HomeMy WebLinkAboutPermit Building 1996-03-21SPFINGF!ELO
RESIDENTIAL PERMIT APPI,ICATION
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUII,DING SAFETY
Page 1
ilob Nusrber: 950038
225 North Fifth Street
Springfield, OR 97477
Location of Proposed work: 357 N 15TH ST L/2
Assessors Map #t L7O33624
Lot: Block:
office:
Inspection Line:
726 -37 59
725 -37 59
Tax Lot #
Subdivision
07900
CITY OF SPruNGFIELI', ONEGON
Owner: RICHARD SITOWSKI
Address: 357 L/2 N 15TH ST
Describe Work: REPAIR FIRE DAII,AGE
phone #:
city/state/zip: SPRINGFIELD, OR 97477
NEW
General:
Plumbing:
Electrical-
ConEractor
EHLERS CONSTRUC OOO4231
2065 L/2 Roosevel-t Eugene OR 974020
DON MERRICK PLU 0035533
5000 Sw Meadows Rd Ste 151 Lake Osw
CROW VALLEY ELE OO9591O
PO Box 2220L Eugene OR 974020000
Consu.
Contractsor #Expiree
1-1-/1-e / e7
03/L5/es
oL/05/e6
Phone
689 - 6L7 7
620 -7 538
729 - 5LO8
QUAD AREA: 2RNW
-- OFFICE USE --
LAND USE: 1111
To request an inspection, cafL the 24 hour recording at 726-3769.
A11 inspections requested before 7:00 a.m. will be made the same working day,
inspections requested after 7:00 a.m. wil-l- be made the following work day.
--- REQUIRED INSPECTIONS ---
ROUGH PLI,ITIBING - PriOr IO COVET.
ROUGH MECIIAIIICAL - PriOr IO COVET.
ROUGH ETECTRICAL - Prior to cover.
FRAI{ING - Prior Eo cover.
INSUTATION - Fl-oor; prior to decking Wa11/Ceil-ing; Prior to cover
DRYYVALL - Prior to taping.
FINAL PLIIITIBING - When al1 plumbing work is complete.
FINAL DIECIIAIiIICAL - When alL mechanical work is complete.
FINAL ETECTRICAL - When a]l- electrical work is complete.
FrNAL BUILDING - When all reguired inspections have been approved and
the building is complete.
Item
Main
Garage
ADD 2ND TOILET ROOM
Total Value
Building Permit Fee
Surcharge/admin
--- BUILDING PERMIT ---
Square Feet x $/Square Feet Value
0.00
0.00
800.00
800.00
15.00
L.20
TOTAI. FEE (A)16.20
SPRINGFIELD
Job Nunber: 950038
CITY OF SPruNGFIELD, ONEGON
Page 2
SYSTE}IS DEVEIIOPMENT CIIARGE (SDC)
(B)228.0L
Systems Development Charge is due on all undeveloped properties l,vithin the City
limits and the Citys Urban Growth Boundry which are being improved.
PLIIMBING PERMIT ---
Item
Fixtures
Plumbing Permit
Surcharge/admin
TOTAL CHARGE
3
Fee
30.00
30.00
2 .40
32 .40(c)
(Excluding Electrical)
unleEe otherwiee noted
--- TOTAL A}TOUNT DI'E ---
(A, B, C, D, and E conbined)27 6 .6L
--- BUILDING VALUE, PLAIiI CHECK Al{D BUILDING PERIIIT ---
This permit is granted on the express condiEion that the said construction
shaLl-, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, regulating Ehe construction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
Received By:
Pl-ans Reviewed By: LORNE PLEGER
Building Site Reviewed By:
Date: 03/]-9/96
--- ADDITIONAL COMMENTS ---
REVISIONS TO EXISTING FIRE DAMAGE PERMIT TO CREATE SECOND TOILET ROOM
By aignature, I atatse and agree, Ehat I have carefully examined
the completed application and do hereby certify that all information hereon
is true and correct, and I further certify that any and all work performed
shall be done in accordance with the Ordinances of the City of Springfield,
and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCUPANCY will be made of any structure withouE permission of the
Community Services Division, Building Safety. I further certify that only
cont,racLors and employees who are in compliance with ORS 701.055 will be
used on this project.
I further agree to ensure that al-L reguired inspections are requested at the
proper time, that each address is readable from the street, that the permit
card is focated at the front of the property, and the approved set of plans
will remain on the site at all times during construction.
si gnat Date
SPF!NGFIELD
Job Number: 950038
CITY OF SPruNGFIELD, ONEGON
Page 3
--- VAI.IDATION ---
ReceipE Number:
DaEe Paid:
Amount Received:
Received By:
2e7s 3
znl . o'
s,/zn/qr-
SPFINGFIELEl
Page 1
CITY OF SPRINGFIELD SYSTEMS DEVEIJOPMENT CIIARGE
(RESIDENTIAL)
CITY OF SPruNGFIELD, ONEGON
Name or Company: RIC}ARD SITOWSKT
Location: 357 N l-5TH ST 1,/2
Developement Tlpe: R Building Size:
rTob No.: 960038
Lot Size:Sq Ft
1. STORM DRAINAGE
Impervious Sq Ft
2. SA}iIITARY SEWER - CITY
Number Of PFUs
(see Page 2)
3. TR,A,NSPORTATION
Number Of Uni-ts
5. ADMINISTRATIVE FEES
Base Charge (subtotal Above)
X 0.210 Per Sq Ft =
X 43.43 Per PFU =
X Trip Rate X Cost Per Trip
5
$o.oo
$2L7 .L5
$o.oo
$0.00
$o. oo
$o. oo
$2L7.Ls
$10.85
Transportation Total
4. SA}iIITARY SEWER - MT{MC
Number Of PFUs
0
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SITBTOTAL - (Add ItemE 1, 2, 3 & 4)
Per PFU + MTTMC Admin Fee
18.750
x
x
x 0.50
TOTAI, SDC
Reviewed By: TROY MCALLISTER Date:03/L9/96
$228.01
SPIlINGFIELD
Job Number: 960038 Page 2
FIXTURE I'NIT CAI,CUI,ATION TABI,E
OTT OF SPflNGFIEID, ONEGON
Fixture Type
Number of
New Fixture
Unit
Equivalent
Fixture
Units
Bathtub
Drinking Fountain
Floor Drain
rnLerceptors For Grease/Oi1/sotids/stc
Inteceptors For Sand/Auto Wash/ELc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/Water Station/Euc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residentiaf Kitchen
Urinal, Stall/WaI1
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water CLoset, Private
MisceLl-aneous
TOTAL FIXTI'RE UNITS =
CREDIT CALCULATION TABLE: Based on assessed va1ue. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1ooo)
Year Annexed:
Credit For Parcel Or Land OnIy If Applicable: 0 x 3.47 = 0.00
Improvement (if after annexation date): 0 X 3.47 = 0.00
CREDIT TOTAL = $0.00
(If fand value is multiplied by L then the parce1/land credit is not accurate.)
l,
0
0
0
0
0
0
U
0
0
0
0
0
1
0
4
0
5
)
1
3
5
6
1
3
)
2
2
1
6
4
U
0
0
0
0
0
0
0
0
0
0
1
1
0
225 FTTTH STREET
SPRINGFIELD, OREGON
INSPECTION REQTIEST:
zoning, a
aPPrcval'
nd
97499h"'i'ud
726-3769
LD
2
CAt PERHIT APPLICATION
Ci ty Job Number
3. COHPI^ETE FEE SCffiDULE BELOVoFFICE: 726-3759
1-OF INST
ON
DESCRI ON
Permi non-fera ean
I f vork is not star ted vithi-n 180 d
o f issuance or if vo rk is susPended for
eddress 00'
3z?:tS
DATE:
$Nev Residential-Single or
ll,rf t:.-P"ri1Y Per dvelling unit
Service Incfuded:
A
C
I tems Cos t
s 8s.00
$ 1s.00
$ 40.00
50.00
60.00
r-00.00
130.00
300.00
40.00
Sum
1000 sq.ft. or Less
Each additional 500
q q. ft or Portion
t hereof
a )o
clW €,Yt,-e 1??d Phone
Supervisor License Number
exz .Szt B
Constr Contr' Number
Expiration Date
Signature of SuPervising Electrician
0vners Name
AddresP
Ci tY Phone
ALLATION
Each Manuf'd Home' or
Modular Dvelling
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
2oo amps or less _J
201 amPs to 400 amPS ---401 amPs to 600 amPs
-
601 amPs to 1000 amPs-
over Lb00 amPs/volts
-
Reconnect 0n1Y
SUBTOTAL OF ABOVE
5% State Surcharge
fi ea*:-tistrative Fee
TOTAL
TemoorarY Services or Feeders -il:!;ii;ii"", aii'ration or Relocation
200 amPs''or fess
201 amps to 4oo amPS
-
Over 401- to 600 amPs
over 600 amPs or fbOO-ToTI
Branch Circuits
Nev, Alteration or Extension Per Panel
$ 3s'oo
t"'"t"10 $ 2'oo
One Circui t
Each Addi t iona-L
Circuit or vith
or Feeder Permrt
--
!J)
I
s
s
$
$
s
$
€o
s see above
.00
.00
.00
rrBu
$40sss
$80
.EP_
D
The installation is being made^on
DroDerty r ovn "niln-i= iot intended
ioi'turl, lease or rent'
Ovners Signature:
I'tiscellaneous ( Service/ f eed
-Each installation
Pump or irrigatron
.sinlzoutrine Lightitg--
r-i.ili ted EnergY/Res -.-
iio,it"a EnergY/comm
E
er
$
s
$
s
not included)
40.00
20.00
36 .00
5- *,"-,;f iL:Lf,
RECEIVED
5
do
1"80 daYs.
2. COMRACTOR INSTALTATION ONLY B'
Efectrical Contracto.CROqI Uqf {e{ 6/ecLrr'c
g
Expiratio n oate lC/? 5
7j
R ESID ENIIAL
PERMII APPLICATION
lnspections: 726'3769
Office: 726-3759
LOCAT ION OF PBOPO
ASSESSOBS MAP:
SPrtTnlGF
-l L L5 I dl^e
JOB NUMBER
q
225 Fifth Street
Spring {leld, O regon 97477
TAX LOT:
LOT: BLOCK:
1 PHONE:
ZIP:
bI
/L0..STATE:
') +?-s 2D)
G
LJ)-
CITY:
ADDRESS:
OWNER:
th'lkUMtt-
DESCRIBE WORK:-{r*"i.t
NEW-- REMODEL
RESS
\
i/K
EXPIBES - PHON E
utDv> L)
CONTRACTOH'S NAM
PLUMBING:
GENERAL:
MECIIANICAL:
ELECTRICAL:
CONST.
CONTRACTOB #
I G*tI,.r.
r OF BDRMS:
_ OFFICE USE -
LAND USE:
ZONING CODE:
FLOOD PLAIN:
WATER HEATER BANGF.:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
a OF STORIEST
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recording. All lnspections requested before 7:o0 a.m. wlll be
made the sante working day, lnspections requested after 7:00 a.m. will be made the following work day'
REQUIRED INSPECTIONS
[--l TemporarY Electrlc Rough Mechanlcal - Prior to
cover.
I-l-lfinal Plumbing - When allL-Jy' plumbing worl( is complete.
Site lnspection - To be made
after excavation, but Prior to
setting lorms.
fr Rough Electrical - Prior to inal Electrical - When all
cover.electrical work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prior to cover.
Electrical Service - Must be
approved to obtaln Permanent
electrlcal power.
f1'y'final Mechanical - When allH mechanical work ls camplete.
Foollng - After trenches are
excavated.Fireplace - Prior to faclng
materlals and framing lnsP.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, grouting.
Other
Foundatlon - After forms are
erected but prlor to concrete
placement./Celling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to fllling trench.Drywall - Prior to taping,
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decking'
Post and Beam - Prlor to floor
insulation or decking.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & A1:proach - After
forms are erected bttt Prior to
placemcnt of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Conneclion - When
blocking, set-up, and plumblng
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prlor to filling
trench. ^'
wat er Line - Prior to filling Fence - When completed.
Rough Plumbing - Prior to Street Tress - When all requlred
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.cover,
SUBDIVISION:-
SECONDARY HEAT:
SQUARF. FOOTAGE:
# OF UNITS:
-_
E
[-l Wood Stove - After lnstallation.
[-l lnsert - After fireplace approval
'J and installatlon of unit.
W
E
E
l-71 Framlng - Prlor to cover'
fl
tl
I--l Sidewalk & Driveway - AftertJ excavation is completc, forms
and sub-base material in place.
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
l( yes, this application rnu"t bu signed
and approved by the Historlcal
Coordinator prior totBermit issuance.
APPROVED:
VALUE
\3
(A)
BUILDING PERMIT
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
SO. FT. X $/SO. r:T.ITEM
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Spri ngfield, including theDevelopment Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
Receipt Number:---_
DatePIans Rcviewed By
Date Paid
Received By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge is due on all undevelopedproperties within ilre City lirnits which are being improved.
ITEM
Fix t u res
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
00
@
(c)
FT.
N0
PLUMBING PERMIT
FT.
FT.
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
MECHANICAL PERMIT
(D)
Sq
OOMechical Permit
Dryer
N0
lssuance
State Surcharge
Total Perinit
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have care,ully examlned
the completed apptication and do hereby certify that alllnformation hereon is true ancl correct, and I f urther certlfy
that any and ail work performed shail be done in accordance
with the Ordinances of the City of Springfield, and the Lawsof the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Division.I furthcr certify that only contractors and employees who
are in compliance with ORS 7Oj.O5S will be used on thlsprolect.
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
he site const ruction
gnature
on
L6\)z
plans will remain
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -- ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Pennits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, D, and E Combined)
D
DATE PAID
VALIDATION:
FIECEIPT NUMBE
AMOUNT REC
RECEIVED BY
\
c1um3tr
, crrY oF sPnrxcpdr,ir
Fire & Life Safety
TO:
FR0t'1:
SUBJECT:
FIRE DAI'IP(;E REP[)P.T
OR
ELECTRICAL }]AZARD
nnTr.UhIL.\2-21- q5
Building Departrnent
Spri ngf i el d Ft're Department
Structural Danrage to Building
Address or lccation of building 3s 7 h- \t.,'\\ \f}- <+.""\
Name of o\vner
Tyoe of bui lcl 'i no
Es t jmated va I ue of bu'i I di ng
Est'imated I oss to bui I d'inq
(Dwel 1 i ng,Store, I,iarehous , etc. )
6
D c
Date of fire t2-7q -qr
Location of damage 'in bu'i1di ng c)
(Roof , l,,la'l'l , Exterior, Interior, etc. )
Structural vreakness as a resul t of the f ire ?*, *.4.,\. ICer \rr,\a Dea4a9 , {iir\.
*&\*,
-\rerters, gea;;, .Loists, eta.l
Addj tjonal pertinent j nfcri"nat'ion
El ectri cal l-lazard rV\
(l,Jjrir9, 0
CC:l- fl' 1b ?u
siqn
a.u^<1{ (\q