HomeMy WebLinkAboutPermit Building 1994-10-19iESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726.9769
Offlce:72A4759
LOCATION OF PROPOSED WORK:
Rp
ASSESSORS MAP:
PFIIN IELED
n? &i
t.,
JoB NUMBE ^ ? y/ +2 7
225 Flfth Street
Sprlngfleld, Oregon 97 4774-
rAx Lor 7* - - o. /+
Zfr,
a
+)t -? c/LOTru BLOCK:SUBDIVISION:
PHONE:
STATE:ZIP:
2L
,l?1
OWNER:
ADDRESS:
SCITY:
t{)
REMODEL ADDITION DEMOLISH OTHER
DESCBIBE WOBK:
NEW A
AODRESS EXPIRES
2
J*.
t t-g{
CONTRACTOR'S NAME
PHONE2
MECHANICAL:
ELECTRICAL:
PLUMBING:
GENEBAL:
CONST,
CONTRACTOR #
g
3A
e)
r OF UNI:I'S:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN
ZONING CODE:
r OF BDRMS:
WATER HEAf,ER:
- OFFICE USE -
LAND USE:OUAD AREA:
I OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspecilons requested before 7:00 a.m. wlll bemade the game worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTTONS
[--l femporary Etectrtc l_l Rough Mechanlcat - prtor to|J cover.
Flnal Plumblng - When allplumblng work ls complete.
Slte lnspectlon - To be made ugh Electrlcal - Prlor toafter excavatlon, but p to cover lnal Eleclrlcal - \A,{hen all
settlng 'elec
t rlcal ls
€
Underslab tl Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechan - WhenMechanlcal - Prlo mech anlcal work ls complete.
- After tfenches are
w Flnal Bulldlng - When all
requlred lnspectlons have been
approved and bulldlng lsMaaonry - Steel locatlon, bond
beams, groutlng.
[-l Flreplace - Prlor to faclng
-
materlals and framlng lnsp.
completed.TakSF*'lng
n - After forms are Other
erected but
placement.
r to concrete wallrcbiln
cover.
s
i
st/latlon -to
l-l Underground Ptumblng -lJ to fllllng trench.[--l Orywall - Prtor to taptng
Underlloor Plumblng I Mechanlcal
- Prlor to lnsulatlon or decklng.
MOBILE HOME INSPE TIONS
l--l Wood Stove - After lnstailatton.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
locklng and Set.Up - When ailfllngerl - After flreplace approval
and lnstallatlon of unlt.
blocklng ls complete.
Floor lnsulatlon - Prlor to
decklng.rbcut&Approach-After lumblng Connecllons - When
forms are erected but prlor to
placoment of concrete,
home has been connected to
water and sewer,
Sewer - Prlor to fllllng
ff),/Electrlcal Connectlon - When
f blocklng, set.up, and pturpblng' lnspectlons have been approved
and the homo ls connected to
the servlce panel.
trench.
lk&Drlveway -s complete,
Af ter
Storm Sewer - Prlor to fllllng
trench.
excavatlon I forms
and sub-base materlal ln place.
Llne - Prlor to fllllng Fence - When completed.
trench.al - After all requlred
Stroet Trees - When all requlred
trees are planted.
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
/ Eleclrlcal/
V
cover.
Plumblng - Prlor to
tl
O.,
\\9\D
tl
tl
n
tl
E
\t
"',
Lot faces
Lot sq. ftg.
Lot covorago
Topography
Total [elght
Lol Tyr
A ,n,;,o,
-
Corner
-
Panhandle
-
Cul-de-sac
Setb IS THE PROPOSED WORK TN THE -' HrsroRloAL DtsrRlcr, oR oN
/.'THE HtsrontcAL REGISTER?
ll yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordlnator prlor to permlt lssuance,
APPROVED:
P,L,HSE GAR ACC'
N
S
E
LUE
7Go
,4SS
t60<>
4Ma
r?,( friu,o)rtzaaL
(A)
E
x $/so. Fr.
J4,'o-'
N.4ain
Total Value
Bulldlng Permit Feo
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Gaqage
Carport
Bevl
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltlon that the sald
constructlon shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfield, includlng the
Development Code, regulatlng the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances.
Plan Check Fee;
Date Pald:
Recelpt Number:
Beceived By:
SYSTEMS DEVELOPMENT C
(B)
,OTffi8#Systems Development Charge ls due on all undeveloped
propBrtles wlthln the Clty llmlts wl"iich are being lmproved.
ITEM
Flxtures,
Resldentlai Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
3.1s *
FT.
S
FT.
(c)
PLUMBING PERMIT
Plumblng Permit
State. Surcharge
Total Charge
\,I b{
AD IONAL OMMENTS
---
a
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
N0Vent Fan
Mechanical Permlt
lssuahce
Slate:surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
tho completed appllcailon and do hereby cerUfy that all
lnformatlon hereon ls true and correct, and I f urther cerilfy
that any and all work performed shall bo done ln accordanco
wlth the Ordinances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout permisslon of the Bulldlng Safety Dlvislon.I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thlsprolect,
I further agree to ensure that all requlred lnspectlons are
requested at the proper ilme, that each address ls readablo
from tho street, that the permlt oard ls located at the front
at all tlme constructlon
Date
of plans wlll remalnof the property, and tho approved set
MISCELLANEOUS PERMITS
Total Mlscellaneous permits (E)
ft
ft
Demolltlon
State Surc
Moblle Home
State lssuance
Sldewalk
Curbcut
TOTAL AMOUNT DUE (exctudtng etectrtcat)
(A, B, C, Q and E Comblned)RECEIVED BY
DATE PAID
AMOUNT
VALIDATION:
RECEIPT NUM
N0_
FT,
State Surcharoe t
,f,\ =9ri(-A0rnrA 3S
CITY OF OFEGO'V
SPRINGFIELO
225 FTFIE STREBf,
SPPJNGFIELD, OREGON 97 477
INSPECUON REQUEST: 7
OPPICE: 726-3759
Authoriz€d
1 OF
Permits are ransferable and lre
The followlng,project as submitted hes lhezcnrng, and does not require specfirc i.nj'approval.
zsil|e \q ocTq*
use
EI.ECTRICAL PERHIT APPLICATION
City Job Nuruber
COI{PIJTE FEE SCEEDUI.E BELOV
Nev Residential-Single or
MuIti-Family per dwelling unit.
Service Included:Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
$ Bs.oo
$ 1s.00
L I
A
Sum
if vork is not started vi
of issuance or if vork is
thin 1B0 daYs
suspended for -&180 days.
2. COITTRACTOR TION ONLY
Electrical Contrac o
Address
ci Phone
Supervisor cense Number
Expiration Date,\(-) \qs
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
.,'' - ' SerVice or Feeder $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over L000 amPs/volts
-
Reconnect 0n1Y
Branch Circuits
i
Nev, Alteration or Extension Per Pane1
One Circuit
Each Additional
$ 3s.oo
Circuit or vith Servic
Temoorarv Services or Feeders
rnstallaiion, Alteration or Relocation
200 amps or Iess S 40'00
over Abt to 600 amPs
-
S 80'00
0ver 600 u*p" o.-1bOO *-ft" see rrBrt aSoE
B
{b
$ s0.00
s 60.00
s100. 00
$130. 00
$300.00s 40.00
c
D
Owners
Address
Ci ty
DATE:
-1'l lt .l
Phone
or Feeder Permit 00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/OutIine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
1 2$&ALLATION
The installation is'being made on
piop"tty I ovn vhich is not intended
for sale, lease or rent'
Ovners Signature:
E
5. SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
s 40.00
$ 40.00
$ 20.00
s 36.00
T,E'AE TIIFN R
C)
\
\3r)
t'
Willamalane
Park & Recreation District
fobNo.q4W
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM PHONE:
ADDRE55:
LOCATION OF FROPOSED BU
Street Address if Known:
Platt Name:Tax Lot Number:
1 DEVETOPMENT TypE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Single Family - Detached
Single FamilY home I Manufactured home not in a Park
I X $400 PER UNIT -=$
X $370 PER UNIT =
X $277 PER UNIT =
X $280 PER UNIT =
oo
NO OF UNITS
B. Single Family - Attached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
$
$
$
WPRD SDC $
2. sDc CREDIT (lf applicable) sDc-payer must furnish proof of wPRD Credit
^approval. See SDC'Credit Worksheet )
3. TOTAT WPRD NEI SDC ASSESSED (lf SDC reduced for Credi0 $
Community Services
r-i+., ^( c^.:^^{;^lX
sron Date
I ,ronMorqHlT
ocl@
a
ATTACHMENT B1 ' 1B N0.14 t rL1
CITY OF SPRINGFIELD SYSTEHS DEVELOPMENT CI-IARGE
WORKSHEET
(COHHERCIAL & RESIDENTIAL)
NAI'{E OR COHP/NY:MnRT IN t--lnac, p.1 T
aa^L+bG'rl 3T.11 oz3 ("-Lt - 4*rrr or I 60LOCATION:
DEVELOPHENT TYPE
Ie (L*e
. P.\^J . 1-lol*€ G,^R*Gra
BUILDING SIZE: \.ttto ,a't**o, zo * zz l0T SIZ
1. STORM DRATNAGF
IMPERViOUS SQ. FT.\bao x $0.209 PER SQ. FT. s bazn?
2. SANITARY SFWFR-CTTY
NO. OF PFU'S
(See P.everse)
t6 X $43.26 PER, PFU s 1186:
3 TRANSPORTATION
NO OF UNITS X TRiP RATE X COST PER TRIP
X l.or X 5436.19
x
-
x s436.i9
$ q.{ o'2
x
-
x s436.i9 s
SUBTOTAL (ADD ITEMS 1.2. & 3)
Ft
$
4. SANITARY SFWFR-MWMC
NO. OF PFU'S Ib X $17.19 PER PFU + S1O MI^IMC ADMIN.FEE
(Use PFU Total From Item 2 Above)
MI.Il',lC CREDIT iF APPLICABLE (SEE REVERSE)
T0TAI -Ml.lMc snc
SUBTOTAL (ADD ITEMS 1,2.3 & 4)
5. ANMINISTATIVF FFFS
BASE CI{ARGE (SUBTOTAL ABOVE) X .05
!*L
ry Hornig. P.E.
SDC Coordinator
$ ?rt 4?-
J zeE
s znb+L
s \noob3
$
2eab-
82. SDC
Date:D
TOTAI SNC s ZoooT
Barhtub.....
FIXTURE UNIT CALCUL/ ON TABLE: ru"NUCT Of NCW FiXtt
{NOTE: For remodels, calculate only ttie NEt additional fixturesl*Ua*
O,
FIXTURE TYPE NEW FIXTURES
Drinking Fountain....
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc""""""""'
lnterceptors For Sand/Auto Wash/Etc"""""
Laundry Tub/Clotheswasher. -.. . . " " '
Clotheswasher - 3 Or More..-.
Z
z
2-
TOTAL FIXTURE UNITS
, X Unit Equivalent = Fixture Units
UNIT FIXTURE
EOUIVALENT UNITS
{
la
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
L
Mobile Home Park Trap (1 Per Trailer)
Receptor For Ref rigerator/lvater Statio n/Etc
Receptor For Commercial Sink/Dishwasher/Etc"
Shower, Single Sta|l..........
Shower, Gan9........
Sink: Bar, Commercial, Residential Kitchen"
Urinal, Stall/Wall..l
Wash Basin/LavatorY, Single.
Toilet, Public lnstallation.
Toilet , Private....
Miscellaneous: ,T',!t foP's gtlk
Z
.L
---
2
CREDIT CALCULATION TABLE: Based on assesse lf improvements occurred after annexation dated value in table,
calculate credits seParates.
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x $-
(Rate X Assessed Value)
?".4L xs 1 Z'1,
CREDIT TOTAL -t c-1bf-)-$
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $ 1,OOO
Assessed Value
1979 or before
1 980
1981
1 982
I oQ2
1 984
1 985
s3.46
3.38
3.32
3.21
J.UO
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 001
1 993
$2.46
2.14
1.77
1.37
o.97
o.61
o.44
o.15
t
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finol lvrcbetad e
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*t*+ f, fr,r ttrri {j ,lrfftr rcuel*,-{reA.rl
*{., sil },uc ec..lirlbtt
'lraa. A*r
p-'a6t crll
+anKl
GRAY'S GARDEN CENTERS
/ 17 Vl l,ttr Ave. [-Lrirr:rrc, OR 97.10:, 345..1 .,r
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