HomeMy WebLinkAboutPermit Building 1991-09-22SPRINGFIELE'd!RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBER
Zfr,
225 Fifth Street
Spri ngfield, Oregon 97 477
LOCATION OF PRO ED WO
ASSESSORS MAP TAX LOT
LOT:c BLOCK:SUBDIVISION
OWNER:PHoNE: '7 \1- gG S 1
ADDRESS:) t99 Lor-,-",,. A
CITY:STATE:OR ZIP:q7v ?-)
DESCRIBE WORK:
NEW X REMoDEL ADDrroN DEMoLTSH orHER
CONTRACTOR'S NAME A DRESS
CONST.
CONTRACTOR #EXPIRES PHONE
G EN ERAL:7
PLUMBING:il-on tL nL -n',r
MECHANICAL:
ELECTRICAL:/^unn lvloo r e-
_ OFFICE USE _
QUAD AREA:
# OF BLDGS
LAND USE:\\\ \FLOOD PLAIN:
* OF UNITS:ZONING CODE:
OCCY GROUP:CONSTR. TYPE:* OF BDRMS:,4
* OF STORIES:HEAT SOURCE:tr€-SECONDARY HEAT
WATER HEATER:RANGE:Q-t SQUARE FOOTAGE:1ffi5
To request an inspection, you must call 726-3769. This is a24hour recording. AII inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
fffemnorary Electric Vl Rough Mechanical - Prior to
R cover.
p( Roueh Electrical - Prior toH cover.
x'
X
K
X
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Final Electrical - When all
electrical work is complete.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.ffi Electrical Service - Must be.Uapproved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
MFooting - After trenches arec excavated.Fireplace - Prior to facing
materials and lraming lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.K
tr
Framing - Prior to cover.
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prior to
cover.
pfuna"rground Plumbing - Priors to filling trench.Drywall - Prior to taping
K MOBILE HOME !NSPECTIONS
Underlloor Wood Stove - After installation- Prior to insulation or decking
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
dAoq lnsulation - Prior tot'\-l de;[ing. K"Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.E Sanitary Sewer - Prior to f illing
trench.Electrical Conneclion - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
ffiS,or- Sewer - Prior to fillingq trench.
Water Line - Prior to filling
trench.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
K
E Rough Plumbing - Prior to
cover.a
UfA lrNnA Coopf
Ti.n Noll--
r
Z
Msia"*"lk & Driveway - After fa excavation is compiete, forms
and sub-base material in place.
l--l Fence - When completed.
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
P.L.HSE GAR ACC
N t6'
S ta.(
t6'
E AA,
Setbacks
la +Cul-de-sac
_-T
f ,1ra
_-{
; THE PROPOSED WORK IN T
HISTORICAL DISTRICI OR
THE HISTORICAL REGISTE
Coordinator prior to permit issuance.
APPROVED:
lf yes, this application U
and approved by t l-r H is torical
be signed
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express 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 of
buildings, and may be suspended or revoked at any time
By:
- | zi--
Dateeweb
Recei pt Numbe
upon violation of a p rovisions of said ordinances
Plan Check Fee:
Date Paid
Rec
x$/
11,!g
2s 7 .rg
FT,
_q512-
tb113
(A)
= VALUE
+L LDI
76L2Total Value
Building Permit Fee
State Su rcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT
Main
Garage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)7oo, 70
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N0 /60.M
16C.ffi
fr .oo
k
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
6,Oo
,t .fa
t1.'.'
/ o.oo
/. qfi
3o, 19(D)
oo3
6 ^ocVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERM!T
Fu rnace
Exhaust Hood
NOi-
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with 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 Building 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 is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
ure
-rI
->
on s during construction.site
oi, 2 2 /qq/
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk 6Z t
-icurbcut ( 'fi tt
Demolition
State Surcharge
Total Miscellaneous Permits (E)
2ZJC-/k7C
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)
l// 17,&
DATE PAID
AMOUNT RECE
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
t 66.co
C'TY
SPIIINGFIELO
225 FIFTE STREBT
SPRTNGPIEIJD, oRBGON 97 477
TNSPECTI0N REQUESTT 726-3769
0FPICE: 726-3759
LBGAL DBSSRIPTION
Address
ELECTRICAL PERHIT APPLICATION
City Job Nunber
3. COHPI,BTE PEE SCIIEDUI.E BELOIT
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
h
/ $ 8s.00 Bf,
Sum
JOB DBSffi,IPTIONA,^.-n, lftr 4ri
Permits are non-transferable and expireif vork is not started vithin L80 daysof issuance or if vork is suspended for
180 days.
2. COI{TRA TOR INSTALT.ATION ONLI
EIec trical Con trac tor L rtffi ,QanA
L500 sq.ft. or less
Each additlonal 500
sq. ft or portion
thereof
Eaeh Hanuf,d Home or
Modular Dvelling
Serviee or Feeder
ctrvftz< /fla.€4 Phone ?za-z?f{
Supervisor License Number Z7g S
Expiratlon Date /Z -,1^?Z-
Constr Contr. Number =7Za
Expiration Date
Signature of Supervising Electrician
Ovners I'Ir
Address
Ct ty Phone
OITHER INSTALI.dTION
The installation is being made onproperty I ovn vhich is not intendedfor sa1e, lease or rent.
0vners Signature:
DATE:
RECEI
$ 1s.00
$ 35.00
Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
100 amps or less $
101 amps to 400 amps
-
$
401 amps to 600 amps
-
$
601 amps to 1000 amps- $over 1000 amps/volts
-
$
Reconneet Only $
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps or less I $ 35.00 Z{
201 amps to 4Oo amps
-
$ 4o.oo '''-
over 401 to 600 amps
-
$ Bo.o0
0ver 600 amps or 1000 vofts see rrgrr "ffi[
B
00
00
00
00
00
00
35.
60.
90.
130
300
3s
C
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Tvo to ten Circuits
Each Addt,I ten orportion thereof
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00sign/outline Lighting- $ 36.00
Signal Circuit or
limited energy panel S 36.00
STETOTAL OF ABOVE
5Z State Sureharge
TOTAL
/206
/.'2-a 4,t4(p-
$ 3s.00
$ s0.00
$ 1s.00
E
BRECETYED
5
1.. LOCATION OP INSTATLATION43.< ,vaV.<-Zl* -
I
Metrooolitan
Wastewater
ManaqementtrYLommtsslon
C0,,lt,iiSSt0ri !.ri l,,a-: :.S
A:b Sennt:t-[r!tn€ Clit'.:'';its:'l
Sie\r D!1ly-Eugene La/ ee;reser:aii,r
Scon E:r!si;:n-S;' rglieiC Lay Sep'fse.1;:!.€
C:ris L;i's3n-Sprinltieid Caura,ilals:,r
c hris Lriais3r- L;rir Cou rty r-ay Brp,'eserlai,ve
ierry 3Jsl-Lane Csunl)' Cc'i:li:s;3:t1
l,1ark \"'esiling-!ueene Lay Rei:esen:a:ire
FiFTH AirD A S-iFEETS SPRII.GFIELD CITY HALL SPRII(GFiELD, OFEGCT'J 97277 -lELEi'r.iOirE (5C3) 7{7'i5:i
I-IWMC CONI(ECTION CHARGE
Building Address:
Reference Number:{
0vner:
Add res s
Ci ty:State:
Tax Lot I'Iumber:
Phone Number:
Zipz
- Residential Fee ($222.00)
,7 lz
oc
Commercial Fee (nev non-residential development/
- remodel)
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $ RAA,oo
<$ /g,r/
TOTAL I'IVMC CHARGE s ,4e 7 ,7 7
Credit Due (see reverse of this form)
Date Received:Received
Building Job Number:Reeeipt Number:
il
--
Fi:iture Uni t Calculatio:r Table:
equi val-ents. ii0TE Fcr reirociels
liur,ber of ne'* fii:tr_rres nultiplied by unit, calculate only the liET additional fii:tirres
Fi;<ture Tl,pe
Sathtub
Drinking fountain
Floor drain.
fnterceptors for grease/oil/solris/etc....
Interceptors for *cand/auto vash/etc.......
Laundry tub/clothes la-.her. .
Clo thes r.'asher ( 3 cr nore )l'1obile hone park trap ( 1 per I.i. i.l. ) . . . .Receptor for refrig/vater s tat io:/etc.
Receptor for Cor.;:.er sir:k/dishr.sh::/etc.
Sho'*er, sing).e staIl
Shouer, gang (per head). . . .
Sink, bar, eonnereial.
Sink, eonmereial/industrial/etc. . .Urnial, sta11/va11..
'u'ash basin/lavatory, singleI'ater el-oset, publie instal-
LTater clo-eetr private... .
l{iscellaneous:
i of Unit
Fi x tures Equivalen t s
lat icn
Total Units:
x $i3.25 each = Total Charge: g
Fixture
Units
2
1
)
3
6
2
6
6
1
1)
2
1
2
3
2
1
6
4
Total fixture uni ts
I Credi t Calcul_at ion TabI E.Based on total r'alue of property at tine of permitappl i cation.
va=r 'l sF^r,^Jr...lltE4=uto the Citv
lTbo
191 9
1980
19E1
100a
100'l
10D '
1985
1985
1987
1000
'l oao
100n
,1 . e a bo s_ 19,5t
Credit per $1,OOoassessed vaLue
$2.66
$2.54
92. s3
92.41
S2.1e
92.04
$1. 69
C1 iEIL.JJ
Cl 1Etr.lJ
$0.92
$0. se
$0.23
Creci i t
Rate A,csessed a ue Total Credi t