HomeMy WebLinkAboutPermit Building 1995-07-115qe ffi 6ao,5/
t
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK
SPRIr{GFIELEl
Zfr,
JOB NUMBER
225 Fifth Street
Springfield, Oregon g7 471
r(a2-0 4 AA-ASSESSORS MAP:
LOT:
TAX LOT:v
BLOCK:SUBDIVISION
OWNER:
ADDR
CITY:
PHONE
STATE:ZIP
NTCW '{ REMODEL ADDITION DEMOLISH OTHER
-_
-9r kaDESCRIBE WORK:
IRES PHONEJ^0CONTRACTOR'S NAME
MECHANICAL
ELECTRICAL:
CONST.
CONTRACTOR #ADDRESS
€.(.t ,GENEFIAL:
PLUMBING
\il\q-s.a-
{e
rn
n//
6 MIt-F
\,/A
SQUARE FOOTAGE:WATER HEATER:
_ OFFICE USE -
LAND USE:til l
RANGF.:
SECONDARY HEAT: _:-
# OF BDRMS
* OF UNITS:ZONING CODE:l/D rL
ZCONSTB. TYPE:
HEAT SOURCE;
OCCY GROUP:
I OF STORIES:
QUAD ABEA:
# OF BLDGS
To req
made
uest an lnspectlon, you must call 726'3769. Thls ls a24hour recordlng. All inspections requestecj before 7:00 a.m. will bethe sante working day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
IE i;,1"?t
Mechanrcar - prior to F 5l:;1.?l:tri?-r,;"yffii"iJ:
[ -l Temporary Electric
\-J
Site lnspection - To be madc
af ter excavation, but prior tosetting forms.
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, grouting.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumbing - prior
to fillinq trench.
Underlloor Plumblng/ Mechanical
- Prior to lnsulation or decking.
Rough Eleclrical - prior to
cover.
Electrical Servlce - Must be
approved to obtain permanent
electrlcal power.
Flnal Electrical - When allelectrical work is complete.
Final Mechanlcal - When allmechanical work ls complete.
Plumbing Connections - Whenhome has been connected to
water and sewer.
Eleclrical Connection - Whenblocking, set-up, and plumbing
inspections have been approvedand the home is connected tothe service panel.
E
tr
tr
m
ry
;4
Flreplace - Prlor to faclng
materlals and framing lnsp.
ffi Framlng - prlor to cover.
Final Building - When ailrequired lnspections have beenapproved and building is
completed.
Other
MOBILE HOME TNSPE TIONS
.E
[--l glocking and Set.Up - When ail
-
blocking ls complete.
ffi, Post and Beany - prlor to floorH insulatlon or decking.
ffi Floor lnsulation - Prior to
f decking.
|y| Sanitary Sewer - Prior to fiilingH)! trench.
ffi Storm Sewer - Prior to fillingP trench.
l-Fl Water Line - Prior to filingP trench.
[-] Rough Plumbing - Prior to
fl cover.
ffi OrVwatl - prlor to taping.
J I Wood Stovo - Afrer lnsrailation.
l-.l lnsert - After ftreptace approval
-
and installatlon of unit.
ffi Curbcut & Approach - After'--r- torms are erected but prior toplacernent of concrete.
tr Sidewalk & Drlveway - After
excavation is complete, forms
and sub-base material in place.
l-l Fence - When compteted.
Streel Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, sklrting, decks, andventlng have been lnstalled.
?sa7a?
<P 4t
20L 2q>%op
hw
FLOOD PLAIN:
Wall/Ceiling lnsulation - prior to
cover.7
P.L.HSE GAR ACC
N \1.6
S 5
t\nstE'l'
E '{\b
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
V lnt"rio,
-
Corner
-
Panhandle
-
Cul-de-sac
ks IS THE PROPOSED WORK IN THE
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certlfy
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 thc work described
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Buildirrg Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper tinre, that each address is readable
from the street, that the permlt card ls located at the front
of the property, and the a proved set of plans will remain
on the site at
Slg natu re
6 r37
W
Total Value
Building Permit Fee
State Surchars. lb.6S +\\.\1
Total Fee (A)
101
4tE
X $/SO. FT.
LLAO 56,8
\{.e
\ q" c82 665o' 9:
Ab&.8{
VALUE
6S-9#i.q2
"rB8^l €
-l_1$l.a€j1L?
Lq. B:r
\r
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
firqrYv.t*
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 co0struction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
-:leltsiewed ByPI daG
Plan Check Fee
Date Paid
Reccipt N umbcr:
Received By:
SYSTEMS DEVELOPMENT C
(B)
HARG E (SDC)
#naL#Systems Developmcnt Charge is due on all undeveloped
properties within the City linrits which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge P''CO *Lt'Ba
Total Charge (C)
FEE
tbo qp
\60 "s
tsr" &
UIA
N" 5_
FT.
FT.
&
PLUMBING PERMIT ADDITIONAL COMMENTS
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
A.9a
11.
3\."1
c]o
b-
sJ)
sf(
(D)
. ct5
ro.
3 t4.
\b ea?
98 + .Sl
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
N'L
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
sidewatk &'l rt
curbcut ' ?r: tt
Demolition
uo."5
9gr lY'
_t 1SETotal Miscellaneous Permils
€j\A{
(E)
TOTAL AMOUNT DUE (excluding eleclrica
(A, B, C, D, and E Combined)
*iow{4
7^rt9 f
378o ae
DATE PAID -
g
AMOUNT RECEIVED
-FIECEIVED BY
VALIDATION:
RECEIPT NUMBEB .
Date
ll times ring construction.
FT,
7 tt -4<
State Sqrpharge
oxv,|/ t- ,r 'aer.re
/
CITY OF SPR'A'GFIELD, OREGO'V
SIPR ,'IELD
Tho lol)owing project as srrbmitted has the loll
zcning, e"nd
approval,
does nol require specific lend use
225 FTrT'E STREBT
sPRrNGFrEtD, OREG0N 97477
ELECTRICAL PERI{IT APPLICATION
Ci ty Job Nunber o
COHPI..ETE FBB SCEEDTIIJ BELOTI
A. Nev Residential-Single or
MuIti-I'amiIy per dvelling unit.
Service Included:Items Cost Sum
L000 sq.ft. or less L--' $ 85.00 35.a"
Each additional 500
&JthoCtred
1. LOCATION OF a
LEGAL DESCRTPTION/Eo L oS 7-7 DO 2_
JOB DESCRIFTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if work is suspended for
180 days.
2. COMRACTOR INSTALT.ATTON ONLY
IHiET"},::3ffi" 728&Afr
Ro* Grpordna
sq. ft or portion
thereof ?
Each Manuf'd Home or
Modular Dvelling
Serviee or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPs
-
601 amps to 1.000 amps-
Over 1000 amps/volts
Reconnect 0n1y
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAT
$ 1s.00
$ 40.00
/to,
B.
Electrical Contractor
Address
Expiration Date
Ci. ty
Supervisor License Numbe , l5L 85
E% OR Ynone bElaoQq',
$s0
$60
$100
$130
$300
$40
.00
.00
.00
.00
.00
.00
not included)
40.00
40.00
20.00
9,oo
I
Constr Contr. Number
Expiration Date
Signature rvising Electrician
Ovners Name
Address
Ci ty Phone
OIJNER INSTALI.,ATION
The installation is being made on
property I ovn which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 19.qq
20L amps to 400 amPs
-
$ 5f.gq
over 401 to 600 amps
-
$ 80.00
over 600 amps or rbOOEIts see rtgrt
"ffi
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
o
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E
5
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
-
$
sign/outline Lighting- S
t iilited Energy/Res
-
$
BRECETVED
o
-
NAME:
Willamalane
F"7r. a-n-ecreation D istrict CJob. No. t 50 lol
PHONE l- r{Ds B&1
STATE: -DS-- ZtP:
-
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
L
ADDRESS ..Lq q G 0
LOCATION OF PROPOSED BUILDING SITE:
Street Address:G1 a t \" -\tsP
Plat Name: t B olOS 5& Tax Lot Number O OAIO oA
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculalions and dwelling t
ype definitions are on the back.)
A. Single-FamilY Detached
single Family home Manufactured home not in a park
NO. OF UNITS X $1,000 per unit = $ \ Cn-D Se-
B. Single-Family Attached
NO. OF UNITS X $924 per unit = $
C. Multi-Family Apartment
NO. OF UNITS X $692 Per unit = $
D. Manufactured Home Park
NO. OF UNITS X $699 per unit = $
WILLAMALANE SDC $
2. SDC CREDIT (if applicable) SDo-payer must furnish proof of
Willamalane ireOit'approval' See SoC Crean Worksheet' $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
ent Services
e5<D€-
$\
City of Springfield
ment
- t //-J 7<
Ddte
',n)
CITY OF SPRINGFIELD
COMMIJNITY SERVICES DTVISION
BUILDING SAFETY
AIITHORIZATION TO PROCEED AGREEHENT
s entered into this day of
5vln
ffi$o+t
, 1{5 by and
tate of oregon,THIS AGREEMENT i
betveen the CitY
hereinafter call
the Applicalrt.
of Springfield , amun corporat ono
, hereinafter ca}leded City' and
IIHEREAS, the aPPI icant has applied to the CitY Community Services Building
Division for issuan ce of eertain construction 1 for development
improvements to be located at Springfield,
Oregon or vithin the CitY's Ur ct ea;County
Assessor's Map and Tax Lot nun ber /oe 22-z.
\IHEREAS, the applicant has asked the City to authorize the Applicant to
immediaiely commence development improvements vithout a completed plan reviev or
subsequent approval as required by the Springfield Building Safety Code
Administrative Code section 303(a).
IIHEREAS, the Applicant has submitted to the City a comPleted permit -application,3 (three) sets Lf corrstruction dravings, speeifications, and other data_required
foi the Lity to complete the necessary plan reviev of the proposed development
improvement.
VHEREAS, the intended development improvement is of a nature that requires no-
other reviev approval fron other State or local agencies and is exemPt- from the
eriteria estabiished by -the Building Safety Division, attached as Exhibit A of
this Agreement
VHEREAS, the City has not revieved or approved the submitted materials for the
development improvenent, the City is therefore unable to confirm at this time
vhether the permit applicatio: submitted viII be approved, and vhether the
required construction pernits can be issued.
VHEREAS, the applicant has requested the City to provide expedited authorization
to proceed vith certain phases of construction prior to the completion of the
City's reviev of the permit application.
IIHEREAS, the City's fee for the administrative services rendered in providing
expedited authorization is $150.00.
N0U, THEREFORE, in consideration of the foregoing recitals and of the mutual
promises contained herein, the City authorizes immediate commencement of the
development improvement specified in the permit application subject to the
folloving terms and conditions:
I
Authorization to Proceed Agreement
Page 2.
1 City agrees that the APP licant maY immediatelY commence vith the
developmen t improvements se t forth in the Permit aP p1 ication. CitY's
authorizat ion to proceed is condi tioned hoveverr upon APP licant's agreement
that the Pr oject will be cons tructed as set forth in the attached submitted
dravings and cifications, excePt as may be modified bY City, and vill
comply vith appr icable laws and ordinances.t's iunediatespeaIl
or
cottrmenceEen t of constructiou is at icant's ovn no
assuraDce ts
2. City agrees to reviev Applicant's. permit application in the normal reviev
pro""=" "id to thereafter:
a) issue Applicant the appropriate construction permits; 9!
b) advise Applicant of deficiencies in the proposed construction vhich
must be remldied before permits can be issued; or
c) advise Applicant of any Statutes, ordinances or code provisions vith
"fri"t epplitlnt must conpiy vith before City can issue the permit'
3. Applicant agrees that if City findg Applicant's permit application and
submiited nateiials inadequate or deficient in any manner -including but not
iimitea to, the application or the proposed construction do not comply vith
"ft-"ppti"iUf" statutes, ordinances or code provisions, Applicant vill
"*p"aitiously cure the deficiencies so that the City may issue the required
p"fu,it". Shoita Applicant fail to glpeditiously correct submitted naterials,
ir should correction prove impossiblL, City may in it's discretion, take any
or all of the folloving actions:
a) stop all further construction of the project in the manner prescribed
in the- Springfield Building Safety Code Administrative Code (BSCAC) 'sEcrroN 201 (d)
b) order disconnection of serving utilities in a manner as prescribed in
BSCAC, SECTToN 201 (f)
c) issue a NOTICE }}D ORDER for renoval of aII such vork in a manner as
prescribed in BSCAC, SECTI0N 204. ABATEHEM 0F IJNSAFE, SUBSTANDARD 0R
DANGERoUS BUILDTNGS, STRUCTURES 0R BUILDING SERVICE EQUIPI'IENT. Upon
receipt of such notice, Applicant shall immediately remove the vork
specified in the Notice and 0rder.
4. Applicant agrees, if the issuance of the permit is denied:
a) to remove, at the Applicant's sole cost and expense, all completed
eonstruction or improvements; and
b) to restore the site or structure to it's pre-agreement condition and
free of all hazards
ra
t or eoustruct
ruccons
Authorization to Proceed Agreement
Page 3.
by the City's Building 0fficial . Applicant's Point
.=/--44
5. Applicant agrees that until Applicant's Permit a Iication is aPProved,
cons truction vilI no t to proceed beyond the Point o
PPf authorization apProved
of Authorization is
?rv )a-O
6. Applicant agrees that all vork performed under this agreenent shall be
."".i"iUle and exposed for inspection purposes and that neither the Building
0ffieial nor City shall be liaLle for lhe-expense entailed in the removal or
replacement of any material necessary to allov inspection.
7. Applicant agrees that any or all'deficiencies identified during_the
n.""isary inspEctions vilI te promptly remedied, at Applicant's sole cost
and expense blfore proeeeding vittr- any further construction. Applicant also
agrees that these inspectioni do not replace the required plan reviev nor do
they imply any approval of the submitted materials.
8. Applicant agrees that no vork shall be done on any part of the building
or structure beyond the point indicated in each successive inspection
vithout first obtaining the approval of the Building 0fficial. Such approval
shall be given onLy after an inspection has been made of each successive
step in the construction as indicated on the attached Exhibit B.
9. Notvithstanding any other provisions of this Agreement, this Agreement
shal1 terninate upon issuance of a building permit or thirty (30) days from
the date of this Agreenent, vhichever first occurs. Applicant understands
that all vork on the project shall immediately cease vithout any notice from
;li='ilI.HJt' :riii"::#":::':1" ""-t sffi.-' N( :iffd3'mi
t i s i s sued'
10. Applicant agrees to defend, ina"rniry "nNniu Itty harmless from any
and all costs (including attorney fees), liability or damages of any kind or
nature vhatsoever, for personal injury and property damage arising from theApplicant's early eomuencement of construction and the vork undertaken or
comple ted.
11. The terms of this Agreement shall extend to and be binding upon theparties hereto and tiieir heirs, successors and assigns.
.L2. If any suit, action or other proceeding, or an appeal therefrom, isinstituted to obtain, establish, enforce, or compel any right or obligationresulting from this Agreement, the prevailing party shall be entitled torecover fron the adverse party, in addition to costs and disbursements, suchadditionar sums as the courts, both triar and appellate, may judge
reasonable attorney fees.
Authorization to Proceed Agreement
Page 4
BEFoRE SIGNING TIIIS AGREEMENT, PI,EASE_ READ AND UNDERStrNTD TIIE
UEANING OF EACrI_PANAENAPU OF THIS AENSEMiNT' IT AFFECtrS YOUR
rNtrEREsrs rN TIIE pRopERTy AN;, rN rHE_Ev-E-Nr oF DEFAUI'T, rr PrJAcEs
YOU PERSONALLY AT RISK ETIO, TTN SUBJE;T PROPERtrY AT RISK OF
FORECI,OSURE rON COSTS AN; - EXPENSES T-NCUNNSP BY TIIE CITY IN
ENFORCING 1THE TERMS OF TIII; AGREE!'IENT'
-_iN TUE EVENT TEAT YOU DO
NOT UNDERSTAND ANY TERI{S ON CONOITIONS Oi THIS AGREEUENT' PLEASE
SEEK ANY I.EGAI' OR OUtrSIDE OPINIONS YOU UAY DESIRE'
CITY
City of SPrinqfield
APPLICANT
Contr
By:Business Name,
Building official Address
K/t/4>7aD/, q33'
cc Resistration # &75LG
I.'AND /PROPERTY OWNER (SI
tl WE EAVE READ TIIE ABOVE AUTIIORIZAT ION TO PROCEED AGREEI{ENI'r/I{E
UND ERSTAIID WHAT IT EXPRESSES AI{D TIIE RESPONSIBILIIIES IT PLACES
OWNERS I /wE AGREE TO BE BOLND BY ALI,
UPON US AS TIIE
AGREEMENT.TERMS AND
Name
Address
VALIDATION:
CITY JOB #
RECEIPT NUMBER
DATE PAID
AIvIOUNT RECEI VED
RECEIVED BY
Puroose
TFe pu-pose of this
occur prior to obta
Services Division.
ETHTBTT A
agreement is to allov'certain development improvements to
ining plan reviev approval fron the Springfield Community
Scooe
TE,fise of this agreement shall be limited to certain one and tvo-family
dvellings not complex in nature as determined by the Building Official and
minor alterations or modifications to existing commercial and industrial
buildings vhieh are of a non-structural'type and do not adversely affect any
structural member of the building or any part of the building having fire
resistant eonstruction.
One and tvo-family dvelling plans for structures that are complex in nature that
have been prepared by an Oregon licensed architect or engineer and accompanied
by a letter of reviev prepared by said architect or engineerr stating that the
submitted material is in eompliance uith the One and Tvo-Family Dvelling
Specialty Code, may be considered eligible for this agreenent.
The following itens include but are not limited to certain conditions of
development identified as ineligible for this agreement3
a) development requiring site approval vhich has not been obtained;
b) nev development located on land vith over six-percent slope;
e) lots having expansive (c1ay) soil;
d) development located vithin flood hazard areas;
e) development located vithin vetland areas;
f) pole buildings or other sueh type of structure that is not of conventional
construction.
'l N0.45o1o1
CITYoFSPRINGFIEI,DSYSTEMSDEVEI,oPMENTCHARGE
WORKSHEET
(CoMNERCIAL & RESIDENTIAL)
NAME OR COMPANY MEqEPA DCV.
LOCATION:.4 eJ lSozo Z z - oo407
DEVELOPMENT TYPE:L R- Ll ew
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIoUS SQ. FT.
?. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
\t >1 x $0.209 PER SQ. FT-
X $43.26 PER PFU
x $436. 19
x $436. 19
. Ft.
S
LOT SIZ
1g
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I x l,ol x$436.19
x
x
4. SANITARY SEWER-MWMC
NO. OF PFU'S \ 8 X
(Use PFU Tota'l From Item 2 Above
Mt.lMC CREDIT IF APPLICABLE (SEE REVERSE)
$17.19 PER PFU + $10 Ml.lMC ADM FEE S ?fi+3
q+
' IgIA!:flUUe-SDE
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
5 ADNItttstRRttvr rErs
BASE CHARGE (SUBToTAL ABoVE) X .os
Kip Burdick
SOC Coordinator
,*9
TOTAL SDC sYtqV
s
oate: c /t b/qq
FIXTURE UNIT CALCULATIq,_N TABLE: Number of New Fixtures X-l.Jnit Equivalent :. Fixture Units
(NOTE: For remodels, calculate only ttre -- additional fixturesl
NUMBER OF
NEW FIXTURESFTXTURE TYPE
a +
Bathtub-.-.----
Drinking Fountain....
Floor Drain-
lnterceptors For Grease/OillSotids/Etc--------".-".--
lnterceptors For Sand/Auto Wash/Etc--- --.-.'. " "'-"Z
Laundry Tub/Ctotheswasher-- -----
Clotheswasher - 3 Or More-----
UNIT
EOUIVALENT
?-
?-
TOTAL FIXTURE UNITS
lf improvements occurred after annexation
,+b x$q.gt
(Rate X Assessed Value)x$
(Rate X Assessed Value)
FIXTURE -.
UNITS
t8
date in table,
1*
,l+
2
1
')
J
6
2
6
6
1
J
2
1/H
2
2
1
6
4
Mobite Home Park Trap (1 Per Trailer)
Receptor For Refrigerator/VVater Station/Etc
Receptor For Commercial Sink/Distrwasher/Etc"
Shower. Single Statl...........
Shower, Gang...-..... ."""":'.""'
Sink: Bar, Commercial, Residential Kitchen."'
Urinal, StaltArVall...
Wash Basin/Lavitory, Single
Toilet, Public lnstatlation..
Toilet , Private
Miscellaneous:
CREDIT CALCULATION TABLE: Based on assessed value
calculate credits separates
Credit for.Pgrcel or Land Only lf Appticable
lmprov€ment (if after annexation datel
ead
e
__E-
.?.
7b
CREDIT TOTAL - S 9'b
Year
Annexed
Rate per $1,OOO
Assessed ValueYear ''
Annexed
Rate per $1,OOO
Assessed Value
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
1 993
$2.46
2.14
1-77
i.37
o.97
o.61
o.44
o-15
1 979 or before
1 980
1 981
1 982
1983
1964"
1 985
s3.46
3.38
3-32
3.21
3.O6
2-92
2-73
I