HomeMy WebLinkAboutPermit Building 1998-04-16SPFIiTGFIELD
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RESIDENTIAL PERMIT APPI.ICATION
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
ilob Nrurber: 980198
225 North Fi-fth street
Springfield, OR 97477
Location of Proposed Work: 572 S 41ST PL
Assessors Itlap #: L7023233
Lot: 23 Block:
office:
Inspection Line:
726 -37 59
726-3769
Tax Lot #:
Subdivision:
05000
TIOGA PARK
Owner: TOM JENNINGS
AddrCSS: 572 SOUTH 41ST PIJACE
Describe Work: BEDROO!{ ADDITION
Phone #: 74L-6720
city/state/z|p: SPRTNGFTELD, OREGON 97478
ADDITION
ContracEor
Consts.
Contractor #Expires
02/06/ee
ot/L7/98
06 /27 / e8
oe/01-/ee
Phone
725-5L62
000-0000
'726 -OLOO
7 4L-2236
General:
Plumbing:
Mechanical:
Electrical:
WILLAMETTE VALL 0092654
36492 .]ASPER RD SPRINGFIELD OR 9747
ALERT PLUMBING OOO5722
55753 CHIEF PAULINA RD BEND OR 9770
COMFORT FLOW 0000460
1951 DON ST #D SPRINGFIELD OR 97477
c & s 0003849
PO BOX 1482 SPRINGFIELD OP 97477000
QUAD AREA:
ZONING CODE
VN
SQ FOOTAGE:
3RqC
: LDR
586
-- OFFICE USE --
LAND USE: 1111
OCCY GROUP: R3
# OF UNITS: 1
CONSTR. TYPE:
To requeat an inspection, cal-] the 24 hour recording aL 726-3769
A11 inspect,ions requested before ?:00 a.m. wi]I be made the same work
inspections requested after 7:00 a.m. will be made the following work
--- REQUTRED TNSPECTTONS ---
FOOTING - After trenches are excavated.
FOITNDATION - After forms are erected but prior to concrete placement.
ITNDERFIJOOR MECIIAIiIICAL - Prior to insulation or decking.
POST AIID BEAII - Prior to floor insulation or decking.
INSUTATION - Floor; prior to decking wall-/Ceiling; Prior to cover
ROUGH ELECTRICAL - Prior to cover.
FRAIIING - Prior to cover.
INSULATION - Floor; prior to decking Wal1/Ceiling; Prior to cover
DRYWALL - Prior to taping.
FINAL IIECIIAI.IICAL - When all mechanical work is complete.
FINAL ELECTRICIL - When all elecErical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
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Item
Main
Garage
Total Vafue
Building Permit Fee
Surcharge/admin
--- BUILDING PERMIT ---
Square Feet x
s86
$/Square Feet
64 .66
Value
37,891.00
0.00
37, 891.00
229 .00
1-8.32
TOTAT FEE (A)247 .32
ilob Nr::mber: 980198 Page 2
--- MECIIAI{ICAI. PERMIT ---
DUCT EXTENION
Mechanical- Permit
Issuance
Surcharge/eamin
TOTAL PERMIT (D)
3. s0
26.20
15.00
10.00
L.20
--- MISCETLA}IEOUS PERMITS
Surcharge/admin
SDC
TOTAL MISCELLANEOUS PERMITS
0
L49
00
97
(E)L49.97
--- TOTAL A},TOI'NT DUE ---
(A, B, C, D, and E combined)423.49(Excluding Electrical )
unless otherwise noted
--- BUII,DING VAI.UE, PI,AIiI CHECK ADID BUII,DING PERIIIT
This permit is granted on the express condition that the said constructj-on
shalI, in a1t respects, conform Lo the ordinance adopted by the city of
springfield, inc:-uaing 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 '
ReceipL Number: 28822Plan Check Fee z 234.65 Date Paid:
Received BY:
Plans Reviewed BY: TOM MARX Date:
Building Site Reviewed By: BOB BARNHART
02/1-'7 /98
E3 /E3 /83
.-. ADDITIONAL COMI{ENTS ---
ELECTRICAL PERM]T REQUIRED
By eignature , I 6taEe and agree, that I have carefullY examined
the comPlete d application and do herebY certifY that all information hereon
is true and correct, and I further cerL ify that any and all work Performed
shafl be done in accordance with the ordinances of the CitY of SPringfield,
and the l,aws of the State of oregon Pertaining to the work described herein'
and that NO OCCUPANCY will be made of any struct ure without Permission of the
CommunitY S ervices Division, Building Safety' I further certifY that onIY
contractors and employees who are in compliance with ORS 701.055 will be
used on this Proje
I furLher agree to
proper Eime, that
card is locaEed at
ct.
ensure that
each address
the front of
all required insPe ctions are requested at the
is readable from the street, that the Permit
the Property,and the approved set of Plans
the sit dL times during cons truction.will r ema !-tqqY
te
ignature
SPFIi.OFIELD
,.fob Number: 980198
qTT-OF SPruNGFIEI.O,ONEGON
Page 3
--- VALIDATION ---
Receipt Number:
Date Paid:
Amount Received:
Received By:
A?.{ I j
ut -tL+-?(
S 4 l). o 1/
.$1;
JoB N0.96a/7fr
ATTACHMENT A
CITY OF SPR-INGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY -I hPl d Ev re -'T-e-rt NIN6l
LOCATION 5)Z €,41.-.7't-.
DEVELOPMENT TYPE <tr R ADDrTton)
BUILDING SIZT LCT SIZ F SQ. FI
1 STOR|,I DRAI NiAGI
IMPERV]OUS SO FT 632-x $0 . 225 PER SQ. FT. $ t +L. 83
2 . SAN ITARY SEI{ER -C iTY
NO OF PFU'S X 5.16. 86 PER PF|J
(See Reverse Side;
3. TRANSPORIATiON
NO OF UNITS X TRIP RATE X COST PER TRIP
X x $472 49
x $412 49
x $472.49
S 'S-*
$X
Mt,lMC CREDIT IF APPLICABLI (SEE REVERSE)
5. ADl',llNISTRATIVE FTES
BASE CHARGE (SUBIOTAL ABOVE) X .05
4. SANiTARY ST,^IER-MhJMC
NO. OF FEU'S
$
TOTAL-MWMC SDC $
SUBTOTAL (ADD ITEMS 1,2,3 & 4)$ /4",6t
s 7. /4
$
PER FEU + $10 ML.JMC/ADM FEE $ €-*
X
X
SDC Coordlnator
Date: 3 - Zo'?8
TOTAL SDC 5 I 41 ,? -
$a
. 0r\ r vr rL \rr.r. I vaLrsr-'L.rl I r\Jl\l I ADLtr'' Number Ot New Flxture's X Unit Equivalent = Fixture UnitS
(NOTE:Forremodels,calculateon'eN.il,additionalfixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathrub......
Drinking Fountain....
Floor Drain.'
lnterceptors For GreaselOil/SolidsiEtc"""""""'
lnterceptors For Sand/Auto WashlEtc"""""""'
Laundry TubiClotheswasher... "
Clotheswasher - 3 Or More..'..
Mobile Home Park Trap (1 Per Trailer)"""""""
Receptor For Refrigerator/Water Station/Etc"""
Receptor For Commercial Sink,'DishwasheriEtc"
Shower, Single Stall...'..
Shower, Gang..
Sink: Bar, Commercial, Residential Kitchen"""'
Urinal. Stall/Wall...
Wash BasinilavatorY, Single"
Toiiet, Pubiic lnstallation.
Toilet, Private.....
L
Miscellaneous:
TOTAL FIXTURE UNITS
2
1
2
3
6
2
6
b
3
Z
'ilHead
2
2
1
6
4 /)-
+
CREDIT CALCULATION TABLE Based on assessed value.
cal culate credits seParates
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
Fesroen tiai.,
Commerical
lndustrial....
Governmental
lf improvements occurred after annexation date
x s--
in table,
(Rate X Assessed Value)
XS
(Rate X Assessed Value)
CREDIT TOTAL
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating PurPoses OnlY)
s
... 0.4
.. o.9. o5
.. o.5
Year
Annexed
Rate per S1,000
Assessed Value
Year
Annexed
Rate per $1,00O
Assessed Value
1 979 or before
1 980
1 981
1 982
1 983
1 984
1 985
1 986
$3.97
3.89
3.83
3.70
3.55
3.39
3.20
2.91
1 987
1 988
1 989
1 990
1 991
1 992
1 993
1 994
1 995
1 996
$2.56
2.17
1.73
1.31
o.92
o.74
0.61
0.45
0.31
o.1 7
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFF,C,ENT
225 FTFTE STREEf,
SPRTNGFIEI,D, OREGON 97
INSPECIION REQUEST: 7
OFFICE: 726-3759
1. IOCATTON OF INSTALIATION6]-X 5 tl (s{ })1 n "--'*-
T,EGAL!-] DL 3L D6OTb
JOB
u-t
EIec tri
Address
cal Contractor
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days
2. CONTRACTOR INSTALINTTON ONLY
SP. "GFIELO
Und ws
EI.,ECIRT(XL PERHIT APPLICATION
City Job Nurnber.
3. COHPI,ETE TEE SCEEDT'IJ BELOV
A Nev Residential-Single or
Multi-Family per dvelling unit.
Service fncluded:ftems Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
-Hodular 'Dvelling'
Sertice or Feeder
$ 8s.00
$ 15.00
s 40.00
.B Services or Feeders
Installation, Alterations
or Relocation:
B
Oc
$300.s 40.
Sum
a566
ci
Supervisor icense Number lbsLs
pnone 141- AA3 L
200 amps or less
201 amps to 400 amps
-401 amps to.600 amps
-501 amps to 1000 amps-
Over 1000 amps/volts
Reconnect Only
s
s
$r
$r
00
00
00
00
00
00
50
50
00
30
200 amps''or less $ 40.00
201 amps to 400 amps
-
S 55.00
over 4b1 to 600 amps
-
$ 80.00
0ver 600 amps or 1000ErEs see ,B.
$ 40.00
s 40.00
$ 20.00
s 36.00
Exp iration Date lO - t - q I
Constr Contr. Number 3 S4q
Temporary Services or Feeders
Installation, Alteration or Relocation
c
D. Branch Circuits
Expi rationDate q'l-qy
ture of Supervising Electrician
Ovners Name I, i,{z<r-a-+ry
Address 6-l x a (t I S +>d-4-9--
Nev, Alteration or Extension Per Panel
gneCircuit I $35.00
Each Additional
Circuit or vith Servicq ttor Feeder Permit b S 2.00"
E Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/Out1ine Lighting_
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
0
{
ci 5N"u.x\,Lj Phone 7 '("d----T ,
OVNER INSTALINTION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovner*Signature:
{
tc.
5 4tt(, -'].,n5-
' .1S-
71 4t, Qo
DATE:t"l -
RECETVED
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