HomeMy WebLinkAboutPermit Building 1994-10-25SPRIr{GFIELDB
P
ESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726.3769
Office: 72A4759
-ro" *urrao
?fr,225 Flfth Street
Sprlngfletd, Oregon 97477
LOCATION OF PROPOSED WORK:ZIZ It^
ASSESSORS MAP:lt oLTZ 2-1)(
TAX LOT:C))'l^
LOT BLOCK:SUBDIVISION:
-
-
e_q qI^
ZIP:
b
E?-STATE:
a-
q7.l 7*
v <.2-lL
CITY
ADDRESS:
OWNER:
OTHERDEMOLISH
DESCRIBE WORK:
,./AODITIONNEW- REMoDEL v''
ADDRESS
4z EXPIRES PHONE
14b eb
MECHANICA
Z-
CONTBAGTOR'S NAME
ELECTBICAL:
GENERAL:
PLUMBING:
CONST.
CONTBACTOR #
gR - OFFTCE USE -
FLOOD PLAIN:LAND USE:
ZONING CODE:r OF UNITS:
SECONDARY HEAT:
SQUABE FOOTAGE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
I OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATER:BANGE:
To request an lnspectlon
made the same worklng
[--l Temporary Etecrrtc
Slte lnspectlon - To be made
after excavatlon, but prlor tosettlng forms.
l--l Understab Ptumblng/ Etectrlcat/s Mechanlcal - prlor to cover.
w Foollng - After trenches are
excavated.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Rough Mechanlcal - prlor to
cover.
Rough Electrlcal - prlor to
cover.
Eleclrlcal Servlce - Must beapproved to obtaln permanent
electrlcal power.
l-Vl Ftnat plumblns - When ail-f plumblng work ls complete.
[-\ f lnat Electrlcal - \ rrhen ail+ electrlcal work ls complete.s
N
N
Flnal Mechanlcal - When ailmechanlcal work ls complete.
' you must call 726'3769. Thls ls a24hour recordlng. All lnspecilons requested before 7:00 a.m, wlll beday, lnspectlons requested after 7:00 a.m. wlll be made the foIowrng work day.
REOUIRED INSPECTIONS
rF
ry
ry
[_l Masonry -.Steel locaflon, bond|J beams, groutlng.
m
[l Flreplace - prlor to factng
-
materlals and framlng lnsp.
s
F
F
tl
Framlng - Prlor to cover,
WaltlCeltlng tnstltatlon - prlor to
cover.
Drywall - Prlor to taplng
Wood Stovo - After lnstallatlon.
lneerl - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected brrt prlor to
placement of concrete.
Sldewalk & Drlveway - After
excavation ls complete, forms
and sub.base materlal ln place.
Fence - When completed.
Streel Trees - When all requlred
trees are planted.
Flnal Bulldlng - When allrequlred lnspecilons have beenapproved and bullding lscompleted.
MOBILE HOME INSPECTIONS
[-_l Blocklng and Ser.Up - Whep ail
-
blocklng ls complete.
Plumblng Connectlons - Whenhome has been connected to
water and sewer,
Electrlcal Connecllon - When
blocklng, set-up, and plurpblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Final - After all required
lnspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
tl
N
w
tr
tr
F
ry
ry
Underground Plumblng - prlor
to fllllng trench.
ffiil:f;:1,:'Jf,T!:[1ff:
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulallon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllling
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to fllllng
trench.
Rough Plumblng - Prior to
cover.
qltv.
?>
PHoNE: lLl" - Ll t 4S
\\\\
tr OF BDRMS: ._
[-l orher
E
.. rj4
Lot facos
Lot sq. ftg.
Lot coverage
Topography
Total tlelght
Lot TyF
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WOBK TN THE -
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit ls granted on the express conditlon that the said
construction shall, in all respects, conform to the Ordlnance
adopted by the City of Springfield, including the
Development Code, regulatlng the construction and use of
buildlngs, and may be suspended or revoked at any time
upon violatlon of any provisions of sald ordlnances.
r.o/atltq
Plan I DateBy
Beceived By;
Plan Check Fee:
Date Pald:
Recelpt Number:
BUILDING PERMIT
ITEM SO. FT.
Main
Gar.age
Carport
\81.*
\
(A)
X $/SO. FT. = VALUE
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
5.e82
B.?S+3t - \'\---e
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)
d 24.89
Systems Development Charge ls due on all undeveloped
properties wlthin the City limlts which are being lmproved.
ITEM
Flxturest
Resldentiai Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
No
rE.e
lS+32
tt l.9-\ro
t
FT.
FT.
FT.
(c)
,Ib
PLUMBING PERMIT
FEE
\o.q82
Plumblng Permit
State_ Surcharge
Total Charge
ADDITIONAL COMMENTS
C
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
\ s. clo.
.-?E+ 3?
(D)
t)2-b Le\
N0Vent Fan
Mechanical Permlt
lssuahce
State Surcharge
Total Permit
MECHANICAL PERM!T
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed appllcation and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the Clty of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance with OFIS 701.O55 wlll be used on thls
project.
I further agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls readable
from tho street, that the permlt card ls located at the front
u rlng
Slgnature
Date
theof the property,set of plans wlll remaln
on the slte at tructlon.
MISCELLANEOUS PERMITS
Moblle Homo
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Domolltlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlng etectricat)
(4, B, C, D, and E Comblned)
$6.qE
9'zoa
d
BECEIVED BY
AMOUNT RECEIVED
DATE PAID l0-
VALIDATION:
RECEIPT NUMBER
q.q"-
tg
CITY OF orv
SPRINGFTELC,
*,ii: #sr#r$es oubrnittod has lheregurrespecific
E
PERHIT APPLICATION
$ s0.00
s 60.00
s100. 00
$130.00
s300.00
$ 40.00
225 FIFTE STREET
SPRTNGFTELD, oREGoN 97477
INSPECTION REQUESTz 726-3TG9n
OFFICE: 726-3759
city Job Nuuber q4\451L
1
Permits are non-transferable and expire
if work is not started vithin 1B0 days
of issuance or if vork is suspen?ed for
180 days.
2. CO}TTRACTOR INSTALI..ATTON OT.ILY
El-ectrical Contractor
Address
Ci ty Phone
Super'visor Li ense Number
Aarr^ C0XPLETE FEE SCffiDUI,E BELOY
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service fncluded:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Modul-ar Dvelling
Service or Feeder
s 8s.00
s 1s.00
$ 40.00
Services or Feeders
Install-ation, Alterations
or Relocation:
/;t:rr.;.....: r1
Sum
B
200 amps or less
20L amps to 400 amps
-401 amps to 600 amps
-60L amps to 1000 amps-
Over 1"000 amps/volts
-Reconnect 0n1y
QWr
0ne
Each
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Alteration or Extension Per Panel
circuit I s3s.oo 2[9OAddi t ional .:-
Ci ty Phone
OVNER
The installation is being made on
property I ovn which is not intended
for sa1e, fease or rent.
t
0vners Signature:
DATE:
RECETPT
Expiration Date
constr contr. Number
Expiration Date
Signat f Supervisi
Ovners ame
Address
C Temporary Services or Feeders
fnstallation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 40L to 600 amps
-
$ 80.00
Over 600 amps or 1000 voTts see rtgtt uffi
Branch Circui ts
trician
Zb4l45
5
::';::i":'rllll,"'"'"1c s 2.oo \WD
Miscellaneous (Service/feeder not included)
-Each i.ns tallation
Pump or irrigation S 40.00
Sign/0ut1ine Lighting- $ 40.00
Limited Energy/Res
-
S 20.00
RECEIVED I}Y:
36.00\a)
I
C. el
t\t lA\.nt'lLItl o.l.
JoB N0 . a4/ /s7
CITY OF SPRINGFIELD SYSTEMS DEVELOPI - IT Ch{ARGE
WORKSHEET
(COMMERCIAL & RESIDENIIAL)
iU}.lE OR COMPAI.{Y:
LOCATION:2rz ry'45n
DIVELOPMENT TYPE:/zH-fu/ /
J
BUILDING SIZE SIZ Ft
1. STORI4 NRAINAGF
IMPERVIOUS SQ. FT.hz fu--o\X $0.209 PER SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
* o///X $43.26 PER PFU
TRANSPORTA.TION
NO OF UNITS X TRiP RATE X COST PER TRIP
x
-
x $436.i9
x
-
x s436.i9 $
x _ x s436.19 s
SUBTOTAL (ADD ITEMS 1,2. & 3)s 7o'z /
4. SANTTARY SEI{FR-MhIl'4C
N0. 0F PFU'S x $17.19 PER PFU + $iC Ml^l}.lc ADMiN.FEE
(Use PFU Tota'l From Item 2 Above)
M|.Il',lC CREDIT iF APPLiCABLE (SEE REVERSE)
TOTAL-MWHC SDC
SUBTOTAL (ADD ITEMS 1.2,3 & 4)s 7a-27
5. ANMTNISTATIVF FFFS
BASE ABOVE) X .05 .f/
7-:d- ?7
Har
SDC
(
ig. P
.27
82. SDC
i nat
Date:
TOTAI SOC s 7 /.?d
s "Z