HomeMy WebLinkAboutPermit Building 1994-06-09PHONE:
STATE:ZIP:
oWruen:
ADDR
CITY:
\r\ \
e.t
6R - OFFICE USE -
RANGE:
* OF UNITS:
LAND USE:
r OF BDRMS:OCCY GROUP:
ZONING CODE:
FLOOD PLAIN
WATEB HEATEB:
Y OF STORIES:
CONSTR. TYPE:
HEAT SOUBCE:SECONDARY HEAT:
SQUARE FOOTAGE:
QUAD AREA:
r OF BLDGS:
o?oo;q38 fu-r/g/ff ,
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 72A8759
LOCATION OF PROPOSED WOBK:
ASSESSO
LOT:
D
N DEL
tNGF
z
BLOCK;
DDITION DEMOLISH
JOB NUMBER
225 Flfth Street
Springfleld, Oregon 97 471
TAX LOT
SUBDIVISION:o +a- ytr
z
OTHER
CONTNACYOR.S NAME
MLC}IN NICl\L:
[-l femporary Electrlc
Slte lnspection - To be made
after excavatlon, but prior to
setting forms.
Masonry - Steel locatlon, bond
beams, groutlng.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
{gxigijffirecrric.ar/
X*::H"- Arter trenches are
f6'
lVltough Mechanlcat - prtor toftover.
TVAough Etecrrlcat - prtor to
,),ccovor.
-ffflectrlcal Servlce - Must be/\approved to obtaln permanent
electrlcal pow€r.
E
<1
Flreplace - Prlor to faclng
materlals and framlng lnsp,
Wood Slove - After lnstallatlon
lnsert - After flreplace approval
and lnstallatlon of unlt.
Trees - When all requlred
EXPIFiES PFIONE
E 5o3- S 7
Flnal Plumbing - When allplumblng work ls complete.
Flnal - After all requlred
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
ffi flnat Etectrlcat - When alt
,flelectrlcal work ls complete,
ffflnat Mechanlcat - When ailj (mechanlcat work ls complete.
ffiflnat Buttdtng - When ail
_,)rJ{-(equtred lnspectlons have been
approvod and bulldlng ls
completed.
ADDIlESS
CONSI.
CONTRACTOR '
-t
GENENN L:
PLUI'{BING 3I:TS
Post and Beam - Prlor to floor
lnsulatlon or decklng.
ELECTNICAL:
To request an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspecilons requested before 7:oo a.m. wlil bemade the same worklng day, lnspectlons requested after 7:oO a.m. wlll be made the followlng work day.
REOUIRED TNSPECTIONS
-*
K
lVFoundatlon - After forms arez^erected but prigr to concreter placement.
-ftt"-lng - Prlor to cover'
ffi WaltCeillng lnsutarlon - prlor to,frcover.
2F7lDtr*alt - Prlor to taplng'
MOBILE HOME INSPECTTONS
Blocklng and Set-Up - When alt
blocklng ls complete.
Plumblng Connecllons - When
home has been connected to
water and sewer,
Eleclrlcal Conneclion - When
blocklng, set-up, and plumblng
lnspections have been approved
and the home ls connected to
the servlce panel.
tl
MHoo. lnsulatton - Prlor to
,la(oecxtns,
F:r""*ary
Sewer - Prior to fllllns
Firt'J5,.sewer
- Prlor to llrllng
plf;*llrno - Prror to rrrrrns
ff,fr:
Plumblns - Prror to
are planted.
E
.b_ _E-es-,qs ?b-a?1-qo?$
E
E
fl
pfCurbcut & Approach - After,)4forms are erected but prior to
placement of concrete.
pf SiOurrulk & Driveway - After
,)Aexcavatlgn ls complete, forms
and sub.base materlal ln place.
n Fence - When completed.
l-_l o.therll
7/car?
/)A z,-s-l
lilP-
E
't, ,
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
X tn,"rlo,
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
a/@
4Zo
THE PROPOSED WORK IN THE ,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved bY the Historlcal
Coordinator prlor to permit lssuance'
APPROVED:I
P.L.HSE GAR ACC
N 5/
s g!5J
W (4
E 20
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield' includlng the
Development Code, regulating the construction and use ol
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances'
iewed By
q4?#/
Receipt Numbe
Plan Check Fee:
Date Paid:
Received
#'74Ssef
/o7t/xt7,?o --Zfl.fi
(A) 3a4' 4
X $/SO. FT.zp
BUILDING PERMIT
/y''o '=@,oo
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT.
/'jo
//@D
ITEM
Main
Garage
Carport
VALUE
zn/2&lo
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) f/s$z
ADDITIONAL COMMENITS
ITEM
Flxtures
Residentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
B,* *4?o 12?'
'72.9o(c)
aO
FT.
FT.
FT.
No-
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent 2d)
.//- {o
/0,*
l,?7,3t +.50
(D)
4?o
Vent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood
No-3
By slgnature, I state and agree, that I have carefully examlned
the completed applicatlon and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther certlfy
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 pertainlng to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Buildlng Safety Division.
I further certify that only contractors and employees who
are ln compliance with ORS 701.055 wlll be used on thls
project.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address is readable
from the street, that the permlt card ls located at the front
rty, and the approved set of plans will remaln
nature
Date
of the prope
structionon the slte at all times duri
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Stdewark diO tt
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
6aar
2<37 ?
z+
',
,- ra//-
3 ,o'Curbcut
Demolltlon
State Surcharge
DATE PAID
VALIDATION:
RECEIPT NUMBER
AMOUNT REC
RECEIVED BY
. _ ii,r
I
O o'o
27,9,
i',,. :clTY oF OBEGO'U
SPR!NGFIELD
m
225 ?\YIE SIREBT
SPRTNGPTEU), oRBGON 97477
INSPECTION REQUBST: 726-3
OPPICB: 726'3759
The {otlowing Prolect
zoning, and does not
approval.
E9 submittod hm ths
requiro spocific lanC use
A
E
EI.JCTRICAL PERHIT APPLICATION
769 zonins [-D(--
-
'City qcb\g
o*"-!4L
1
permits are non-transferable and expire
if vork ls not started vithin 180 days
of lssuance or lf vork ls suspended for
180 days.
!
2. CO}ITRACTOR INSTALI.ATION ONLI
Electrlcal Contractor ROSE C0RP
Address 8997 DAY LANE
Ci tY rttCrt'ir Phone E86.-19O5
Supervisor Llcense Number 1 568S
Explration Date 10/1/95 ,'
Constr Contr. Number
, ,-i
54431
Explratlon Date
Slgna Supervlsing Electrician
0vners Name
Address
Ci ty Phon
OUNER INSTALI,ATION
The.installatioh is beirig made on
property I ovn vhich is not intended
for sale, lease or rent.
Onners Signature:
DATE:
Job Nunber
PEE SCEEDTII.^E BELOS
Nev Resldential-Single or
HuIti-Family per dvelling unit.
Service Included:
I tems Cos t Sum
1000 sq.ft. or Iess
Each additional 500
sq. ft or portion
thereof
One Circui t
Each Additional
Circui t or r.ri th Service
or Feeder Permi t
STETOTAL OP ABOVB5f State Surcharge
TOTAL
I
A
85
@$ 1s.00
Each Hanuf'd Home or
-Hodular DveIIing
Service or Feeder s 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
s s0.00
$ 60.00
s100.00
$130.00
$300.00
$ 40.00
c
D. Branch Circuits
Nev, Alteration or Extension Per Panel
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
Temporary Services or'Feeders
Installation, Alteratlon or Relocation
200 amps or less $ 40.00
0ver 401 to 600 amps S 80.00
0ver 600 amps or 1000 voT[s see *8" a56if
$ 8s.00
s 3s.00
$ 2.00
Miscellaneous (Service/ feeder
-Each installation
Pump or irrigation SSign/0utIine Lighting- SLimited Energy/Res
-
$
Limi ted Energy/Comm S
not included)
40.00
40.00
20.00
r
RECEIVED
5 _---_aaa-
/27,*5.7raJ,/r
Willamalane
Park & Recreation District
fob No.
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
PHONE:
ADDRESS:
LOCATION OF FRO POSED BUILDINC SITE:
Street Address if Known:
Platt Tax Lot Number:
DEVELOPMENT TYPE .
(Check appropriate dwellingG). sDC calculations and dwelling type
aeflmtions are on the back.)
srArE:U$ r,, 79KVl
Manufactured home not in a Park
X $400 PER UNIT -=$
A. Single Family - Detached
I sinele FamilY home---+--
NO OF UNITS
B.Single Family - Attached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufactured Home Park
5
1
X $370 PER UNIT =
X $277 PER UNIT =
X $280 PER UNIT =
$
$
$
WPRD SDC
approval. See
(lf aoplicabte) SDC-PaYer
iot'creait worksheet'2. SDC CREDIT
$
must furnish Proo{ of WPRD Credit
$
$
3. TOTALWPRD
ior Credi0
93-,
CitY of
NEt SDC ASSESSED (lf SDC reduced
Date
q
g)
JOB NO.
7/oGs-z
. NAI'IE OR COI'1PAI'IY:
CITY OF SPRINGFIELD STSIEHS DEVELOPMENT CHARGE
,,0,,,0H31[t#58L,0,-, .
/n* on D €y,
LOCAT IOI,{:q/g 5. 46 44 5,2
5trRDEVTLOPI.iENT TYPE:
BUILbING SIZE:sQ. Ft.
I. STORI.I DP.AINAGE
IHPERVIOUS SQ. FT.22/8
OT SiZ tr
x so.2o3 PtR sQ. FT.
2. SAN ITARY El{ER- C I TY
I{O. OF PFU'S
(See Reverse)
/O X 542.08 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x o x s424.31
x --- x $424.31
x s424.31
/c $15.125 PER PFU + S10 MI{MC ADi't FEE
s
X
4. SANITARY SEltlER-I'lI\|I'lC
NO. OF PFU'S
(Use PFU Total From
MI,IHC.,CRTDiT iF APPL
Y
Item 2 Above )
r.cABLE (SEE REVERSE)
5. ADHINISTRATIVE FEES
BASE E(AB0VE) X .05
TOTAL-MWMC SDC
SUBT0TAL (ADD iTEMS 1,2,3 & 4)
3E.77
,2f
/ /7 o'1*'
'^ -i:-lL
Coord i nator
TOTAL SDC s 1 ff3,37
^)--
s
s 2r2. oO
- l'l .'--'-'rr i'1 llc"; [ ;r"riJ;-( i '/' Irr"i [:q'';ir';ilc'l i '
liLrl".:rrii C'i-
I(E\\,FIX'iUNES
Ll li iT
llcLll\"it LI',i
r.-i,',Ji() i'lrtl-'' i'r'- '
r I ril Lli:,i:
I UIIIT S
'i'.- '3-*=- ,'
fjf:SI Y'TL1,3*h : i, q1':: l: :'1:'15
FIKTUFE N'PE
'z'*tt*;'l:l;
,^, ,:: :" " " ' ,,;;I;:;;;;; For G ree seloit / eorid si E tc
i"i:;;;;i;* For Sand,/Atrto \\'ash/Ltc"""" "" " '
;I.J; Tub/c)oihesvrasher" " "'
Clotheswaqher - 3 Or 1"4ore".'.'""
u"un. uOrii" Park Trap (1 Per Trailer)"""'
Receptor For R efrigerator/Wat e r Station/ El c.. " " "
Receptor For Commercial Sink/ Dishrvasher/Etc..
.,,-
1
.l
J
6
6
E
I
,
1
2
2
I
6
Shower, Single'Stall.
Showe( Gang..................
Sink, Bar, (bmmercial.....
' Urinal. StallfVall....
Wash Basin /l-eva|ory, Sin91e..........
Water'C)osel puUiic lnstallation.....
\\'ater Closet Prh,ate.
l,liscellaneous:
Head
2
TOT;.1FIXTURtr Ui(ITS
2
--- e-
CREDIT CALCULATION TABLE: Based on assesseC value.
caJculate credhs separates.
lf imp;'ovements occurraC afier annexation date in table,
Year
Annexed
Rate per Sl,C'33
Assessed Va!ue
Yezr
Annexed
Rate per S1,000
AssessaC Value
1979 or before
1980
1981
1982
1983
.- 1984
'1985
s3.21
3.13
3.08
Z.YJ
2.82
2.63
2.51
1985
1 S37
1 9E3
1S9
.r oo')
1991
't992
s 2.24
1.93
1.57
1.i 8
0.79
0.14
0.28
CrACit foi Parcd or l-ard Only lf Applicabte
lmfrovement (rf after annexation date)
7,2 x's
(Rate X fusessed Value)xs
f2, //o 36.77
(Rate X Assessed Value)
CBEDIT TOTAL $ ?8,?7
RUNOFF COEFFICIENTS FOR STORM DHAINAGE
Residential.
commercial ... ........""" "'t"-"""" o'4 '
lndusrrial.... ..... 3.:t
Governmenial....... 0.5
lMPERVlous AREA = TorAL Lor stzE x RUNoFtr coEFFtctENT
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I
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