z -Sfrk)5T. t,/rilr*tlr \n:Sp**rr", ct€ L#')ef,^OWNER:
ADDRESS:
CITY:
t-€x- SrolzDESCRIBE WORK:Zmo
DEMOLISH OTHERNEW y' REMoDEL ADDtloN
ELECTRICALT _
ADDRESS EXPIRES PHON ECONTRACTOR'S NAME
MECHANICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
E_
Vlt)
?t
,wu -o
WATER HEATER:
ZONING CODE:
* OF BDRMS:
RANGE:
* OF UNITS:
LAND USE:
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
,+ OF STORIES:
QUAD AREA:
r OF BLDGS:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recording. All lnspections recluestecl before 7:00 a.m. will be
made the same worklng day, lnspectlons requested after 7:00 a.m. will be made the followlng work day.
REQUIRED INSPECTIONS
,K
&
Temporary Electric
Site lnspection - To be made
after excavatlon, but prior to
settlng forms.
Underslab Plumblng / 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 Plumbing - Prlor
to filllng trench.
Rough Mechanical - Prlor to
cover.
Framlng - Prlor to cover,
Wall/Celling tnsulatlon - Prlor to
cover.
Drywall - Prlor to taping
Wood Stove - After lnstallatlon.
lnserl - After flreplace approval
and lnstallatlon of unlt.
Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base materlal in place.
[-l Fence - When completed
Trees - When all requlred
trees are planted.
Final Plumbing - When allplumblng worl< is complete.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.Vf Electrical Service - Must beJA{approved to obtain permanent
'electrlcal power.
l--l Fireplace - Prlor to factng
-
materlals and framlng lnsp.
Xx
K
X
K
"E
X
,X
X
,x
"KlFinal Building - When ail
requlred inspections have been
approved and building is
completed.
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When att
blocking ls complete.
P.lumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - Vy'iren
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel,
Final - After all required
inspections are approved andporches, skirting, decks, and
venting have been installed,
Xvg:lxtrffir,T::rtff:
F(7Post and Beam - Prior to floorJA{ lnsulatlon or decklng.
fi7 Ftoor tnsulation 4 Prior toJA\decxlng.
ffi Sanitary Sewer - Prior to filling
Atrencn.-
EI ,lT;.Sewer - Prior to rllrins
[Vt Water Llne - Prior to fillinglzA\trench.
ffi RouOh Plumbing - Prior to
'----\cover.
€-r ).zet l€
lt FLOOD PLAIN:
Rough Electrical - Prior to
cover.
l--l otner
rl
E
tl
-!,irr 1;r' .rl -
.l I
Lot faces
Lot sg. ftg
Lot Ty
-
lnterior
y' corn",
ks r lS THE PROPOSED WORK tN THE -. HISTORICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
42^ o
Lot coverage 452
roposraphy 4Z?,
Total height $i -
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N 24 4
S 20
/o
E /o
lye
23 {r*/4?'
(A)
X S/SO. FT.
<F- UL
Main
Garage
Carport
= VALUE
/azl/Ze
'9a2?.aa
//#22.">
4.f ao
?^{1
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ, FT.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the expre6s condition that the said
construction shall, in all respects, conform to the Ordinance
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.
Plan Check e.u, 5O1.89
Date Paid:
Fleceipt Num
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC),b
(B)#u,q n7l2/
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
state surcharse q./z * €y'7
PLUMBING PERMIT
FEE
Plumbing Permit wTolal Charge
0 J@/3
FT.
FT.
FT.
(c)
AD ITIONAL CO MENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
_1eP
State Surcharse /.OS+ ,O3
Total Permit
Z
a_@
2_/d'2
(D)
6e
No2
MECHANICAL PERMIT
Qao
6o-o
Mechanical Permit
lssuance
Fu rnace
Exhaust Hood
Vent Fan
?) d64)< |
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certify that all
lnformatlon hereon is true and correct, and I f urther certity
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Bullding Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card is located at the front
e approved set of plans will remain
st ct
Y,
Date
es during
\Z-
/Signature
of the propert
on the site at
MISCELLANEOUS PERMITS
Mobile.Home
State lssuance
State Surcharge
sidewark /2O n
curbcut 3t - n
Demolition
State Surcharge
Total Miscellaneous Permits (E)
0s
oo
&os
TOTAL AMOUNT DUE (exctuding electricat)
(4, B, C, D, and E Combined)3?{
ot'?-s o t
5AMOUNT REGEIVED
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBEH
/?aa
&S
4*tq-
"{
I
3 N0. 15o+18
CITY OF SPRINGFIEIJD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0I'IMERCIAL & RESIDENTIAL)
NAME OR COMPANY:5r. Vt*ce Lr r TX- ?A,,ru
LOCATION:. b5r!bt-
DEVELOPMENT TYPE : LDK E^I DUPLr-r'
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVI0US SQ. FT.
2. SANITARY Et,lER-CITY
NO. OF PFU'S
(See Reverse)
SI
7 x $0.209 PER SQ. FT.
X $43.26 PER PFU
TOTAL-MI^IMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
. Ft.
'ba+
.7,
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
z x I,ol x$436.19
x _ x $436.19
x _ x $436.19
4. SANITARY SEWER-MWMC
NO. OF PFU'S
(Use PFU Total From Item 2 Above)
Ml.lMC,CREDIT IF APPLICABLE (SEE REVERSE)
$
d.)
IB22$17.19 PER PFU + $10 MI,JMC ADM FEE $7AA
a+
$ boo>t6
5. ADMIN,ISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
*:B..*A*-L Date
Kip
sDc
Burdick
Coordinator
$ brrv
$ artlL
Q
+f z+fq^
TOTAL SDC
7l
. j.,1:.
I
N.TABLE:Number of New Fixtur^X Unit Equivalent :' Fixture Units
, ET additional fixturesl
. NUMBER OF
NEW FIXTURES
(NOTE: For
FTXTURE TYPE
L'NIT
EOUIVALENT
FIXTURE -.
UNITS
-E-
L
_. r....i.,., : ..
Bathtub..---
Drinking Fountain...-
Ftoor Drain-
lnterceptors For Grease/Oil/Sotids/Etc.
lnterceptors'For Sand/Auto Wash/Etc.
Laundry Tub/Clotheswasher..-.-.
Clotheswasher - 3 Or More---.-
Mobite Home Park Trap (1 Per Trailer)
Receptor For Refrigerator/Water Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc-.
Shower, Singte Statl........-.
Shower, Gan9......... .-----.--.:...----
Sink: Bar. Comrnercial. Residential Kitchen--.-
[*1, mrffi'"",m;: :
:-: :- - :-
Toilet , Private.
Miscellaneous:
?-
L
L
L
TOTAL FIXTURE UNlTS
2
1
2
J
6
2
6
6
1
J
2
1tH
2
)
1
6
4
ead
aa
CREDIT CALCULATION TABLE: Based on assessed value- lf improvernents occurred after an nexation date in table,
calculate credits separates.
Credit for Parcel or Land Only lf Appticable
lmprovement (if after annexation date)
3,(o X S IZ,'Z 4@
(Rate X Assessed Value)
(Rate X Assessed Value)
CREDIT TOTAL _ $4t q4
x $--
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $1.OOO
Assessed Value
1979 or before
19BO
1 981
1 982
1 983
1 984
1 985
$3.46
aaa
3_32
3.21
3-06
2-92
2-73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
o.61
o-44
o.15
Z
SPAINGFIELT)
%
The {olloxing,Pro
cval.
D
nct requir':
225 FTYTE STREET
SPRINGFIELD, OREGON 97 477
INSPECTION REQUEST:726-3769
OFFICE: 726-3759
1.
PTION
EI^ECTRICAL PERHIT
;'-rr.r,a:-d0k.''Ci tY Job Number.
FEE SCffiDI.ILE BELOV
dential-Single or
Multi-FamilY Per
Service Included:
dvelling un
Items
apirr
PTION f\*/
OAC
it.
Cos t
s 85.00
s 1s.00
$ 40.00
Sum
1000 sq.ft. or less
gach addi.tional 500
sq. ft or Portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Sertice or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
P,tlCP&
&@ q)
Permi ts
if vork
of issu
re
isn
ance
non-transferable and exPire
ot started vithin 180 daYs
or if vork is susPended for
180 daYs.
2. CONTRACTOR ON OIILY
Electrical Contract r
Address
ci Phone
Supervisor cense Number
Expiration Date
Constr Contr. Number
Expiration Date
ture of Suqervising Electrician
Ovners Name
Address
Ci ty Phone
OVNER AILATION
The instalLation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
C
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/Out1ine Lighting-
Limited Energy/Res _Limited EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAL
200 amps or less
20L amps to 400 amPs
-
401- amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect 0n1Y
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less S 40.00
Over 401 to 600 amps
-
S 80.00
over 600 amps or rbOO voTTs see 'rBrr a66tt
Branch Circui ts
Nev, Alteration or Extension Per Panel
s s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
!2c!ci-
}Is
40
40
$
s
$
s
20
36
00
00
00
00
5
DECET\TFN
6)
(
A
d
Willamalane
Park & Recreation District
<,
PHON
X $280 PER UNIT =
Iob No.
qilw
E: \ott 5BZO
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
NAA4A
ADDRESS:b
LOCATION OF FROPOSED BUILDINC SITE:
]o* Address if Known:.\
Platt Name:
1
D. Manufactured Home Park
' NO OF UNITS
-l
Tax Lot Numbec
NO OF UNITS X $277 PER UNIT =
srereW zP (HDZ-
&
DEVELOPMENT TYPE (Chect appropriate dwellingG). SDC Calculations and dwelling type
definitions are on the bactc)
A Single Family - Detached
single Family home Manufactr"rred home not in a park
NO OF UNITS
B. Single Family - Attached
X $400 PER UNIT -='
t..
$
NO OF UNITS
C. Multi-Family Apartment
X $370 PER UNIT ='$
$
$
WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. Se SDC Credit worl<sheL
3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credi0
$xD.cro
d
q4DF'$
fnmar' 'nifr t \n.rtrirae f)are
$
AA I A t f\ ?6*{l-Or\.r.llF3
\\rnoonJ- ht,nt
J