HomeMy WebLinkAboutPermit Building 1995-06-051_
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RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726-3759
SPrlINGFIELt)
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JOB NUMBEB
225 Fif th Street
Springf leld, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
,2
TAX LOT:o//Oa
LOT
-
BLOCK; SUBDIVISION:
-
d
PHONE:
ZIP
rL
STATE:q,LtryCITY:
ADDRESS:
OWNER:
REMODEL x ADD|IoN _*_DEMOLISH OTHER
DESCRIBE WORK:
NEW
-ADDRESS EXPIRES PHONE
-a\i A] i. ll(tr
n IA) Ntr1
CONTRACTOFI'S NAME
ELECTRICAL:
MECHANICAL:
CONST.
CONTBACTOR #
GENERAL:
PLUMBING
\
OUAD AB
- OFFICE USE -
ZONING CODE:
LAND USE:
I OF BLDGS:+ OF UNI S:
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS: --
RANGE:
FLOOD PLAIN:
OCCY GFOUP:
* OF STORIES;
CONSTR, TYPE:
HEAT SOURCEI
To request an lnspectl
made the same worklr
[--l femporary Electrtc
Slte lnspectlon - To be madeafter excavatlon, but prlor tosettlng forms.
lon, you must call 726'3769' Thls ls a24hour recordlng. All lnspectrons requested before 7:00 a.m. wlll beng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
l-l Rough Mechanlcat - prtor to N7
-
cover. / ..t
Flnal Plumbing - When allplumblng worl< ls complete.
tl Underslab Plumblng/ Electrical /Mechanlcal - Prior to cover.
fi(rootlng - After trenches are
-excavated.[l Masonry - Steet tocailon, bondlJ beams, groutlng.
fffounautlon - After forms areE\ erected but prlor to concreteplacement.
l-l Unaerground plumblng - prtor.J to filllng trench.
JjJl unaertto@uechantcatts\ - Prlor to*lnsulatlon or decklng.
ffi eost bnd Beam - prlor to ftoorHlnsulatlon or decklng.
Xf:"""-l;;suratron
* Prror to
l-l Sanltary Sewer - prior to filting
-
trench.
[-l Storm Sewer - prtor to filling
-
trench.
l-l Water Llne - prtor to fiiling
-
trench.
ffi nougtr Plumbing - prior to
/,r.apover.
Electrlcal Servlce - Must beapproved to obtaln permanent
olectrlcal power.
[-l Flreplace - prtor to factng
-
materlals and framlng lnsp.
X
Rough Electrlcal - prlor to
cover.
Framlng - Prlor to cover.
Wall/Celllng lnsulatton - prlor to
cover.
Drywall - Prlor to taplng.
Wood Stovo - After lnstallatlon.
Sldewalk & Drlveway - Afterexcavatlon ls complete, forms
and sub.base materlal ln place.
Fence - When completed
Street Trees - When all requlred
trees are planted.
Final Mechanical - When ailmechanical work ls complete.
Flnal Building - When altrequlred lnspecilons have beenapproved and building lscompleted.
MOBILE HOME INSPE TTONS
PJumbing Connectlons - Whenhome has been connected towater and sewer.
[! final Etectricat - When ailfl5:lectrlcal work is complete.
Final - After all required
ins'pections are approved andporches, sklrting, decks, andventlng have been lnstalled.
B
tr
E
E
lnsert - After flreplace approval
and lnstallatlon of unlt.
[-_l Alocking and Ser.Up - When ail.J blocklng ls complete.
Curbcut & Approach - After
forms are erected but prlor toplacemont of concrete.
Eleclrlcal Connection - Whenblocking, set.up, and ptumblng
lnspections have been approvedand the home is connected tothe service panel,
A) -a (ro,(tst
L,(^R.,e .Do '^ ,
WATER HEATER:-
[_l ottrer
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty
V rnrcrror
Corner
-
Panhandle
-
Cul.de-sac
( IS THE PFIOPOSED WORK IN THE -. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? -_-
lf yes, thls applicailon must be slgnedand approved by the Historical
Coordinator prlor to permlt issuance.
APPFIOVED:
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 all work performed shall be done ln accordance
wlth tho Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
herein, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Bullding Safety Divislon.
I further certlfy that only contractors and employees who
are ln compliance with ORS 7Oj.O55 will be used on thls
project.
I further agree to ensure that all required inspections are
requested at the proper ilme, that each address ls readable
from tho street, that the permit card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all times duri ng constructlon.
'rr, *I
2,*
PL.HSE GAR ACC
N
S
E
BUILDING
ITEM
Main
Garage
Carport
/@Ad
Total Value
Building Permit Fee
State Surcharge /,?9 Y7,/6
Total Fee (A)
VALUE
<o?4-l/,sl
/?,oo
a,oa)Br'
ERMIT
SO. FT.X $/SQ. FT.
s6,b
7476,oo
?${?
BUILDING VALUE, PLAN CHECKAND BUTLDING PERMIT
Thls permit ls granted on the expre€s condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfteld, includtng theDevelopment Code, regulating the constructlon and use ofbuildlngs, and may be suspended or revoked dt any tlme
upon violation of any provisions of said oldinances.
ewed
Date Pald
Recelpt Number:
Received
Plan Check Fee:o3
SYSTEMS DEVELOPMENT CHAR(8, \Wb Systems Development Charge is due on all undeveloped
properties wlthin the City limits which are being lmproved.
Residential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
Plumbing Permlt
State Surcharge /,f,O * ,9O
Total Charge (C)
FEE
?2 y'o
tu1
/-o
FT.
No
FT.
FT.
PLUMBING PERMIT
ITEM
Fix tu res
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanlcal Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
MISCELLANEOUS PERMITS
Mobile ,Home
State lssuance
State Surcharge
Sidewalk
--
ft
Curbcut
--
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (exctudtng electricat)
(A, B, C, D, and E Comblned)?? 7b
VALIDATION:
RECEIPT NUMBER
AMOUNT RECEIVED
RECEIVED BY
DATE PAID
Date
tu re dr/.ru<-
.r, lr:.'},rh
"4 I
2<
C;ITY OF OFEGO'V
225 FIITH STREET
SPRINGFIELD, OREGON 97
INSPECTION REQUEST: 7
OFPICE: 726-3759 A.uthorized
1. LOCATION OF9ZUL/,r,
I,EGAI DESCRTPTION
JOB DESCRTPTION
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 INSTAII,.ATION OIILY
Electrical Contractor
Address
Ci ty Phone
Supervisor License Number
Exoiration Date
Constr Contr. Number
Exoiration Date
Signature of Supervising Electrician
0vners Name
Address izS A/, ssh s /t
Ci ty fff^\ vnone 2-L,-53?G
OVNER INSTALT,ATION
The i.nstallat ion is being made on
property I ovn vhich is not intended
for saIe, lease or rent.
0vners Signat
DATE:
BI.E TRICAL PERHIT APPLICATION
Ci ty Job Nunber
3.COHPTETE FEE SCffiDtII^E BELOV
A. Nev Residential-Single or
MuIti-FamilY Per dvelling uni t.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dvelling
Service or Feeder
s 8s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
C
SPRI 'IEL['
One Ci rcui t t--
Each Additional
Circuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAT
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPS
-
601 amps to 1000 amPs-
Over 1000 amps/vo1ts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
?fr,
I
"
:' :g',lt]r* ffi "",1, ?ffiff$::Jf '' "H
+" r iow i ns
200 amps''or f ess S
201 amps to 400 arnps
-
S
over 4b1 to 600 amps
-
S
0ver 600 amps or 1000-voITs se
Branch Circuits
Sum
s 1s.00
aEove
3s.00 35*
2.O0
40.00
5s.00
80.00
e lrBlr
D
E
Nev, Alteration or Extension Per Panel
s
s
Miscellaneous ( Service/feeder
-Each installation
Pump or irrigation $
sign/outline Lighting- S
Limited Energy/Res $
Limited Energy/Comm S
not included)
40.00
40.00
20.00
2<oO
),? €o.f
5
RECEIVED
./.8a
s s0.00
s 60.00
$100.00
s130.00
s300.00
s 40.00
OB NO . ?9ogo1
CITY OF SPRINGFIEIJD SYSTEMS DE\rELOPMENT CHARGE
WORKSHEET
(coilmERcrAL & RESIDENTIAL)
NAME OR COMPANY:bab T)AME-
LOCATION:b26 N . ?26 Tt+ =f,.
DEVELOPMENT TYPE:
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVT0US SQ. FT.
2, SANITARY SEWER-CITY
NO. OF PFU'S
SI
Z+x $0.209 PER SQ. FT.
X $43.26 PER PFU
x $436.19
x $436.le
. Ft.
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x
x
x _ x $436.19 $
$17.19 PER PFU + $10 Mt,lMC ADM FEE $
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
$
4 SANITARY SEWER-MWMC
NO. OF PFU'S
(Use PFU Total From Item 2 Above)
MI,IMC CREDIT IF APPLICABLE (SEE REVERSE)
$ 503
5 ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
Burd ck
5D;@-L--)
-
Coordi nator
Date:1;5 TOTAL SDC $ .# ,o7
oZ
FTXTURE UNIT CALCULA{ON TABLE: Number of New Fixtu '( Unit Equivatent :.Fixture Units
(NOTE: For remodels,'calci_rtate only .NET additional fixtures)
NUMBER OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTURE -.
UNITSFIXTURE TYPE
Bathrub.....
Drinking Fountain....
Floor Drain.
tnterceptors For Grease/Oil/Solids/Etc
lnterceptors For Sand/Auto Wash/Etc. -. -.......... -.-.
Laundry Tub/Clotheswasher.....-
Clotheswasher - 3 Or More.----
Mobite Home Park Trap (1 Per Trailer)
Receptor For Refrigerator/Vvater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc..
Shower. Single Stall..........
Shower, Gang......... ..........:.......
Sink: Bar, Commercial. Residential Kitchen....
Wash Basin/Lavatory, Single
Toilet, Pubtic lnstallation..
ead
2
,l
2
J
6
2
6
6
1
.)
2
1/H
2
2
1
6
4Toilet , Private..--.
Miscellaneous:
TOTAL FIXTURE UNITS
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 $'l ,OOO
Assessed Value
1979 or before
1 9BO
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
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
o.6i
o.44
o-15
Credit for Parcelor Land Only lf Appticable
lmprovement (if after annexation date)
(Rate X Assessed Value)
(Rate X Assessed Vatue)
x $--
CREDIT TOTAL $