HomeMy WebLinkAboutPermit Miscellaneous 1991-7-30
225 FIITH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
LOCATAl~OJ;. IN.sJ~ \.. "-
\~ ell \ \ \~ \n l)~ (')l.~) A.
LEGAL .m:~P'f;rQN
\'\(')Ch!' \ \.""\
f'io \.[)0F)
JOB pE:;CRIfTION
\. IY\ N ~')O Yl)
f\.
Permits are non-transferabl nd expire
if vork is not started vithI 180 days
of issuance or if vork is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Heritaae Elect
Address 855 West 24th Avenue
City
Euaene
Phone 344-1500
Supervisor License Number 9455
Expiration Date
10/1/
Constr Contr. Number 63137
Expiration Date
12/27/
Signature of Supervising Electrician
~ tV. ~ 'll/5-S
Ovners Name
Address
City Phone
v..,"" INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Owners Signature:
--------------w-- -. .
DATE: '1' . q ,
RECEIn i: ....... Tf::"t=i\~
RECEIVED BY: .c:t~O
---
Ci ty Job Number
3.
COMPLETE FEE SCHEDULE BELOV
Nev Residential-Single or =*
Mul ti-Family per dvelling uni t. .. .
Service Included:
Items Cost Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 85.00
$ 15.00
--8. $ 40.00 p.O
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
40.00
40.00
20.00
36.00
no t included)
5.
$
$
$
$
M.CO
~./iY
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
.
.
.
Fixture Unit Calculatio:1 Tab1€,: ::c:€,' d H',' fi:.:tures r..ultiplied by \lilit
equivalents. livTE: For n;;,od"ls, calcJ}~te only the ::;::T acditional fi:-:t~:rEs.
Fb:ture Type
of Unit
F xtures Equi~aleJ'ts
Fixture
l'nits
3athtub.................................. .
Drinking foun tain. . . . . . . . . .. . . . . .. . . . . .. . .
Floor drain...............................
Interceptors for grease/oil/soli(s/etc....
Inteiceptors for sand/auto ~ash/E:c.......
Laundry tub/clothes ~asher.... ............
Clothes ~asher (3 or !:lore)................
Hobile home park trap (1 per !.L ~. ) .. . .. . ..
Receptor for refrig/~ater statiC~!!tc.....
Receptor for Co~~er si~k/dish~s~:.'!tc.....
Shower, single stall.... ..................
Shover, gang (per hEad)..... . .. .. .. .. .. . ..
Sink, bar, com:r:ercial.....................
Sink, commercial/industrial/etc...........
Urnial, stall/vall........................
Vashbasin/lavatory, si~gle...............
Vater closet, public installatio~.........
Vater closet, private.....................
!'.iscellaneous: ..........
2
1
2
3
6
2
6
6
1
3
2
1
2
3
2
1
6'
4
..........
..........
Total Units:
Total fixture units
4 ~13.25 each = Total Charge: $
Credit Calculation Table: 3ased ~n total value of property at time of permit
application.
Year ';..:"lZie.:.:sd
to t~e Citv
Credit per $1,000
2.ssessed va1ue
\9/:>4-
1979
1980
1981
1982
1983
In~
1985
1986
1987
1988
1989
1990
$2.66
$2.64'
$2.53
$2.41
$2.19
$2.04
$1.69
$1. 35
$1.15
$0.92
$0.59
$0.23
Rate
.. S 10) '3tc...o
r.ssessed Val-.;e
= $
Credit
Total Credit
Metropolitan
Wastewater .
Managernent
Commission
.
(.:.'.'",' :. ~ .: '. ',': .':.:. ~ ~
C.: ~. ~~'.'! ::_ f~'~: ',! C:'.: ::: ;'!: .
~.:r.i L'~:'~'-~L;t:,t :~~ =.,::ntOT",t
~:~:::: ;!:': ":,,,-~:' '.;',t-: ~t. :r:':::"Z'.~
C','I: ~.'~:..-~;':~;'it,: .~:~.: :("::.,
(~.'.~ ':~~:;~.~;:~~~~ ~ :;,.~.a,~:.;~Jl. ~~:: !~.~ .~. ~~ ~ ~
r.~c;:., \','U::::-';-:~;r..t l;, :.~: 't~i ~.:::.f;
r=lr-iH ;';";0 A 51P.EEi'S - S;:r.;>~GF::.LD CiTY ~;':.LL - ~~~;::\Gr:ELD. Cr=.EGC!J ;7:.77 TELEr':-:G:\~ [:C::) 7:.j.':::i
!1','KC C(I!'liECTION CHARGE
Building Address:
III 3'1
Me llUcl'ISk (lJ)Uff"t
Refere8umber: 1'10 3 2.. ~ , :3. . Tax Lot Number: 6 f" & 00
Ovner: D0J]CU) r f\. i_ /~()AJ~~1Lf.-S .
Address: \\C\C\ .\\ '\~~_)0[\ \: ' Phone Number: lo<?<6-Q\23
City: fA.J(l60JLL State: (\)jW.D~BY\ZiP: Qf\4()'L-
~ Residential Fee ($222.00)
$r0Q~ ~
Commercial Fee (new non-residential development/
remodel)
Total fixture unit charge (see reverse of this form)
$
SUBTOTAL
$
<$ d '7.45 >
Credit Due (see reverse of this form)
TOTAL KVr.C CHARGE
$ \C\L\ .~~
Date Received: 1'7 d) q (
Receipt Number: .m~.~
Received By: A
Building Job Number: --9J 0 '7 I CJ
-c, ,_ ..
.
SPRIFIELD
DEVELOPMENT SERVICES
PUBUC WORKS
METROPOUTAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that with the approval of the attached
manufactured homes viII be placed at
Springfield, Oregon, City Job Number
Development Code, I understand and agree
Pf~i,t;;, one~"tQ"e J.gJ.lowing "L ')
\ uf} \\ \~ \~ Q1\ J... "''- .'
C,;\ IT1 \,-\ '. ~
o
Class A Manufactured Home. A manufactured home of not less than 24
feet in width and 16% (not less than 2:12) roof pitch, with exterior
dimensions enclosing a space of at least 960 square feet, with roofing
and siding materials that are commonly used or compatible with site
built homes.
o
Class B Manufactured Home. A manufactured home of not less than 12
feet in vidth and 16% roof pitch, vith exterior dimensions enclosing a
space of not less than 500 square feet, with roofing and siding
materials that are commonly used or compatible with site built homes.
I further state, by my signature below, that I have been provided with the
folloving information:
- Mobile home blocking
- Sanitary sever connection
Vater line connection
- Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
,(\ >>~~;,~
\~naiure
. --"'-----"
7/30h/
Date
Lot fa~es ..
Lot Type .
,
'Lot sq, fig. .
Interior
Lot coverage
Corne r
Topography
Panhandle
Tolal height
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT.
Setbacks
HSE GAR Accl
I
--1
I. -.
I
I P.L.
IN
5
,W
IE
Main
x S/SO. FT. = JRfRS
Garage
Carport
. .,
., THE PROPOSED WORK IN THE
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
, APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permllls granted 'on the express condition that the said
construction shall,ln all respects, conform to the Ordinance
adopted by the Clly of Springfield. Including Ihe
Development Code, regulallng the construction and usa of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordlnnnccs.
~ Plan Check Fee'
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
(~~.~1 Received By:
State Surcharge
Total Fee (A) Plans Reviewed By Dale
SYSTEMS DEVELOPMENT CHARGE ~DC)
(B) ,"=Y'>f1.03
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Perm II
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaur,t Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryor Vent
"..1echanlcal Per:nlt
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home ,
State Issuance
State Surchawe
Sldewal , ,+S' It
Curbcut
It
Demolition
State Surch2rge
Total Mlscel,anews Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D. a~d E Combined)
FEE
,!J.")
6)6
~
0f),W
1'1.05
IJ f<,. rJ. 5
..,..
(/)
Pfl/i'=)
j 0 /L!5
....J:) .(0
\I () . iLs
~~ \!llt:
Systems Development Charge 1.5 due on all undeveloped
properties wllhln the Clly limits which are, being Improved.
. ADDITIONAL COMMENTS
By slgnature,l stat~ and agree, that I have carefully examined
the completed application and do hereby certlly that a"
Information hereon Is true and correct, and I further certify
Ihat any and all work performed shall be done In accordance
wllh the Ordinances of the Clly of Springfield, and the Laws
of the State of Oregon perlalnlng 10 the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certlly that only contractors and employees who
are In compliance wllh ORS 701,055 will be used en this
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the sireet, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the lie at all times during coo..structlon.
)~.~If< ~
7/.30/;/
"
,.
VALIDATION: I'" ~ ~
RECEIPT NUMBER '0[') ~=--,
DATE PAID'l <:2{....r -1 I_
AMOUNT RECEIVED ~f:I( ) ,:\ )
RECEIVED BY (CJ) V~
~ti;l
LOCATION OF PROPOSED WORK, 15..7;.1 /Yl.!::..T/J///C:; h
N/A \ I(X-.5~'ll.~' .
. ~O BLOCK: ...5
" '.lI. ',l'
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT'
OWNER'
Lochaven Partners
ADDRF<::<::'
1199 N. Terry St.
CITY'
Eugene
DESCRIBE WORK: Mobile Home set UP
NEW X REMODEL ADDITION
SPRINGFIELD
STAT'"
OR
JOB NUMBER Li \tJl \q
225 Fifth Street
Springfield, Oregon 97477
r 1Jq,r? T
N/A
01.0 {OrfJ
, TAX LOT:
SUBDIVtSION'
Lochaven.
688-9123 -~
~,
PHON'"
...
ZIP'
97402
.- Concrete strino.ers - Accessorv Value st1'lfD
DEMOLISH OTHER M. H. Value S I 'i(j ~S;-
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAl' Ernie & Son's 87922 LaPorte Dr.. EUl!. 41497
PLUMBING' Harrison Construction 1441 N. Hwv. 99 20-236PB
MECHANICAl' Ernie & Son I s 87922 LaPorte Dr.. Euo.. 41/.97
ELECTRICAl' Herita2e Electric 855 \~. 24th 20-280C/63137
EXPIRES PHONE
2/2/92 484-6505
689-7762
2/2/92 484-6505
344-\500
\(<,\\\0 - OFFICE USE -
QUAD AREA: LAND USE: ,\ \ ~() FLOOD PLAIN'
. OF BLDGS' \ . OF UNITS' \ ZONING CODE: -UJ (c.-
R~ . OF BDRMS' ':2--,.
OCCY GROUP' CONSTR. TYP'"
\ ~'G --
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: _'1' ) RANGE: V SQUARE FOOTAGE:
'"
To request an Inspection, you must call 726.3769. This Is a 24 hour recording, All Inspections requesled 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
o Temporary Electric
o Rough Mechanlcat - Prior to
cover. .
D Site Inspection - To be made D Rough Electrical - Prior to
after excavatlon. but prior to cover.
setting forms. ~)
J7'1/underslab Plu g/Eleclrl~ 10 Electrical Service - Must be
~.Mechanfcal - Prlo ..... OJ""HU. approved to obtain permanent
. electrical power. .
il7Jl Footing - After trenches are
~ excavated. 0 Fireplace - Prior to' facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
ri1I Sanitary Sewer - Prior to filling
~ trench,
, r.f:;)slorm Sewer - Prl.or to filling
L.:f=" trench. ..
-rfl Water Line '- Prlo; to fI,llIng
~ trench. .
o Rough Plumb,Ing - Prior to
. cover, .
~., . \ ",
o Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to'
cover,
D Orywall - Prior to ta~lng.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcu\ & Approach - Aller
forms are erected but prior to
placement of concrete.
~'dewalk &.Orlveway - After
xcavatlon Is complete, forms
.and sub-base material In place.
o Fence - When completed.
o Street 1r~es ....: When all required.
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete..
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
~IOCklng and .set.Up - When all
T ~IOCklng Is complete.
~I umblng Connections - When
home has been connected to
water and sewer. .
, '
, ~'ectrlc81 Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
~nal - Aller all required
, spectlons are approved and .
porches, aklrtlng, decks: and
venting have been Installed.