HomeMy WebLinkAboutPermit Building 1993-11-01," "l t"-
RESrDEru"nxt,
PERMIT APPLICATION
lnspections: 7?6-3169
Office: 726-3759
I.OCATION OF PRO
SPFlINGFIELC)
%1131
880 South 45th pLace
JOB NUMBER
225 Fillh Street
Springfield, Oregon 97 477
# sp as
POSED WOBK: - -18020512NSSESSORS MAP TAX LOT:7700 _
LOT:136 BLOCK:
OWNER: -
Capstone Homes, Inc. of Oregon
SUBDIVISION Lucerne
PHONE:6 89-5 567
P -o.ADDRESS:
Box 22636
Euqene, OR 97402
SingTd FamiTg Residence
STATE:ZIP
DESCRIBE WOFIK
hanicalPlumbirr
NEW --X-_ FIEMODEL ADDITION DEMOLISH OTHER
CON TRACTOR'S NAME ADDFIESS
CONST.
CONTRACTOR #PHONE
(IENERAL: Capstone Homes,. Incl of OR p.O?8.226 589-5 s67
I)t UMBING FridTund p lumbing 85628 Di77eg Lane__Eu 746-9433
MT.,()HANICAL Garibas !"_r!:!s_ 4307 r!. sth 4u_e.'E_qg-Qg_eJ4_02 *Jr.54i_ 12-2j_-93_34_4e4!-t
IiI-ECTRICAL Hauck/Hananer Elect. i53 S.6gth pl.Spt_7iJ- pR 97478 8q42 ? 3-5_-94_ 744-l-755
n---
fl Temporary Eleclrictl
Site lnspection - To be made
:rlter excavation, but prior to
setting lorrrts.
Underslab Plumbing / Electrical /
Mechanical - I:'rior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bot'l(l
bearns, grouting.
Underground Plumbing - Prior
to filling trench.
Underl
- Prior
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to f illing
trench.
,X i:::: !E:;"'z)*,y:r." K
x1
LNND USE
r OF UNITS:
Rough Electrical - Prior to
oovet.
Electrical Service * Must be
approved to obtain permanent
clcctrlcal power.
Fireplace - Prior to facinO
uraterlals ancl framing lnsp.
Wood Stove - After installation
lnserl - After llreplace aPProval
ancl installation of unit.
Curbcut & Approach - After
forms are erected but Prior to
placement ol concrete.
Streel Trees - When all required
trees are planted.
EXPIBES
62078 10-78-93
ZONING CODE
Final Plunrbing - When all
plumbing worl( is complete.
Final Mechanical - When all
mechanical work is complete.
lSlFinal Electrical - When alljA\etectrical work is conrplete.
E
3R$-__OUAD AREA:
r OF BLDGS:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:r OF BDRMS:
HEAT SOURCE:SECONDARY HEAT:
SQUARE FOOTAGE:WATEHHEATF-R: .--.RANCE:
To request an inspection, you must call 726-3769. Thls ls a24hour recording. All inspections requested before 7:00 a.m. will be
rnacle the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
K
E'
B
X
[Yf Final Building - When alllArequired inspectlons have been
approved ancl building is
complete(1.
l\7/Foundation - nfter forms arejA\erected but prior to concrete
placement.
( tt'-t"g - Prtor to cover'
EI yj:i:eitins tnsulation - Prior to
,{otwult - Prior to ta'ing'
Other
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When all
blocking ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, arrd 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.
M Post and Beam - Prior to floor
JAinsulation or decking.
f71 Floor lnsulation - Prior toAdecking.
,X
E T7 Si.lorlr"lk & Driveway - Af ter
JAJ excavation is complete, forms
and sub-base material in Place.
E-y;l*Llne - Prior to rirrins
E Rough Plumbing - Prior to
cover.
o
_ OFFICE
fl
r
G
il
l--l Fence - When comPleted.
tf
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
7e@
Lot Type
)C tnt"rio,
-
Corner
-
Panhandle
---. Cul'de-sac
Setbac S ro THE I'ROPOSED WORK-IN THE
HISTOFIICAL DISTRICT, OR ON
THE I'IISIORICAL REGISTER? -- --.ll ycs, this application must be signed
anrl ;tpptovecl by tllc l{istorlcal
Coorcjin;,rtor prior to petmit issuance'
AI't)i:loVEt):
ACC
/4?"
Z??O
aw-
S !9_-
E /a
GAFIP.L.HSE
tlN
BUTLDING VALUE, PLAN CHECK
AND BUTLDING PERMIT
Thisperrrlitisgrarrtedontlreexplessconditiorrthatthesaic.J
construclion shall, in e'rll respects, conform to the Ordinance
acloptc<J by tht: City of Sprirr(lficld, irrcluti itrg thc:
Dcvclopttlent Cotle, rcgr-rlatirrg thc constrlrctiotr and trse of
buildings, ;lrrd may be susper-rded or revol<ed at any linle
upon violation of any provisions of said ordinances'
PIan check r..t --@e--
Receipt Number:--
tet:vicwccl ByPI
7s/o-/,
Date Paicl
Rcc eivecl
BUILDING PERMIT::: iliD
"r,"n" Al5-
VALUEqffi\
-5823
(A)
X$Q. FT,
_43)?
-2/,Qs
#-'l+6s
L,O ll
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systenrs Developnrcnt Char gc is ciue on all undcveloped
properties witirin the City limits wllich are being improvcd'sYSr EMS D EV E Lo P * r*r,"1 *
^ TI:j3_B
t
I
I
DITI
\
NAL. C MMENTS
T I
M{"
.? 3 fr5/4
ITEM
Fixtures
Residential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Mobile Home
FEE
t?2*1
(c)
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnscrt/Fireplace Unit
M ECHANTCAL PERMIT
n /3Z,
(D)
eP/o
''lEpfrDr+o*_6ea*E__
b3
No
va)T
00
Mechanical Permit
lssuance
State Surcharge
Total Permit
/5:!-cOO
L:r"
4z{o-
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state anc.l agree, that I have caref ully examined
the completed application and do hereby certify that all
informationhereonistrueandcorrect,andlfurthercertify
that any and all work perforrnecl shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of tlre Stale of Orcqon llcrtaining to the work describccl
Ircrcitr, :rtrtl tlutt NO OCCLlPANCY will br-' tttade of atny
structure witltorrt pot trril;sion of tlre Builclirrg Safcty Division'
I turther certify tll.tt orlly contractors anri cmployecs who
are in cornpliance with ORS 701.055 will be used on this
projcct.
I f urther agree to onsure that all reqr-rired inspections are
requested at the propcr time, that each address is readable
f rom the street, that thc permit card is located at the f ront
of tlre property, and tltc approved set ol plans will retn;rin
on the site ;rt all times during construction'
J L-_1_i --
Signature --
Date
-
MTSCELLANEOUS PERMITS
Total Miscellaneous Permits (E)
20-?!
J4-"-
M,//h: r(F,, "
3o
Mobile Home
State lssuance
State Surcharge
Demolition
State Surcharge
Sidewalk
Cu rbcut
/2"-P-n
TOTAL AMOUNT DUE (exclucling electrical)
(A, B, C, D, and E Combined)
SiozsJz
VALIDATION:
BECEIPT NUMBEF} -,ffi;;--[-[,
AMOUNT R
rl; r l:IVED
ECEI
4
-- 063f . __zbz!]
_ / F,o?
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
}IORKSHEET
(c0t'lt'IERcIAL & RESIDENTIAL)
NAME OR COMPANY:C*e NT o
Ttl b o o
LOCATION:
?/DEVELOPMENT TYPE:lU.e-ZtrrL
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2. SANI TARY EI.IER-C ITY
NO. OF PFU'S
(See Reverse)
LOT SiZ
lq.{ o x $0.203 P'ER SQ. FT.
X $42.08 PER PFU
[.ot x $424.31
x $424.31
x
-
x $424-31
sQ. Ft.
?b
3 TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
lx
$x
s
4 SANITARY SEt.lER-Mt,ll4C
'l From ItemNO. OF PFU'S
(Use PFU Tota
Mt^lMC.CREDIT IF APPLICABLE (SEE REVERSE)
ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABovE) x 'os
$15.125 PER PFU + $10 Mt'lMC ADM FEE
2 Above)
g7
s
z.-Ib6,
5
TOTAL-MI,IMC SDC
suBToTAL (ADD ITEMS 1,2,3 & 4)$2tr .?,
Kip Burd ick
3b
sDC Coordinator
TOTAL SDC $2 g
JoB N0 . aztzz t
q12-b.
bz
FIXTURE UNTT,CALCU^LIT ' -,N TA"LE: Numoer of New Fixtures X
;;;;,"".;. *r"uraiJo;'"n" Nf additionalnxtures)
NEIitSlrSt^r,
. Equivalent
UNIT
EOUIVALENT
= Filrure Units (NOTE:
FIXTURE
UNITS
FIKTURE TYPE
Bathtub---""
Drinking Fountain"""
calculate
TOTAL FIKTURE UNITS
lf imProvements
x $ l\.o
X Assessed Value)
\2
1
2
J
6
2
6
'6
1
3
2
1
z
2'
z
.L,
\z
zb
f
/Head
2
2
1
b
4
Miscellaneous:
CREDIT CALCUIATION TABLE:Based on assessed value
Credit for Parcd or lard Only lf Applicable
lmprorement (f after anne>cation date)
occurred after annexation date in table'
16 9r
3.1-\
(Rate
(Rate X
x$
Assessed Value)7'
CR EDIT TOTAL $
Assessed Value
Rate Per $1'000
Year
Annexed
Assessed Value
Rate Per $1,000
Year
Annexed 1985
1987
1988
1989
1990
1991
1992
s2.24
1.93
1.57
1.18
0.79
0.44
0.28
1979 or before
19BO
1981
1982
1983
1984'1985
s.21
3.13
3.08
2-96
2.82
2.68
2.51
RUNOFF COEFFICIENTS
Commercial
lndustrial--..
FOR STORM DRAINAGE
0.4
0.9
0.45
0.5
Govemmental...
IMPERVIoUSAREA=ToTALLoTSIZExRUNoFFCoEFFICIENT
Sink. Bar'
Urinal.
Wash
Water
Water Closet.
------ -:-.-
'1, I
Zq
CITY OF OREGO'U
SI IGFIELO
:h
s 8s.00
s 15.00
s 40.00
der not inc
s 40.00
$ 40.00
$ 20.00
s 36.00
# SP 63
Sum
aSoE
luded )
The lollowing proiect es
225 ?Tr,rE S1TBBT zoning, and does I !Ui
SPRINGFIEI.D 0RBGON 97477
INSPBCf,ION REOUEST: 726-3769
OPFICE: 726-3759 ll: r":
1 LOCATION OP INSTALI.ATION
880 South 45th PTace
LEGAL DESCTTPTION18 02 05 I 2 rL 7700
JOB DESCRIPTION
Sin Le Famil-Residence
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. CONTRACTOR INSTALI,ATION OT{LY
Electrical Contractor f{A.rL^( f g6r^^,, €lo.r
Address 35.3 9. Gf 'n Pe
Ci ty Sf+D or- Phone ?ut'l-( | G5'
Supe
q1v.17
rvisor Liteirse Number 3SfrS
Expiration Date -if
Constr Contr. Number 81.,lzit
Expi ra t ion Date .?-5 -1y
Signature of ing Electrician
BIJCTRICAL PERHTT APPLTCATION
City Job Number
COHPI,.BTB PEE SCEEDUI.A BELOII
Nev Residential-Single or
MuIti-FamiIy per dvelling unit.
Service Included:Items Cost
A
B
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular DvelIing
Service or Feeder
Services or Feeders
InstaIIation, Alterations
or Relocation:
STIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
I
3_
tr
*s
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0nIy
2oo amps or less I S 4o.oo
201 amps to 400 amps
-
S 55.00
over'401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 voTfs see .8,
s s0.00
s 60.00
s100.00
s130.00
s300. 00
$ 40.00
*/
0vners Name
Address
cit Phone
OSNER
The installation is beirig made on
property f ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE:
D. Branch Circuits
Nev, Alteration or Extension Per Pane}
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permi t $ 2.00
E Miscellaneous (Service/fee,
-Each instalLation
Pump or irrigation
Sign/0utline Lighting-
Limited Energy/Res
-Limited Energy/Comm
5
RBCEIVBD
d)
., !.1