HomeMy WebLinkAboutPermit Building 1995-04-18RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Of{ice: 726.3759
SPFI IELt)
2fr,
JOB NUMBEB ?ro 34o
225 Fif th Street
Sprlngfleld, Oregon 97477
s*LOCATION OF PBOPOSED WOBK:
ASSESSORS MAP
LOI:50e,0
339 Z?-TAX LOT:3rco
BLOCK:SUBDIVISION:
t
PHONE:q35
C\R.STATE:ZIP:
-tLt 1 - Ort35
\BI S\
CITY;
ADDRESS:
OWNER:
*a* B REMoDEL V ADDrroN X DEM.LT.H orHER
..J&l \'.,^$tGClq^DESCRIBE WORK:
ADDRESS EXPI RES PHON E
t)('trt et \-l
CONTRACTOR'S NAME
MECHANICAL;
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
V
WATER HEATEB
r OF BDHMS:
HEAT SOUHCE;
CONSTR. TYPE:
- OFFICE USE -
LAND USE:
Y OF UNITS:
BANGE:
SECONDABY HEAT:
SQUARE FOOTAGE:
OCCY GBOUP:
I OF STORIES:
QUAD AFEA:
I OF BLDGS:
\t
To request an inspectlon, you must call 726'3769. Thls ls a24hour recordlng. All lnspectlons requesred before 7:oo a,m. wllt bemade the sante worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTTONS
Temporary Elsctric
Sito lnspectlon - To be madc
after excavatlon, but prlor to
settlng forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Underground Plumblng - Prior
to fllllng trench.
Post and Beam - Prlor to floor
lnsulatlon or decklng,
Sanltary Sewer - Prior to f IIling
trench.
Slorm Sewer - Prlor to fllling
trench.
Waler Llne - Prlor to filling
trench.
Bough Plumblng - Prlor to
cover.
,X
[--l Sidewalk & Drlveway
'J excavatlon ls comple
Rough Mechanlcal - prlor to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
Wood Stovo - After lnstallation
lnsert - After flreplace approvql
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected bUt prior to
placoment of concrete.
Flnal Plumbing - When allplumblng worl< ls complete.
Final Mechanical - When all
mechanical work ls complete.
Flnal Building - When all
requlred lnspectlons have been
approved and building is
completed,
,x
lV Foundatlon - After forms are
flerected but prlor to concrete
placemont.
"K
,X
X
D(3;;"11 Erectrrcar - Prior to l![ rlnal Etecrricat - When aill,+electrlcal work is complete.
[-l Flreplace - Prtor to factng
-
materlals and framlng lnsp.
ffitt"-'ng - Prlor to cover.
flf WatltCelllng tnsulatlon - prlor toJ4,cover.
fiotr*"ll - Prlor to taplng.
,x
X
,K
X
U n d e rl I oozflffibinD M ec h an ic a I
- Prior to-'ifrrratTfi or decking,
Other
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumbing Connectlons - When
home has been connected to
water and sewer,
rel:?1,1;suratron - Prror to
l-_l Fence - When completed
[--l Street Trees - When all requlred
-
trees are planted.
- After
tc, forms
and sub-base materlal ln place.
Electrlcal Connection - When
blocklng, set.up, and plumbing
lnspectlons have been approved
and the home ls connected to
the servlce panel,
Final - Af ter all required
inspectlons are approved and
porchos, sklrtlng, decks, and
ventlng have been installed.
o .lq-19*,
\<)
\
l.&5
FLOOD PLAIN:
ZONING"OO.,--LDF-
E
tl
tl
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Tytr. _
-
lnterlor
-- Corner
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK IN THE .
HISTORICAL DISTRICT, OR ON
THE HISIOBICAL REGISTER?
-
lf yes, thls applicaflon must be slgnedand approved by the Hlstorlcal
Coordinator prlor to permit lssuance.
APPROVED:
i
BUILDING PERMiT
VALUE
z?rnz14A-*p?&/o ss
State Surcharse { 3%
Total Fee (A)
/o9?7
3b
{6 2o
ITEM
Main
Garage
Carport
SQ. FT,
195
Total Value
Building Permit Fee
/L?tzzf
t16 Fo
X $/SQ. FT,
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
Thls permrt is granted on the express condrilon that the saidconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprlngfletd, includlng the
levelopment Code, regulating ine Jonstiucilon and use ofouaorngs, and may be suspended or revoked at any ilmeupon vlolatlon of any provislons of sald ordlnances.
ewed v ilr#'
Recelpt Numbe
Beceived
73
Date Pald:
Plan Check Fee:
RGE (SDC)
#T,tb2-'#
YSTS E M DS EEV LO P EM TN HC A
(tJ
Systems Development Charge is due on all undevelopedpropertles within the City limits which are betng lmproved.
ITEM
Flx t u res
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBTNG PERMIT
q)3
N0
FT
FT.
FT.
(c)
Plumblng permlt
State Surcharg" +3ft
Total Charge
ADDITIONAL COMMENTS
MECHANTCAL PERMIT
Furnace
Exhaust Hood
Vent Fan \NnMfiflJ/n
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
State Surcha's" { 3t)
Total Permlt (D)
lsp
Mechanlcal permlt
lssu ance
By slgnature, I state and agree, that I have caref ully examinedthe completed appllcailon and do hereby cerilfy that alllnformatlon hereon ls true and correct, ani I f urther certlfythat any and ail work performed shail be done in accordancewlth the Ordinanccs of the City of Springfield, and the Lawsof the state of oregon pertarnrng to the work descrrbedheroln, and that NO OCCUPANCy wlll be made of anystructure wlthout perrnission of the Bulldlng Safety Dlvislon.I further cerilfy that only contractors andlmptoyees whoare ln compllance wtth ORS 7O.1.OS5 will be used on thlsproject.
I further agree to ensure that all requlred lnsrequested at the proper ilme, that each add
from the street, that the permlt card ls loof the property, and the approved set of
pections are
ress ls readable
cated at the front
plans will remalnon the site at all imes d con st ructlon.
Slgnature
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharoe
Sidewalk -.=.- ft
Curbcut _ ft
Demolitlon
State Surcharge
Total Miscellaneous permlts (E)
PL.HSE GAR ACC
N
S
E
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEDTOTAL AMOUNT DUE (excludtng electricat)(A, B, C, D, and'E Combtned)RECEIVED BY
l'j
By:
E@-\@
7
-'B N0.72pru9_
CITY OF SPRINGFIELD SYSTEMS DEVEI'OPMENT CHARGE
WORKSHEET
(cot'tMERcIAL & RESIDENTIAL)
NAME OR COMPANY:1{Co<<
nZS l>t- 1r \1 obb6zz - \b oooLOCATION:
a.- Ao r<roNDEVELOPMENT TYPE:VD
BUILDING SIZE: \ 6 * 15.5 cr*rcLupEeEN'/4\0T sIZ
STORM DRAINAGE
IMPERVIoUS SQ. FT.2+b x $0.209 PER SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
1 X $43.25 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x x $436. 19
X x $436. 19
X x $436.19
4. SANITARY SEl,lER-Ml^lMC
NO. OF PFU'S $17.19 PER PFU + $10 Mi,lMC ADM FEE $
(Use PFU Total From Item 2 Above
MI,IMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-Ml^lMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
ADHINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
Burdick
Coordinator
. Ft.
I
$
$
)
5
svbt
bo'>\?
-G
Date:zz q5
TOTAL SDC sblz 7a
X
FTXTURE UNIT CALCULATION TABLE: tlumucr of New Fixture
(NOTE: For remodels, catculate onty ttr I additional fixtures]
NUMBER OF
FIXTURE TYPE NEW FIXTURES
Unit Equivalent :-Fixture Units
UNIT FIXTURE -.
EOUIVALENT UNTTS
Z
4 ---T-
Bathtub-----2
i
2
J
6
2
6
6
i
2
1
2
2
1
6
Drinking Fountain....
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc
lnterceptors For Sand/Auto Wash/Etc. - - - - - -.. - - - - - - - --
Laundry Tub/Clotheswasher.... -..
Clotheswasher - 3 Or More.--.-
Mobile Home Park Trap ('l Per Trailer)------
Receptor For Refrigerator/Vvater Station/Etc-----..-
Receptor For Commercial Sink/Dishwasher/Etc-.
Shower. Single Statl....-....-
Shower, Gang......... ---.----.:"""
Sink: Bar. Commercial. Residential Kitchen.
Urinal, StatUwall...
Wash Easin/Lavatory, Single
Toilet, Public lnstaiiation..
Toilet , Private.
Miscellaneous:
/Head
II
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occu rred after annexation date in table,
calculate credits separates
Credit for Parcel or Land Only lf Applicable
lmprovem'ent (if after annexation date)
X$
(Rate X Assessed Vatue)
X$
(Rate X Assessed Value)
CREDIT TOTAL =+
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $ 1,OOO
Assessed Vatue
1979 or before
1 980
't 981
1 982
1 983
1 984
1 985
$3.46
220
3-32
3.21
3-O6
2-92
2-73
1 985
1 986
1 987
1 988
1 989
1 990
'r 991
'1993
$2.46
2.14
1.'17
1.37
o.97
o.61
o-44
o.15
-7
Year
Annexed
\fr.
SP'|'N( -LD
The followin
zorring, end
approval.
97477
726473q' D$re 5* |
':7*DL
qp
,,3:3f*?ffi?*H:*n'*
;;[""ueucrnrcar,PERXIT APPLICATION225 YTYTB SIREET
SPRTNGPTEIID, OREGoN
INSPECTION REQTIBST:
0PPICE: 726-3759
1. LOCATION Signature M
JOB DESCRT
permits are non-transferable and expire
if vork is not started vithln 180 days
of lssuairce or lf vork ls suspended for
180 days.,
2. CO}rIRACf,OR INSTALUTTION ONLY
ElecLrlca1 Contractor nIx6N Ft F1TRTt:
Address 1130 BAILEY HILL RD #24
Ctty ' EUGENE
Supervisor Llcense Number 36145
Expl ration Date L0/Llg5 *
. ..-,
Constr Contr. Nunber 66894
Expiratlon Date
Slgna of Supervlsing Electrician
Ovne
Address
3.COXPI^ETE PEE SCEEDIII.E BELOU
dentlal-Single or
HuIti-FamiIy per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Service or Feeder
$ 8s.00
s 15.00
$ 40.00
B. Services or FeedersInstallation, Alterations
or Relocation:
c.
D. Branch Circuits
Circuit or vith Service
or Feeder Permit 2 S 2.00
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Beconnect 0nly
Temporary Services or' Feeders
Installation, Alteratlon or Relocation
200 amps or Iess S 40.00
0ver 401 to 600 amps $ 80.00
Over 600 amps or 1000 voT[s see ttgrt "ffi
Sum
$ s0.00
s 60.00
$100.00
$130.00
s300.00
$ 40.00
Nev, Alteration or Extension Per Panel
one circuiq : $ 35.00 32Each Additionalcitfua2- 7f.phone- 74r/>2
OVNER INSTALI.ATTON
The. installatioir is beirig made on
property I ovn vhlch is not intendedfor sale, lease or rent.
Osners Signature:
DATE:
tD9
_/*
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/OutIine Lighting-
Limited Energy/Res
-Llmited Energy/Comm
STETOTAL OP ABOVE
5Z State Surcharge
TOTAL
C-C?*5r7 / ./>
/?, /2.
s 40.00
$ 40.00
$ 20.00
s 36.00
RECBIVED
5
'city Job Nunbe. ?Z*O
IJGAL DESCRIPTION/,-,d,^z-zq*-?3 /zeD
Phone_344.#pj_