HomeMy WebLinkAboutPermit Miscellaneous 1994-11-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORI<'
.
SPRINGFIELD
"?o-?-? 47/l'h'/ ~"
/ 7-CJZ -,5':;>-3,';;'
BLOCK:
ASSESSORS MAP'
LOT:
OWNER. //7t?C/e->?- 6'A-Z--~
ADDRESS: /22h/Z.' ~NZ;'R..J ~,i2.
CITY' ;S;tCI~~rY-=.J~ STATF'
/7,;[?
PESCRIBE WORK.
NEW ----- REMODEL
,/J;A..t//}~A /'?__'r"'.7?~
,~Lh""
?/ ~/7?6?..u2-V--
ADDITION
CONTRACTOR'S NAME
GENERAI'&;:"-''''::;-- tfb7=P~
I(
PLUMBING:
I(
MECHANICAL: _
r .J
ELECTRICAl' ~ ~A '"ZPn-..d.Ut'.
DEMOLISH
OTHER
.OB NUMBER ct4l4fSL
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
..5:..,,--.,<J(')
PHONE:
7.yg.
ZIP:
4? :?<7'??
ADDRESS
.,::;'0,2/ /J;A-h</
CON ST.
CONTRACTOR'
yZc/? z-
PHONE
72? -.2/ //
/('
/1
EXPIRES
//4/
'/
Q'
4~~ - OFFICE USE -
OUAD AREA: LAND USE: \\SCl FLOOD PLAIN:
. OF BLDGS: \ . OF UNITS: ZONING CODE: lJ)R....
OCCY GROUP: p,;-:>, CONSTR. TYPE: viJ . OF BDRMS: ~
\~ HEAT SOURCE: ~[) -
. OF STORIES: SECONDARY HEAT:
WATER HEATER: V/ RANGE: ~.J SQUARE FOOTAG E: :f} ~ ( L
To request an inspection, you must call 726-3769. This Is a 24 hour recording. AI/InspectIons requested 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but pri to
setti n rrn
~Unders m I Electrlcall
~_ Mechanical - Prj to cove
Wooting - After trenches are
(' excavated.
D Masonry - Steel locatIon, bond
beams, grou.ting.
~FOUndatlOn - Atter forms are
erected but prior 10 concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D
Underlloor PlumbingJ Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
[2PSanitary Sewer - Prior to (1lIlng
l/"ltrench.
~Storm Sewer - Prior to filling
'P trench.
~Water Line - Prior to filling
~ trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to facing
materIals and framing Insp.
D
Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - After installation.
D Insert - After fireplace approval
and Installation of unIt.
D
Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
D
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
D Fence - When completed.
D
Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work is complete.
D
Final Mechanical - When all
mechanical work Is complete.
D
Final Building - When all
required inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
Ii9BloCking and Set.Up - When all
~ blockIng Is complete.
~ Plumbing Connections - When
~ home has been connected to
water and sewer.
~ Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
~Final - Atter all required
'P Inspections are approved and
porches, skIrting, decks, and
ventlng have been installed.
Lot Type ,. 'IS THE PROPOSED WORK IN THE
Lot faces Setbccks
Lot sq. fig. Inlerior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is and approved by the Historical
Topography Panhandle Iw Coordinator prior to permit Issuance.
Total height Cui-dc-sac IE
APPROVED'
BUILDING PERMIT
ITEM SO. FT.
x $/SO. FT.
=~
,., (Y)
Main
Garage~ 4-~O
\ \1\~
4f1CO
4'n,?ID
(o2COJ ~o,so
&<63-1'\.10 <:\. ~
101.03
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
1.2 fJ:J3'. 9()
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldenllal Bath(s)
N'
Sanitary Sewer
FT
~~
4.CL
L\(j
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Jtb~
5,25 +3.6 P>~O
\ \3."\0
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
d
Total Permit
(D)
MISCELLANEOUS PERMITS
\~~
dj D.OO
'-C),~S
Mobile Home
Stale Issuance
State Surch~
Sidewalk ~ fI
Curbcut ~, It
Demolition
State Surcharge
Total Miscellaneous Permfls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
B-~~.S&
I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on tile express condition that the said
construction shall, in all respects, conform to the Ordinance
adopled by the City 01 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.
,","y/
Receipt Number' C""- '\\.>"
7'
Plan Check Fee:
Date Paid:
Received By:
,
Plans Reviewed By
Dale
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
\ 9\+ i~CLt~'w
~\\N. '. \ L\ \ en
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby cerllfy 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 Ordlnanc~s of the City of Springfield, and the Laws
of the Slale of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building ~afety Division,
I further certify that only contractors and Jmployees who
are In compliance with ORS 701.055 will be used on this
prolec\.
I further agreo to ensure that all r~qulred Inspections are
requested at the proper time, that each address Is readable
from the street, thai the permit card Is located at the front
of the property, and the approved set of plans will remain
on the sile at all times. du.::,ng./rn.
s,gnatud- ('-8- (
Dato d-~.-P7
VALIDATION: . I
RECEIPT NUMBER I c;,';)/ Y
DATE PAID II -/ =-q 4 - rJ
AMOUNT RECEIVED (; / ~'L Y G\ ~
RECEIVED BY ~
.
SpnINGFI~,.~'
Thelollowlng proj...'t as oubmlltod has the lollo'N1n
zoning, and doe. not roquira opeclllc land UIlO
225 FIm STREET apprO'la\. . (2; ELECTRICAL PERMIT APPUCATION
SPRINGP'IELD, OREGON 97477 .. Zon!n!, L...P /LA \A~1
INSPECTION REQUEST: 726c~.,~6_~.. I ~ '-!-. Ci ty Job Number '-f"t r-t.... ')
OFFICE: 726-3759 ,
;' . Authorized Slgnotur.L~ C/'lJilLl'T" "'!E SCDEDULE BELOV
I: LOf1~~~~$_)
LEGAL DE~I.2."-:-1 '
\\ (}'L ~ .~O~S[Y)
~~~~]J'\L
Permits are non~ransferable and eKpire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
'2." CONTRACTOR INSTALLATION ONLY
. .
Electrical Contractor I-tF-RrrAGF-_tl..tC/.
lOX? J:Jn-... r;, .- . -
Address "".--;."'; 'n0r-~ ,,'lr;\ AJF~
Ci ty_l=,Il. h\r.-AI F_ Phone 72.-<1 -l'5DO
(]'-\-,l.C' {,';;_/(,oo
Supervisor License Number -,~.)
Expiration Date
\.0 --I -q<=')
Constr Contr. Number (O3\?l1
Expl'ration Date
I 2. -7... -<13
'i!
The installation is behig made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
.'
DATE: ----;- 'J I -- J -1';:j~--------------~
RECEIPT, ,: . " ~-?1 y
RECEIVED BY: /~
A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd 1I0me or
Modular Dvelling I)
Service or Feeder ~
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
unit.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
~O
$ 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
D.' Branch Circuits
$ 40.00
$ 55.00
S 80.00
see flDtI
above
Ne~. Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ~ith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE Pf) ~
5% State S~arge "\ .(JCj
- ,;:;)70 ' r{l.~n
S(O~
.
.
o Y.'!i!IJ!!,!!~!~.!!~
Job No. CJ414~1
SYSTEMS DEVELOPMENT CHARGE
WORKSHEff
NAMe ~l\lUt
ADDRESS: VL ru: 0 \ 17 -
PHONE: f)\\,.q~
. ~~\Jc STATE:~IP q1t17
Platt Name:
\\r\....
¬
Tax Lot Number. \ ~OL ~~ 33 oSSCXJ
LOCATION OF ~ROPOSED BUILDING SITE: \N'"\f\';. ~
Street Address if Known: ,\l).~~~ \
1. DEVElOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back'>
A. Sim!le Familv - Detached
NO OF UNITS
1 Manufactured home not in a park
$1f;DpD
Single Family home
{
X $400 PER UNIT _=
.
B. Sim.le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
, $
C. Multi-Familv Aoartment
,NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$~()~
$ff
$4()D~
2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD Nff SDC ASSESSED (If SDC reduced for Credit)
~ci\,
Commu-nity Servic
r:.... .....(C"......:.........+:......I...f
I
I
Date
'""vu "v. I / I 1---'
C. OF SPRINGFIELD SYSTEMS _LOPMENT CHARGE
WORKSHEET-'
(COMMERCIAL & RESIDENTIAL)
N.AJo1E OR COMPANY: 0.u.:- JJI..IAfA
LOCATION: 1" 3 3JJ1~ ,/. I
DEVELOPMENT TYPE:./k ___, .,~;~ L-.., j, ~~1 jk/ ~~
BUILDING SIZE: (4?.<.17-)/zo;<M)I.!OX20) tOT SIZt' SQ. Ft.
1. STORM DRAINAGF
IMPERVIOUS SQ. FT: }./ t- (,
2. SANTTARY SFWFR-rTTY
NO. OF PFU'S . /"(
(See Reverse)
3. TRANSPORT A TT ON
X $0.209 PER SQ, FT.
~
~
X $43.26 PER PFU
. $(i-;r~)
NO OF UNITS X TRIP RATE X COST PER TRIP
I X /,()/ X $436.19
X
X
X $436.19
X $436,19
~
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $ Ie. 'f.<t.OI
4. 56NlIARY SFWFR-MWMr.
NO. OF PFU'S /'i x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ ?',,;~2
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~/.~2
. , IQIAI -MWMr snc s.:-z" '" . ~
SUBTOTAL (ADD ITEMS 1.2,3 & 4)$ /94/.lf/
5. ~nMTNTsTATTVF FFFS
BASy-cHARGE (SUBTOTAL ABOVE) X .05
d /iL Date:
~ MaryJHornig. ~
SDUoordinator
c(r;t'.o~
7- 30 -7'-72
TOTAl SDC
$..(038.'/0
B2. SDC .
. .". _.-- ---.. _. ~.....___..-... .-.- .. .---. ......'.............. ....... .........,...-.. -.... -..,....._._..~ ~ ............... .......l~
(NOTE: For remodels, calculate only the tiEr additional fixtures), I
. NUMBER
FIXTURE TYPE NEW FIXT ES
Bathtub....,................,.......,......."......,.,....,......,..,...,.. .
Drinking Fountain..............,.,........"...,.............,..,.....
Floor Drain................,.............,..,.,...........,............,...
Interceptors For Grease/Oil/Solids/Etc....,............
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher..,.,......,.,...,.......,..,......
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorlWater Station/Etc.......,
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.,.......................,.,.....................
Shower, Gang....,...........,......,.,.:..............................
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, StaIlIWall..:........,.....,.,.....,........,..............,....,.'
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation........,...............................
Toilet, Private,.......,...........,....,........,........,...........
Miscellaneous: ,TANI TCP'.$ $,fNr
2
I
I
'2
7
TOTAL FIXTURE UNITS
UNIT
EOUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
.2.
=
FIXTURE
UNITS
4'-
z
z.
2..
~
/?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
L
1979 or before
1980
1981
1982
1983
1984
1985
1985
1986
1987
1988
1989
1990
, 1991
1993
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Credit for Parcel or Land Only If Applicable
3/1(; X $ /1, '120
fRate X Assessed Value)
X $
(Rate X Assessed Value)
Improvement (if after annexation date)
=
=
Rate per $1,000
Assessed Value
$2,46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
.5'/,(;, 2
-------
CREDIT TOTAL = $ S /, C, 2.