HomeMy WebLinkAboutPermit Building 1991-07-22RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JoB NUMBER ?/A.? 28
225 Fifth Street
Springfield, Oregon 97 477
rc N BB*h s[
ASSESSORS MAP:17-oz^ v/^/3 TAX LOI
LOT BLOCK:SUBDIVISION:
741 qSqLPHONE:
ZIP:
wi
162-STATE:
I
OWNER:
ADDRESS
CITY:
NEW
-
REMODEL ADDITION /< DEMOLISH OTHEB
DESCRIBE WORK:
EXPIRES PHONEADDRESS
,uor{ + e$. SLq
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PLUMBING:
GENERAL:
CONST.
CONTRACTOR #
F<srF.
_ OFFICE USE _
* OF BDRMS:
RANGE:WATER HEATER:
LAND USE:
S OF UNITS:
FLOOD PLAIN:
ZONING CODE
SECONDARY HEAT
SQUARE FOOTAGE:
QUAD AREA:
# OF BLDGS
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24hour recording. All 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
Temporary Electric N,.f Rough Mechanical - Prior toJAJ cover.
l\z[ Rough Electrical - Prior tolal cover.
Final Plumbing - When all
plumbing work is complete.
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.
Underground Plumbing - Prior
to filling trench.
Mech
ton or
Post and Beam - Prior to floor
insulation or decking.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
Drywall - Prior to taping.
Wood Stove - After installation
lnserl - After fireplace approval
and installation 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.
Street Trees - When all required
trees are planted.
fV/finat Electrical - when allA electrical work is complete.
VlFinal Mechanical - When allAl mechanical work is complete.
l)<f Final Buildins - When alltal required inspections have been
approved and building is
completed.
ITunderlloor Plumbir-\t - Prior to insulat
anical
dFoundation - After forms areGerected but prior to concrete
placement.
(tt'-'ng - Prior to cover'
ffi Walt/Ceiling lnsulation - Prior to.-cover.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocking is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
l'V/Floor lnsulation - Prior toIZ] decking.
Sanitary Sewer - Prior to f illing
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
a4:;4o
,3Rtfcr
.3\n-
r
E"
tl
E
tl
f_l Fence - When completed.
E
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
, THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED
BUILDING PERMIT
ITEM SQ. FT.
Main
X S/SO. FT.VALUE
Garage
CarporthD- V a7./4Za)
/R/ ,c 7
( g,'i'
,t, ?3
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)//27 +"
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
upon violation of any provisions of said ordinances.
Plan Check r"e, 1y' D 3
Date Paid
Receipt Numbe 2
Received
Plans ewed By v( ei(r,
SYSTEMS DEVELOPMENT C
(B)'o*3:51.#',*Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
Fixtu res
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
N0
FT.
FT.
FT.
Plumbing Permit
State Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
ftfati Aqcfs H/P,
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
/ s.oo
oo
/,2 €
---2/ Z>.4(e,
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 f urther agree to ensure that all requlred 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
on
the d the approved set of plans will remain
truction
-,l signatu
e site at all t
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER ?-o 76 g
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
L-
LZ
TOTAL AMOUNT DUE (excluding electrical
(A, B, C, D, and E Combined)
Z-z-
D.
St"ttNGFtELO
225 HTFTS STREET
SPBJNGTTELD, ORBGoN 97477
INSPBGIIOH REQI Bsf,:. 726-3769
OPEICE: '726-3759
1
Jr
PERHIT APPLICATION
Ctty Job Nunber CI
PBE SCIIEDT'E, BELOS
ev Resldentlal-Sing).e or
Hultl-Faml}y per dvelllng unlt.
Servlce Included:
ftems Cost
1500 sq.ft. or less $ 85.00
Each additlonal 500
sq. ft or portion
thereof $ 15.00
Each Hanufrd Home or
-Hodular DveIIing
Service or Feeder $ 35.00
Servlces or Feeders (10 Branch Circuits
included). Installation, Alteratlons
or Relocation:
h
74
UIJGAL DBSCRIPTION
Pernlts are non-transferable and expirelf vork ls not started vithin 180 daysof lssuance or if vork ls suspended for
180 days.
2. COIfTRACTOR INSTALIiTION ONIT B.
ElectricaL Contrac rcr f/4 r /,fUl E/:rr.
Address fr 6 ,4,2,,/ 4/zt
Ctty E t, qEr -,2- Phone 48 f ^ 7a 7F
Supervlsor Llcense Nunber 7rd d ,
Explratlon Date tO ..- t --( Z
c.
Constr Contr. Number f F6e r,
Explratlon Date /-27-tz
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
-601 amps to 1000 amps
Over 1000 amps/volts
Reconnect 0n1y
rs Name
JOB
Sum
syPhone
OUNER
The lnstallatlon ls belng made onproperty I ovn rhleh is not lntendedfor sale,lease or rent.
0vners Slgnature:
Temporary Services or FeedersInstallatlon, Alteratlon or Belocatlon
above
D
Nevr.Alteratlon or Extenslon Per Panel
One Circuit
.Tvo to ten Clrcults
Addt,I ten orportion thereof
E. Mlscellaneous (Servlce/feeder not lncluded)
-Each lnstallation
Pump or lrrigation $ 36.00Sign/out1ine Lighting- $ 36.00
Slgnal Clrcuit orlimited energ:y panel_ g 36.00
5. srrrlToTAl, oP ABoVB 3 { *
of lng Electrlcian
\
s 3s.00
$ 50.00
$ e0.00
$130.00
$300.00
$ 3s.00
200 amps or less g 35.00
201 amps to 400 amps g 40.00
over 401 to 600 amps
-
g Bo.oo
0ver 600 amps or 1000JrcITs see nBrl
Branch Circuits
Y
Address
$ 35.00
$ so.oo
s 1s.00
DATE:5f State Surcharge
TOTAL
1
REEETW:IJ BY:
7r
o11
't.
l.--
CITY O' SPRITIGFIE srEHs DEVELC 'rEt{T CHARGE
*?ro6'>bLD SY
woR KSHEET * I
NAHE OR COHPANY:
iDxe p eu- 4
I
aNoer !d iuur t
LOCATION:r!!o-L'1i t 3 - Od2t>oe>
DEVELOPHENT TYPE:
BUILDING SIZE:
I. STOR'.I DRAINAGE
IHPERVI0US SQ. ET. 3lo X $o
(See Reverse For:,Runoff Coefficients If Ac
OT SIZ e c-{ /a sq. Ft.
.186 PER SQ. FT.s 6lbb
tual Imperv. Area Is Unknown)
2. SANITARY SEI,IER-CITY
NO. OF PFU'S N{ /A X $38.55 PER PFU
3
(See Reverse To Determine Total PFU'S)
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x x $388.61
v,a x $388.61
x _ x $s88.51
(See Attachment C To Determine Trip Rates)
SUBTOTAL
$
(ADD ITEMS 1,2, & 3) S 51*
$
(
s
4. ADI.IINISTRATIVE FEES
BASE.CHARGE (SUBToTAL ABoVE) X .05
(Use PFU Total From Item 2 Above)
MltMc CREDTT IF AppLICABLE (SEE REVERSE)
L,/*--
Xip Burdick
SDC Coordinator
s zig
TOTAL-CITY SDC s@o =*
5 CREDITS
IF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL:
T0TAL-CITY SDC X (s0%) = ADJUSTED CITy SpC 5 u/a
6. SANITARY SEl'lER-Ht.lHC
NO. OF PFU'S $13.25 PER PFU + SIO Hl.lHC ADMIN. FEE s
I
S
TOTAL-HI{MC SDC $ €
TOTAL SDC S bO6:
t-I,
<\
FIXTURE UNIT CALCUl-A'. JN TABLE: Number or New Fi:ctures X
For remodels, calculate only the NIE[ additional fixtures)
NUMBER OF
H}CTURE ryPE NEW FIXTURES
rit Equivalent = Fixture Units (NOTE:
uNlT l
EOUIVALENT
FItrTURE
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.........
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorAVater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall
Sink, Bar, Commercia|.................
Urinal, StallflVall.
Wash Basin / l-avatory, Single......
Water Closet, Public lnstallation.
Water Closet, Private..
Miscellaneous:
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits
2
1
2
3
6
2
6
6
1
3
2
1
2
I
1
b
4
ead/H
<^-. ^- ^^a^-^
1980
1981
,1982
1983
1984
)..46
2.U
2.53
2.41
2.19
2.04
::aa
1986
l:rO,
1988
19&9
19gl
Year
A.nnexsd
Rate per 51,000
Assessed Value
1.35
1.15
0.92
0.59
o.23
credit for Parcel or [-and only lf Applicable x s
--
(Rate X Assessed Value)
lmprovement (if after annexation date) X S
-
(Rate X Assessed Value)
CREDIT TOTAL -a-J
Year
Annexec
Rate per $1,000
Assessed Vaiue
RUNOFF COEFFICIENTS FOR STOBM DRAINAGE
Residential...
Cornmercial..
lndustrial.
iu
o.i"
c.5
tMPERVloL,s AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
a