HomeMy WebLinkAboutPermit Building 1993-05-08SPrlI}{GFIELE)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JoB NUMBE " %eS<8
225 Fifth Street
Springf ield, Oregon 97 477Qfr,z
ASSESSORS MAP:TAX LOT:
LOT:/1 /A BLOCK:SUBDIVISION
To request an inspection, you must call 726-316q This is a 24 hour recording. All inspections requested before 7:00 a.m. will be
macte the same working day, inspections reguested after 7:00 a.rn. will be made the following work day.
REQUIRED INSPECTIONS
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X
K
F
B
K
E
X
KI
K
F
E
Temporary Electric
Site tnspection - To be made
af ter excavation, but Prior to
setting forms. tAfBPk-S
Underslab Plumbing / Electrical /
Mechanica! - Prior to cover.
Footing - After trenches arc
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but Prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
U nderll
- Prior t
Post and Beam - Prior to floor
insulation or decking.
Floor lnsu!atiolr - Prior to
decki ng.
Sanitary Sewer - Ptior to {ilring
trench.
Water Line - Prior !o filling
trench.
{tt'-tng - Prior to cover'
Fvfwrttlceilino lnsulation - Prior to
lAcover.
fi ot,*u'l - Prior to taPing'
Rough Mechanical - Prior to
cover.
ough Electrical - [)t'ior tc
over
Electrical Service - N4ust be
approved to obtain Permaient
electrical power.
Fireplace - Prior to facing
materials and f raming lnsP.
Wood Stove - After i;'rstallation
lrrsert - ,After {irepiace aopi'cval
and insta!lation of t,,iit-
Curbcut & APProach '- Alter
for'ms itte erectt'd f't'l prior to
placernent o{ r;onctete.
Sidewalk & DrivuwaY - After
excavation is contPletc', lorr ns
and sub.basc rrate!.iai tn ltiace
Fence -- When cornl.rleted
l\f,/rinat Plumbing - Whcn all
.I4{plumbing work is complete.
l\Tfrinat Electrical - When all
JA{ electrical work is complete.
deinat Mechanicat - When alljA mecnanical work is cornPlete.
FfFinal Buildino - When all
/A r"qrired insp-ections have been
' approved and building is
completed.
n
Other
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When all
blocking is complcte.
lVf Stot* Sewer - Prtor to fi!ling
),4trench
t:]
Plumbing Conneclions - When
nr;me has been ccn!'rected to
water and sevJer.
Electrical Connection - When '
blocking, set-up, and Plumbing
inspections have been lpproved
and the home is connected tc
the rcrvice panel.
Final - After all required
inspections are approved and
nc'rrches, skirting, decks, and
',,entrnq trilve been installed.
,K
PHONE:
zlPSTATE:CITY:
ADDRESS:
OWNER
NEW - )C, BEMoDEL ADDlrloN DEMoLIsH orHER
DESCRIBE WOFIK:
EXPIRES PHONE
z€ose01z,
C R#SN
ELECTRICAL:
CONTRACTO
t\4ECHANICAL
CONST.
GENERAL:
PLUMBING
CONSTR, TYPE
OUAD AREA
_ OFFICE USE _
LAND USE: - -
r OF BDRMS:
WATER HEATER:
HEArsouFrce:Zaa fr/
RANGE: _ ECEZ-
,7 OF UNITS: .-
-
SECONDARY HEAI
SOUARE FOOTAGE:
FLOOD PLAIN:
ZONING CODEr OF BLDGS: -
OCCY GROUP:
I OF STORIES:
anrc
K:ru: Prumlirrs - Pri5r 1s
@,',t:?t,,1;:''::;.,f
I't:n ar! requtrec
i_l
(z4ryz1aa
ztry6
.qRS-
r
r-j E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lol. TypeV)r-- lnterior
(
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L HSE GAR@ ACC
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICI, OR ON
THE HISTORICAL FIEGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
12%
llA5
E 11
N 5
€
4z
5
V,A LU E
&?3__
(A)
7q62.1,
llC_
X $/SO. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
a4Qr_?4
-3,7-?,oo/93{j? 7.?5
_57L7,*
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
/?as.D_
1e/,<a
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
'I'lris l-rcrrrrrt is qrantcd <>n thc express con(lition thart tlrc said
construction sherll, in all respects, conform to the Ordinance
adoptr:d by the City of Springfield, including the
Develc,pment Code, regulating the construction and use of
buildings, and may be suspended or revoked at any lime
upon violation ot any provisions of said ordinances.
evi cwcd
s/-t/rs
-/n;6---
Plan Check Fee 7{
Numbe
Date Paid
Recei pt
Recerve
SYSTEMS D EV ELo P * r *r,ul' ^^81::D *Systems Development Charge is due on all undeveloped
p;roperties within the Crty irmits which are being improved.
ITEM
Fixtures
Flesidenrial Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
,lbu.
/bo-s.L
(c)
NU
Fr.
FT.
FT.
8P
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
C I
R-/
/l
ADDITION-72
I
t
AL COMMENTS
I
_/:
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
@
3.q?
N0
/)
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
22_13
/o.oo
4r4{o
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
?" a3
By signature, i state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther. certif y
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Laws
of the Statc of Oreg;on pertaining to the work described
herein, anrj thal NO OCCUPANCY will be rnade of any
structure without permission of the Building Safety Division.
I further certify that onty contractors anct employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
f rom the street, that the permit card is located at the f ront
of the property, and the approved set of plans will remain
Date
1,nature _
on the site at all times ring construction.
f? ,/'
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewatk 6O .tt
curbcut 3L tt
Demolition
State Surcharge
-li:?J@-
3?,e,Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrica!)
(A, B, C, D, and E Combined)
2@q
95sz
6o
DATE PAID
VALIDATION:
RECEIPT NUMBEFI
-
AMOUNT ITECE,IVED
NECEIVED BY -_-
S
_q422_
2
JOB NO. ?o 5 b8
?
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0MNERCIAL & RESIDENTTAL)
NAME OR COMPANY:o
LOCATI0N : 88 85.40 rJ+ Sr /9ozos tz -o7 500
DEVELOPMENT TYPE:
BUILDING SiZE:
R
OT SIZ F s a. Ft.
1 STORM DRA iNAGE
IMPERVIOUS SQ. FT.'7-bo*x $0.192 PER SQ. FT.
2. SANITARY SEt,/ER-CITY
3. TRANSPO RTAT I ON
NO OF UNITS X TRIP RATE X COST PER TRiP
x /,o05 x $40r .05
X x $40r.05
X x $401.05
4. ADMINiSTRATiVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X .05
5. SANITARY SEt,lER-MWMC
,s
(Use PFU
U
T bove)otal From Item 2 A
MhIMC CREDIT IF APPLICABLE (SEE REVERSE)
L*s
Kip Burdick
SDC Coordinator
TOTAL-CITY SDC $ lb "q
v
$13.62 PER PFU + $10 MhlMC ADMIN. r* $ ZAbt9
Z 4s
X $39.78 PER PFU
SUBT0TAL (ADD ITEMS 1,2, & 3)$ /5a r+J
TOTAL-MWMC SDC
NO. OF PFU'S
(See Reverse)
ls
NO. OF PF
1 tco!
{1z
TOTAL SDC $1 8 al'9
s
$
l6 x
CALCUIATION TABLE: r'tumoer of New Fixtures X Unit Equivalent = Fixture Units (NOTE:
FIXTURE UNIT
For remodets, calcutatJ."'v *" NEJ additional {ixtures)
NUMBER oF UNIT FIKI-URE
NEW FIKTURES EQUIVALENT UNITS
FIKTURE TYPE
Bathtub......-
Drinking Fountain""""""""" ""
Shower, Gang...."""'
Sink, Bar, Commercial
Floor Drain..
i ;;;;ilt" For Grease/oil/Solids/Etc" "'' " " " " "'
i"i"r""p,"* For Sand/Auto wash/Etc" """"""""
Laundry Tub/Clotheswasher"" " "
Clotheswasher - 3 Or More"""""'-
;ilil;;;re Park Trap (1 Per Trailer)" "',;,""""
;;;;;"t;"r Ref rigeratorAVater stat ion / Etc" " " "
H"""brot For Commerciai sint<Toishwasher/Etc"
Shower, Single Stall""""""'
'1-
2
v
TOTAL FIKTURE UNITS
Llt
'1-
aL'
Z
q
ls
2
1
2
3.,
6
2
6
6
1
3
2
1 /Head
2
2
'l
6
4
Urinal, StallAvall""
Wash Basin/t-avatory, Single"'
Water Closet, Public lnstallatio n.......
Water Closet; Private""'
Ii/iscellaneous:
CREDIT CALCULATION TABLE
calculate credits
Basedonassessedvalue.lfimprovementsoccurredafterannexationdateintable,
4s7.s3
(Rate X
x $ 1,71
Assessed Value)x$
2 7
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed
CREDIT
Value)
TOTAL
+e2-t
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
-$
Year
Annexed
Rate Per $1,000
Assessed ValueYear
Annexed
Rate Per $1,000
Assessed Value
1985
1986
1987
19BB
1989
1990
1991
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
1979 or before
1980
198'l
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICTENT
---------.-.----;
I
I
C'TY OF OFEGO'U
225 PIYTB STREBT
SPRINGPIELD, oREGoN 97477
INSPBCTT0N BEQUEST: 726-3769
0PPICB: 72:,6-3759
1. LOCATTON OP INST
LEGAL DESCRTPTION
LDY< BLBCTRICAL PERHIT APPLICATION
rl,* l1t
SPFlINGFIELO
1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular DveIIing
Service or Feeder
Services or FeedersInstallation, Alterations
or Relocation:
STIBTOTAL OP ABOVE
5Z State Sutcharge
TOTAL
+ S 1s.oo @
s 40.00
3
A
B
New Residential-Single orMulti-Family per dvelling unit.
Service Included:
Items Cost Sum
JOB DBSCRIPTION<, F, ,"R/)as*
Permits are non-transferable and expireif work is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI,ATION ONLT
Electrical Contractor
Address
ci Phone
Supervisor License Number
Expi ration Date
constr contr. Number
Expi ration Date
Signature of Supervising Blectrician
Ovners Name
Address
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signa
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps
0ver 1000 amps/vo1ts
-Reconnect 0nly
s s0.00
s 60.00
s 100. 00
s130.00
s300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteratlon or Relocation
ci w r!//tr r,- l, (',eno"{? Q)1A1*z O
OSNER INSTALI.,ATION
rrgrr
"ffi
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $.2.00
B. Miscellaneous (Service/feeder not included)
200 amps or less t/ S'201 amps to 400 amps
-
$
over 401 to 600 amps
-
$
0ver 600 amps or 1000Effs se
4.
-Each installation
Pump or irrigation
Sign/0utIine Ligh ting-
Limited Energy/Res
-
40
55
80
rg
oa00
00
00
s 40.00
$ 40.00
s 20.00
$ 36.00
5 Oo
RBCEIVBD
ture:
Oo
^ city Job nvnber ?3?SO?.4
* eoxptlrTB pEB scffiDrrt,e BELos{
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