HomeMy WebLinkAboutPermit Building 1993-02-24q4-gfcN 4*4r t?Lltlz_
iESIDEII.|TIAL,ERMIT xPPLICATION
rspeclions: 726.3769
)llice:726'3759
CONTRACTOB'S NAME
GENERAL:
PLUMBING:
REMODEL
:t t-'"t I fta r.rF ! E l- 1,,
DRESS
-ocAnoN oF PRoPosED woRK:_3s€.
3 NUMBER
225 Flllh Streel
Sf;rlngfleld, Otegon 97 477
TAX LOT:-lr-
PHONE:-Do 6:ctl -4oa
STATE:7tP:.
TtoN ---
ASS
LOT:
ESSO RS MAP:
L-,,
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
CONST.
CONTRACTOR #
g ()3
5
3
IRES PHONE
7?o
(
MECHANICAL:
ELECTBICAL:
lo
E-
V t,;
\
,l
7,WATER HEATER:
_ OFFICE
RANGE:
, OF UNITS:
LAND USE:FLOOD PLATN:
ZONTNG CODE:
, OF BDRMS:
OCCY GROUP:
I OF STORIES:
OUAD AREA:
, OF BLDGS
CONSTR. TYPE:
HEAT SOURCE:SECONDARY HEAT:
SQUARE FOOTAGE:
record lng.AI lnspectlon s req uested before 7:OO a.m wlll be
lns pec tl on you must cal 7 26-3 769.Thls 24 hour
To re qu an requested af ter 7:OO a.m.wl il be m ade the lol lowtng work day.
made he same worklng day,lns pectlons
Temporary Electrlc
REOUIRED INSPECTIONS
Site lnsPeclion - To be made
after excavation, but Prior to
settlng forms'
w Rough Electrlcal - Prlor to l"-.71 Flnal Eleclrtcal - When all
lJCl electrlcal work ls comPlete.cover.
Underslab Plumblngt Electrlcal /
Mechanical - Prior to cover'w Eleclrical Servlce - Must be
approvecl to oblaln Permanent
electrlcal Power.
w t.
Flnal Mechanlcal - When all
mechanlcal work ls complete'
8 Footlng - After trenches are
excavaled'I---l Flreolace - Prlor to faclngU materlals and framlng lnsP.
W Frcmlng - Prlor to cover'
ffi watllCelllng lnsulallon - Prlor to
r++J cover.
fTA Flnal Bulldlng - When all
!'U requlred lnsPectlons have been-
apProved and bulldlng ls
comPleted.
Masonry - Steel locatlon, bond
beams, grou'tlng.Other
l-171 Foundatlon - Afler forms are
L4J erected bul Prlor to concrete
placement.
[---l Underground Plumblng - Prlor [-Jl Orywall - Prlor lo taplng| | to filllng lrench' W MOBILE HOME INSPE TIONS
a
w
d
Underlloor Plumblngl Mechanlcal
-'Pii"t to lnsulation or decklng'
Post and Beam - Prlor to floor
lnsulatlon or decklng'
l-l Wood Slove - Alter lnstallatlon'
l--l lnserl - After llreplace approvalI I and lnstallatlon ol unlt'
l-.17 Curbcut & Approach - Afterl,x I fotrn" are erected but PIlor to
Placement o[ concrete'
l-l7t Sidewalk & Drlveway - After
LX);;;;:;;tton ls complete, lorms
and sub'base materlal ln Place'
F--l Fence - When comPleted'll
l-l Blocklng and Set'UR - When al!| | blocklng ls comPlele'
Floor lnsulalion - Prlor to
decking.
Sanitary Sewer - Prlor to lllllng
lrench.
Slorm Sewer - Prlor to fl!llng
trench.
Water Llne - Prlor to fllllng
lrench.
Rough Plumbing - Prior to
cover.
l--l Plumblng Connecllons - Whenl-J 6qm6 na! been connected to
water and sewer.
wq
a
w
Electrl cal Connecllon When
hl ocklng'.A t-up,and pl u
lns pect lons h ave been aP proved
nd the h o me connec ted to
the se rvlce panel.
Streef Treee - When all requlred
trees are Planted.w
Flnal - Atter all requlred
inioectlons are aPProved and
o"t'cftes. sklrtlng. decks, and
i"niing it"re been lnstalledl
NEW 4
I
g
.$RSC z
t/\\/-n)
t
\\
ls a
r
n
E
Lol laces
Lot sq. ltg.
Lol coverage
Topography
Total helght
@
*a-*
\\L5'
Lo!'Tv . -
X tr,t.rto,
-
Corner
-
Panhanclle
-
Cul-de-sac
Se i IS THE PROPOAED WORK IN THE
HISTORICAL DISTRI6{. OR ON
THE HISTORICAL FEGISTER?
-
lf yes, tltls appllcatlon musl be slgned
and approved bY the Hlstorlcal
Coordlnator prlor to permlt lesuance.
APPROVED:
-C{,
tnto
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permrt rs granted on lhe express condlilon that the saldconslrucllon shall, ln all respecis, conlorm lo lhe Ordlnanceadopted by the Clty . of SpitngltetJ, inctudlng thepe.ye.lopment Code, regulailng it. "ln"trr"ilon and use olbulldlngs, and may be suspended or revoked al any tlmeupon vlolailon of any provlslons of seld orJlrr..r""".
Plan Check Fee:
Dale Pald:
Becelpt Nu
By:
q
ffi
P.L.H I GAR ACG
N
S sl6 ,4
W 4/'
E 3
, $,sO. FT. - VALUE.*?<ff
/?-/? qs2?
BUILDING PERMIT
4.AG
(A)
'3t+SO. FT. X
Carporl
ITEM
Maln
Tolal Value
Bulldlng Permlt Fes
Slale Surcharge
Tolal Fee
/afrf
9>."f,
EMS DEVELOPMENT CHA
(B)
R
24
E (sDc)SYST
Syslems Developrnent Charge ls due on all undevelopedpropertles wlthln the City llmlts whlch are belng lmproved.
ITEM
Flxlures
Resldential Bath(s)
Sanllary Sewer
Waler
Slorm Sewer
ivloblle Home
PLUMBING PERMIT
FEE
3--%
FT.
FT.
(c)
FT.
./4D-4
168_*
Plunrblng permll
Slalo Surcl.rarge
Total Charge
ADDITIONAL COMMENTS
Wood Slove/lnsert/Flreplace Unll
Dryer Verrt
MECI{ANICAL PERMIT
,/e-+
(D)
, 3
-+N0
7,-a
at<>
Mechanlcal permlt
lssuance
Slale Surcharge
Total Permlt
.95
?.2)
Furnace
Exhausl Hood
Venl Fan
I
By slgnature, r srale and agree, that r have careruily examrnedlhe compteted appllcatlon and do hereby perUly lhat a,llnlormatlon hereon ls lrue and correct, anO i tulther oerUlythat eny and ail work perrormed shail be done rn accordancewlth the Ordlnances ol the Clty of Sprlngfleld, and the Lawcof the state or oregon pertarnrng ro rhe work descrrbedhereln, and that NO OCCUPANCy wllt be made of anystructure wllhoul permlsslon of the Bulldlng Sataly Dlvlslon.I further certlly that only contractors anOimployees whoare ln compllance wlth OHS 7O1.O5S wllt be ussd on lhlsprolect.
I furlher agree lo onsure that all rggulred I
tlme, lha\ach
pormlt card ls
>r1
remalnat
/
nspecllons arerequested at lhe proper addregs ls readablelrom the street, lhat the located at the lrontof lhe property, and the approved set o, ptans wlllllmosdurlng construcllon.
-7
MISCELLANEOUS PERMITS
Moblle Home
Slatc lssuance
Stale Surchargo
Sldewalk 1O n
curbcur Vn
Demolltlon
Slale Surcharge/' ;r7 s fac
rp-e'
-
/,u+
4>-4
A='Total Mlscella neous Permlts
TOTAL AMOUNT
(4, B, C, e ancl E
o"Hff:J1ns erectrrcat)
{1t
a
RECEIVED BY
DATE PAID
AMOUNT
VALIDATION:
BECEIPT N "'-qo
tb h
Garase ?Z-ffi,r_
No-
-
.2
(E)
15 PTPTE STREET
,RTNGFTELO, oREGoN
ISPECTTON BEQIIEST:
'PICE: 726-3759
0 INST
DE
.*it" are non-transferable and expire
vork is not started vithin 180 daYs
issuance or if vork is suspended for
) days.
CONTRACf,OR INSTALI.ATION ONI.Y
rctrical Contracto. Rose Corp
re99976 Day Lane
v Euqene Phone 686-0905
ervisor License Number 1 568-S
iration Date 1 0-01 -93
str Contr. Number 5443I"
tration Date 9-30-95
lature 1S Blectrician
rs Name
€SS -8j)-97-6-_D-arr T.anc
gr*gerre-Phone -6{}6-0905-
OVNER INSTALI..ATION
installation is being made on
erty I ovn vhich is not intended
saIe, Iease or rent.
rs Signature:
SP'I'NGF,ELD
The following prolacl es submitted has the fo,ilowir€
d.Je$ n*t raqvire specffic land US'ELECTRICA.L PERXIT APPLICATION
97 47i " ''
7 26-37 6 Ci ty Job Nurnber,
D-iie )lA a10,4 3. COHPLETE FEE SCEEDULE BELOV
.'. jr
A. Nev Resident ial-Single or
HuIti-FamiIy per dvelling unit.
Service Included:
I tems Cos t
EB
(rrm
ON 1000 sq.ft. or fess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular DvelIing
Service or Feeder
Services or Feeders
InstaIlation, Alterations
or Relocation:
-{s Bs.oo 3€
Z S 1s.oo 7a
s 40.00
B
200 amps or }ess
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect Only
s s0.00
s 60.00
s100. 00
si30.00
s300. 00
$ 40.00
s 40.00
s 40.00
s 20-00
$ 36.00
C Temporary Services or Feeders
InstaIIation, Alteration or Relocation
.00
.00
rrgrr
"f,f,fi
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S .2.00
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utIine Lightin
Limited Energy/Rep
Limi ted Energy/Comm
S(MTOTAL OF ABOVE
5I State Surcharge
TOTAT
200 amps or less $
201 amps to 400 amps
-
$
over 401 to 600 amps
-
S
0ver 600 amps or 1000EITs se
0040
55
80
r€
g-
a
:VED
5
Willamalane
Park & Recreation District
BUILDIN TE:
SYSTEMS DEVELOPMENT CHARCE
WORKSHEFT
lob No.
PHONE:_Db-M\N
ADDRESS:
LOCATION OF PROPOSED
Street Address if Known:
1
D.
NO OF UNITS
WPRD SDC
DEVELOPMENT TYPE (Check aPProPri
Aei,nitiontare on the back.)
A. Single FamilY - Detached
{I Single FamilY home
Platt N
NO OF UNITS
B. Single FamilY - Attached
NO OF UNITS
C. Multi-FamilY APartment
NO OF UNITS
Manufactured Home Park
Tax Lot Number:
ate dwelling(s). SDC Calculations and dwelling type
Manufactured home not in a Park
X $400 PER UNIT =$
X $370 PER UNIT =$
X $277 PER UNIT =$
X $280 PER UNIT =$
srArELr)A ,,r 4&#'lO
M
,4tD
t
$
2.sDcCRED|T(lfapplicable)SDC-payermustfurnishproofofWPRDCreditL'
fip-tr*I. G sDt' Credit worksheet'$
$
d
3. TOTAT WPRD NEf SDC ASSESSED (lf SDC reduced for Credit)
-Z:ZZLZZ
City
ision Date
Services
tv,
CITY OF SPRIflGFIELO SYSTEMS DEVELOPMENT CHARGE
}IORKSHEET
(cot'lt'IERcIAL & RESIDENTIAL)
NAI,IE OR COMPANY:
LOCATION 5b 5 4e"rH /8 ozoS t2-O 5 too_B
DEVELOPMENT TYPE: LPg - TIEW ;FE
LOT SiZ Ft
1. STORM DRAINAGE
IMPERVIOUS Sq. FT Z7o 5 x $0.203 PER SQ. FT.
2. SANITARY SEt,lER-CITY
NO. OF PFU'S
(See Reverse)
X $42.08 PER PFU
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
ol x $424.31
x $424.31
x $424.31
4. SANITARY SEWER-MWMC
5 z8z?3
lg
3
xt
s
x
x
s
NO. OF PFU'S
(Use PFU Tota I From Item 2
Ml.lMC CREDIT IF APPLICABLE (SEE REVERSE)
$15.125 PER PFU + $10 MhlMC ADM FEE
Above)
TOTAL-MhlMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
a
t7
5 ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X 'os
-Kip Burd
SDC Coord
v
o
2.4
Z o$
i nator
o 5
TOTAL SDC 2oOO
,' tto. 7a t4 q z
$
Units (NOTE:
Number ot New Fixtu'i Unit Equivalent = Flxlure
5:*Tl'."tlI'3*h?.YJIS[J'1.:]'5;NUI\4BER OF
NEW FIXTURES
UNIT
EOUIVALENT
2
1
2
J
6
2
6,6:
1
3
2
1l
2
2
1
t)
4
FIKTURE
UNITS
FIXTURE TYPE
Bathtub-
Drinking Fountain.--'-""-"'-'
Floor Drain"""'
lntercePtors For Grease/Oil
lntercePtors For Sand/Auto Wash/Etc.
Laundry Tub/G otheswasher
Z
I
GotheswaEher - 3 Or More"""'
Mobile H6nie Park TraP (1 Per Trail6r)
Shower. Single'Stall...
Shower. Gang......-....
Sink, Bar, Commercial
Urinal, StallflVall....
Wash Basin /l-avatory, Single-. -... --.
Water Closet, Public Installation.--..-'
Receptor For R efrig eratorAVate r Station/Etc" " " "
Receptor For Commerclal Sink/ D ishwash er/Etc"
Head
I Z
?-
Water Closet, Private.-.....--z
Miscellaneous:
TOTAL FIXTURE UNITS _tg
calculate credits. seParates.
Credit for Parcd or tand Only lf Applicable
lmprovement (if after annelation date)
x$,11 ztU
-$
--8
?.2 1
(Rate X Assessed Value)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
19BO
1981
1982
1983
1984'1985
$3.21
3.13
3.08
2.96
2.82
2.68
L51
't986
1987
19BB
1989
1990
1991
1992
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
IMPERVTOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
cREDlr CALCUI-ATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,