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Home My WebLink AboutPermit Building 1999-03-22RESIDENTIAL PEBMIT APPLICATION lnrprotlonr: 7204709 Ollloc: r2tA7C0 JOB NUMBEH fgotz 225 Fllth Street Sprlngfleld, Oregon 97 477 6 LOCATION OF PROPOSED WORK: ASSESSOBS MAP:i7/)3 1/ z L TAX LOT o LOT BLOCK:SUBDIVISION: - PHONE: STATE:ZIP: 7/q^oq /bOWNER: ADDRESS: CITY: NEW --- REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: 0d EX R t L. .n PHONEADDRESSCONTRACTOR'S NAME GENERAL:t/, ELECTRICAL; MECHANICAL: PLUMBTNG: CONST. CONTRACTOR , t,a?f SQUARE FOOTAGE:WATER HEATER:RANGE: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspecilons requested before 7:00 a.m. wlil be made the same worklng day, lnspectlons requested af ter 7:00 a.m. wlll be macje the followlng work day. IRED INSPECTIONS h Mechanlcal - Prlor to Plumblng - When ail blng work ls complete.plumr. [--l Underslab Plumblng/Electrlcal/lJ Mechanlcal - Prlor to cover. l_l Footlng - After trenches arelJ axcavated. l-l remporary Electrlc Slte lnspectlon - To lre mado after excavatlon, but prlor to settlng forms. Maconry - Steel locatlon, bond beams, groutlng. Foundatlon - After forms are erectccl.but. prlor to concrete placemont. Underground Plumblng - Prlor to fllllng trench. Undcrltoor Plumblngl Mechanlcal - Prlor to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulatlon - Prlor to decklng. Sanltary Sewer - Prlor to fllllng trench. Slorm Sewer - Prlor to fllllng trench. Water Llne - Prlor to fllllng trench. h Plumblng - Prlor to h Electrlcal - Prlor to Electrlcal Servlce - Must be approved to obtaln permanent olectrlcal power. Flreplace - Prlor to faclng materlals and framing lnsp. Framlng - Prlor to cover. Wall/Celllng lnsulatlon - Prlor to cover. al Electrlcat - When all trlcal work ls complete. Mechanlcal - When all anlcal work ls complete. nal Bulldlng - When all requlred lnspectlons have been approved and bulldlng is completed. Other MOBILE HOME INSPECTTONS Blocking and Set.Up - When all blocklng ls complete. Plumblng Connectlons - When home has been connected to water and sewer. Electrlcal Connecllon - When blocklng, set-up, and plumbing lnspectlons have been approved and the home ls connected to the servlce panel. Flnal - After all required lnspectlons are approved andporches, sklrtlng, decks, andventlng have been lnstalled. tl E tl [-l Drywall - Prlor to taptng n Wood Stovo - After lnstallatlon lnserl - After flreplace approval and lnstallatlon of unlt. Curbcut & Approaclr - After forms are erected but prior toplacement of concrete. Sldewalk & Drlveway - After excavation ls complete, forms and sub-base materlal ln place. n Fence - When coiilpleted Streot Troes - When all requlred trees are planted. 2/L trT tlh USE: UNITS: asotll-saln.l TYPE: ^-RMITSI{ALL HEAT SOURCE:,oF , OF BDRMSI _ E fl ...1 q Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - - lnterior - Corner - Panhandle i' - Cul-de-sac (-1s THE PROPOSED WORK TN THE . HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - ll yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordlnator prlor to permlt lssuance. APPROVED: P.L.HSE GAR ACC N S E (A) t Total Value Building Permit Fee State Surcharge Total Fee X $/SQ. FT. = VALUE BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VqTUE, i5MU CHECK AND BUILDING PERMIT This permit is granted on the express conditlon that the said construction shall, in all respects, conform to the Ordlnance adopted by the City of Springfleld, lncludlng the Development Code, regulating the constructlon and use of bulldings, and may be suspended or revoked at any tlme upon violation of any provisions of sald ordlnances. Plan Check Fee: - Receipt Number:- Plans Reviewed By Date Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls due on all undeveloped properties wlthln tlro City llmlts whlch are belng lmproved. ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE 3o ?0,d0 i,to /f o -?:"to(c) FT. N' FT. FT. PLUMBING PERMIT Plumbing Permlt State Surcharge Total Charge ADDITIONAL COMMENTS r*t t bt Wood Stove/ lnsert/Flreplace Unit Dryer Vent 7f, oo (D)L6 MECHANICAL PERM!T /1, o'C Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon hereon is true and correct, and I lurther cerilfy that any and all work performed shall be done ln accordance wlth the Ordinanccs of the City of Sprlngfleld, and the Laws of the State of Oregon perlalnlng to the work descrlbed herein, and that NO OCCUPANCY wlll be made of any structure wlthout permission of the Bulldlng Safety Dlvislon. I further certify that only contractors and employees who are In compllance with ORS 701.055 wlll be used on thls prolect. I further agree to ensure that all requlred lnspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln \ Slgnature Date on the site at all durlng construct MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolitlon State Surcharge 50L Total Miscollaneous Permits (E) 7,/6^4? TOTAL AMOUNT DUE (excludlng electrlcal) (A,B,qQandEComblned)fifrg 2>f033>z )VAI-IDATION: BECEIPT NUMBER DATE PAII) AMOUNT BECEIVEO RECEIVED BY ) INSPECf,ION REQUEST: 7 OFFICE: 726-3759 Authorized Srgnatrrre 1 DESCRTPIION JOB Permits ire non-transferable and expire lf vork is not started vithin 180 days of issuance or if vork is suspended for 180 days 2. CONTRACTOR INSTALI,ATION OI'{LY Electrical Contractor L.l{, (I Address 421 Ci ty.t?eo Phone 1q1- a(ll Supervisor License Number a aa(o I Expiration Date Constr Contr. Number ofrBr Expiration Date 1 -g-71 Signa of ing Electrician Ovners Name JO E- Address wn1 Ui uesL bau) Ci ty e(ru'Phone 'DL ;oe11 OVNER INSTALLATION The installation is being made on property I ovn vhilh is not intended for sale, Iease or rent. SPFIINGFIEL(, EEE SCEEDUIJ BELOV Residential-Sing le or Mu iIy per dvelling unit- Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf 'd llome- or Modular.'Dve11ing' Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 @fi, 225 FTFTE STREET SPRINGFIELD OREGON 97, Sum .8. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPs - 401 amps to.600 amps - 601 anps to 1000 anPs- Over 1000 amPs/vo1ts - Reconnect OnIY SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee C. Temporary Services or Feeders Installaiion, Alteration or Relocation 200 amps"or less t 19'99 201 amps to 400 a,P" - t ::'99 0ver 600 amPs or fbOO vofEs see (Brr above D. Branch Circuits. ; .' Nev, Alteration or Extension Per Panel Sllntililtlo""r I s 3s'oo Circuit or vith Service. ;;F;iei-Permit I $ 2'oo E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/OutIine Ligh ting- Limited EnergY/Res - Limited EnergY/Comm s s0.00 s 60.00 s100.00 s130.00 s300.00 $ 40.00 s 40.00 s 40.00 s 20.00 $ 35-00OvnerHsignature: 9 b 5 Tn.nAr 3-r o-+ (I M BEt- Doa) ozl JOURNAI -q JOB NO.?Et s 73 ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET LOCATION a; DEVELOPMENT TYPE BUILDING SIZE OT SIZ Ft 1. STORM DRAINAGE IMPERVIOUS SQ. FT X $0.227 PER SQ FT. $ 2. SANITARY SEWER-CITY NO. OF PFU'S 7 X $47.14 PER PFU , j21 ?f (See Reverse Side) 3. TRANSPORTATION 4. SANITARY SEWER-MhJI"1C A. REiMBURSEMENT COST: 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) X .05 SDC Coordi nator ATTACH 'A. I,.JPD NO OF UNITS X TRIP RATE X COST PER TRiP X x $475.32 x _ x $475.32 i) $ NO. OF FEU'S X PER FEU B. IMPROVEMENT COST: NO. OF FEU'S X PER FEU Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ $ <$ TOTAL_M[^JMC SDC $ $ 10.00 s 91Qf $/6 r? Date: TOTAL SDC ,3lb t( tr NAME OR COMPANY:Jal r, ,t/ c no /t rlr t +ry FIXTURE UNIT CALCtt' \TION TABLE: Number or New F - ,r€s X Unit Equivatent = r-ixture Units(NorE: For remodels, calculate orrry the NET additional fixtures) ' NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EqUIVALENT UNITS Laundry Tub/Clotheswasher ., ( T- -11_ -.:- 7 Clotheswasher - 3 Or More Mobile Home Park Trap (1 Per Trailer) Shower, Single Stall Bathtub. Drinking Fountain. Floor Drain. lnterceptors For Grease/Oil/Solids/Etc. lnterceptors For Sand/Auto Wash/Etc. Receptor For Refrigerator/Water Station/Etc....... Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Gan9................ Sink: Bar, Commercial, Residential Kitchen.... Urinal, StallArVall... Wash Basin/Lavatory, Single........ Toilet, Public lnstallation. Toilet, Private....... Miscellaneous: 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 6 4 /Head TOTAL FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value lf improvements occurred after annexation date in table, calculate credits Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) (Rate X Assessed Value)x$ (Rate X Assessed Value) CREDIT TOTAL - $ Year Annexed Rate per $1,OOO Assessed Value Year Annexed Rate per $1,OOO Assessed Value 1979 or before 1 980 1 981 1982 1 983 1 984 1 985 1 986 1 987 1 988 $4.27 4.18 4.12 3.99 3.83 3.68 3.48 3.18 2.82 2.42 1 989 1 990 1 991 1992 1 993 1 994 1 995 1 996 1 997 $1.98 1.55 1.15 o.96 o.83 o.67 0.52 o.38 o.21 RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Onlyl Residential Commerical... lndustrial....... Governmental.... o.4 o.9 o5 o.5 FIXUNIT.WPD IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT I x $_: