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Home My WebLink AboutPermit Building 1994-03-30t RESID ENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK:2 ASSESSORS MAP:og 2- JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT:/ a?) LOT BLOCK: ZIP:r STATE:7 PHONE:7n6 *6 rg7 C)re a c tJ OWNER: ADDRESS: c NEW /, REMODEL ADDITION DEMOLISH OTHER - DESCRIBE WORK: MECHANICAL: ELECTRICALi ADDRESS EXPIRES PHONEOcrJrler CONTBACf,OR'S NAME CONST. CONTRACTOR # GENERAL: PLUMBING SE-U \SRSE- RANGE: * OF BDRMS: WATER HEATER: - OFF]CE ZONING CODE: FLOOD PLAINLAND USE: * OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIEST QUAD AREA: * OF BLDGS: CONSTR. TYPE: HEAT SOURCE: To request an lnspection, you must call 726-3769. Thls ls a24hour recordlng. All inspections requested before 7:00 a.m. will be made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Electrlc El Rough Mechanical - Prior toAcover. $p[ Rough Electrical - Prior to4cover. K Final Plumbing - When all plumbing work is complete. E K K Site lnspection - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrlcal / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel locatlon, bond beams, grouting. Foundatlon - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Sanltary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Water Llne - Prlor to filling trench. Rough Plumbing - Prior to cover. Electrical Servlce - Must be approved to obtain permanent electrlcal power. Wood Stove - After installation lnsert - After fireplace 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. Street Trees - When all requlred trees are planted. 'l!f Final Electricat - When atl.,,a\ electrical work is cgmplete. M finat Mechanical - When alllAJ mechanical work is complete. X[-l Flreplace - Prlor to faclngu materlals and framlng lnsp. ffi framlng - Prlor to cover. F7l watttCelllno lnsulation - Prior to14 cover. ,Koo*"ll - Prlor to taoing' Final Building - When all required lnspectlons have been approved and building is completed. Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When all blocking ls complete. Plumbing Connections - When home has been connected to waterrand sewer. a 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. VI u nde.l ! oo rffffibii-ilt/l ec h a n ic al,l t.- Prior to-ihElrr6'ti6n or decking. F7 Post and Beam - Prior to floor5{ insutation or decking. l\/ Floor lnsulation - Prior to .A{deckins. /G.ql SUBDIVISION: - E74 stn E tl E E i .S THE PFIOPOSED WOFIK IN THE'" HrsronrcAL Drsrntcr, oR oN THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved bY the Historlcal Coordinator prior to permit issuance. APPROVED: { Lot faces Lot sq. ftg. Lot coverage TopographY Total hei L.oyType A tnturio, - Corner - Panhandle - Cul-de-sac tbacks w HSE GAR ACCP.L, N S E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said consiruction 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' pran check ,"u. izi0 ,cl Q' Reviewed By 7 i:tit ' PI IReceipt Numbe Date Paid: Received BUTLDING PERMIT.' VALUESQ. FT.<lo #t,o4pE-&qsrt- (A) s'z f\.\()'s4 g ,7e, X $/SQ. FT. (Z.LE ITEM Main Garage Carport Total Value Building Permit Fee state surcharge Total Fee ZZG ,z e '<4 ?+ s ?s.5o Systems Development Charge is due on all undeveloped properties within the City limits which are being improved.SYSTEMS DEVELOPMENT C (B) HARGE (sDg) /d1 # l4>tY rt- ADDITIONAL COMMENTS ITEM Flxtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 2.€o fr9-o5 (c)5 €o N0 FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unlt Dryer Vent 2rr), /5,e ,-? 25.7r(D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rn ace Exhaust Hood By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance wlth the Ordinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the slte at al times duri construction. Date Xign.,u MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, q D, and E Combined) 44e^.za Gb 3DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER /*zv Z FT. FT. /o-"o Ja-....tua rLLU 0fr 225 FIFTB STREET 8r+ submr$sd hae the SPRINGFIELD, OREGON require specdic,md INSPBCTI0N REQUBSTT 726-3 L LOFFTCE: 726-3759 : ,,#?lF',rsfjsi::i ELECTRICALfollawhlg u8€ PERHTT APPLICATION City Job Num ber -q 1 3.COHPLETE PEB SCEEDULE BELOU Residential-Sing1e or Hu t mily per dvelling un it. Cos t $ 8s.00 $ 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 290 1 LOCATI ,ON OF INST G3 S.S I,EGAL DESCRIPTION 2-S 2-l o a/oo JOB DESCRIPTTON Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days 2. COIII"A(TOR INSTALI,ATION ONLY Electrical Contractor Address Ci Phone Supervisor License Ntimber ExP iratlon Date Constr Contr. Number Exoiration Date Signature of Supervising Electrician 0vners Nanie Address z Service fncluded: I tems 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder 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 SIIBTOTAL OP ABOVE 5Z State Surcharge TOTAL c.TemporarY Services or Feeders Insiallaiion, Alteration or Relocation 200 amps or less $ 40'00 over 4b1 to 6oo amps - $ 8o.oo -Over 600 amps or 1000 volts see 'rBrr above Branch Circuits Nev, Alteratlon or Extension Per Panel one Circuit L-'/ S 35.00 35,* Each Additional Circuit or vith Service or Feeder Permit 7 $ 2.00 E. Miscellaneous (Service/feeder not' included) -Each installation Pump or irrigation Sign/Out1ine Lighting-- Limi ted EnergY/Res _- Limited EnergY/Comm b60--1tTT---gT7{ Sum s s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 D. ciq VP enone 72G'b497 OITNER INSTALI,ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovne Signa DATE: RECEIPT S: A 00 00 00 00 $40 $40 $20 s36 RECEIVED BY: 5 Permit No:O Address: lssued Date OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSI BILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 1I- z.E 3.4 I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT My general contractor is , Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.< I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibitities on the reverse side of this form. e,ler/r/ ature o rm licant dat5------------- CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 s/tr/gz7-------1 .08 N0.74o zo o CITY0FSPRINGFIELDsYsTEMsDEVEL0PMENTCHARGE }IORKSHEET (ComMERCIAL & RESIDENTIAL) rv1 Pb,NAME OR COMPANY:I ubee LOCATION:b5 5 44 -tt 5r l8o 7052t - 100 DEVELOPMENT IYPE LD& - AAPITION BUILDING SIZE: tz x 48 (ut €evr:>) LoT SiZ a. Ft. I. STORM DRAINAGE IMPERVI0US SQ. FT.51 b x $0.203 PER SQ. FT- 2. SANITARY SEl,lER-CITY NO. OF PFU'S (See Reverse) 5 x $42.08 PER PFU TRANSPORTAT ION NO OF UNITS X TRIP RATE X COST PER TRIP x $424.31 x $424.31 x $424.3i $ SANITARY SEvlER-t'4hlMC N0.0F PFU'S x $15'125 PER PFU + $10 MI,IMC ADM FEt (ii:; ;'FU'i.til-#*rt* 2 Above) Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MI^IMC SDC SUBT0TAL (ADD ITEMS 1'2'3 & 4) $ $va 1 2 5. ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) x '0s T L. 3 X x x $ 4 b Kip Burd ck nator Zto49 SDC Coo rdi TOTAL SDC $?+?1o nit Equivalent = Fixture Units (NOTE FIXTUREUNIT,CALCUI.J^oNTABLE:NumberofNewFixtures For remodels, catcutbie only the NET additional fixtures) NUN4BER OF FIKTURE TYPE NEW FTXTURES UNIT EOUIVALENT FIXTURE UNITS Drinking Fountain...-."' 2 1 L J 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 Floor Drain-- lnterceptors For Grease/Oil/Sollds/Etc"""'-""""' lnterceptors For Sand /Ar-rto Wash/Etc Laund ry Tub/Clotheswasher.... -- -- Clotheswaqher - 3 Or More......- Mobile Hdme Park Trap (1 Per Trail er)................. R eceptor For Refri geratorAVater Station/Etc........ Receptor For Commerclal Sink/Dishwasher/Etc.. Shower, Single Stall.. Shower, Gan9......-.... Sink. Bar, Commercial Urinal, StallflVall..... Wash Basin/Lavatory, Sin91e......... Water Closet, Public lnstallation.... Water Closet, Private...... Miscellaneous: TOTAL FIXTURE UN{TS CREDIT CALCULATION TABLE: Based on assessed value calculate credits separates. lf improvements occurred after annexation date in table, Credit for Parcd or Land Only lf Applicable X $ (Rate X e.r".."d Vdu"f lmprovement (rf after annexation date)x$ (Rate X Assessed Value) CREDIT TOTAL $ Year Annexed Rate per $1,00O Assessed Value Year Annexed Rate per $1,000 Assessed Value '1979 or before 1980 1981 1982 1983 1984 1985 $3.21 3.13 3.08 2.96 2.82 2.68 2.51 1986 1 987 1988 1989 1990 1991 1 00, S 2.24 1.93 1.57 1.18 0.79 0.44 0.28 RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.. Commercial............-...... lndustrial...- Governmental.. 0.4 0.9 0.45 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT I --Z-- TI