HomeMy WebLinkAboutPermit Building 1994-05-26Lqlazai)
IESIOENTIAL,EBMIT APPLICATION
rrpactlong: 7?6'3769
)lltce: 726-3759
C!TY;
oESC:ntFF W(}BK
".* J-NEMODEL
CONTRACIOR'S NAME
GEr*tEFtr\L:
PLUMRI
MECHAN
ELECTRICAL:
' QF BLOCIS: -.
OCCY GROUP;
, OF BTORIES:
tl'-lltrrl rF
ADONESS
LANO USE;
r OF UNI'TS:
CONSTFI. TY PE:
rHEAT SOU
J(,d NUMBEN
225 Flftlt Slre€l
Sprln0lteld. Orogon 97'(77
-?7fua;=,ocArlol.I 31 PFIOPOAED woRK:
\SSESSoFIS MAPi -.--' -
,oT:BLOCK,
CwNEfl: .
AODNESS:
TAX Loli
sUBDI vlsloN
P}IONE:
STATE:
DEMOLISI{ O-IHER
ZIP:
F lnal Mechenloal - When ell,
work lc cgrnpl€l0,
*
l
iON
coN$r.
CONTHAqTOR 'EXPIRES PHQNE , 1.,
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Tq roqueel an Inspecllon' You muBl csll 728'3769' Ttrll le a 24 hour
marlo ths sama worklng rlan lnspecllons rsquealod allor 7:00 e'm'
WATER HEATER:
TelnporarY Electrlc
Slta lnspeatlon - To be tnedo
Eflor excSvollon, bul lrrlor to
eottln0 lolms.
Urrilerelab Ptunrblngl Elcotrlcal J
Mechanloel - Prlor to cover'
FLOOO PLAIN:
ZONING CODE:
r Of BDRMS;
SECONDARY HEAT
$OUAFIE FQOTAGE:
recordlng. Alt lnspectlons ;6qu€al€d belorc 7:0O o'm'wlll bt-
wlla ba rnado th€ fotlowln0 work dey'
,r
(^)
RANGE:
n
E
i:i
REQUIRED INSPECTIONS
f(nougtt Msclronlcal - Prlor lo
*ovor.
l{nough Elootrlcol - Prlor lo
l'-,t 6qv6r,
F
-f7f Flnal Plumblng - When ell
p erumUlng work 18 comPlotp.
lVl Flnrl Eleotrloal - Whcn oll
-Aslqotrlcql work lt comglolo.
8
tr
Underlloor PlumblnglM"q!:$::t l-1 wood Stove - Atlsr lnetellatlon.
- Prlor to Inuulstlon or d€cKlng. t . I --
ffif'Footlng .. Alter lr€nchos Ere
"aercavaterJ.l-l Flroolaoe - Prlgr ro laclngU rnetillols and lramlng lnrP
Moeonry - Steet locallon, bond
beame, 0rou,tlng'
idrorr,d"tlon - Aller lormo ars,K-J 6ysqlsd but prlof to conorolo
Plecornonl.
fXftt",r,r.e - PrloT lo oov6r.
I
ffiw"rtlcolllng Inrulallon - Prlor lo
f covor.
[-l ott er
MOBILE HOME lNSPEqnoH9r
f]
lnopoollone
porbhot, lkl
Yentlng have been
Undergrountt Plumblng - Ptlor
lo lllllng lrsncn.
Fosl end Besm - Ptlor to lloor
lnrulatlon or decklng-
XT $anltarY Sswer - Prlo. to lllllng
!rgrrcll-
Dg-i,fj3r,sower - P'ror to lrrrlns F
r#etut LlNo - Prlor lo (llllng
rinCh"
Rough Plumblng - Prlor lo q
Eleclrlca! Ssfvlee - Must be
approved lq oblaln Polltlanonl
elsotrloel gowor.
- Prro. to taplng.
lnrrrl - Alter llrqplsce apProva!
rnd lnolallEtloo ol unlt.
Slrlowaltr & DtlvtwoY - Altor
oxcrYallon lo oornplol€, (crnl
[nd oub-boss mstoflrl ln glrce'
Fenoc - When completsd.
Slreet Treer - Whcn all tgqulrgd
trsor oro glsntoC'
d en"t Bulldlne - wh.n ril
l! raqulred lnrDeollong hovt baan/ apgrotcd and bulldlng la
oomPlatod.
tl
tVFtoo, ltrsulatlon - Prlor 16
lAJ ooct<ins.lVl Culbsut & Approaah - AltorLFF|.,rr,e are crlolod bul prlor lo
I Ptrcemonl Qf oalrotele'
I /iii! rl
7A4 HU-I:E, F66T lilhPt^l LLVN L6Z gDZ : 'lrN :NOHd lNI .l-NltldDl=af0 UOr-lSLJl.,l : t'rr-'|I -1
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IS THE PROPOSED WORK IN THE
ISTORICAL DISTRICT, OB ON
THE HISTOFIICAL REGISTER?
-
lf yes, thls appllcatlon mi.rst be slgned
and approved bY the H lstorlcal
Coordinator prlor to permlt lssuance.
APPFIOVED:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Lot Type
{tnturto,
-
Corner
-
Panhandle
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
Setbacks
llayTotal he
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express conditlon that the sald
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Sprlngfleld, lncludlng the
Development Code, regulatlng the construction and use of
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlsions of sald ordlnances.
Date
5
Recel pt Numbe
Plan Check Fee:
Date Pald:
Hecelved By:
BUILDING PERMIT
\4.1O
+lL3r]
VALUE
\n9,\1Jp
trb tt
l&sr-
SfrF
(A)
5{".2D
3-7
@
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
Systems Development Charge ls due on all undeveloped
propertles wlthln the Clty llmlts whlch are belng lmproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
/RI {zua., z
ADDITIONAL COMMENTS
ITEM
Fixiures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sevrer
Moblle Home
FEE
r4.80
.a
@
(c)lb
No
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work described
herein, and that NO OCCUPANCY wlll be made of any
structure wlthout permlssion of the Buildlng Safety Dlvlslon.
I further certlfy that only contractors and employees who
are ln compllance wlth ORS 701.055 wlll be used on thls
project.
I f urther agree to ensure that all requlred lnspections are
requested at the proper tlme; that each addr€ss ls readable
from the street, that the permlt card ls located at tho front
of the property, and the approved set of plans wlll remaln
Slgnature
Date
on the slte at I tlmes constructlon.
MECHAI.{ICAL PERMIT
Fu rnac e
Exhaust Hood
Vent Fan
Wood Stove/lnserti Flreplace Unlt
Dryer Vent
Mechanical Permlt
lssu ance
State Surcharge
Total Permlt
No b q.6
3 oc)
l^t3
3&1a3-
+.\"8
(D)
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
state Surcfffi
Sidewalk \l/ I 11
curbcut '.%- t,
Demolltion \
Surcha
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlng electri
(A, B, C, D, and E Comblned)
VALIDATION:
BECEIPT NUMBE
DATE PAID
AMOUNT REC @
FIECEIVED
M5.a
[..6
t.so
d&.so
r\cy)
OFEGO'VC'TY OF
225 North Fifth StreetSpringfield, Oregon 97417
PENCE PERHIT APPLICATION
CITY OF SPRINGFIBLD
BUILDING SAFBTY DIVISTON
SPRIt\lcFIELO
0ffice:
INSPECTION LINE:
726-3759
726-3769
Job Location:
Assessors Map #:
I st-
o - .-)z-- ?Tax Lot #: OD4
S
0wner, 7 l| i<a,-C..{t^*-
Address:
Ci ty:State: f /
Phone #,->O ) 4 Z y-U'{ (t?
Zi p ,n q*(+I I
Fence Permit is 95.00
Contrac tor/Ins tal1er :
,
Address:
Ci ty:
Phone #:
State z Zio:
Construction Contractors Registration f ,C e6 -? O,?_ Expires:_---
6Value of Fence:Z
xy signing this permit/apprication, r agree to carl for an inspection once myfence has been constructea (zzo-g769). "r arso stated that arl information onthis apprication/permit is correct and that r vas provided vith the springfierdDevelopment code requirements for fence standards.
ture
Date of Applieation:
Receipt #
TotaI Amount CoI1ected:
FOR OFFICE USE
JOB *:
A Issued By:
e
Checked for Delinqueneies:
oo
Checked for Historieal. Statrrs:
,/
/t
. C/,TY OFSPR OFEGO'U
The.lottowlng prolca
zoning, end does'not
ae rubmlttcd h*th.follarlng h
require epecllic lrnd *rrgc:ttrcAt. PERHTTapprwal
SPR!NGFI€LO
Ci ty Job Nurnber
COHPI,ETB FEE SCffiDT'I,E BELOS
Nev Residentlal-Single or
Hultl-FamilY Per dvelling unit'
Service Included:
225 FIFTE SITBE|r
SPRINGPIEII), OREGoN
INSPECIION RBOIIBST:
OFEICE: 726-3759
1
Perml ts are non-ferable and exPlre
lf vork is not sta rted vlthln 180 daYs
of lssuairce or lf vork ls susPended for
'180 daYs.
CO}II?ACTOR INSTALI,ATION ONLY
EIec cal Contractor
Address
cl
Supervisor Ll ber
Expiration Date,
Constr Cont Number
Explrat Date
of Supervlslng Elect
Onners
Address
cl Phone
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf 'd llome or
Hodular Dvel}ing
Servlce or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
A.
B
200 amps or
201 amps to
401 amps to
601 amps to
Over 1000
Reconnect
less
400 amps
600 amps
1000 amps
Cos t
$ 8s.00
$ 1s.00
s 40.00
$300.
$ 40.
Sum
$
$
$
$
00
00
00
00
00
00
50
60
100
130
.00
.00
.00
.00@-
amps/vo
0n1y
Its
c TemporarY Services or'Feeders
Installalion, Alteration or Relocation
2oo amps or ress J,- q 19.99 &-
over 4b1 to 600 amps
-
S 80.00
over 600 amps or rbOO-GT[s see uBn affi
Branch Circuits
Nev, Alteration or Extension Per Panel
-Each lnstallation
Pump or lrrigation
Slgn/0utllne Lightlng
Llmited EnergY/Res
Llmited Energy/comm
.T
D,
One Circuit $ 35.00
Bach Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
l{iscel}aneous (Servlce/feeder not included)
OITNER INSTALI.,ATION
The installatloir is belrig made on
ptop"tty f ovn vhlch ls not intended
for sale, lease or rent.s
$
$
$
40
40
20
36
Ders:
5. SUBTOTAL OT ABOVB
5Z State Surcharge
TOTAL
RECEIVED
turc:
+306 adsnin tt<
97477
Atn,prEed
B.
SPrlINCFIELEl
225 ?TYTE SlREEf,
OPPICB: 726-3759 ; :i - r::
1 OF
DESCRTPTION
permits are non-transferable and expire
if vork is not started vlthln 180 days
of lssuance or lf vork ls suspended for
180 days.,
2. CO}ITBACTOR INSTALI^ATION ONLY
ElecLrlca1 Contractor RoSE CoRP
Address 8997 DAY LANE
citv@
Supervisor Llcense Number I EGBS
1 95
Constr Contr. Number 5443i '-i
Expiratlon Date
Slgnature ing Electrician
Ouners
Addres
ci
ALI.ATION
The installatioh is beirig made on
property f ovn which is not intendedfor sa1e, Iease or rent.
Osners Signature:
DATE:
ELECTRICAL PERHIT PLICATION
Ci ty Job Nurnber
3. COXPLETE PEE SCEEDI.ILE BELOV
A. Nev Resldential-Single or
HuIti-Family per dwelling unit.
Service Included:
I tems
'i{ic land use
E
m
_lg
Cos t
s 8s.00
$ 1s.00
$ 40.00
$ 2.00
!Iq!EIIIPT-0RBG0N e!!77 _- <?bINSPECf,ION REOIIEST: 726'-3'7$9 a
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Eaeh Hanuf'd Home or
ilodular Dvelling
Servlce or Feeder
&
3D
Exp lration Date 1
B. Services or FeedersInstaIIation, Alterations
or Relocation:
$ s0.00
s 60.00
s100.00
$130.00
$300.00
$ 40.00
c
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
s 3s.00
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0nIy
Temporary Services or'Feeders
Installation, Alteratlon or Relocation
200 amps or less S 40.00
0ver 401 to 600 amps S 80.00
0ver 600 amps or 1000 voTls see uD" a56IE-
One Circui t
Each Addi tional
Circuit or with Service
or Feeder Permi t
SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S 40.00
Sign/outline Lighting- S 40.00
Limited Energy/Res
-
S 20.00
Limited Energy/Comm S 36.00
5 I
+ 315
RECEIVED -7 ts.@
:.:t', 1:clTY oF
Phone_686-{90I__
0c
JoB No . ? fa 7rr
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI{ARGE
t.IORKSH EET' (CoHMERCTAL & RtSTDENTTAL)
NAI'IE OR COI,IPAI{Y:
LOCAT IOI'I:
DEVELOPI.IENT TYPE:., rR
BUILDING SIZE:T SiZ F sQ. Ft.
I. STORI{ DRAINAGE
IMPERVIoUS SQ. FT.23fo x so.2o3 PER SQ. FT.
?. SANITARY SEL'ER-CITY
NO. OF PFU'S
(See Reverse)
/7 X $42.08 PER PFU
3 TRANSPORTAT ION
NO OF UNITS X TRIP RATE X COST PER TRIP
I x /.a/x s424.31
x x s424.3t
x _ x s424.31
4. SANITARY SEI{ER-Hl.lI'IC
N0.0F PFU'S 'V x $15.125 PER PFU + $10 Hl.lMC ADlit FEE
(Use PFU Total From Item 2 Above)
Mwl.rc CREDIT IF AppLICABLE (SEE REVERSE)
TOTAL.MWMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
N
BASE C BTOT '] ' '0s
(
s
82,2{
3,
5
Z
4 Er.
tr. t5'
?6,0 /
SDC di nator
,f
"/ToTAL SpC S 20/6.22
4/ /Z-.
FIXTURE UNIT CALCUL-{f ION TABLE: t''rri,L',er ot Nerv l:irlrrrcs-X Urril Erlrrir':rlctrt = Fixltrre Units (I'JOIE
For rcmodels, c;rlctrllrlc orrly llre t''l[ .lttiiir-rrurl {ir.lrlrt':')
FIXTURE N'PE
Bathlutr.......
Drinking Fotrrrl:rirt......
Floor Drain. ......'.'.:........
lnlerceptors For Grease/Oil/Solids/8tc.................
lnl erceplors For Sand//ruto \'/aslt/Elc..................
4
Laundry Tub/Clothesrvaslrer.........
l,,iUl.lSt.tt Ol:
I{E\i' I:IXIUNES
2
Ltlt lT
t-OLll\'rit Il,Jf
TIXTURE
UI.JITS
/7
7
?
I
?
3
G
2
6
6
I
z
---T-
f
Clothes*'aqher - 3 Or More......
llobile Hdme Park Trap (1 Per Trailer)
Heceplor Fgr HefrigeratorAVater Station/Etc........
Beceptor For Commerctal Sink/Dishrvasher/Etc..
Shower, Single'Stal1..........
I
3
2
1
2
2
1
D
Shower. Gan9...............
Sink. Bar. Commercial
' Urinal. StallflYall....
Wash Basin /Lavalory, Single.
\\'ater Closel Public lnstallation.......
Vy'ater Closet, Private...............
l'4iscellaneous:
I
ead/H
2
TOLT.L FIXTUAE Utr'lTS
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in tabte,
calculate crxihs separates.
Year'
Annexed
Rate per 51,0OO
AssesseJ Value
Year
Annexed
Fate per 51.OO0
Assessed Value
1979 or before
1980
't981
1982
1983
1994
1985
s3.21
3.13
3.08
2.*5
2.82
2.68
2.51
1996
1987
1988
1989
1990
1991
1992
s 2.24
1.93
1.57
1.18
0.79
o.44
o.2B
Credit for Parcd or krd Only lf Applicable
lmprovement (rf after annexation date)
9.2/ x s 7 lto
(Rate X Assessed Value)xs
(Rate X Assessed Value)
CREDIT TOTAL
3/.17_
= ,=r--
RUNOFF COEFFICIENTS FOR STOBM DRAINA'GE
Governmenlal.0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
2.
Willamalane
Park & Recreation District
NO OF UNITS
B. Sinsle Familv - Attached
C. Multi-Familv Apartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
fob No.
ADDRESS:
LOCATION OF FROPOSED BU LDINC
Street Address if Known:
Platt Name:Tax Lot Number:
DEVETOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A- Sinsle Familv - Detached
srArE:Uhr,rqel7
-+ Single Family home Manufactured home not in a park
X $400 PER UNIT -=
NO OF UNITS X $370 PER UNIT =
PHONE:
X $277 PER UNIT =
X $280 PER UNIT =
Sfo
1
(
$
$
$
CD
WPRD SDC
2. SDC CREDIT (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)
$
$
City of
Date
a
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
$ 4ED.'D
Services
lo %