HomeMy WebLinkAboutPermit Building 1993-12-28Qc*wrU c14,-t-lo fi utb
_JB NUMBER
g2-
225 Flllh Street
Sprlnglleld, Oregon 97 477
TAX LOI
SUBDIVISION:
1^/.,)
5t-?aat\alrF aEr-1,
RESII Et.tl,AL
PERMIT APPLICATION
lnspections: 726-3769
Olfice: 726-3759
LOCATION OF PFIOPOSED WO
ASS
LOT
ESSOBS MAP:
h,
BLOCK:
ztP..
\_-,,
STATE:
PHoNE: t-ac:6' )12-t/03 IOWNER:
ADDRESS
CITY:
TtoN ___DEMOLISH OTHER
DESCRIBE WORK:
BEMODELNEW4-
PHONE
7
L
5-
)
MECHANICAL:
CONTBACTOR'S NAME
GENERAL:
PLUMBING:
ELECTRICAL:
CONST.
CONTRACTOR '
USE -
vNoccY GRou*R3 r ,n
E \/r)
it v
t
,
\
OF
r OF BDRMS:
RANGE:WATER HEATER:
, OF STORIES
ZONING CODE:
FLOOD PLAIN:OUAD AREA:
, OF BLDGS
SECONDARY HEAT
SOUARE FOOTAGE:
CONSTR. TYPE
HEAT SOURCE:
I OF UNITS:
LAND USE:
To request an lnspectlon, you must call 726.3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:OO a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
[Tl remRorarY Eleclrlc
REQUIRED INSPECTIONS
l-7 nough Mechanlcat - Prlor lo4 cover.
fA aougn Elect lcal - Prlor loEH cover.
l-71 Flnal Plumblng - When alll4 plumblng work ls comPlete.
F7 Flnal Electrlcal - When alll4J eleclrlcal work ls complete.
Slte lnspecllon - To be made
afler excavation, but prlor to
settlng lorms.
Underslab Plumblngl Electrlcal I
Mechanlcal - Prior to cover.w Eleclrical Servlce - Must be
approverl to obtaln permanent
electrlcal power.
E i
Flnal Mechanlcal - When all
mechanlcal work ls complete.
w Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
q Flnal Bulldlng - When all
requlred lnepectlons have been
approved and bulldlng ls
completed.Masonry - Steel locatlon, bond
beams, groutlng.w
w
m
E
Framlng - Prlor to cover.
OtherwFoundallon - Afler lorms are
erected but prlor to concrete
placement.WalllCelllng lnsulatlon - Prlor to
cover.
E
w
W
a
W
4
d
w
Underground Plumblng - Prlor
to fllllng lrench.Drywall - Prlor lo taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumblngl Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Stove - After lnstallallon
Post and Beam - Prlor to lloor
lnsulallon or decklng,lnserl - Afler flreplace approval
and lnstallallon of unlt.
Blocklng and SetrUp - When
blocklng ls complele.
all
I
I
Floor lnsulallon - Prlor to
decking.W Curbcut & Approach - Alter
forms are erected but prlor to
placement ol concrete.
Plumblng Connecllons - When
home has been connected to
waler and sewer.
Sanltary Sewer - Prlor to fllllng
trench,E Electrlcal Connecllon - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Slorm Sewer - Prior to filllng
lrench.
fT1 Sldewalk & Drlveway - AfterEU er"ar"tlon ls compiele, lorms
and sub-base materlal ln place.
Waler Llne - Prlor lo fllllng
trench,
Fence - When completed.
Slreel Trees - When all requlred
trees are planted.
Flnal - Alter all requlred
lnspectlons are approved and
porchos, sklrtlng, decks, and
ventlng have been ln3talledl
Rough Plumblng - Prlor to
cover.w
fl
olzt
C'v?uL
?-
n
Lol laces
Lot sq. llg.
Lol coverage
Topography
Total helght
Lot Type
X tntertor
-
Corner
-
Panhandle
-
Cul-de-sac
Selbacks4W2-6
15 THE PROPOSED WORK IN THE
HlsroRlcAL otsTRtgr. oFt oN
THE HISTORICAL REGISTER?
-
It yes, llrls appllcatlon muel be slgned
and approv€d by the Hlstorlcal
Coordlnalor prlor to permlt lasuance.
APPROVED:
a*
llsb
P.L.HSE GAR ACC
N "*
S ?g',
W U
E u'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granled on tlro expiess condltlon lhat the ssld
conslrucllon shall, ln all respects, conlorm to the Ordlnance
adopted by lhe Clty ol Sprlnglleld, lncludlng the
Development Code, regulatlng the conslrucllon and use ol
bulldlngs, and may be suspendod or revoked at any llme
lnu+t$
cx)
Z if5+-+
Date
Recelpl
et
I y1 lq'b
upon vlolallon ol any provl slons ol eald ordlnances.
Plan Check Fee
Dale Pald:
Recelved
VALUE
tSqf z#fr321tr€,f2.^
(A)
x $/so. FT.
&-22_
/q-/6
Tolal Value
Bulldlng Permll Fee
Stale Surcharge
Total Fee
F//v2?*/*-?u
74^ zt{
BUILDING PERMIT
ITEM SQ. FT,
Maln
Garage
Carport
Syst€ms Developrnont Charge ls due on all undeveloped
properlles wlthln the City llmlts whlch are belng lmproved.
sYSr E M s D Ev ELo P * . r r,"l, *fri:r:"8 #
ADDITIONAL COMMENTS
tTEM
Flxlures
Resldentlal Bath(s)
Sanltary Sewer
Waler
Slorm Sewer
Moblle Home
FEE
/F
2t *(c)
FT.
FT.
FT.
N02
PLUMBING PERMIT
Pluntblng Petmlt
Slato Surcharge
Tolal Charge
/62'*9-?
Wood StovellnsertlFlreplace Unlt
Dryer Verrt
4-!;>
(D)
4.*
7--6
Vent Fan
Mechanlcal Permlt
lssuance
Slate Surchatge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood
Nol
/a.,v
/a-€,€3
2^ 27
I
By slgnature, I slale and agree, that ! have carelully examlned
lhe completed appllcatlon and do hereby psrtlly that all
lnlormatlon hereon ls true and correct, and I lurther certlly
that any and all work perlormed shall be done ln accordance
wlth the Ordlnances of tha Glty ol Sprlnglleld, and the lawo
ol the State ol Oregon pertalnlng to the work descrlbed
hereln, and lhat NO OCCUPANCY wlll be made ol any
structure wlthout permlsslon ol the Bulldlng Salety Dlvlelon.
I further c€rllly that only contractors and employeeg who
are ln compllance wlth OBS 701.055 wlll be ueed on thlc
prolecl.
I lurther agree lo onsure that all rggulred lnlpootlono ete
requested al the proper llm€, that each addrees le readable
lrom the slr€st, that ths pormlt card le located at the lronl
ol the proporty, and lhe approved set ol plane wlll remaln
!
ure
%
VALIDATION nA{=BECEIPT NUMBFR
DATEPATD -H#
on the slte at all tlmes conslrucllon.
RECEIVED BY
AMOUNT R
MISCELLANEOUS PERMITS
Moblle Home
Slate lssuance
State Surcharge
Sldewalk 62 t
Gurbcut 72 ,,
Demollllon
Slale SurclrargeU( z,r zff:zt -7><
Total Mlscellaneoue Permlts (E)
/e
t44Su
?2Zru=
/a
TOTAL AMOUNT DUE (excludlng eloctrlcal)
(A. B, C, D, and E Comblned)
?^<_%
UN'\CV
9/?/.4-
j
I
JO B No. 1bt41z
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
T.IORKSHEET
(C0MMERCIAL & RESIDENTIAL)
NAME OR COMPANY:4
z 5.4 tr! St /9ozo5 t o4 9oo - t3
LOCATION:E
- New SFRDEVELOPMENT TYPE:LD
BUILDING SIZE:SIZ
1. STORM DRAINAGE
IMPERVI0US SQ. FT.2"O,x $0.203 PER SQ. FT.
2. SANITARY SEl,lER-CITY
. Ft.
z5
NO. OF PFU'S
(See Reverse)
l8 X $42.08 PER PFU
3 TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I x x $424.31
X
X
x $424.31
x $424.31
4
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X -os
SANITARY SEWER-l4l,lMc
NO. OF PFU'S /9 *
(Use PFU Total From Item 2
Mt^lMC CREDIT IF APPLiCABLE (SEE REVERSE)
$15.125 PER PFU + $IO MI,IMC ADM FEE $<tL
Above)
1
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)I
zr4
K p Burdick
CoordinatorsDc
TOTAL SDC SZ ooo -
q
$
./
FIXTURE UNIT.CALCULA ON TABLE: r.rumoer of New Fixlures rit Equivalent = Fixture unitg(N)TE:
ioi i"r"oa"rs, catculaie onty the NET addirionat fixrures)
NUN4BER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
L
Bathtub..
Drinking Fountain--..--
Floor Drain.-
lnterceptors For Grease/Oil/Sollds/Etc'
lnterceptors For Sand/Auto Wash/Etc"'
Laundry Tub/Clotheswasher---. -. -.
2
1,
J
6
2
6
6
1
3
2
1
2
2
1
6
4
Clotheswaqher - 3 Or More.
Mobile Hdme Park Trap (1 Per Trailer)
Receptor F6r RefrigeratorAVate r Station/Etc" " " "
Receptor For Commerclal Sink/Dishwasher/Etc"
tmprovement (rf after annexation date)
Shower, Single'Stall..
Shower. Gang.-2
Sink. Bar, Commercial
Urinal. StallflVall....
Wash Basin/tavatory, Single---...--"""'
Water Closet, Public lnstallation-
Water Closet, Private..--. ----
Miscellaneous:
TOTAL FIXTURE UNITS l8
cREDlr cALcut-ATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table'
calculate credits
Credit for Parcd or Land Only lf Applicable Z.Lt x $q.1 I bttL
ead/H
ll
a2-
(Rate X Assessed Value)x$
(Rate X Assessed Value)
CREDIT TOTAL $?t'3
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
s.21
3.13
3.08
2.96
2.82
2.68
2.51
1985
1987
1988
1989
1990
1991
1992
$ 2.24
1.93
1.57
1.18
0.79
0.44
o.28
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
IMPERVIOUSAREA=ToTALLoTSIZEXRUNOFFCOEFFICIENT
I
L
a,lr..J:E-
COHPLtsTII t'BB SCIIEDULB BELOU
Nev Residential-Single or
s!.r ilN(:l: ll:Lt,
amily per dve
Included:
%
2-25 I]IIJTII STRI':IIT
sPTuNGFIELI), ORI':GON 97h77
INSPIIGI'ION REQUIII;T z 72-6-3'169
oFPICE: 7?-6-3751)a
ELBCTRICAL PERHIT AP PLICATION
Cl ty Job Number
orI A1
r i-F IIing unit.
Items Cost
(ffKlffi !)
r(Q-,-r
Exp
Signa ture sup crvising Electrician
CRIPT
Oune rs
Add
cit Phon
INS'I'ALLATION
llhe installarion is being made on
property f ovn vhich is not interrded
for sale, Iease or rent.
ovners Slgnaturc:
DATE:
L000 sq.ft. or less I $ B5'OOON
Permits are non-transferable and explre
if vork is not started vlthin 180 days
of issttance or if vork ls suspencled for
180 days.
2. CO}NTACTOR INSTALIJ\TION ONLY
Iilectrical Contracto r Rose Corporation
Addr:es s 89976 Day Lane
Ci ty Eugene Phone 686-0905
Supr:rvisor License Nunrber 1 s68-s
Expiration Da te 10-0 1 -93
Constr Contr. Number 54431
iration Date 9-30-95
L Se
Sum
Each additional 500
sq. ft or portlon
thereo f
Each Manuf 'd llome or
Modular Dwelling
Service or Feeder
L €D$ 1s.00
$ 40.00
$ s0.00
$ 60.00
$1o0. oo
$130.00
$300.00
$ 40.00
D Services or Feeders
Installatlon, Alteratlons or
Relocation:
200 amps or Iess
20L anrps to 400 amps
-
401 amps to 600 amps
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect 0nIY
200 amps or less
201 amps to 400 amps
-
Over 401 to 600 amPs
-
Over 600 amps or 1000 voltr
SI'DTOTAL OP ADOVE
5I State Surcharge
TOTAL
l'liscellaneous (Service/ feeder
-Each installation
Plrmp or irrigation $
signzoutline Ligltting- S
Limi ted Energy/Res - S
ld
a5o!il
$ 2.00
not included)
40. 00
40.00
20. oo
c Temporary Services or Feeders
Insiallatlon, Alteration or Relocation
s
00
00
00
Drl
$40
ss5
$80
see
D. Branch Circults
Nev, Alteration or Extenslon Per Panel
One Ci rcu i t
Each Addi t ional
Circui t or vi th Service
or Feeder Permi t
$ 3s.00
E
I 2
III.ICI.:IVT.:D II
5
CJIE
CI
&
Willamalane
Park & Recreation District
SYSTEMS DEVELOPMENT CHARC E
WORKSHEET
PHONE:
lob No.
ztP
NAM
ADDRESS:
LOCATION OF PROPOSED
Street Address if Known:
Platt Name:
1
Com ices
BUILDINC SITE8(o.j oh 4[c'tN.fic
,r/r)4
Tax Lot Number:
X $400 PER UNIT =$nCIr)
PEVETOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Single Family - Detached
II Single Family home Manufactured home not in a park
NO OF UNITS
B. Single Family - Attached
NO OF UNITS X $:ZO PER UNIT =
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
X $277 PER UNIT =
X $280 PER UNIT =
$
$
$_
4ilnc0WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAT WPRD NEf SDC ASSESSED (lf SDC reduced for Credit)
$
$
A
City
)
rd
n Date
C+
$
qK.\rp
$
)