HomeMy WebLinkAboutPermit Building 1992-05-26SPrlI GFIELE)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726"3769
Olfice:726-3759 h,
JOB NUMBER
225 Fif th Street
Spri ng f ielcl, Oregot"r 97 47 7
-€*rfl,+ /7qLOCATIOI{ OF PFIOPOSED WORK:
ASSESSORS MAP:/70 3) 3/
Lor: 1a BLOCK
TAX LOT:1?J_
SUBDIVISION
PHONE:
',
ztPSTATEIEc"ttu--t
Cil+A I
SQLT-
REMODEL ADDITION DEMOLISH OTHER
I,DESCNIAE WORK
*.* /-
CONTRACTOR'
GENERAL:
PLUMBING:--
MECHANICAL:
'S NAME ADDRESShc>[--aquilfb-ile EXPIRES PI]ONE
--Q33oz
CONST.
CONTRACTOR /
_ OFFICE
LAND USE:
I OF UNITS:
CONSTR. TYPE:
HEAT SOUFICE
RANGE
r OF BDRMS: --
ZONING CODE:
FLOOD PLAIN
WATER HEATER:
r OF STORIES:
QUAD ABEA:
SECONDARY HEAT:
SOUARE FOOTAGE:
I OF BLDGS:
-OCCY GROUP:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
ntac,e tlle same working day, inspections requested after 7:0O a.m. will be rnade the following work day.
REOUIRED INSPECTIONS
I I 'Icmporary Eleclricll w Rough Mechanical - Prior to
cover.tx Final Plurnbing - Wlren all
plumbing worl( is complete.
L_l Silc lnspection - To be made
af ter excavation, l)ut prior to
settirlg fornrs.
w Rough Eleclrical - Prior to w Final Electrical - When all
electrical work is cornplete.COVCT,
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.w W Final Mechanical - When all
mechanical worl( is corrtplete.
w Fooling - Af ter trenches are
excavated.Fireplace - Prior to facing
materials and framlng lnsp.
E
Masonry - Steel location, bond
bearns, grouting.w
w
w
Framing - Prior to cover.
Foundation - After forms are
erected but prior to concrete
placemen t.
Wo'nu'
Wall/Ceiling lnsulation - Prior to (oncover.
w
w
w
LZ
w
w
w
w
Underground Plumbing - Prior
to filling lrench.Drywall - Prior 10 taping
MOBILE H MEI ECnON
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - Af ter installation
Post and Beam - Prior to floor
instrlation or decl<ing.lnsert - After fireplacc ap1;roval
arrcl install;rtion of unit.
Blocking and Set-Up - Wherr all
blocking is cornplete.
Floor lnsulation - Prior to
decki ng.x Curbcul & Approach.- After
forms are erected but prior to
placernerrt of concrete.
Plumbing Conneclions - Wlren
home has been connected to
water ancl sewer.
Sanitary Sewer - Prior to filling
trenctl.Electrical Conneclion'- When
blocking, set-up, and plumbing
inspections have been approvcd
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - Alter
excavalion is complete, forrns
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completed
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumblng -'Prior to
cover.K
OWNER:
ADDRE.SS:
CITY:
tl
Dil
fl
Electrical Service - Must be
approved to obtain Permanont
electrical power.
Final Building - When all
required inspections have been
approved and building is
completed.
Lot SetbacksLot faces
Lot sq. ftg.
Lot coverage
TopographY
Total heiglrt
Eeze-ln te rior
Corner
--- Panhandle
--
Cul'de-sac
PL.
N
oo2?a,m'
E
ACCt'.tsE GAR
/8'
3g/
/7'
"5'^,
f THE PROPOSED WORK IN THE
YIISTORICAL DISTRICT, OR ON
THE HISTOFIICAL REGISTER?
--lf yes, this application tnust be signed
and aPProved bY the Historical
Coordinator prior to perrnit issuance'
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express conditiorr that the said
construction shall, in alt respects, conform to the Ordinance
adoptecl by the City of Spring(ield, including the
Developnlent Coclc, regulating the construction and use of
buildings, and may bc suspenrJed or rcvokcd at any time
upon violation of any provisions o{ said ordirranccs'
ir-.wt:r>irt<: /-
Plan Chcck Fce
Datc Paid
Rcccipt Nuntbcr:
Reccivccl BY
VALUE
"426
(^)
37.22
BUILDING PERMIT
ITEM SO. FT.
Main ZZ$O:-
Garage
Carport
Total Valuc
Eluiltlirtll [)ct tlri t [--t:c
State Sur<;lrargc
lot;rl l:cc
/a4.*
24.?(za-z
x $/so. FT,
Systems Developtnent Charge is clue on all undevcloped
properties witlrin the City limits which are being itnprovecl'SYSTEMS DEVELOPMENT CH
(B)
#
s
ARGE (SDC)
89
AD ONAL COMMENTS
ITEM
Fixt u res
Flesidcntial Bath(s)
SanitarY Sewer
Watcr
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
222-<
(c)
F'T.
FT.
v2a.-././ b/b.vvG.*
Plumbing Pcrlnit
State Sttrch:rr1;c
'l-otal Cltarglc
vzxk--
FT.
M ECHANICAL PERMIT
Fu rn ace
Exhaust Hood 2.Y7'd;?
Woo<j Stove/ lnsert/ Fi replace Unit
Dryer Vent 7/<7
ab2/.
/O'oo
=z'4-,(D)
2f,
N" 7r 7
-2 a>1a,
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
.? az2e-'2-
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
informationhereonistrueanclcorrect'andlfurthercertify
that any and all work ;-rerformed shall be done in accordance
with the Ordinances of the City of Springf ield, and tlre Laws
of the State of Oregon pertaining to the worlt describcd
lrerein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division'
I f urther certify that only contractors and employees who
are in compliance witlr ORS 701'055 will be used on this
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
St
Sig
Date
d tltea11
on the 'e at all tintcs
ted
d
s
the front
mainplan
from the street, th mit card
of the proMISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidcwark €6-- ,,/'/3'.
curLrcut /il5-- tt
Demolition
Statc Surcharge
Total Miscellaneous Permits (E)
/5.qe
a>
EZ@
,/2
DATE PAID
AMOUNT RECEIVED
FIECEIVED BY
VALIDATION:
FIECEIPT NUMBEFI
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, O anrJ E Combined)
zZZdQ7
a
,/r'
\
7ta* fra' ',v--
225 FIFTB STP&Ef,is
SPRINGFIEI.,D, OREGON 97477
TNSPBCTToN REQTTBST-. 726-1769
0FFICE: 726-3759 , \rfn
1 0N 0r
IJGAL DESCRIPTION
OB DBSSRIPTION
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COI,ITRACTOR INSTALI,ATION ONLY
cirv 4?FCb Phone 7/7a42
Nev Residential-Single or
"' {[uIti-FamiIy per dvelling unit.
Serdtc'e.IncIuded :
Items Cost
slDrrtNGrtELu
BLECTRICAL PBRHIT APPLICATION
Nu b", ?2O%?
PEB SCEEDULE BELOU
Sum
,rry
1000 sq.ft. or Iess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0nly
z $ 8s.oo 2
2- g ls.oo &
$ 40.00
60.
100.
130.
300.
40.
7
Supervisor License Number 252,0 S
Expirat ion oate /O1*72
Constr Contr. Number /252
Expiration oate €-S?7
Signature of Supe rvrs Electrician
rs Name
Address y/ l*/ ,/AG
The installation is being made on
property I own vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE: ,*?6+2
RECEIPT *:
B
$
$
$
$
$
$
00
00
00
00
00
00
50
citv F4;a,<z vnone 4i B 7 *F7va::"litt:l"litn
service
09NER INSTALL,ATI0N or Feeder Permit S 2.00
D. Branch Circuits
Nev, Alteratlon or Extension Per Panel
One Circui t $ 3s.00
E. Miscellaneous (Service/feeder not included)
Temporary Services or Feeders
Installation, Alteration or Relocatio-n
SUBTOTAL OT ABOVE
5Z State Surcharge
TOTAL
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 40L to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see [8" above
-Each installation
Pump or irrigation $
Sign/Outline Lighting_ $
Limi ted Energy/Res _ S
Limi ted Energy/Comm $
40.00
40.00
20.00
36.00
5
RECEIVED B
%.a>,- d_---4--2' -a-
ir$e
Electrical Contrac t"rfiVf ;H: &q-
tddress -ZZ>,r/,Affi?i<- 7 y?.
c.
a ,a a
stitttN(;FtELlJ
A n.l a.s Air
225 FIFTII STREET
SPRINGFIELD,0REGON 9747 I
INSPF,Cf,ION REQUEST:
oFFICE: 7?.6-3759
1
ON
Permits are non-transferable and expire
if vork is not started vlthin 180 days
of issuance or if vork is suspended for
180 days.
2. CoITTR CToR ONLY
Electrical Contractor
Address
PERHIT APP LICATION
Ci ty Job Number
3. COHPI^BTE PEE SCTIEDULE BELOV
Residential-Single or
Mu Iy per dvelling unit.
Service fncluded:
Items Cost
1.000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 85.00
$ 1s.00
s 40.00
Services or Feeders
Installation, Alterations or
Relocation:
2oo amps or less A,201 amps to 400 amps
401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconneet 0n1y
$ s0.00
$ 60.00
$100.00
$130.00
s300.00
$ 40.00
C
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
One Ci rcui t
Each Addi t ional
s 3s.00
-Each installation
Ptrmp or irrigation
Sign/OutIine Light ing-
Limi ted Energy/Res
Limi ted Energy/Comrn
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
37
Aufru,;eo
Sum
5i:LtTft',t'i-
Ci ty ?"rum q(Y
B
[,ffi_
Ph
Supe rv isor fi.ense Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature sing Blectrician
Owners Name
Add ress
Ci ty Phone
OVNER ALI.,ATION
The installation is being made on
property f ovn which is not intended
for sale, Iease or rent.
Owners Signatrrre:
DATE:
Temporary Services or Feeders
Installatlon, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see I'Brr above
(
E
Circuit or vith Service^ aA
or Feeder Permi t /l ) $ 2. OO JU ,
Miscellaneous (Service/feeder not included)
$
$
s
s
00
00
00
00
40.
40.
20.
36.Dct)o)
C
RIiCEIVED I}
5
I
/
IbbKS
q q))
JOB r{0. azo'bb1
CITY OF S INGFiELD SYSTEMS DEVELOPMT
WORKSHEET,
(cor{r{ERcIAL & RES IDENTIAL)
_
CI{ARGE
NAI'IE OR COMPANY : Gee-eA V,+uueY Co. or o Tr.tc-
L0CATiON: l-1-1 4 trt 3ur-rr+ Loop l-'l o z %z- = t - tn \r-
OEVELOPMENT TYPE: MDe- - L\E\{Dueue.*
3
BUILOING SIZE:LOT SI
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. tqq4 X 50.186 PER SQ. FT.
(See Reverse For Runoff Coefficients If Actual Imperv. Area
?. SANITARY SEI.IER-CITY
NO. OF PFU'S .F 7Z X 538.55 PER PFU
(See Reverse ffi PFU'S)
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
L x l,oo5 x s388.61'x x $388-61
4 ADI.IINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABoVE) X .os
(Use PFU Total From Item 2 Above)
Mt,lMC CREDIT IF APPLICABLE (StE REVERSE)
S a. Ft.
s bto9
Is Unknown)
s lzoocl
s 1gt9
s uqL:
s 1o2
ToTAL-ilWfiC SDC S bn479
T.TAL sDC s ?bqgt!
,:
i@FmenFto-DEteraine t'lfir$6iiilt*,
rrEr{s l,z, & 3) s zz2oey-"
TOTAL-CITY SDC S'?,qo+Y
5. SANITARY SEt.lER-HT.'fiC
N0. 0F PFU'S bz x S13.25'PER PFU t SlC l{t{t{C ADH IN. FEE S 4A12
b
Kip Burdick
SDC Coordinator
To? oNuy t d+z.rl't,^t ld Q,*r-y oF z ".b,'',ttg'D.
N'*
Qsvt *uH 1oc i,or*v (zxao t ,rcb) l'o5 3 U":
a
FTXTURE UNIT CALCULATION TABLE: i.:,.rnrber ot Nen,Fi(ures X Lrnii lqun'aiettl = Fixlure Uniis (I'JOTE
For rernodels, calculate only the NET
-
iiiionsl fixrures)
NUMBEF OF .- UNIT FIXTURE
FIKTURE TYPE NEW FIKI-URES EOUIVALENT UNITS
Bathtub.......
Drinking Fountain- .-..-.-.----------.----
fl oor Drain-.... -...-. :.-....--.
lnlerceptors For Grease/Oil/Solids/Etc----------------.
lnterceptors For Sand/Atrto Wash/Etc.---------:-------
')+
Laundry T
Clotheswasher - 3 Or More-..--..---.
Mobile Home Park Trap (1 Per Trailer)--------
Receptor For Refri gerator/-\A/ater Station/Erc- - - -. - - -
Receptor For Commercial Sink/Dishwasher/Etc-:
Shower. Single Stall..---...--.
Shower. Gang....--...-.
Sink Bac Commercial
Wash Basin/t-aratory, Single.------.
Water Closet Public lnstallatioru-
Water Closet, Prtvate.--...-
+
2
1
t
J
6
2
6
6
1
J
2
1
2
2
1
6
4
ead/H
Miscellaneous:
TOTAL FD(URE UNTTS 7z
/
cREDtT CALCUIATION TAB! tr: Based on assessed vatue- lf imprOrements occtrrred after annocation date in table.
. calcrdate credtts
z-.GU x s t6,bt *o 17-
Credit for Parcd or tand Only lf Applicab{e
lmprorement (f after annmtion date)
(Rate X Assessed Value)xs
(Rate X Assessed Value)
CREDIT TOTAL = $4o 1z
Year'
Ann€t(ed
Rate per S1.O0O
Assbssed Vatue
Year
Anneratd
Rate paS1.0OO
Assessed Value
1985
1986
1987
1988
1989
1990
s1.69
I.JJ
1-15
o-92
0.s9
0.23
1979 or before
1980
1981
79132
t98g
1984
sz66zu
253
241
2'19
L04
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
I
Resrdential--
Commercial----...-..-..... -
lndustrial----- ...--....-.... 0-45
Governrnentat--.-.--------------- '-"""--- 0'5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
0.4
0.9
4
225 North Fifth Street
Springfield, Oregon 97471
FENCE PEITHIT APPLICATION
CITY OF SPRTNGTIEI.D
BUILDII{G SAFETY DIVISION
SPRINGFIELD
Office:
INSPECTION LINE:
726-3759
7 26-37 69
-OBEGO'VCITY OF
Job Location:(-ZEI *#Lq^/ffit'\,al
Assessors Map #:lloLv rax Lot *,0 (1 I L
Phone #:
zi p:
Ovner:
Address:
Ci ty:
Value of Fence:
Con t rac t orlIns taller :
Address:.0
State:6 0
Fence Permit is $5.00
I'jhone #:bl4 t\L
Ci ty:State:
Construction Contractors Registration li:q4 Expi res :6:1 :73r>t
By signing this permit/appl.ication, I agree to caII for an inspection once myfence lras been constructed (726-3769). I also stated that atl information onthis application/pernit js correct and that I was provided r^'ith the Springfield
Development code requirements for fence standards.
7 -7 2_
S gna ture Date
FOR OFFICE USE
0v-,AW
Date of Application:4-z 4 z--JOB {t:Qze3gz
Receipt #(,, (E Issued By:
Tota} Amotrnt Collected , ff5'dD
Checked f or Delinquenei es: ./-Checked for Historical Statrrs: ----
.<\ -