HomeMy WebLinkAboutPermit Building 1994-09-22SPRINGFTELED
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ASSESSOBS M
LOCATION OF PROPOSED WORK
SUBDIVISIONBLOCK:
JOB NUMBER
RESINENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
TAX LOT:
225 Flfth Street
Spri ngfield, Oregon 97 477
PHONE:
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STATE: A< ZIPCITY:
ADDRESS
OWNER:
DESCRIBE WORK
ADDITION DEMOLISH OTHER*.* /^EMoDEL
ADDRESS
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PHONECONTRACTOR'S NAME
G EN ERAL:
PLUMBING
MECHANICAL:
ELECTRICAL:
EXPIRES
tr4y' 2
CONST.
CONTRACTOR #
€,<u.g
LGqr
F
\\5
C( --/
_ OFFICE USE _
RANGE:
'ry OF UNITS:
LAND USE:FLOOD PLAIN:
WATER HEATER
ZONING CODE:
# OF BDRMS:CONSTR. TYPE:
HEAT SOURCE:SECONDARY HEAT
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
OUAD AREA:
r OF BLDGS:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a'm. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day-
REQUIRED INSPECTIONS
[-l Temporary Electric
ll
Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
af ter excavation, but Prior to
Rough Electrical - Prior to MI inal Electrical - When all
COVET lectrical wor k is comDlete.
tI)^'\D
ical - wne) at
setting fo
U nde rsl ab N Electrical Service - Must be
approved to obtain permanent
etectricat power.
\N{
Fireplace - Prior to (acing
materials and framing lnsP.
Final Mechan
Mechanical Prior to cover,mechanical work is complete.
f7 Footing - After trenches are
Fexcavated.
Final Building - When all
uired inspections have been
Masonry - Steel location, bond
beams, grou.ting.
approved and building is
completed.
Framing - Prior to cover.
Other
Foundalion - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulalion - Prior to
cover.
Underground Plumbing - Prior
to filling trench.[--| Drywall - Prior to taping.
MOBILE HOME INSPE TIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.lnsert - After firePlace aPProval
and installation of unit.R
K,
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.tr Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Slorm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in Place.
Water Line - Prior to filling
trench.
Fence - When completed
Final - After all required
spections are approved and
Slreet Trees - When all required
t!'ees are planted.
porches, skirting, decks, and
venting have been installed.
tr-
B
Rough Plumbing - Prior to
cover.
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#
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tl
R E
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Wood Stove - After installation.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type -
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Se
P.L.HSE GAH ACC
N
S
W
E
'J THE PROPOSED WORK IN THE'
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use ol
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Fleceipt Numbe
Plan Check Fee:
Date Paid
Recelved By:
VALUX $/SO. FT,
cb5L4)
(A)
Ca
Garage
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Main
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being lmproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) #$ste {+
ADDITIONAL COMMENTS
C2L' oll {r^/Mo.an' t{6PQ-'ITEM
Fixtures
Residential Bath(s)
Sanllary Sewer
Waler
Storm Sewer
Moblle Home
FEE
,r.Yfl:
(c)
No
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
Stato Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By signature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformation hereon is true and correct, and I further certlfy
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 will be made of any
structure without permission of the Building Safety Divlsion.
I further certify that only contractors and employees who
are ln compliance with ORS 701.055 will be used on lhls
prolect.
I further agree to ensure that all required inspections are
requested at the proper time, 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 remain
3^ ?) -qL/
on the site at all times during con ct
Signatu
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surchargqr
sidewark ll, ,,
curbcur /A ,,
Demolition
State Surcharge
Total Miscellaneous Permits (E)
d)
TOTAL AMOUNT DUE (excluding electric
(A, B, C, D, and E Combined)"$34tr3e1
R
RECEIVED BY
AMOUNT R
DATE PAID
VALIDATION:
RECEIPT NUM
.q4D
-6-
)
il
OREGONCITY OF SPR
SPRIr!GFIELD
DEV E LO PM ENT S ERV I CES D EPART M ENT 225 FIFTH STREET
SPRINGFIELD, OR 97477
(50s) 726-3753
FAX (503) 726-368e
MANUFACTIJRED HOME SET-UP AGREEMENT
As required bY the City of SPring field Development Code, I understand and agree
that vith the aPP roval of the attached Pe s one of ng
manufactured home s viIl be placed at
Springfield, Oregon, City Job Numberxe I Manufactured Home.A rnulti-sectional (double vide or vider)
un t all enc os o or area of not less than 1,000 square feet,
that has a noninaf roof P itch of 3 feet in height for each 12 feet in
vidth, that has no bare me tal siding or roofing,and that has been
certified by the manufactu rer to have an exterio r thermal envelope
mee t ing performance standard s vhich reduce heat loss to levels
equ i val ent to the Performa"nc e standards required of single family
dwellings constructed under the State SpecialtY Codes
t
Tvne II Manufactured Home. A unit of not }ess than L2
ea of not less than 500 square
a nominal roof pitch of 2 feet in height for each 12 fe
that has no bare metal siding or roofing'
I further state, by my signature belov, that I have been provided vith the
folloving information:
- Manufactured Home blocking
- Vater ]ine connection
- Street tree standards
ture
feet in lridth
feet, that has
et in vidth and
- Sanitary sever connection
- Electri.cal connection
- Minimum requirements for permanerrt steps
te
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the per:imeter vith itone, brick or other masonry materials,
and vith no more than L2 inches of the enclosing material exposed above grade.
,
JoB No. 14ozlb
CITY OF SPRINGFIELD SYSTEI4S DEVELOPMENT CHARGE
I.JORKSHEET
(collMERcIAL & RESIDENTIAL)
NAME OR COMPANY:Geo L T. -/ RAVers
LOCAT ION :5ob xl ?5r! Sz tTozat"'l ll00 (
DEVELOPMENT TYPE:LDR - NEN M*u u. 4oue.
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
CA*ftFJ S+{ED D.W
20< tL
tt
r siz . Ft.
3 TRANSPORTAT ION
NO OF UNITS X TRIP RATE X COST PER TRIP
x l,ot x$424.31
\btz x $0.203 PER SQ. FT.
X $42.08 PER PFU
x $424.31
x $424.31
X
X
s
4. SANITARY SEWER-MWMC
$
$15.125 PER PFU + $IO MhlMC ADM FEE s ZEZ ?b
NO. OF PFU'S
(Use PFU Total From Item 2 Above )
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
ADMiNISTRATiVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .05
Kip Burdick
SDC Coordinator
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)$ lB02 70
5
Lb63
L
TOT SDC $ rEqz€9
FrxruRE UNTT,CALCULA __?N TABLE: ruumUer of New Fixlures' rir Equivarent = Fixlure unirs(NorE:
For remodets, catcutAie only the Alui-oaltional fixtures)
NUN4BER oF uNtT FlxruRE
FIXTURETYPENEWFIXTURESEOUIVALENTUNITS
'?-2
1
2
J
6
2
6
6
1
3
2
1
2
2
'l
Drinking Fountain-...
Floor Drain--
l nterceptors For G rease/Oil/S ol ld s/-Etc" " " " " " " "'
I nterceptors For Sand/Atrto Wash/Etc"""""" "" "
Laundry Tub/Gotheswasher. " ""'
Clothes-walher - 3 Or More.-.."""'
Mobile Hdnie Park Trap (1 Per Trailer)'
Receptor For Ref rigeratorflVater Station/Etc" " " "
Receptor For Commerclal Sink/Dishwasher/Etc"
Shower, Single'Stall-.
Shower. Gang......-----
Sink. Bar. Commercial
Urinal, StallflVall...--
Wash Basin/Lavatory, Single-.-"""
Water Closet, Public Installation""
Water Closet, Private---..-
Miscellaneous:
calculate credits
Z
L
TOTAL FIKTURE UNITS
2,.71 X $to.5
(Rate X Assessed Val ue)x$
Z
z
a
l8
/Head
6
4
CREDIT CALCUI-ATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in tabte'
Credit for Parcd or t-and Only lf Applicable
lmprovement (rf after annexation date)
(Rate X
c
Assessed Value)
REDIT TOTAL $b t1l
RUNoFFcoEFFIcIENTsFoRSToRMDRAINAGE
Besidential. """""""' 0'4
Commercial----.---.---.--"" """""""' 0'9
lndustrial-.-- """""""' 0'45
Governmental.....-.-..----. """""""" 0'5
tMPERVlous AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Year
Annexed
Rate per $1,0O0
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
s.21
3.13
3.08
2.96
2.82
2.8
2-51
1986
1 987
1988
1989
1990
199'l
1992
$ 2.24
1.93
1.57
1-18
0.79
o.44
o.28
74
Willamalane
Park & Recreation District
fob No.
SYSTEMS DEVELOPMENT CHARG E
WORKSHEET
PHONE:12io ,t1 INAME:
i
ADDRESS:
LOCATION OF PROPOSED BUIL NC
Street Address if Known:
srnr*G2 r,, q]118
e{
LY
n lcJ
1
Platt Name:Tax Lot Number:
DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Sinsle Familv - Detached
It Single Family home
NO OF UNITS
B. Sinsle Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
Manufactured home not in a Park U)
L X $400 PER UNIT =$
X $370 PER UNIT =$
X $277 PER UNIT =$
X $280 PER UNIT =$
WPRD STrc
2. SDC CREDTT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credit)
$
$
$
Comm ron
City of eld
Date
,@
CITY OF OREGO'U
SPflIl{GT rEL0
h
i'
225 TIPTB SIRBET
SPRTNGETBI,D,oRBGoN 97477
INSPBCf,ION RBOTIBST
OPEICE: 726-37 59
1:OP
Permits are transferable and lre
lf vork is not started vlthl.n 180 days
of lssuance or lf vork ls suspended for
180 days.
2. CO}TTRACTOR INSTALI.ATTON ONI.Y
z 726-3769 :vf)o
r.,'n ? )z>_lq_y-3.COHPLBTB PEB SCIIEDT'LB BELOI'
',,,,...-\p-tev-&es_ld.eart-al_Single
or
PERHIT APPLICATION
City Job Nunber q4D
HuIti-Family per dvelling unlt.
Service Inclttded:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf 'd llome or
-
s Bs.oo
s 1s.00
Hodular Dvelling
Servlce or Feeder $ 40.00
Services or Feeders
InstalIation, Alterations
or Relocation:
200 amps or less
201 am-ps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amPs-
Over 1000 amps/volts
Reconnect 0nIy
Sum
Electrl
Address
Clty (r \z--^l Phone 1Lq 'tffio
Supervisor Llcense Number 1\c,\ 6t-ieoo
Exptratlon Pate tD'-t -cl6t
c
Cons tr Contr. Number lo \3?
Expl 'ratlon Date IL -7:1-q3
SfsDa ture of SuPervlslng Electrlclan
A), /hn,--
0vners Name
Address
Temporary Services or Feeders
Installation, Alteratlon or Relocation
200 amps or ]ess
201 amps to 400 amps T0ver /r01 to 600 amps
Over 600 amps or 1000 voft
Dranch Circults
Nev, Alteration or Extension Per Panel
one circult $ 35'oo
Each Addi tional
Circuit or uith Service 7 /)or Feeder Permi t I $ 2.00 a,
Hiscellaneous (Servlce/feeder not incltrded)
-Each installation
Pump or irrigation $ 40.00
sign/outline Lightlng- S 40.00
t iilited Energy/Res
-
$ 20.00
caL tr actorflat*
B.
E
s s0.00
s 60.00
s100.00
$130.00
$300. 00
$ 40.00
$40
$ss
s80s see
.00
.00
.00rrgrt u$l[
b
cl Ftru r$?h"".1!-[o '?-,lrJ I
"il-S;;LArroN
The installatlon is belrig made on
property I oun vhich ls not intended
for sale, Iease or rent.
Otmefs Slgnature:
5 SUBTOTAL OP AtrOVB
5Z State Surcharge
TOTALDATB:
RECEIVBD
d)
.- rl
EI.ECTRICAL
(