HomeMy WebLinkAboutPermit Building 1992-11-02SP,lINGFIELr)
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Office: 726-3759
LO CATION OF PROPOSED WORK
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97 477
TAX LOT*JlQD_tffr \
+ASSESSORS
LOT:ItlLocK
STATE:
,1-,z
PHONE:bfr3-Jt-O(/owNEB:
-222rt/--
Z.Vz,
ZIP:?JlatADDRESS:
CITY:
*a* !/ BEMoDEL ADDtrtoN DEMoLIsH orHER
DESCBIBE WORK:
PHONEADDRESS
a/)
CONTRACTOFI'S NAME
CONST.
CONTRACTOR ,f
ELECTRTcAL,
n )r(1-
sRlN-__
La
HEAT SOURC
RANGE:
FLOOD PLAIN:--
_ OFFICE
LAND USE:
a OF UNITS:
--CONSTR. TYPE
ZONING CODE:
E OF BDRMS:
WATER HEATER:
SECONDAFIY HEAT
SQUARE FOOTAGE:
OUAD AREA:
I OF BLDGST
OCCY GROUP:
# OF STOFIIES
To request an inspection, you must call 726-3769. This ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
macle the same working day, inspections requested after 7:00 a.m. wlll be made the followlng work day,
REQUIRED INSPECTIONS
N4 Footlng - After trenches are
ts\excavated.
l\lZ[ Floor lnsulallon - Prior toA{ decktng.
.E|,";lt"t;ry Sewer - Prlor to rllllng
X[irl'^tg.sewer - Prlor to rlllins
Xly*:lLrne - Prror to rrrrrns
,X $#r: Plumblns - Prlor to
p;f Slaewalk & Drlveway - AfterJq excavation ls complete, forms
and sub-base materlal ln place.
[-l fence - When compteted
Flna! Bulldlng - When alt
requlred lnspectlons have been
approved and bulldlng ls
completed.
ELotn"'
MOBILE HOME INSPE TIONS
l--l Alocklng and Ser.Up - When ailtJ blocklng ls complete.
Plumblng Connections - When
home has been connected to
water and sewer.
Electrical Conneclion - When
blocklng, se t-up, and plumblng
lnspectlons have been a pproved
and the home ls connected lo
co panel
lns
ul
vent lng lnst
Temporary Electric
Slte lnspectlon - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing / Eleclrlcal /
Mechanlcal - Prior to cover.
Masonry - Steel location, bond
beams, 0routlng.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulation or decking.
Rough Mechanlcal - Prlor to
cover.
Rough Eleclrical - Prlor to
cover,
Electrlcal Servlce - Must be
approved to obtain permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Framing - Prior to cover.
Wall/Celllng lnsulation - Prlor to
cover.
Drywall - Prlor to taplng
Wood Stove - After lnstallatlon
lnsert - After flreplace approval
and lnstallatlon of unlt.
Curbcul & Approach - After
forms are erected but prlor toplacemenl of concrete,
Slreet Trees - When all requlred
trees are planted.
ffifinat Plumblng - When ailF--+plumblng worl< ls complete.x Flnal Electrlcal - When all
electrlcal work ls complete.
Final Mechanlcal - When all
mechanical work ls complete.
X
x.
x
K
K
K
w
F
x.
K
lVfounaallon - After forms are
,)A-{ erected but prior to concrete
placement.
Kx
,G\\
SUBDIVISION:
9? \rt u\[-,
MECHANICAL:,<rla
PLUMBING:
G EN EFIAL:
W
f ' sE
4A/t?a/
tl
Flnal -
I
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total helght
Lot Type
--
C0rner
-
Panhandle
-.
Cul'de-sac
tbacks
APPROVED
@ Xtnterlor
l*%ffi
HSE GAR ACGP,L.
/2,
S /'2
17'
E 2/l
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granled on the express condition that the said
construction shall, irl all respects, conform to the Ordinance
the City of Springfleld, including the
regulating the construction and use of
be suspended or revoked at any time
ffi a/ap+
c\w"a
adopted bY
Development Code,
bulldlngs, and maY
sions of said ordinances.upon violatio
Plan Check Fee
Date Paid
Recei pt Nutnber:
Recelved BY
BUILDING PERMIT
5z5,ss
50
(A)
$tb=dff"4s*
<o3
ITEM
Maln
Garage
Carport
Total Value
Bulldlng Permlt Fee
State Surcharge
Total Fee
Systoms Develol.rmr,'tlt Charge ls ciue on all undeveloped
properties wlthlrr the City limits whlch are belng lmproved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) &Z"be
ADDITIONAL COMMENTS
*z
ITEM
Fixtures
Ftesidential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Moblle Horne
PLUMBING PERMIT
FEE
Oro
FT.
FT.
/br
7{e4(c)
tt"Z//b
Plumblng Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Fu rn ace
ExhaustHood Ze y'so
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent 2 dL >
/,or
(D)
&2
@6
D.a o
6,oo
/?o
Z?9
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permlt
No ze3
By slgnature, I state and agree, that I have caref ully examined
the completed appllcation and do hereby certify that all
lnformatlonhereonlstrUeandcorrect,andlfurthercertlfy
that any ancl all work performed shall be done ln accordance
with the ordlnances of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure without permission of the Building Safety Division'
lfurthercertifythatonlycontractorsandemployeeswho
are ln compliance with OFIS 701'055 will be used on this
proJect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card ls located at the front
ol the property, and the approved set of plans wlll remain
-\on ctionthe slte at all times during con
Signatu
MISCELLANEOUS PERMITS
Moblle Home
State l6suance
State Surcharge
sidewatk bO tt
curbcut 3o t
Demolltlon
State Surcharge
Total Miscellaneous Permits
-h!:-a? rfo/il*o ('i',
(E)
//- 2 -7L
3q.oL
FIECEIVED BY
--
DATE PAID
AMOUNT RECEIVED -
VALIDATION:
RECEIPT NUMBEFI
TOTAL AMOUNT DUE (exclud
(A, B, C, D and E Gomblned)
oL
ing electrical)
N
n(C, O ll
Jry:rt(
FT.
/r
/ y','"
J THE PROPOSED WORK IN THE
HtsToRlcAL DlsTFllcT, oFl oN
THE HISTORICAL BEGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved bY the H lstorlcal
Coordinator prlor to permit issuance.
ctfv oF OREGO'U
st'r Ui'r(;l: t['Lu
c*rtl
Aur'r",...---._, ,r\ial
eb
225 PIFTII STR.EET
SPRTNGFIELD, OITEGON 97477
INSPECTI0N REQUEST: 72.6-3769
OFPICE: 7?.6-3759
a Job Number
PEE SCTTEDULE BBLOV
A. Nev Residenti a ingle or
HuIti-FamiIy per dvelling unit,
Service fncluded:
Items Cost
APPLI
iz
1
ON
Pernri ts non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CO}ITRACTOR
Iilec t rical Con t rac
Addr:ess
Ci ty Phone
Supe rv isor cense Ntimber
Expiration Date t0
Constr Contr. Number
1.000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hanuf'd Home or
Modular Dwelling
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/voIts
Reconneet 0niy
A
-t4*
tlD
gD
B
$ 8s.00
$ 1s.00
$ 40.00
Sum
aSove
I
s s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
40.00
55.00
80.00
e rBil
Expiration Date
Signature sing Blectrician
0vners N
Add res s
Ci ty Uoaans-,Phone 1o(3-3
6
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECETPT
Temporary Services or Feeders
Installatlon, Alteration or Relocation
200 amps or less $
201 amps to 400 amps $
over 4b1 to 6oo amps
-
S
0ver 600 amps or 1000 volts se
Branch Circuits
q 30 q.3
C
D
e
Y{.)Nev, Alteration or Extension Per Panel
One Ci rcui t
Each Addi tiona]
Circuit or vith Service
or Feeder Permi t
s 3s.00
s 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0u tline Light ing-
Limi ted Energy/Res
Limi ted energy/comrn
-STIDTOTAL OT ABOVB
5f State Surcharge
TOTAL
2ote.a
-/o o?
$ 40.00
s 40.00
s 20.00
$ 36.00
5
RIICHIVED I}Y:
2 -7L ?/ooo
'., I t
;.: i
0
108 N0.qzt.tL+C
CITY0FSPRINGFIELDSYST^EI4SDEVEL0PMENTCHARGEWORKSHEET
(C0MMERCIAL & RESIDENTIAL)
t)
NAME OR COMPANY:AKIIE L DAV t5
LOCATION:
z
DEVEL0PMENT TYPE: [tA-pe - stew ffi- Dueua)L
SIZ S a. Ft.
BUILDING SIZE:
1 STO DRAI E
2
3 TRANSP ORTA TION
IMPERVIOUS SQ. FT.Zbbo x $0.1e2 PER SQ. FT.
SAN ITARY SEI,.ITR-C ITY
NO. OF PFU'S bL X $39.78 PER PFU
(See Reverse)
NO OF UNITS X TRIP RATE X COST PER TRIP
X l,oo9 X$401-05
$
NO. OF PFU'S
x $401.05
x $401.05
x
X
X
$
suBToTAL (ADD ITEMS 1,2, & 3) s zqzu+z
4 ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X '05
5. SANITARY SEWER_MWMC
L-CITY SDC $Zt-bz 1,
TOT
$13.62 PER PFU + $10 Mt,lMC ADMiN' FEE S '{*ltsjbz
(Use PFU Total From Item
Ml,lMC CREDIT IF APPLICABL
A^&-
Kip Burdick
2 Above)
E (SEE REVERSE)
b2
L _Mt^,MC SDC
7"-
SDC Coordinator
1o
TO
TOTAL SDC $(-l .l+
FIXTURE UNIT CALCUI-ATIUN TABLE: t'tumuer of New Fixtures
For remodels, calculate only the NEJ additional fixtures)
NUMBER OF
NEW FIXTURES
L
Bathtub.......
Drinking Fountain""'
Credit lor Parcel or Land Only tf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x$
Residential--
Commercial
lndustrial-.---
X Ur,,. Equivalent = Fixture Units (NOTE:
UNIT FIXTURE
EQUIVALENT UNITS
--q-
=$bt v9
GE
Floor Drain.
i ni.rc.ptots For Grease/Oil/Solids/Etc""""""""'
t n,"r""p,ot. For Sand/Auto Wash/Etc"""""""""
Laundry Tub/Clotheswasher"""
Clotheswasher - 3 Or More""-'
ftloUifl Horne Park Trap (1 Per Trailer)"".:"""""'
n"""pto, For RefrigeratorflVater Station/ktc""""
nu""b,ot For Commerciai sinxToishwasher/Etc"
Shower, Single Stall"""'-""-
2
H
2
1
2
3
6
2
6
6
1
J
2
1/
2
2
1
6
4
ea d
+
J
\6
Shower, Gang----
Sink, Bar, Commercial
Urinal, StallflVall--"
Wash Basin/Lavatory, Single""-""
Water Closet, Public lnstallation""
Water Closet, Private"'-""-"""
Miscellaneous:
CREDIT CALCULATI
calcul ate credits seParates-
a
TOTAL FIXTURE UNITS bZ
oN TABLE: Based on assessed value. lf improvements occurred after annexation date in table
b,2.e> x $1\
- (Rrt" X Assessed Value)
CREDIT TOTAL
RUNOFF COEFFTCIENTS FOR STORM DHAINA
0.4
0.9
0.45
0,5
Governmental
Year
Annexed
Rate Per $1,000
Assessed ValueYear
Annexed
Rate Per $1,000
Assessed Value
1985
1 986
1 987
.1988
1989
1990
1991
$2.16
1.90
1.60
o.25
o.87
0.50
0.16
1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICTENT