HomeMy WebLinkAboutPermit Building 1992-11-16SP}IINGFIELf)
RESIDENTIAL
PERMIT APPLICATION
lrrspections: 7?6-3769
OIf ice: 720 3759
JoB NUMBER ?2/ 5E€
225 Fifth Street
Springlield, Oregon 97 477
LocArroN ot' PRoPosED WoRK: -2225---Z- 3f
ASSESSoBS rvtae: / ? O 2^ j^e- --41
-
rAx Lor ---94Ae
LOT.tlLooK SUBDIVISION
_L
owNER: -d/zzr--{J-- /+-
ADDnESS: I2--(<-1---o.,- .*1 Za --crrY; ZZ2e-e
PHoNE: 115-< Z--23
ZIP: -Ae
New E- nEMoDEL ADDtrtoN DEMoLISH orHEFl
DESCn|BE Wr)RK: _ _
GENEBAL: ---
PLUMBING:
MECHANICAI.
ELECTRICAL:
EXPIRES PHON EADDNESS
E4- da.-*.2z/a 2/1,/-/6- 7 3 6:&r-Z
CONTNACTOFi 5; NAME
CONST.
CONTRACTOR #
OUAD AREA:
, OF BLDCS: -,-
occY cf 1( )ul'
a oF sTOt]lEli:
WATER llEATt-l-l: -
LAND USE: -
E OF UNITS:
CONSTR. TYI'I,
HEAT SOURCE:
RANGE:
--
FLOOD PLAIN:
ZONING CODE:
E OF BDRMS:
SECONDARY HEAT: -
SOUARE FOOTAGE: -
_ OFFICE USE -
I Orywall - Prior to taping
Wood Slove -- After installation
lnserl - After flleplace approval
and installation of unit.
Curbcut & Approach - After
fortns are erected but Prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is cornplete, forms
and sub-b;tse material in Place.
Slreet Trees - When all required
trees are ltlarrted.
Final Electrical - Whcn all
electrical worl< is corttlrlete.
Final Mechanical - Whr:n all
mechanical work is corrrpletc.
Final Building - When all
required inspections have been
approved and building is
completed.
To recluest arr inspectiorl, you must call 726-3769. This ls a24hour recording. All inspections requested before 7:00 a.m. will be
macte the sanre working ciay, inspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Tempor ary Electric Rough Meclranical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
D(
Site lnspection - To be made
;rfter ext;avalion, bttt Prior t<)
setting lorms.
Underslab Plunrbing/ Eleclrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
bearrrs, grouting.
Foundalion - Aftcr forrns etre
erectc(l l)Lrt Prior to concrcte
placcntcttl.
Underground Plumbing - Prior
to lrlling trench.
Underlloor Plurnbing/ Mechanical
- [)rior to insulatiorr or clecking.
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
deck i ng.
Sanilary Sewer - Prior to filling
t ren (: ll.
Storm Sewer - Prior to filling
tren(;h.
Water Lirre - Prior to filling
trench.
Rouqh Plumbing - Prior to
covor.
Rough Electri(;al - Prior to
cover.
Electrical Service - Must be'
approved to obtain l)ermiinent
electrlcal power.
Fireplace - Prior to facing
materlals and f raming lnsp.
Framing - Prior to cover
Wall/Ceiling tnsulalion - Prior to
cover.
Bo,nurM*rJ
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocking is corilplete.
Plumbing Connections - Whert
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approvr:ri
and the horne is connected to
the servlce panel.
Final - After all required
inspectlons are approved and
porches, skirting, decks, and
venting have beerr installed.
STATE:
r
E
tl
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fl
l-l Fence - When comPleted'
r
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
--
Corner
.- Panhandle
-
Cul-de-sac
Setbacks rHE PROPOSED WOFIK IN THE
IJISTORICAL DISTRICT, OR ON
TI-IE HISTORICAL RE,GISTER? --.-., .,,,_ -
lf ycs, tlris application must be slgned
an<-l approved by tlrc Historical
Co()rdinator prior to pct'ttrit issttance.
API]ROVED:
P.L.HSE
N
S
GAR ACC
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrnit is grante(l on tlle express conditio|r llrat the said
conslruction shall, in all resl;ects, conform to tlrc Ordinance
adopted by the City of Springfield, including the
Development Cocle, regulating the construction and use of
buildings, and rnay be suspended or tevoked at any tirne
upon violation of any provisions of said ordirrances'
DatePlans Rcviewed [3Y
Plan Check Fee: .-
Date Paid
Rcceipt Nunrbcr:
Receivecl By:
VALUE
(A)
X S/SQ. FT
PERMIT
SQ- FT,
BUILDING
II'EM
lrrlain
Garage
Carport
Total Value
Building Permit Fee
Statc Surcharge
Total Fee
Systems Develolltttr:trt Clrarlle is dtrc on llll tlrl(lovr-'loped
properties witirirr thc City lirrrits whiclr are l-rr:irtg trrtlrroved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
1539
N
-4eP
FT.
FT.
54ZE .f,o.
(c)
75
FT. %
-;a-ry
Plumbing Permit
State Surcharge
'l-otal Charge
WoorJ Stove/ lnsert/ Fireplace Unit
Drycr Vcrrt
MECHANICAL PERMIT
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan No
By signature, I state ancl agree, that I have caref tllly examined
the completed application and do hereby ccrtify that all
information hereon is true and correct' antl I f ttrtlrcr cerlify
that any an<J all work pcrformed shall be done irr accordance
with the Ordinances of the City of Springfield, anrl tlrc Laws
of lhe State of Orctlrlrr llcrtainlng to thc wolk <lr:scribctl
Irerein, and that NO OCCTiPANCY will be ttr;r<le of any
structure without perrnissiotr of the Building Safety Division'
I f urther certify that orrly contractors and enrployees who
are ln compliance with ORS 701.055 will be used on this
proiect.
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
natu
on the site at all times during construction.
o^t" ./,'/- /5 -2?
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -__=-- ft
Curbcut -_=-- ft
Dernolition
Statc Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER
DATE PAID -,. - J
-7 2\'
AMOUNT FIECEIVEI)
82-gz/ /z*f-z
RECEIVED BY - -
TOTAL AMOUNT DUE (excluding electrical)
(A, a, C, D, ancJ E Combined)
{2,7J
{'ln
CITY OF SPRINGFIELD SYSTEHS DEVELOPI''IFNT CHARGE
WORKSHEET
NAME OR COMPANY:
LOCATIOi{:/h 7zo- t,a?4
nrrrrrUCVLLUTTILI\I III'L:
BUILDING SIZE:
1. STORM DRAINAGE
Il'iPERVIoUS SQ.FT.
v a^A 1a n-h h-rl )iv. i6 ( LK rru
sQ. Ft
s #7#a,try
S -r4
J
aJ
S
LOT SiZ
2
x $0.192 PER SQ. FT s'*
/c^^ D^,,^-.^ c^- D,,^^sa a^^f5;^.:^-+^ i: A^+,,-''l T-^^-., n*^- ;^;:-t,-^,.-\\Jsc t\trYEl Jtr r Ul t\UllUl r \.UEl l lLrcllLJ lr r1LLUql 1lilPcl Y. nl tro' J.) Ultl.\llUYrlr,/
cAltT-rAnvJni\ I l^n I SEl'lER-C ITY N,A
ltn nr nrttrcI\U. UT TTU J
(See Reverse T
3. TRANSPORTATION
o Deteri-ri ne Tota f nrt r / c \I rru J/
NO OF UNITS X TRIP RATE X COST PER TRIP
x x 5401 .0s
A x s40i .05
x s40t .05
(See A.ttachnrent C To Deternj ne Tri p P.a+-es)
SUBT0TAL (ADD ITEI'IS i,2, & 3)
, ANMTTI T'" . /'11/r'l I l! I TIVE FEES
BASE CHARGE (SUBTOTAL AB0VE) X .os
TOTAL - C ITY SDC S
5. CREDIT
iF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL:
ToTAL-CITY SDC X (507r) = ADJUSTED CITY SDC
6. SANITARY SEI^lER_Mt,Il'{C
NO. OF PFU'S $13.62 PER PFU + $10 l'4I,lMC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
HI^JMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-Ml,lM C SDC S rt-
s Z.gs-
1b
$
(.-a^--l-,+ ttlLth,
Ki p Burdick
SDC Coordinator
()TOTAL SDC s*ffi
fb
E
FIXTURE UNIT CALCUIA "ON TABLE: t'tumuer of New Fixtures '
For remodels, calculate only the NE[ additional fixtures)
NUMBER OF
FIXTURE TYPE NEW FIXTURES
nit Equivalent = Fixture Units (NOTE:
UNIT FIXTURE
EQUIVALENT UNITS
Bathtub.......
Drinking Fountain.....-
Floor Drain-
I nterceptors For Grease/Oil/Solids/Etc""""""""'
I nterceptors For Sand /Auto Wash/Etc"" " " " " "" "
Laundry Tub/Clotheswasher....-.-..--
Clotheswasher - 3 Or More.-...--..-.......,i...'.""""""'
Mobile Home Park Trap (1 Per Trailer)""""
R eceptor For RefrigeratorflVater Station/Etc" "" "
Receptor For Commercial Sink/Dishwasher/Etc"
Shower, Single Stall.'...'--.--..
I Z
Shower, Gang..........-..--...ISink, Bar, Commercial.
Urinal, StallflVall....
Wash Basin/Lavatory, Single..-.......
Water Closet, Public lnstallation.
Water Closet, Private..
TOTAL FIXTURE UNITS lro
CREDIT CALCUI-ATION TABLE: Based on assessed valUe. lf improvements occurred after annexation date in table,
calculate credits separates.
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
?-
z
I
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x$
(Rate X Assessed Value)
(Rate X Assessed Value)
CREDIT TOTAL = $N.A.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
't984
$2.83
2.76
2.71
2.60
2.46
2.33
1 985
1986
1987
1988
1 989
1990
1991
$2.1 6
'1.90
1.60
0.25
o.B7
0.50
0.16
RUNOFF COEFFTCIENTS FOR STORM DRAINAGE
Residential...
Commercial.
0.4
0.9
0.45lndustrial.....
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
I
Miscellaneous:
x$
t
Sl'lllNGFlf:L()
RESIDENTIAL
PERMIT APPLICATION
lrrspeclions: 726-3769
Oltice: 720-3759
ASSESSORS MAP:
JoB NUMBE R -?2 / 5og
?fr,
LoCATIoN of'PRoPoSF-D WoRr(: - 22?--,{ --Z-LI-
-_3 4, -- rAx Lor:
-8r'-a-2
225 Fltth Street
Springlleld, Oregorr 97477
LOT: ...-- --B K:SUBDIVISION
_L
*u, -13--L:12 z3
CITY:SrATE: -Ae ZlPi _
2
Dos€tt /<o a2_/..
OWNlll-l:.
22e-e
nOOneSS:. /
New --y'= nEMoDEL ADDriloN DEMoLTSH orHER
DESCnIBE WORK:
--
ADDNESS EXPIRES PHONE
PLUMBTNG: E4 -8,--/<C, &2:/2//23
CONTRACTOR'S NAME
GENERAL
ELECTRICAL: r---
MECI-IANICN L
CONST.
CONTRACTOR ,#
OUND AREA:
ocCY cill()tJl',
,t Of STOtrlE:;: _---
WATEn I{EAl-t-ll: ----
FLOOD PLAIN:
ZONING CODE:
I OF BDRMS:
SECONDARY llfiAT -
SOUARE FOOI^CE: .-
LAND USE: -I OF UNITS: - .
coNslrn. TYt,t_
HENT SOUFICE:
RANGE:
_ OFFICE USE _
Site lnspecllon - To be rnade
:ilter exr:avatiorr, l>ul prior to
senitlg lornrs.
Underslab Pluntbing/ Electrical I
Meclranical - Prior lo cover.
Footing - After trenches are
excavatecr.
Masonry - Steel locatlon, bond
bearrrs, Orouting.
Foundalion - After forrns are
crecle(l l)ut Prlor lo concrcle
placcn rcrr t.
Under-qround Plumbing - Prlor
to lilling trench.
Undcrlloor Plutlrblngl Mechanical
- ['rior to lnsulation or decking.
Posl and Beam - Prlor to ,loor
insulation or clecl(lng.
Floor lnsulallon - Prlor to
decki ng.
Sanllary Sewer - Prlor to lilllnO
t ren (; ll.
Slorm Sewer - Prlor to lilling
trench.
Water Line - Prlor to fllling
trench.
Rough Pltrnrblng - Prlor to
cov(.'r.
Rough Eldctrical - Prior to
cover,
Electrlcal Solvice - Musl be
approved lo olrtain l)crrnanent
electrlcal power.
Flreplace - Prlor to faclng
materlals anrl framing lnsp.
Framing - Prior to cover,
Wall/Ceiling lrrsulalion - Prior to
cover.
Drywall - Plior to tapinO
Wood Slove -- Alter lnstallation.
lnsert - After flreplace approval .,
and lnslallatlon of unlt.
Curbcut & Approach - After
forrns are erected but prior lo
placement ol concrele.
Sidewalk & Orlveway - Aftcr
excavation ls complete, lorms
and sub-base materlal in place.
Fenco - When completed
Slrool Trees - When all requlred
tre(rs arc J;lanted.
Flnal Electrical - Wlrr:rr all
clectrical worl( is conll)letc.
Flnal Meclranical - Wlrcn ;rll
mecllanlcal work ls c<-rilrpleto.
Flnal Building - Wtrer.r ;rll
requlred lnsp<.:ctions lrave been
approved and building is
completed.
To reclucst an inspection, you rnusl call 726-3769. Thls ls a 24 now recordlng. All lnspectlons requested bcfore 7:00 a.m. will t)c
macle the same working day. lnspecllons requested after 7:00 a.m. wllt be made the following work day.
REOUIRED INSPECTIONS
Temporary Eleclric Rough Mechiinlcal - Prlor to
cover.
Final Plumbing - Wlren all
plurnblng worl< is cornplcte.
tr
ff. o, n o' 2&Z c.-,+zrail at
MOBILE HOME INSPE TIONS
Blocking and Sel-Up - When all
l)locking ls coilrplete.
Plumblng Connections - Wlrerr
home has been connected lo
water and sewL)r.
Electrical Connection - When
blocking, set-up, arrcl plurnbing
inspectlons have been approvc'tl
and the hornc is connectcd to
the servlce panel.
Final - After all recluired
lnspectlons are approved an<J
porches, skirting, decl(..;, an(t
venlinO have l)cen insl;rlle(|.
)//4 2
fl
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IS I'HE PI.IOPOSED WOHI( IN THE
IJISTORICAL DISTRICT, OR ON
TI.IE }.IISTOFIICAL REGISTER?
-.,-._lf ycs, lllis application musl bc slgned
and al)provcd by tlrc Historlcal
Coorclirr;rlor prior to pcrlnit issttance.
APPROVED:
LoI fa<;cs
Lot sq. ltg.
Lol covcr;rgc
Ttrpograplty
Total lrcight
Lot Type
-
lnterior
--
Corner
_- Panhandle
-_ Cul'de'sac-
PL.HSE,GAR
N
S
E
Sctbacl<s
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrnit is grante(J on tlle express condition that the said
consiruction shall, in all rest)ects, conform to tlte Ordinance
adopted by the City ol Springfield, inclutling the
Developrnent Cotle, regulating the conslruction and use ol
buildlngs, and trlay l.rc strspended or revoked at any titne
upon violation o[ arry provisions of said ordinances'
Plan Check Fee:
-.----
DatePlans Rcvicwed [3Y
Date Paid
Fleceipt Numbcr:-.
Received By:
BUILDING PERMIT
VALUE
(A)
ll'L.M
Main
Garagc
C;rt:;rort
lbtal Value
Builcling Pcrnrit Fcc
Sl;rtc Surcll;tr1;c
Ttrtal Fee
Systems Dcvclolrrrtr:tll Cll;rr1;c is dtre on ;rll trrrtlovclopcd
propertics witlrirr tlrc City lirrrits wlriclr aro bcirtg itrt;rrovcd.
SYSTEMS DEVELOPMENT C
(B)^o^ff'fffis
ADDITIONAL COMMENTS
Tt/e 2-
5u,<
/,r*+f,4* ?,
4
L*t
/<
'1-
/,
?
"5b
-/o,
SP" r+>trtt)
?6=
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Watcr
Slorm Sewer
Mobilc Hotne
FEE
/ sle
2"s
/cr%
$@Zs--uV--
(c)
NO
FT.
FT.
FT.
5Jr
PLUMBING PERMIT
Plumblng Permit
Statc Surcharge
Tr;tal Charg;c
Wood Stovc/ lnsert/Fireplace Unit
l)r'yr:r Vont
(D)
NoVorrt Fan
Mcchanical Pertnit
lssuance
State Surcharge
Tolal Pcrtnit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agrce, that I have carefully examined
the completed applic:rtion and do hereby ccrtily that all
lnformalion hereon is truc and corrcct, an<l I ltrt tlrr:r cerlily
that any and all work perfortncd shall be done irr ac,cordance
with thc Ordlnances of the Ci ty of Springlleld, ancl thc Laws
of lhc Slalc of Orcl;orr llerlalnlng lo lhc worl< <lr:scrlbccl
Irereln, and lhat NO OCCI.IPANCY will bc trta<le of any
struclure without permission of the Buildlng Satcty Division.
I further certify tlrat ortly conlractors and enrllloyees who
are ln compliance with OFIS 701.055 will lre used on lhis
project.
I further agree to ensure that all required inspeclions are
roquested at the proper time, that each address ls readable
from the street, that tl.re permit card ls located at the front
of the property, and the approved set of plans will rentain
natu
o^r" //-'/6 .22
o ngthe site at all tilnes duri construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
Statc Surcl'targe
Sidewalk ---- lt
Curbcut ---.-- lt
Dcrn<.rliliott
St;rtr: Strr<;ltargc
-lot;rl Miscollilnco(ls Pcrmits (E)
VALIDAI"ION:
RECEIPT NUMBER
DATE PN ID -,-
a7 ?.?,
/ /--/G-:2.2--*
TOTAL AMOUNT DUE (excluding electrical)
(t\, B, C, D, and E Comblned)
AMOUNT FIECEIVED
RECEIVED BY --- ,
"f,
SO. FT. X $/SO. FT.