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Home My WebLink AboutPermit Building 1994-04-18SPRINGFIELE, RESIDENTIAL PERMIT APPLICATION I ns pecti ons: 726'3769 Office: 726-3759 LOCATION OF PROPOSED WORK ASSESSOFIS MAP: d JOB NUMBER 225 Fitlh Street Spri ngfield, Oregon 97 477 TAX LOT:a LOT:9:BLOCK:SUBDIVISION PHONE: Z/ ZIP:STATE:{t}<CITY: ADDRESS: OWNER: REMODEL ADDITION DEMOLISH OTHER A/,V, S, E Eaf,,DESCRIBE WORK: NEW / EXPIRES PHONEADDRESS 7g /L CONTRACTOR'S NAME ELECTRICAL: MECHANICAL:2572',o CONST. CONTRACTOR # G EN EBAL: PLUMBING E_ _FT US \ \ €:q) u/n (\r- OFFICE RANGE:WATER HEATER * OF UNITS: LAND USE: * OF BDRMS: ZONING CODE: FLOOD PLAIN CONSTB. TYPE: HEAT SOURCE:SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: * OF STORIEST To request an inspection, you must call 726-3769. This ls a 24 hour recording. All inspections requested before 7:00 a.m. wlll be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REOUIRED INSPECTIONS Temporary Electric Site lnspection - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrical/ Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Water Line - Prior to filling trench. []l Rough Mechanical - Prior to ?a( cover. llTRough Electrical - Prior to -!t cover. I-\f,/Electrical Service - Must be\A.pproved to obtain permanent electrical power. Final Plumbing - When all plumbing work is complete. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. Final Building - When all required inspections have been approved and building is completed. h K F +x K x x tr K K Fireplace - Prior to facing materlals anC framing Insp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover. Wood Stove - After installation lnsert - After flreplace approval and lnstallation of unit. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Fence - When completed Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When all blocklng is complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When blocking, set-up, and plumbing lnspections have been approved and the home is connected to the service panel. IVI Floor lnsulation - Prior totA decklng [X1- tr K E x F f;"t: Prumbins - Prior to {:,ml:"iil"-,"Hn"" arr required Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. ?/o/-7/ 4 QUAD AREA: S OF BLDGS: E Drywall - Prior to taping.E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot rype v X ,nruno, - Corner - Panhandle - Cul-de-sac Setbacks P.L,HSE GAR ACC N S E WORK IN THE ICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be slgned and approved by the Historlcal Coordinator prior to permit issuance. APPROVED: @ E ?/ (A) SO. FT.. lDtaS 34C\ X SISO. FT. - -lo-N) I BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee ITEM Main Garage Carport 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 buildlngs, and may be suspended or revoked at any time upon violatlon of any provisions of said Fle By Plan Check Fee: Date Paid Recelpt Nu ved By: Date nances. SYSTEMS DEVELOPMENT C (B) HARGE (SDC_) *Bi tqzE+3 n Systems Development Charge is due on all undeveloped properties within the City limits which are belng improved. ITEM Flxtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE J CD (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS \ (/ Wood Stove/ lnsert/ Fireplace Unit Dryer Vent <.cD (D) lcVent Fan =) Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace Exhaust Hood N0 & By slgnature, I state and agree, that I have carefully examlned the completed application and do hereby certify that all lnformation hereon ls 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 wiil be made of any structure without permission of the Building Safety Division. I further certlfy 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 tlme, that each address ls readable from the street, that the permit card ls located at the front of the property, and the approved set of plans will remain IDate the slte at natu re during construction MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharget-,..) Sidewalk .l )_ ) tt curbcut *'l- ,, Demolition TOTAL AMOUNT DUE (excluding electrical)' (A, B, C, D, and E Combined) ts (E)I Miscellaneou Su rch I R BECEIVED BY VALIDATION: RECEIPT NU DATE PAID AMOUNT W X I rB No. 11a414 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE LIORKSHEET (C0MMERCIAL & RESIDENTiAL) NAME OR COMPANY:Trpt Nou:-e 35r S z1f!I -70L zt41-?o4LOCAT I ON : LPF . NEN ;FPDEVELOPI"IENT TYPE: BUILDING SIZE:LOT SiZ F sQ. Fr. l.STORM D RAINAGE IMPERVIOUS SQ. FT.i.148 x $0.203 PER SQ. FT 2. SAN iTARY SEt,lER -CITY NO. OF PFU'S (See Reverse) X $42.08 PER PFU TRANSPORTAT ION NO OF UNiTS X TRIP RATE X COST PER TRIP 3 xl ,o I x $424.31 x - x $424.31 x x $424.31 $ $ 4. SANiTARY S EI^lER _Ml,lMC NO. OF PFU'S 7q 252 gq(Use PFU Total From Item 2 Above ) Mt^lMC CREDIT IF APPLICABLE (SEE RTVERSE) $15.125 PER PFU + $10 Ml,lMC ADM FEE TOTAL-MWMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4) q? 5 ADMINISTRATIVE FEES . BASE CHARGE (SUBT0TAL AB0VE) X -05 Ki p Burdick SDC Coordinator TOTAL SDC $t1L5!L t* FTXTURE UNIT,CALCULAT'-'{ TA'BLE: ruumuer of New Fixtures X t i* L",J",s. calculSie only the Ng additional fixtures) NU*BER ot- FIXTURE TYPE NEW FIXTURES I Bathtub.-..---- Drinking Fountain--.... Floor Drain-- lnterceptors For Grease/Oil/Sol ids/Etc" " """"" "' lnterceptors For Sand/Auto Wash/Etc" "" " "'-"" " Equivalent : Fixlure Units (NOTE: Clotheswasher - 3 Or More"""""' Mobile Hdnie Park Trap (1 Per Trailer)""'-""""" Receptor For Ref ri geratorAVater Station/ ttc- "" "' Receptor For Commerclat Sink/Dishwasher/Etc-' Laundry Tub/CIotheswasher"" " "' Shower. Singte'Stall-- Shower. Gang---------.- Sink, Bar, Commercial Urinal. Stall/Wall--.- Wash Easin /L-avatory, Single""""' Water Closet, Public lnstallation"""' Water Closet, Private....'-"- Miscellaneous: calculate credhs se L TOTAL FIXTURE UNITS q .bt (Rate X Assessed Value)x$ H 2 1 I J 6 2 6 6 1 3 2 1/ 2 2 1 6 4 I UNIT EOUIVALENT 'Lq $L1 q FIXTURE UNITS T u ? 8 tfl ead I .REDTT CALCUT-AT,.N TABLE: Based on assessed varue. lf improvements occurred after annexation date in table, gq Credit for Parcd or [-aM Only lf Applicable lmprovement (if after annexation date) b.7 , x$ ---ln"t" x c Assessed Value) REDIT TOTAL Year Annexed Rate per $1,O00 Assessed ValueYear Annexed Rate Per $1,0OO Assessed Value 1986 1987 1988 19a9 1990 1991 1992 $ 2.24 1.93 1.57 1.18 0.79 o.44 0.28 1979 or before 1980 1981 1982 1983 1984 1985 s.21 3.13 3.08 2.96 2.82 2.68 2.51 RUNOFF COEFFICIENTS FOR STORM DRATNAGE Residential. Commercial-..----------.--." lndustrial.... Governmental.. 0.4 0.9 0.45 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT 7- 225 FIPTE STREET SPRINGFIELD, OREGON 97477 INSPECTTON RBQTBSTz 726-3769 OFFICE: 726-3759 1 ON OF t.EGAt ON JOB 180 days. 2. CoI\]TRACTOR ON ONLY Electrical Contrac Address Ci ty Phone Supervisor I Cense Number 36111 S Expiration Date lD,\.q5 Cons tr contr. Number o q+b Expiration Date 3.b .q'5 Signature of SuPervis ing Electrician SPF!ilGFIELE' ELB TRICAL PERUIT APPTICATION City Job Number COI{PI,ETE FEE SCEEDTILE BELOS Nev Residential-Single or Multi-FamilY Per dvelling unit. Service Included:Items Cost s 8s.001000 sq.ft. or Iess Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Servi.ce or Feeder 3 A I g ls.oo Sum 8s ISPermits are non-transferable and expire if work is not started vithin 180 days oi i."u.nce or if vork is suspended for ON B. c D. $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or lessior "ri" to 400 amps -40L amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amPs/vo1ts - Reeonnect 0n1Y TemporarY Services or Feeders Insiallaiion, Alteration or Relocation 200 amps or less $ 40'00 over abr to 6oo amps - S 8o'oo Over 600 urp" ot-ibOO "off" see "Bt' aEG- Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35'00 f."f, aaaitional Circuit or vith Service oi-r""a"tPermit - $ 2'00 Miscellaneous (Service/feeder not ineluded) -Each installation Pump or irrigation Sign/0ut1ine Lighting' Limited EnergY/Res -SUBTOTAL OF ABOVE 52 State Surcharge 3% Administrative Fee TOTAL $ s0.00 $ 60.00 s100.00 $130.00 $300.00 $ 40.00 Ovne Addr Ci ty rs Name ess OIJNER Phone The installation is being made on property I ovn vhich is not intended for sale, lease or rent' Ovners Signature: E $ $ $ $ 40 40 20 36 00 00 00 00 CD DATE: ( RBCErVED B 5 CITY OF OREGON C'TY OF SPRINGFIEL OFEGO'U SPRII ELO The following Proi tonlng, and does approval. ect as not require specilic lend usg m 225 TIFTE SMEEf, SPRINGPTEI.D , oREGoN INSPEGTION REQIIEST: ELBCTRICAL PERHIT APPLICATION -q ,(q401H OPPICB: 726-3759 AuthoriteJ Si5 1 Pernits are non-transferable and expire if vork is not started vithin 180 days of lssuance or lf vork is suspended for 180 days., 2" COTflRACTOR INSTALI.ATION ONLY Electrlcal Contractor LYNN'S ELECTRIC Address PO BOx A 726_7895@7nsB' Phone Supervisor License Number z335ry -S Explration Date o eonstr Contr. Number A3 I ._iot Elxpi ration Date Signa ture of Supervlsing Blectrician Owners l Adrlress Cl ty Phone OIINER The installatioir is beirig made on property I ovn vhich is not intended for sale, lease or rent. 0mers Signature: EATE: City Job Nunber rEE SCEEDT'LE BELOS Nev Residential-Sing1e or HuIti-Family per dvelling unit. Service Included: I tems Cos t A B Sum I C. Temporary Services or Feeders Insta1lation, Alteratlon or Relocation 200 amps or less $ 40.00 over 401 to 600 amps - S Bo.oo Over 600 amps or 1000 voTIs see trgtt "ffifi D. Branch Cireuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Service or Feeder Permit S 2.00 E. Hiscellaneous (Service/feeder not included) 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Hodular DveIIing Servlce or Feeder Services or Feeders Installation, Alterations or Relocation: STIBTOTAL OF ABOVE 5Z State Surcharge TOTAL 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _601 amps to 1000 amps 0ver 1000 amps/volts -Reconnect 0n1y -Each installation Pump or irrigation $ Sign/Outline Lighting- $ Lirni ted Energy/Res - S Limited Energy/Comm $ s 8s.00 $ 1s.00 s 40.00 l_5 ei s s0.00 s 60.00 $100. o0 $130.00 $300.00 $ 40.00 40.00 40.00 20.00 36.00 RBCBIVBD 5 co Willamalane Park & Recreation District lob No. SYSTEMS DEVELOPMENT CHARCE WORKSHEET t\bttLNAME:PHONE: ADD STATE: LOCATION OF FROPOSED Strea Address if Known: Platt Name:Tax Lot Number: 1 DEVETOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling typeffik.l A. Single Family - Detached , __l_ Single Family home Manufactured home not in a park NO OF UNITS B- Sinsle Familv - Attached NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS X $400 PER UNIT -=$ X $370 PER UNIT =$ X $277 PER UNIT =$ X $280 PER UNIT =$ WPRD SDC $ P 3 x_)) 2. SDC CREDTT (lf applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credit) $ Community Services City of Springfield on Date $ i OO \ A-,1E..,4-