HomeMy WebLinkAboutPermit Building 1994-09-29f
INGFIELD
ESIDENTIAL
ERMIT APPLICATION
R
P
lnspec'
Oflice:
JOB NUMBER lqtt+
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:D
tions: 726-3769
726-3759
LOCATION OF PROPOSED WOBK:30s d
)...."o"S MAP:rh l^l.{I 7
LOT:BLOCK:
4r
z4
7
PHONE:
ZlPiaR^STATE:?7 455
#OWNER:
ADDRESS:
CITY:
o fcD
N
G
ODEL
-
ADDITION DEMOLISH OTHER
ADDRESS EXPIRES PHONE
E-
WATER HEATER:
E \
0 5 0
l c
\
?-.lA\r n
QUAD AREA:aR-rOk)
r OF BLDGS:
r OF BDRMS:
ZONING CODE:
FLOOD PLAIN
CONTBACTOR'S N
GENERAL:
_ OFFICE
PLUMBING:
RANGE:
r OF UNITS:
LAND USE:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STOBIES:
CONSTR. TYPE.
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng, All lnspections requested before 7:00 a.m. wlil bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
Temporary Etectrlc
drounaatton - After forms aretAerected but prlor to concrete
placement.
F
Ytl
K
afi
X
Slte lnspectlon - To be made
after excavatlon, but prior to
settlng !q,rms.
,tr.,",rW,,
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decking.
Floor lnsulallon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllllng
lrench.
Slorm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filllng
trench.
Rough Plumbing - Prior to
cover.
Rough Mechanlcal - Prlor to
cover.
Rough Electrlcal - Prlor to
cover
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Fram
Walt/ng lnsqlallon - Prlor to
cover.
Flnal Plumbing - When allplumblng work ls complete.
Flnal Eleclrlcal - When all
electrical work is complete.c
Flnal Mechanlcal - When all
mechanlcal work ls complete.
al Buitdlng - When alt
requlred lnspectlons have been
approved and building ls
completed
Other
Plumbing Connecllons - When
home has been connected to
water and sewer.
Electrical Connection - When
blocklng, set-up, and plurpblng
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspectlons are approved andporches, sklrtlng, decks, andventlng have been installed.
l---l Drywall - Prlor to taptng,
Wood Stove - After installatlon.
lnserl - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sldewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base materlal in place.
n Fence - When completed.
Street Trses - When all requlred
trees are planted.
MOBILE HOME INSPECTIONS
\4
l\l\Blocklng and Set-Up - Whep ail
lf(Jblockl ni ts com pteie.t-
F
SUBDIVISION:
-n/,q<73
t
E
E
E tl
E
$^CIqf"
I:]
tl v
!r'; I ,- ,t,,t.-j "..
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lgt Type
R tnturio,
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
,S THE PROPOSED WORK TN THE,.
HISTORICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
BUILDING PERMTT
ITEM SO. FT. X $/SQ. FT.-qVALUE
l/9a
7*
rl
(A)
b+A
" 2r7a
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
l\r-4ain
Galage
Carport
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 Beviewed By Date
Date Paid
Receipt Number:
Beceived By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)4r/.Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
,
t
Resldentiai Bath(s)
Sanitary Sewei
Water
Storm Sewer
Moblle Home
FEE
N0
3nS
FT.
FT.
(c)
PLUMBING PERMIT
ITEM
Fixtures
Plumblng Permit
State. Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
(D)U-
Mechanical Permit
lssuahce
State Surcharge
Total Permit
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfietd, 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 Bullding Safety Division.
I further certlfy that only contractors and employees who
are in compliance with ORS 7O1.O5S will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, that oach address is readable
from the street, that the permlt card ls located at the front
slg
pl
du g const
y, and the approved set wlll remalnof the propert
on the site at
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
:':i":iW',
a@ron .]%
State Surcharge
Total Miscellaneous Permits (E)
EDtr,q
3,.1s
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
DATE FAID
AMOUNT RECEI
BECEIVED BY
VALIDATION:
RECEIPT NUMBER
APPROVED:
f,6.2=
1€-?/
h-
Willamalane
Park & Recreation District
fob No.
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
HONE:
0[o,,qftsADDRESS:
LOCATION OF FROPOSED BUI SITE:
)Stre€t Address if Known:S \n SVI^\r
1
\1\00
) r*a"nuf"ctured home not in a Park dr)
t4DD
Platt Name:Tax Lot Number:
DEVELOPMENT TypE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back-)
A. Single Family - Detached
Single FamilY home
NO OF UNITS
B. Single Family - Attached
NO OF UNITS
C. Multi-Family Apartment
NO OF UNITS
D. Manufuctured Home Park
NO OF UNITS
3. TOTAT WPRD NET SDC
ity
X $400 PER UNIT =\$
X $370 PER UNIT =
X $277 PER UNIT =
X $280 PER UNIT =
(lf SDC reduced for Credit)
$
$
$
mp$WPRD SDC
2. SDC CREDIT (lf applicabte) sDC-payer must furnish proof of wPRD Credit
approval. See SDC Credit Worksheet.$
$
t^2+. , a4 c ^.: ^^f; ^l x
Date
ATTACHMENT B1 r0B N0.z //*s,r
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI-IARGE
I^IORKSHEET
(COMMERCIAL & RESIDENIIAL)
NME OR COMPAI,IY:,eic
LOCATION:to, ,1. zs 4
DEVELOPMENT TYPE:
BUiLDiNG SIZE
STORH NRAINAGF
IHPERVIOUS SQ. FT.
3
'i
vr6.4 7 II oT sizE sQ' Ft'
X $0.209 PER SQ. FT.
1
z, fo
x /,o/ x s436.i9
x
-
x s436.i9
x
-
x $436.19 (
SUBTOTAL (ADD iTEMS 1.2. & 3)52,
4. SANITARY SFl^lER-l'4hlMC
N0. 0F PFU'S tY x $17.19 PER PFU + $10 MI,IMC ADMIN.FEE
(Use PFU Total From Item 2 Above)
s 3l 7.12
2. to*rroRv srwrR-cTTY
NO. OF PFU'S
(See Reverse)
tV X $43.26 PER PFU
TRANSPORTATION
NO OF UNiTS X TRiP RATE X COST PER TRIP
HI.IMC CREDIT IF APPLICABLE (SEE REVERSE)
T0TAI -MI.IMC StrC
SUBTOTAL (ADD ITEMS 1,2.3 & 4)
5 AMINISTATIVE FFFS
CFIARGE ABOVE) X .05
Date: 7-ze-7o
,#6;^r-
s
ig,
$ ^ o32,7/
S s2./5
82. SDC
Coordi na
TOTAI SDC s z/ s /.cf
r .:.,t,. . .
tsJ*-.-.--.-
FIXTURE UNIT CALCULI ON TABLE: Numuer of New Fixtures X Unit Equivalent = Fixture Unirs
(NOTE: For remodels, calculate only the NET additional fixturesl
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.....
Drinking Fountain.....'...............
Floor Drain
A 4.
lnterceptors For GreaselOil/Solids/Etc
lnterceptors For Sand/Auto Wash/Etc ---z -Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More....
Mobile Home Park Trap (1 Per Trailer)......
Receptor For Befriger'atorflVater Station/Etc.....'...
Receptor For Commercial Sink/Dishwash'er/Etc..
Shower, Single Stall
Shower, Gang......... ................
Sink: Bar, Commercial, Besidential Kitchen.._z
Urinal, StallAVall.
Wash Basin/Lavatory, Single.2
Toilet, Public lnstallation.
Toilet , Private....z
Miscellaneous: tTlut nPt g,lt
TOTAL FIXTURE UNITS /?
z^
v
2
1
2
3
6
2
6
6
1
3
2
l iHead
2
2
1
b
4
,R
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Fate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 991
1 993
$2.46
2.14
1.77
1.37
0.97
0.61
o.44
o.15
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
G x$
(Rate X Assessed Value)xs
(Rate X Assessed Value)
//, / ad 3 t.81
CREDIT TOTAL -$)P.at
I
I
SPllINGFIELO
zoning, and net require 6Peci{ic land use
225 FIFTE STREET
SPRTNGFIELD, OREGON
INSPECTION REQTIEST:
OFFICE: 726-3759
approval. _ n
zonins-LW.
-'li:6btrlfFg*e*/
ELECTRICAL PERHIT
Ci ty Job Number
3. COHPI,ETE FEE SCffiDTILE BELOS
Nev Residential-Single or
Multi-Family Per dvelling unit.
Service Included:Items Cost
1-000 sq.ft. or }ess
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Refocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-
601 amps to L000 amPS-
Over 1000 amps/volts
-
Reconnect 0n1Y
c Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 4b1 to 600 ambs
-
S 80.00
Over 600 amps or fbOO voT[s see nB" a55Td-
Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circui t
Each Additional
$ 3s.00
s 2.00
AuthorizeC Signatui's,
1
PTI
Permi ts are non-ferable and
if vork is not started uit hin LBO
A
Sum
re
s
of issuance or if vork is suspended for
180 days.
2 . CONTRACTOR INSTALLATION ONLY B
Electri
Address
Ci ty
Supervi
Exp'i ra t
Cons t r
I on t racC
Phone
sor cense Number
ion Date
Contr. Number
Expiration Date
Signat f rs EI
nc\
$ s0.00
s 60.00
s100.00
s130.00
$300.00
$ 40.00
cf €In
D
0vners Name
Addr
cir Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEI
Miscellaneous (Service/feeder not included)
-Each installation
Circuit or vith Servicg
or Feeder Permi t I &
I
Pump or irrigation S
sign/outline Lighting- $
t,iili ted Energy/Res
-
$
Limited Energy/Comm
-
$
E
5
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTALRECEIVED
q)