HomeMy WebLinkAboutPermit Building 1994-12-30SPRII\rGFIELO
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WOBK:
ASSESSORS MAP;
LOT:/+l-l
?fr,
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
LA,
13 1=tt TAX LOT:
SUBDIVISION:L FI?
SourE Q€t|"r,t ?ru-l L CIEfL S 7L++oqt GPHON E:
6 l.)
ZIP:
L L
STATE:QILL 11
OWNER;
ADDRESS:
CITY:
BEMODEL ADDITION DEMOLISH OTHER4_
.(trDESCRIBE WORK:
NEW
ADDRESS EXPIRES PHONE
L--"f 8r
/f rtS
L
L
4
d{
I
1Ll1 b,9( (ELECTRICAL:
o i-(
h tvs&
3qt
?L
MECHANICAL:
PLUMBING:
CONTRACTOR'S NAME
GENERAL:3 our
CONST.
CONTBACTOR #
L l+ ltto
?r
V
SOUARE FOOTAG
-\
- OFFICE USE -
\\\\
* OF UNITS:
LAND USE;
OCCY GROUP:
SECONDARY HEAT:
I OF BDRMS:
WATER HEATER:
r OF STORIES:
ZONING CODE:
FLOOD PLAIN
CONSTR. TYPEI
HEAT SOURCE:
QUAD AREA:
r OF BLDGS:
To request an lnspection, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED TNSPECTIONS
l7'Footlno - After trenches areF{ excava-ted.
[-l remporary Etectrlc
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrlca! /
Mechanlcal - Prlor to cover.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundallon - After forms are
erected but prlor to concrete
placement.
Underground Plumbing - Prior
to fllllng trench.
Un
- Prior to
Post and Beam - Prlor to floor
lnsulatlon or decking.
Floor lnsulatlon - Prior to
decklng.
Sanltary Sewer - Prior to fllling
trench.
Storm Sewer - Prior to filling
trench,
Water Line - Prlor to fllling
trench.
Rough Plumblng - Prior to
cover.
Rough Mechanlcal - Prlor to
cover.
Rough Electrlcal - Prior to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and lramlng lnsp.
Framlng - Prlor to cover.
Watl/Celtlng lnsutallon - Prlor to
cover.
Drywall - Prlor to taplng.
Wood Slovs - After lnstallatlon.
lnserl - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Flnal Plumbing - When all
plumblng work ls complete.
Flnal Electrlcal - When all
electrlcal work ls complete.
Flnal Mechanlcal - When all
mechanlcal work ls complete.
X
X
-tr
"x
,K
K
X.
F
K
K
Nt Sidewalk & Driveway - Af ter
flexcavatlon ls compiete, forms
and sub-base materlal ln place.
Xt"n"t - when compteted'
fifrPtreet Trees - when all required
Lfltr.u" are planted.
ffi ftnal Buitdlng - When ailqrequlred lnspectlons have been
approved and bullding is
completed.
,X o,nu, d+s/" "
MOBILE HOME INSPECTIONS
Blocklng and Set-Up - When all
blocklng ls complete.
Electrical Connection - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
,x
X
&
x
X
"a
X
K
14t ?3?
Wdfi" fin*^e f
rRsrJ
BANGE:
l--l Plumblng Connectlons - WhenIJ home has been connected lo
water and sewer,
E
t.,
Lot faces
Lot sq. tts. ////-9.
Lot coverage A-A
Topography HLt
Total helsht L4-
Lot Type)/- lnterior
-
Corner
tr
-
cur-de-sac
. S THE PROPOSED WOBK ]N THE ,--HrsrontcAL Drsrnrcr, oR oN
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED
Setbacks
o
%
/ u"d:4^nhandre
PL.HSE GAR ACC
N L?'
s i7'
L ,3
E /t'
VALUE
22-,>14 t3,#
(A)
Main lTJf
Garage
Carport
X $/SQ. FT.
5r.2D
Total Value
Building Permit Fee
State Surcharge
Total Fee
lE+4646f"?< 73JJA?4r ?'
BUILDING PERMIT
ITEM SO, FT.
Leoo 14.tD
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Spri ngfield, including the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
ewed ByPI
Plan Check Fee:
Date Paid
Recei pt Number:
Received
upon violation of provisions of said ordinances.
SYSTEMS DEVELOPMENT CHARGE (SDC)
/ ztar.z /(B)
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
Plumblng Permlt
State Surcharge gre + 49
Total Charge (C)
FEE
-,12--.b
/@PN"2
FT.
FT,
FT.
/7L*"
PLUMBING PERMIT ADDITIONAL COMMENTS
o
o
o
-e/
7,
replace U
5/,€o
/o,tu
2^59 t lE
(D)
a.+< "^ ; u/,/
N0
bP
4.so
4,/3
65.e t
Mechanical Permit
,bo"
/ 5,e
?ao
5:'
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stove/ln
Dryer Vent
By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do hereby cerilfy 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 th6 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 wlthout permission of the Building Safety Division.
I further certily that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
prolect.
I further agree to ensure that all required inspections 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 will remaln
T
rl
?
structlonon the slte at all
Date
<./slonatu
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
srdewark 59 t
curbcut Z( t
Demolltlon
Slate Surcharge
t .l rnIO o-
,A ,,""",laneous Permlts (E)37,?d-
7o
6o
spD-
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Comblned)Z?%27
R
D
BECEIVED BY
DATE PAID
AMOUNT
VALIDATION:
RECEIPT NUM
%#,5
E#teD
/#2t
SPFlINGFIf
gs
requliti m
225 .FIFTB STREEf,
SPRTNGFIBLD, OREGON 97477'
nisrsCirrON REQUBST z 726-37ffi^,
EIJCTRICAL PBRHIT APPLICATION
Ci ty Job Ntrnober
PEE.SCEEDUI^E BELOVUOFFICE: 726-3759
1 OP
Authorizeej Gignatur
I NE (tr0d
ON
DESCRIPTION
Permlts are non-transferable and ex
lf vork ls no t started'vlthld 180 d s
of lssuance o r lf vork ls susPended for
180 daYs
? . CONTRACAOR TNSTAI,I-ATION ONLY
Electrical Contractor 1.il, /lhrfls il87-
Address 4
Phone .7 47 - a?l!
Supervisor Llcen-se Number 3 ooL-,
Expiration Date,0-_f5
c.
Cons t r Contr. Number ot ?3
Nev Resldentlal-single or
HuIti-FamlIY Per dvelling
Service .Included, ,,"*u
1000 sq.ft- or less
Pach additional 500
sq. ft or Portion
thereof
Each Hanuf'd Home or
Hodular Dwelling
Servlce or Feeder
TION U A uni t.
Cos t
$ 8s.00
Sum
?S
B.Services or Feeders
ir rr l .-. . i,.--1rl5 L.l-L:dL^L,1, ii^''-'
or Relocation:
SIIBTOTAL OE ABOVB
5Z'State Surchhrge '
+3ob AAmin Fe-<
./$ 1s.00 7o
$ 40.00
$ s0.00
s 60.00
$100.00
$130.00
$3o0. oo
s 40.00
Explration Date L_
Slgnat eof ervlsing Electrician
Ovners Na;ne,O /.A/
Address
Cl ty Phone
DATE:
200 amps or less
ioi ;;;; io l.oo amps --
Over 401 to 600 anPs - '
Over 600 amPs or 1000 volts
Branch Circuits
Temoorary Services or'Feeders
i;;i;ri"iion, Arteration or Relocation
.00
.00
.00
ilBn
$ 3s.00
f5
200 amps or Iess
201 amps to 400 amPS '
401 amps to 600 amPS --
601 amps to 1000 amPs-
Over 1000 amPs/vo1ts .--
Reconnect OnIY
-Each lnstallation
Puinb or. lrrigation'.
stgir/outlin€ t,i gtr t lng
Llmited EndtgY/Res
-
"*
$40
$ss
$80
see
/
Nev, Alteratlon o! Extension Per Panel
OSNER INSTAII-{TION
The.installatloh ls belrig made on
;;;p;;ty-i-"'; Yhtch 1s not intended
for iile, 'lease or rent'
One Clrcul!
Each Additional' Clrcuit or vlth Ser.vice.
E. Hiscellaneous (Servlce/feeder not included)
.00
.00
.00
.00
$ 2.00
$40
$40
$ ,20
$ 'so
O C./
9
RECEIVED
5
D4 'aO
ctty 5/f/ .
Onners Slgnature:
Willamalane
Park & Recreation District
ILDI SITE:
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
NAME:
ADDRESS:
LOCATION OF FROPOSED
Stred Address if Known:
1
srArE:M-,, q'H1-7
PHONE:
Platt Name:Tax Lot Number:
DEVELOPMENT TypE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Single Family - Detached
__L Single Family home Manufactured home not in a park
(.
g)
NO OF UNITS
B. Single Family - Attached
NO OF UNITS
C. Multi-FamilY Apartment
NO OF UNITS
D. Manufuctured Home Park
NO OF UNITS
x $400 PER UNIT *=
X $370 PER UNIT =
X $277 PER UNIT =
X $280 PER UNIT =
$
$
$
$
oo
WPRD SDC $
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit n
approval. See SDC Credit Worksheet +
3. TOTAL WPRD NET SDC ASSESSED (tf SDC reduced for Credi0 $
Community Services
/-i+., ^( C^.:^^finlX
Di Date
c
ad
,ob*o.g+ll3l
[$t
ATTACHMENT 81
B NO.4r't 737
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NA},IE OR COMP/NY:
LOCATION:
DEVELOPMENT TYPE:5/tt
BUILDING SIZE:SI Ft
1. STORM NRAINAGF
IMPERVIOUS SQ. FT.X $0.209 PER SQ. FT
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
X $43.26 PER PFU
3 TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x /,ol x$436.8>.ss
x _ x $436.19
x
-
x $436.19
SUBTOTAI. (ADD ITEMS 1.2. & 3) $ /6 7/,5/
4. SANITARY SEl/lFR-Hl^lMC
N0. 0F PFU'S 2 I x $17 . 19 PER PFU I $10 t,ll^lMc ADMIN. FEE
(Use PFU Total From Item 2 Above)
Mt^ll'4c CREDIT IF APPLICABLE (SEE REVERSIJ
:lOlxl-wuc-sDc
,
SUBTOTAL (ADI) ITEMS 1.2,3 & 4)
5. AOMINISTATIVE FFFS
3 O,7
$ 2o65.s o
G
6(EOrT
AG/4Wsf
CA,.rrerynlrrt.
$
s
BASE
82. SDC
ABOVE) X .05E
},lary ig
SDC
/;"*-Zz- zV
g6.of
t,16
1o3.2V$
Coordi n
Date:
TOTAL SDC z/ An 7
I
FIXTURE UNIT CALCULA . tON TABLE: Nunrber of New Fixtu
(NOTE: For remodels, calculate only the NET additional fixtures)
NUMBER OF
FIXTURE TYPE T.IEW FIXTURES
X Unit Equivalent = Fixture Units
UNIT FIXTURE
EOUIVALENT UNTTS
Bathtub.....
Drinking Fountain....
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc
lnterc6ptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher....Z
Clotheswasher - 3 Or More
Mobile Home Park Trap (1 Per Trailer)......
Receptor For RefrigeratorMater Station/Etc
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall..........
Shower, Gang.........
Sink: Bar, Commercial, Residential Kitchen...
A T
Urinal, StaU/lVall
Wash Basin/Lavatory, Single.......fi: : i ;:E: ; k';,,r ):: : :. : :'',{V
Toilet, Public lnstallation.
Toilet , Private
Miscellaneous:
4
tTttttoBl *at
TOTAL FIXTURE UNITS 3.f
CREDIT CALCULATION TABLE: Based on assessed value. lf irnprovements occurred after annexation date.in table,
caiculate credits separates.
I
ad/He
2
1
2
3
6
2'
6
6
1
3
2
1
2
2
1
6
4
I
+-
2-
f
/b
2
Credit for Parcel or LanC Only lf Applicable
lmprovement-(if after anncxation date)
x
(Ratc X Assessed Value)x$
(Rate X Assessed Value)
CREDIT TOTAL =$
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per 51,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
o.97
o.61
o.44
o.15
t'
CITY OF OREGO'U
SPRINGFIELO
The
zoning, 8nd doe8
approval.
not requlre specilic land use
ELECTRICAL PBRHIT APPLICATION
225 PIF:TB SIREE;r
SPRTNGPIBLD OREGON 9747 City Job Nunber,
INSPBCf,ION RBQI'BST z 726
oFEtCE: 726-3759 Authorized signature% SC*DUL.E BBLOU
1 INSTALI,ATION
JOB DESCRIPTION . C
Permits are non-transferablg "ld "*piiuif vork ls not ";;;i;e-;iir'i'i 180 dlls
;; i;;;"i',"u ot lf vork ls susPended for
%
B. Services or Feeders
Installation, Alterations
ELEIT: or Relocation:
C.
D.
Nev Resldentlal-Single or
Hultt-faml1Y Per dvelling unit'
Service Ineluded:Items Cost
1000 sq.ft. or less $ 85'00
Each additional 500
sq. ft or Portlonthereof $ 15'oo
Each Hanuf'd Home or
Hodular Dwelling
Servlce or FeedEr $ 40.00
--)
$ 3s.00
$ 2.00
r
a6oF
L A
I^EGAL DESCRIPIION Sum
180 daYs
2. CONTRACf,OR INSTALL'ATION ONI'Y
Electrlcal Contractor L,LI, [tu)/?t?l,
Address Te.
Cl tY Phone -ok(l
Supervisor Llcense Number 3oaL- 9
Expiration Date o-
Constr Contr. Number o/{3r
Expiration Dat e
Slgna ture of SuPewlsing Electrician
Onners
Address
Onners Signature:
200 amps or less $ 50'99
ioi ;,;" to 4oo amps T t-q9'99;oi ;;;" to 6oo "ri,s -- t199'99ioi ;;;; to looo amps-- $130'oo
Temporary Services or'Feeders -i""["ri"iion, Alteration or Relocation
200 amps or less I I 19'00toi ;;; to 4oo amPs I $ ss'oo
o;;r-46i io 6oo amPs T $ 8o'oo
0ver 600 amPs or fbOO-6Tfs'.see rrBr
Branch Cireuits
PhoneCltY , :: . rrrurrs-------:-
OITNER INSTALI,ATION
The.installatloh is belrig made on
;;;;;ti-i-o"n vhlch ls not intended
tor- ia1e, 'lease or rent'
Nev, Alteratlon oL Extension Per Panel
Onb Circulq
Each Additional' Circuit or vlth Service
or Feeder. Pe.rml.t
E. Hlscellaneous (Servlce/feeder not included)
-Each lnstallation
Puinb or. lrrigation
Slgn/Outllnb Lightlng-- .
Llrqi ted EneigY/Res
-
Llmlted EnergY/Comm
: l'
SUBTOTAL OP ABOVB
5Z'State Surcharge
TOTAL
+3ob Adtnin FL<
$ 40.00
$ 40.00
$ 20.00
$ 36.00
--
DATE:
RECEIVED B
.+cr 5
cO
t L.
I - q.5
. ,a 4'9