HomeMy WebLinkAboutPermit Building 1994-07-27RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:tba4 * ltp2tr,.n ST
JOB NUMBER
225 Fifth Street
Spri ngf ield, Oregon 97477
TAX LOT:
SUBDIVISION:
a
ASSESSORS MAP:- ltl,D3&st3
LOT:4 BLOCK:
PHONE
STATE:C*. ICITY:
ADDRESS:
OWNER:
NEW >/ BEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDBESS
s 7 I
€L
-t z6<bL t r?,*
CONTRACTOR'S NAME
GENEFIAL:
PLUMBING
MECHANICAL:
ELECTRICAL:
EXPIRES PHONE
CONST.
CONTRACTOR #
\
L
* OF BDFIMS:
- OFFICE USE -
CONSTR. TYPE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN:
HEAT SOURCE:
RANGE:
* OF UNITS:
LAND USE;
OCCY GROUP:
* OF STOFIIES:
QUAD AREA:
* OF BLDGS:
To request an inspectlon, you must call 726-3769. Thls ls a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspectlons requested after 7:00 a.m. will be made the following work day.
REOUIRED !NSPECTIONS
[ {l remOorary Eleclric--r-ffi
tr
w
F
Site lnspection - To be made
after excavation, but prior to
settlng forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underf loor Plumbing/ Mechanlcal
- Prlor to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.
Floor tnsulation - Prior to
decki ng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - prior to
cover.
Rough Mechanical - Prior to
cover.
Rough Electrlcal - Prlor to
cover.
Eleclrical Service - Must be
approved to obtaln permanent
electrical power.
Flreplace - Prior to faclng
materlals and framlng lnsp.
Framlng - Prlor to cover.
Wall/Ceiling lnsulation - Prior to
cover.
Drywall - Prior to taping
Wood Stove - After installation
lnsert - After fireplace approval
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concretb.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Final Plumbing - When all
plumbing work is complete.
Final Electrical - When alt
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
F
F
rytr
F
ry
ry
lt'] UnO"rground Plumbing - Priorur to filling trench.
r
ffi
ry
F
Final Building - When all
required inspections have been
approved and building is
completed.
Olher
MOBILE HOME INSPECTIONS
Plumbing Connections - When
home has been connected to
water€nd sewer.
a
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
I-l Fence - When compteted.
[Yl Street Trees - When ail required-l+' trees are planted.
I
Sf -'.? €,'"/),ztp, 97q?{
ABnnJ
SECONDARY HEAI_
SQUARE'OO'OO''ffi
E
E
tl
E
il
[--l Blocking and Set.Up - When atl.J blocking is complete.
[-l Final - After alt required
-
inspections are approved andporches, skirting, decks, andventing have been installed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
X tnturio'
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
w
ro THE PROPOSED WORK lN THE
ISTORICAL DISTRICT, OR ON
THE HISTORICAL FIEGISTER?
-
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPFIOVED:
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 of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances'
Plans z/#ftBy
.4^/-"{Date Paid
Receipt Number:
Received By:
Plan Check Fee:@,-
BUILDING PERMIT.'
(A)
E
\oR
s/so. FT.
5o Zn
FT. X
(rszr,)ro
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SD
fzt?2
c)_
6d
IONAL CO MENADD
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
I8A3D
(c)
FT,
FT.
N0
FT.
Gs.drW
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
6 uE)i. os
q@*
CDb
(D)
N0
19.(t)'
D.
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
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 State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
/,nn^ru L
7y'Date ,Z s/-
on the site at I times during construction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut 3Q t,
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/s,@
DATE PAID
AMOUNT BECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)
35/13
PdB ar (' ', ,
727 ,i
7 7a do/
. Ft.
CITY OF : .{INGFIELD SYSTEMS DEVELOPI',=f{T CIIARGE
I-IORKSH EET' (C0HHERCIAL & RESIDENTIAL)
NAI'IE 0R C0l,lPAlrlY:
LOCAT IOI'I:2G
DEVELOPI.IENT TYPE:
BUILDING SIZE:
I. STORH DRAINAGE
IMPERVIoUS SQ. FT.
?. SANITARY SEI{ER-CITY
NO. OF PFU'S
(See Reverse)
3
A2-
x _ x s424.31
x
-
x s424.31
oT siz
72 x so.2o3 PER SQ. FT.
X 542.08 PER PFU
x s424.31
2r
TRANSPORTAT ION
NO OF UI{ITS X TRIP RATE X COST PER TRIP
Z x /,o
4
Use PFU Total From Item 2 Above)
Hlllr'rc CREDIT IF AppLTCABLE (SEE REVERSE)
S
$15.125 PER PFU + S10 l{hrMc ADH FEE
o
TOTAL-MhIHC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)szG
TAL AB0VE) X .0s
-/o - 7*
TOTAL SDC 2
s
s ?/1 -
5. ADMINISTRATIVE FEES
SAN I TARY S EL'IR -I.lI{I'lC
NO. OF PFU'S ZZ
BASE
Y
7f,
7<
(
(
o?72-
SDC Coordinator
' 7?a 03{
rs7!
#.
/ -ts -7r'
[-lx l uHtr ul\l l .vA1 r-\/v IJ1 . r\-./tr r ^'rr-Jl_(-. 1!(rr])11(rl Qt {\clv t t\r(rrv5 n L'il,r L\(vrr.,.!r.r
For rcmodels. c:rlcutjrlc only tlrc l![:I atJ.Ji:ii'rrr;rl lirirrrt':.)
FIXTUNE N'PE
Ball'r1ub.......
Drinking Fourrl.rirl......
p1o96 erain. ..........:... . ..
lnterceplors For Grea sc/O il/Solidsi Elc.. "....
I nl erceplors For Sand/Aul o Vr'a shrzEtc.........
2-
t-a undry Tub/Clot h e srvas l'r e r
Beceplor For B ef rigeral orlffat e r Sta t ion/Et c.......
Fleceptor For Crcmmerclal S ink/Dishrva sh er/El c.
Shorvei Single'Sta11.........
Sink, Bar. Commercial
' Urinal. Stallf\'a11....
Wash Basin fL:Yelory, Single
\l'ater Closet, Public lnsiallation.
V/ater Closet, Prh,ate........
l,{iscellaneous
t,tLr,.ls[,t L-)l: Lt;{lI' rlxlunE
t..,8\i',t:1.\lul'iES l:oLliVi.LE,JT UlJltS
---T-
A
A
TOTi.L FIXTUNE Ui{ITS
z
r
/He,d
I
3
6,
6Oothesvaqher - 3 Or l'4ore...................
lJobile Hdme Park Trap (l Per Traiter)6
1
J,
I
2
2
1
6
CREDIT CALCUUTION TABLE: Eased on assesseC vatue. lf improvements occurred afier annexation date in table.
cajculate creiiis rates-
Credit for Parcd or krd Only lf Applicable
lmprovement (rf after annexation date)
9.2 xs
(Rate X Assessed Value)x s-
(Rate X Assessed Value)
CREDIT TOTAL
2/.75O 0ft:
b?r3=$
Year
Annexed
Fate per 51,m0
AssesseJ Value
Year
Annexed
Rate per 51,OO0
Assessed Value
1,o79 or before
199C
1931
1 932
1993
1934
'1985
s3.21
\r.rJ
3.08
2.*5
2.92
2.69
2.51
1935
1 937
19e3
1999
,rG1'l
1931
1&,
s 2.24
1.93
1.57
1.18
0.79
o.44
0.28
RUNOFF COEFFICIENTS FOR STOBM DRAINAGE
.?
2
Z2-
CITY OF ONEGO'U
0D/I
IH,l?:gino#f',?ffi,?S*#t'ff
225 FIrTB STRBBT aPProval.
SPRINGFIBID, oRBGON 97477 ,--,-
rNspEcrroN REoudi;' iib-vor0nlns lnftrr'J-'
OPFICE: 726-3759 aae-}*)'\
SPRI'{GFIELO
u8e
ELBCTRICAL PERHIT APPLICATION
City Job Number
3. COHPI.,ETE FEB SCEBDTILB BBLOV
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost
1.S#
JOB
Permi ts are non-transferable and expire
if vork is not started vithin 180 days
of lssuance or if vork is suspended for
180 days.
2. COIiITRACTOR INSTALI,ATION ONLY
Electrical Con tractor v (rc7ZtC 2.-C-
Address 5,/4"
Ct ty -\t71r:: c44'D Phone J
Supe rvisor License Number /f71 S
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dvelling
Servlce or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
STIBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
d-
Sum
110
so
V -?$ 8s.00
$ 1s.00
$ 40.00
$ s0.00
s 60.00
$100.00
s130.00
$300.00
$ 40.00
B
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
601 amps to 1000 amps-
0ver 1000 amps/volts
Reconnect 0nIy
-Each installation
Pump or irrigation
Slgn/0utIine Light ing]
Limited Energy/Res
-Limited Energy/Comm
Expiration Date 'd .-J5
Constr Contr. Number ?"t7*
Expiratlon Date ,/ol- >'5
of lsing Blectrician
Owners
Address
Ci ty Phone
OgNER ON
The installation is beihg made on
property I ovn vhlch ls not intended
for sale, lease or rent.
Omers Slgnature:
DATE:
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or Iess $ 40.00
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 voT[s see rrBx am-
D. Branch Circuits
Nev, Alteration or Extension Per Panel
'0ne Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permi t $ 2.00
B. Miscellaneous (Servlce/feeder not included)
s 40.00
$ 40.00
s 20.00
$ 36.00
RBCEIVED
'-2 q
f-
5 laP.cD
Willamalane
Park & Recreation District
fob No.
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
ADDRESS:
LOCATION OF FROPOSED BUI NCS
Street Address if Known:
1
Community Services
City of Springfield
srArE:$Lr,r 9!W
tt
PHONE:
\Platt Name:
DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwellingtype
definitions are on the back-)
A. Single Family - Detached
Single FamilY home Manufactured home not in a Park
NO OF UNITS
B. Single Family - Attached
NO OF UNITS
C. Multi-Familv Apartment
NO OF UNITS
D. Manufuctured Home Park
NO OF UNITS
X $400 PER UNIT =$
X $370 PER UNIT =
X $277 PER UNIT =
X $280 PER UNIT =
ax Lot Number:
00$
$
$
@
WPRD SDC $
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
;tp;"*I s o iot'ii"ait worksh&r" $
3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credi0 $
Date
d