HomeMy WebLinkAboutPermit Building 1992-09-24SP INGFIELE'
RiS ID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Of fice: 726-3759
JOB NUMBER
225 Fitlh Street
Spring field, Oregon 97 477efi,
LOCATION OF PIIOPOSED WOt]K:-{o ) N z,rrk
ASSESSORS MAP:
r-oT:BLOCK:
TAX LOT:
SUBDIVISION
OWNER:T,-t Atull-e-PHONE:
ADDRESS: & tql?--T;;F-
crrY:
-SpCd,
STATE:7-tP:
- Sr"ti*- -E2,al7 R*-rt*P:e- -- -REMODEL ADDII'ION DEMOLISH OTHERY
DEfICIIIBE WONK
NEW
EXPIRES Pl-ioNEESS
I -q3 ----?-Y2962Cot
NDCONTRACTON'S NAME
ELECTRICAL:
CONST.
CONTRACTOR '
r OF BLDGS: -
OCCY GROUP: ,-
Y OF STORIES: --
WATEFI HEATER:u\tz
OUAD AREA
RANGE:
HEAT SOURCE:Vtt
- OFFICE USE _
* OF BDFIMS:
LAND USE:
CONSTR. TYPE:
II OF UNITS:
FLOOD PLAIN:
ZONING CODE
SECONDARY HEAT:
SOUARE FOOTAGE:
To rcquest a6 inspection, you must call 726-3769. Tlris ls a24hour recording. All inspections requested before 7:00 a.m. will be
ma(lc thc s;.rnre workirrg <lay, inspections requested after 7:00 a.m. wlll be made the following work day.
REOUIRED INSPECTIONS
l- I Temporary Elcctric1r
Site lnspection - To be madc
af ter excavation, but prior to
setting lornts.
Underslab Plumbing/ Electrical /
Mechanical - F'rior to cover.
Masonry - Steel location, bond
bearns, grouting.
Underground Plumbing - Prior
to filling trench.
Underlloo
- Prior to insu at decki ng
Sanilary Sewer - Prior to filling
tren c h.
Rough Plumbing - Prior to
cover.
Rough Mechanical - Prior to
cover.
Rough Electrical - Prior 1o
cover,
Fireplace - Prior to faclng
materlals and framlng lnsp.
Wood Stove - After installalion
Irrsert - Af ter llreplace approval
and lnstallation of unit.
Sidewalk & DrivewaY - Af ter
excavation ls complete, forms
d sub-base nlaterlal in Place.
Fence - Wlren comPleted.
Street Trees - When all required
,lrees are plantcd,
Final Plumbing - When all
plumbing worl( ls complete.xr
X "k
Mfooting - After trenches are
Aexcavated.
Vf rlectrical Service - Must be,AL,rpprovcd to obtain pcrmanent
ticctrical power.
\f,-TFinal Electrical - Wlren all
/A,\etectrical work is complete.
['7 finat Mechanical - When allJA\.mecnanical worl( ls complete.
Vy'Pinal Buildins - When all
flrequired lnspections have been
approved and building is
completed.
,K
Vfoundation - Aftcr forms are
,,lAcrected but prior to concrete
placement.
ff"-tng - Prior to cover'
4"*i:eilins
lnsutation - Prior to
{]tr*'ll - Prlor to ta,ing'
Olher
MOBILE HOME INSPE TIONS
Blocklng and Set.Up - Whr.ln all
blocking ls completo.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, an<1 plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, sklrtlng, decks, and
ventlng have been installed.
)V Post and Bcam - Prlor lo lloor.,Qinsulation or decking.
F7( Floor tnsulation - Prior to
A\4ect<ins.
X
,4,::t;n.sewer - Prior to rirrins
fl;;lnLine - Prror to rirrins
lVf curbcut & Aooroach - After
zlAfor.s are erected but prior to
placement of concrete.
o ?/ z//'
l.,rr + AfruP+ cf
?vt -'1
D8 9'lyll
I
)l
Gt-:NERAL: -----
fiLUMBING: ---,,
MECHANICAL:
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.HE F'ROPOSED WORK IN THE
HISTORICAL DISTRICT' OR ON
THE HISTOFIICAL REGISTER? _-
lf yes, this application must be signed
ancl apProved bY the Historical
Coor<Jinator prior to permit issuance'
APPROVED:
HSEP.L.
/D'N
5/S
/&'
//AE
Lot faces
Lot sq. ftg'
Lot coverage
TopographY
Total height
Lot Type
-
lnterior
-
Gorner
-
Panhandle
X .r,-ou-"""
J
a47
2i2"
ks
FI
1Z9o
\b'
;;
BUTLDING VALUE, PLAN CHECK
AND. BUILDING PERMIT
This perrnit is grantcd on tlre express conditton tlt
consiruction shall, in all rcspects, conform to the
the CitY of SPringfield, inclu
t Code, regulating the construction an
tJ may bo suspended or revoked at any
ny provisrons o{ said ordinances'
-/rr"b-'
Plan v
at the said
Ordinance
ding theadopted bY d use ofDeveloptnentirnebuildings, atr
/s2/s,
ewed B
Flccei ved
upon violation of a
Plan Cl-reck Fee: , -
Date Paid:
Fleceipt Number:--
BUILDING PERMIT
VALUE
/oa3 -d
---/b-{r
(A)
{e /o
3 </ 60
SO. FT, X $/SQ. FT.
/c 56
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
_6SLe_/
Systems Developnrcnt Charge is due on all undeveloped
properties witl'rin tlrc City limits which are being improvcd'SYSTEMS DEVELOPMENT CHAR
(B)
&GE (SDC)
,zt'30tt
ADDITIONAL COMMENTS
_Wtl
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
/@?L
(c)
N0
FT.
FT.
FT,
PLUMBING PERMIT
Plumbing Permit
State Surchargc
Total Charge
^-a OAD
IZ-8,=
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
Mechanical Permit
(D)
/Z 5o
da
<g-
j uo_
,93
2a-33
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan No/
By signature, I state ;rttd agrer-', tllat I have care{ully examined
the completeci application and do hereby certify that all
information hereon is true ancl correct, and I f urther certi{y
that any ancl all work performed shall be dorre tn accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Ore-qon 1>ertaining to the wor[< described
herein, and that NO OCCUPANCY will -be nrade of any
structure witlrout pernrission of the Building Safety Division'
I turther certify that only contractors and employees who
are in compliancc witl.r ORS 701.055 will lle used on this
proicct.
I f urtlrer agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that tl-re permit card is located at the f ront
of the property, and tlrc approved set of 1;lans will remain
Cignature -
Date
on the sitc ;rt all tittt ring constructiort
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewark 1l t,
curbcut 4- ,,
Demolition
State Surcharge
60
Total Miscellaneous Permits (E)
/S
Z1,
nECErPl NUMuErI e-?- / -
VALIDATION
DATE PAID
RECEIVED BY
--
. -
AMOUNT RECEIVED
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)
-3?y'-ts
4o\2
2;7_
-7
7s
%
FENCE PERUIT APPLICATION
CITY OF SPRINGTIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
0ffice:
INSPECTION LINE:
726-37s9
726-3759
OREGO'UCITY OF
Job Location:OI Nl ,bsw
Assessors Map f:bL 31
atrh tl+L
Tax Lot *:Irsog
Ovner:
Address:
Ci ty:%r4 State:cl .
Phone *:
hY-Zip , q1q 11e0
Value of Fence:Fence Permit is $5.00
Con t rac tor/Ins taller :
Address:Phone *:
Ci ty:S tate:zip:
Construction Contractors Registration #:Expi res :
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that aII information on
this application/permit is correct and that I vas provided vith the Springfield
Development code requirements for fence standards.
5DD'
4eSitiature
FOR OFFICE USE
Checked for Delinquenc'ies:
/,
)
Checked f or Hi s tor:i ea I S ta t
Date of Application:
Receipt #
Total Amount Collected:
JOB #:
Issued By:i
lsPFI'{GFIELO
04
JoB Ho. lzrZt*
CITY OF SPRINGFIELD SYST-EI'IS DEVELOPMENT CHARGE
WORKSHEET
(C0I'IMERCIAL & RESIDENTIAL)
NAME OR COMPANY o
358 11o z 3rz+- t l9o5
LOCAT ION :bot r{
B - LIEW ,??DEVELOPMENT TYPE:LP
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
SIZ
ZobY x $o-1e2 PER sQ- FT'
SQ. Ft.
?SAN IT ARY SEUIER _CITY
No. oF pFU's lb x $39.78 PER PFU
(See Reverse) .
3. TRA NS PORTAT I ON
NO OF UNITS X TRIP RATE X COST PER TRIP
XI ,oog X $401.05
BASE CHARGE (SUBTOTAL ABoVE) X .05
5 . SAN ITARY SEWER-MI^IMC
NO. OF PFU'S
(Use PFU Total From I tem 2 Above)
Mt,lMC CREDIT IF APPLICABLE (SEE REVERSE)
&^-rL
Kip Bur d'i ck
TOTAL-CITY SDC S ISqtA]
t6 $13.62 PER PFU + $IO MI,JMC ADMIN. FEE s zrbt9-
$
$
SUBT0TAL (ADD ITEMS 1,2, & 3)$lrV-|9
,cl
TOTAL-MWMC SDC
X
A
x $40I.05
x $401.05
4 ADMi ISTRATIVE F EES
ob
o4tb
SDC Coordinator
L
L[t-TEN/t
TOTAL SDC $ IAZI53
FIXTURE UNIT CALCULATIoN TABLE: NumUer of New Fixrures X Unit tquivalent = Fixture Units (NOTE
For remodels, calculate only the NEJ additional fixtures)
FIXTURE TYPE
Credit lor Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
NUMBER OF
NEW FIXTURES
(Rate X Assessed Value)
X$
UNIT
EQUIVALENT
FIXTURE
UNITS
L
2
1
2
J
6
2
6
6
1
J
L
1
2
2
1
7
Floor Drain.
I nterceptors For Grease/Oil/Solids/Etc""""""""'
Interceptors For Sand/Auto Wash/Etc"""""""""
Drinking Fountain..
Laundry Tub/Clotheswas
Clotheswasher - 3 Or More.-""""""'
Shower, Single Stall......---...
Shower, Gang....-.
Sink, Bar, Commercial
Urinal, StallflVall..-'
Wash Basin/Lavatory, Single...-.."""""
Water Closet, Public lnstallatiotr'.""""'
Water Closet, Private..-....-.......'.--
Miscellaneous:
CREDIT CALCULATION TABLE
calculate credits separates.
Mobile Home Park Trap ('t Per Trailer)"""""""""
Receptor For BefrigeratorAVater Station/Etc"""'
Receptor For Commercial Sink/Dishwasher/Etc"
/Head
o
4
4'
z
b
Z
Z
TOTAL FIXTURE UNITS 1tr
Based on assessed value. lf improvements occurred after annexation date in table'
Z.%b x $o5 z5b:1
(Rate X Assessed Value)
CREDIT TOTAL = $
RUNOFF COEFFICIENTS FOR STOHM DRAINAGE
z5b:
Residential
Commercial
lndustrial.
Governmental.....
0.4
0.9
0.45
0.5
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
'1979 or before
1980
198'l
1 982
1 983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
1 985
1986
1 987
1 9BB
1989
1 990
1 991
$2.1 6
1.90
1.60
0.25
0.87
0.50
0.16
IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT
Bathtub.......
Z
225 FIFTE STREET
SPRINGFIBLD, ORBGON
INSPEGTION REQTIEST:
OFFICE: 726-3759
D,P
9
1
I.,BGAL ON
Permits are non-transferable and expire
if vork is not started vithin i80 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI^ATION ONLY
Electrical Contractor
Address
1000 sq.ft. or less
Each additional 500
sq. ft or portion
t hereo f
Each Manuf 'd iiome or
Hodular DveIling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less t/'
201 amps to 400 amps
-Over 401 to 600 amps _0ver 600 amps or L000 volts see rrBrr above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tional
Circuit or with Service
or Feeder Permit $ 2.00
s.'IIINGFIELo
{
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
CAL PERHIT APPLICATION
Ci ty Job Nuurber
COUPLBTE PEB SCEEDULE BELOII
Nev Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Miscellaneous ( Service/feeder
-Each installation
Pump or irrigation $
Sign/outline Lighting- S
Limi ted Energy/Res $
Limi ted Energy/Comm S
Aie
OF
V
Sum
not included)
40.00
40.00
20. oo
ffis
&
B
,iry 64.t / Ced<vno"e 7z L4 8?{
Supervisor License Number
Expiration Date o Z-'
Constr Contr. Number 23/ 0 /
Expiration Date o
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c
H $ 40.00
$ ss.00
$ 80.00Signature of Supervisi Electrieian
0vners me
Address
Ci ty Phone
OTINER INSTALI..ATION
The installation is being made on
property I ovn vhich is not intendedfor sale, lease or rent.
Ovners Signature:
DATE:
E
5 /o / 70-oo'7,*
TV'Oe
RECEIVED BY:
v
A.
r€>*tt/ neil.