HomeMy WebLinkAboutPermit Building 1994-10-06SPRI IELDRESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Office: 726-3759 h,
JOB NUMBER
225 Fifth Street
Springfleld, Orcgon 97 477
*LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/eoz .ar^/2 TAX LOT:
LOT:BLOCK:
-=2PHONE:
ZIP:STATE:CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
PLUMBING:
EXPIRES PHONEADDRESSCONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
GENERAL:
CONST.
CONTRACTOR #
I IBN-
OCCY GROUP:
RANGE:WATER HEATER:
QUAD AREA:
I OF BLDGS:
* OF STORIES:
- OFFICE USE -
FLOOD PLAINLAND USE:
ZONING CODE:
r OF BDRMS:
* OF UNITS:
SECONDABY HEAt
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour 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 INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.
Flnal Plumbing - When ailplumblng work is complete.
Slte lnspectlon - To be made
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.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to lllllng trench.
Underlloor Plumblng/ 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.
Storm Sewer - Prlor to filling
trench.
Water Llne - Prlor to filling
trench.
Rough Plumblng - Prior to
cover.
Km"t: Electrlcat - Prlor to X Flnal Electrlcal - When atl
electrical work is complete.t
Flnal Mechanlcal - When all
mechanlcal work ls complete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Eleclrical Connection - When
blocking, set-up, and plurpbing
lnspections have been approved
and the home is connected to
the servlce panel.
Flnal - After all required
inspectlons are approved and
porches, skirting, deckS, and
ventlng have been lnstalled.
Electrlcal Servlce - Must be
approved to obtain permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
ptt"'ng - Prlor to cover'
WatltCelllng lnsulallon - Prlor to
cover.
n Drywall - Prlor to taplng.
Flnal Building - When alt
requlred lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME !NSPECTIONS
x
[--l Slocklng and Set.Up - Whep ail
-
blocklng ls complete.tl lnsert - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Street Trees - When all requlred
trees are planted,
t.,
SUBDIVISION:-
??-e
2
tl
E
E
E
E
tf
,k
tf
E
E
tf
Wood Stove - After lnstallatlon.
l--l Siaewalk & Drlveway - After.- excavation ls complete, forms
and sub-base materlal ln place.
l-l Fence - When completed.
fl
E
:l 'i,l ,'i.1 .:
IS THE PROPOSED WORK TN THE -
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the H istorlcal
Coordinator prlor to permit issuance.
APPROVED:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total belght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
ffi_ ^.-v /?.rte 7^/A-
Total Value
Building Permit Fee
State Surcharse Z% tltUa(),
Total Fee (A)
VALUEX S/SQ. FT.
fa
o I
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condltion that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfield, includlng the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
/*#/
a
Plan Check Fee 28.2-?
Receipt Numbe
ewed By
Date Paid;
Beceived
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 6 trS'fa
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Flxfures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State_ Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuahce
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are ln compllance with ORS 701.0S5 wlll be used on thls
project.
I further agree to ensure that all required inspections are
requested at the proper ilme, 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
An",u
Date
on I times durl lon.
MISCELLAN EOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT OUE (excluding etectricat)
(4, B, C, D, and E Comblned)/3?.s6 D
DATE PAID
VALIDATION:
RECEIPT NUMBE
AMOUNT HEC
RECEIVED BY
FT.
CITY OF OREGON
The following projoct as submitted has the'r;
zonirrg. and-dbes not raqulrs sPeciiic land us
approval.
SP .IELO
ELECTRICAL PERHTT
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or 1ess t201 amps to 400 amPS _
401 amps to 600 amps _
601 amps to 1000 amps-
0ver 1000 amps/vo1ts
Reconnect 0n1y
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
%,
Zonirr225 FIFTB STREET
SPRTNGFTELD, oREGON 9747
INSPECTTON REQUEST:. 72Q
OFFICE: 726-3759
hi;.Fzk:7 )
1 OF
I.,EGAT DESCRIPTION/*oLD 5l L 68oao
JOB
Permits are non-transferabl-e and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
CONTRACTOR INSTALI..ATION ONIY
EIe ical Contractor
Address
Ci
Supervisor Li.ber
Expiration Dat
Constr Con Number
Expi ra t n Date
of Supervising Elect arn
Ovners Name
Ci ty Job Number
3. COHPIJTE EEE SCffiDt[^E BELOS
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Sertice or Feeder
s 8s.00
$ 40.00
LocArlty -f
Sum
B
C
E
s 1s.00
s s0.00
s 60.00
s1o0.0o
$130.00
s300.00
$ 40.00
$ 3s.00
.00
.00rrgn Uffir=
e
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less S
201 amps to 400 amps
-
$
over 4bL to 600 amps
-
$
Over 600 amps or 1000-voITs se
0040
55
BO
e
+
D. Branch Circuits
Nev, Alteration or Extension Per Panel
Address r
Ci ty f1 1e-Phone 7/4 - z7+g
OVNER INSTALI-ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
DATE:
One Circuit
Each Addi tional
Circuit or vith Servicer,
or Feeder Permit 11
MisceLlaneous (Service/feeder
-Each installation
Pump or irrigation $
sign/outl-ine Lighting- S
t i.mited Energy/Res
-
$
Limi ted Energy/Comm S
s+
s 2.00
not included)
40.00
40.00
20.00
36.00
\o-
RECEIVED B
dZ*o-
5
Permit #:
Address:
Issued by:Date:lD,b-+?
Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires restdential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill the appropriate blanks and initial boxes I and2, and either box 3A or 38:
1. I own, reside in, or will reside in the completed structure
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
38. I will be my own general contractor
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and thatl have read and dounderstand the Information
Property Owners about on the reverse side of form.
c
OR
(Signature of
(White copy to issuing agency perrnit file,
pink copy to applicant)
Notice
/()
(Date)
ATTACHMENT BI
JOB NO.q4/s7s'
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI-{ARGE
WORKSHEET
(COHHERCiAL & RESiDEITTiAL)
NME OR COHPA}.IY:
LOCATION: ??7 S. ZO
DEVELOPMENT TYPE v
BUILDING SIZE:2 x OT SIZ
1. ffiqeytr
IHPERVIOUS SQ. FT 37/X $0.209 PER SQ. FT.
2. .^*troo, sFwFR-cTTY
NO. OF PFU'S
(See Ret,erse)
X 543.26 PTR, PFU
TRANSPORTATTON
NO OF UNITS X TRiP RATE X COST PER TRIP
x
-
x s436.19
x
-
x s436.i9
x
-
x s436.i9
SUSTOTAL (.A.DD ITEI',IS i.2. & 3)F
4. SANTTARY SFI,IFR-MWI'1C
NO. OF PFU'S x S17.i9 PER PFU + SiC MhIMC A9MIN.FEE
(Use PFU Total From item 2 Above)
lf'.ll'lc CREDIT IF APPLICABLE (SEE REVERSE)
T0TAI -Hl,fi'{c snc
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
a. Ft
J
(
S
5. ANMTNISTATIVF FFFS
2
s 7/,72
S /.o q
BASE
ary g, P.E
SDC
(SUBTOTAr}BOVE) X .05
v -27-7L
F ,7?
82. SDC
n
i nator
Date
TOTAI SDC s 7,r.7o
S lA
FIXTURE UNIT CALCUI^TION TABLE: NUMUCT OI NCW FiX .es X Unit Equivalent = Fixture Units
{NOTE:remodels, calculate only the NET additional fixtutesl
FIXTURE
Bathtub.
Drinking Fountain
Floor Drain.
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
2
tnterceptors For Grbas,
lnterceptors For Sand/
Laundry Tub/Clothesw
Clotheswasher - 3 Or More.
Mobile Home Park Trap (1 Per iler)
Receptor For RefrigeratorflVater
Receptor For Commercial Sink/Dis
l/Solids/Etc 3
6
2
6
6
1
3
2
1
2
2
1
6
c........
/Etc..
Shower, Single Stall
Shower, Gang
Sink: Bar, Commercial, Residential Kitchen..
Urinal, StallA{all
Wash BasinAavatory, Single
Toilet, Public lnstallation.
Toilet , Private....
Miscellaneous:
CREDIT CALCULATION TA
calculate credits separates.
Credit for Parcel or Land Onty lf Applicable
lmprovement (if after annexation date)
occurred after annexation date in table,
x $_
(Rate X Assessed Value)xs
(Rate X Assessed Value)
CREDIT TOTAL s
ad/He
2
4
AL FIXTURE UNITS
Based on assessed value. tf imPro
t\,
anne\
Rate per $ 1,OOO
Assessed Value
Year
Annexed
Rate per $ 1,OO0
Assessed Value
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
0.97
0.61
o.44
o.15
$3.46
3.38
3.32
3.21
J.UC
2.9?
2.73
or before
1
81
197
982
1 983
1 984
1 985
Wash/Etc.