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Home My WebLink AboutPermit Building 1995-4-24 RESIDENTIAL PERMIT APPLICATION ,Inspections: 726.3769 Office: 726.3759 . SPRINGFIELD ><'ASSESSORS MAP: , (LOT- /0/' LOCATION OF PROPOSED WORK:~) ~DL~ I.. O? ~?- ,~ t--- . JOB NUMBER 9:'5""'o~B 225 Fifth Street Springfield, Oregon 97477 (VrdAhz{lI1l1A-?j addNf/#~) , TAX LOT: I~ l?vie. SUBDIVISION~~ o' BLOCK' ~ ~#/!,A'~r-~r? _~~~~""':-:'.:14~PHONE: ~~~"'~:9 ADDRESS: ~"3~'3 ~YW"".oV "'57 '9'>/-/5"".),.0 ~/r;:: Eh-"'E - STALE: _~".?:? _ ~ 97%:>/ -,r (')\1 m n Ir "^ ,'.I $f '" V\ K 1'/"'\. 'l' - DESCRIBE WOR!" 0 P t..11liA 0 {'\Q.Q.. _ ( NEW ...--- REMODEL CITY' ADDITION DEMOLISH OTHER CONST, CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE ./ LL.-.A.-.JCl> # ""'~~-",.!-,:.:.t' e; GENERAL~-""~'ffi,""_,?~2::::.".?-.-q.~{- ?~( ~-~ ~"97~ PLUMBING~/:i-,~ <p~..r 101 Lo2.4- B. \S.qC; ~~.rnlS MECHANICAL:.{~.n~ ~2rA7' ffilo~~, rOrilo ,(1(0 l4}.n =J lnl'] ELECTRICAL' P-?~-;>'~ - A=f1~ -3. \1-l.\\(J ~om' 6011) ? t QUAD AREA: ~J 1 OCCY GROUP: ~~-H'Y1 I f . OF BLDGS: _ . OF STORIES' WATER HEATER: - OFFICE USE - III J I CO NSTR, TYPE: VI$ HEAT SOURCE: t9'A-:::r-/?~... C LAND USE: . OF UNITS' RANGE: _ FLOOD PLAIN: ZONING CODE: VOl!- . OF BDRMS: --$ SECONDARY HEAT: SQUARE FOOTAGE: J.g.iP?J.~ To request an Inspection. you must call 726.3769, This Is a 24 hour recording, All Inspections requested before 7:00 a,m, will be made the same working day. Inspections requested after 7:00 a.m. will be made tho following work day. CJZf Temporary Eloctrlc D Site Inspection - To be made after excavation, but prior to seltlng forms. D Underslab Plumbing I ElectrlcalJ Mechanical - PrIor to cover. I\Zl Footing - After trenches are 7 excavated. rnl Masonry - Steel location. bond I:)!J beams, grouting. rm Foundation - After forms are L.N erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench, rY1 Underlleor Plumbing/Mechanical { - Prior to Insulation or decking. r\7h Post and Boam - Prior to floor ~ Insulation or decking. r\7l Floor Insulation - Prior to ~ decking. CYl Sanitary Sewer - Prior to filling (..... trench. r\T1 Storm Sewer - Prior to tilling ~ trench. IYJ Water Line - Prior to filling T trench. rYl Rough Plumbing - Prior to ~ cover. REQUIRED INSPECTIONS m Rough Mochanlcal - Prior to r cover. rYl Rough Electrical - PrIor to '--('d cover. f\1i Electrical Service - Must be ~ approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. Ofl' Framing - Prior to cover, CYI Wall/C'elllng Insulation - Prior to I cover. ~ Drywall - Prior to taping, D Wood Stovo - After Installallon. D Insert - After fireplace approv." and Installation of unit. ~ Curbcut & Approach - After forms are erected but prIor to placemont of concrete. rX1 Sidewalk & Driveway - After ( excavation Is compietc, forms and sub-base material In place. D Fence - When completed. ~ Street Troes - When all required ~ trees Bre planted. I'll Final Plumbing - When nlt ~ plumbing work Is complete. rd1 Final Electrical - When all ~ electrical work Is complete. rq] Final Mechnnlcal - When all ~ mechanical work Is complete. rvr Final Building - When all l.....f"L required Inspections have been approved and building is compleled. D Othor ""1 {~'5 i~~ ,rl---urp "".... p".!.,,\~ " cc.rq/M MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, and plumbing Inspections have been approved and tt:le home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skIrting, decks, and venting have been Installed. rNtclf A~ /\1 (A) 44\ .l~ SYSTEMS DEVELOPMENT CHARGE (SDI~).w1 (B) '/1;2.2-24 _ If" Lot faces .w.... ..~ Lot sq, ltg, Lot coverage ~?.. Topography L,2. ~~ Total height 11. <'1') BUILDING PERMIT ITEM SO, FT, MaIn I~~ ~~J Garage Carport Tolal Value Building Permit Fee State Surcharge -\- ~/O Total Fee Lot TYP. V Interior Corner Panhandle Cul.de.sac X $/SO. FT, _ PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' A SanJlary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Piumblng Permit Slale Surcharge 4-~ Tolal Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/inserl/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge +~ Total Permtl (D) MISCELLANEOUS PERMITS Mobtle Home State Issuance State Surchar~e ^ Sidewalk ~LV (I Curbcut .....q) fl Demolition State Surcharge Setbacks I PL, I HSE GAR I ACC i IN 1/7 /71 I ~II wl~ lLJiLLL_ BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT VALUE sy~<.- "~.~~> FEE .LU')pJ / td) .(1) ~A ,00 J1~~ ~~ w .W J!5 '1.,.00 \C1. ::D If) ,as I. Sf) ~/.O~ ~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding eleclrICal)rl4()S.~ (A, B, C, D, and" E' Combined) " ~.~." . /~ .;~. 'IS THE PROPOSED WORK IN THE. ....HiSTORiCAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Hlstorlcai Coordinator prior to permit Issuance, APPROVED: _ This permit is gran led on Ihe express condition Ihallhe said construction shall, in all respects, conform 10 Ihe Ordinance adopled by the City ,of Springfield, Including the Development Code, regulating the construction and use of butldlngs, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee:::?iG5":.sS- Date Paid: ~.::::;?r3~ Recelpl Number' /h.??L) ~\er By: ~~ PI~~ Reviewed By L.t/~1S D~le Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved, ADDITIONAL COMMENTS ~<'-:~0->::> ~/'-:> -At:[ : '* tJliIJ () . b'D IBh'Maft ) " AJJj.J{;x : 'I , Qc{0 ~~idJ h/(ul)JtWl- , ~~ ~ -d.::" ~__r /( , :~/~~1~., __ ,_ "_: 'J ;~~;/JltJ;;n~ v:~~;;:'~1 IS~~;$~~.~(. By slgnalure. I stale and agree, that I have carefully examined the compleled application and do hereby certify 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 Stato of Oregon pertaining to the work described herein, and thai NO OCCUPANCY will be made of any struclure without permission of Ihe Building Safely Division, I further certify that only contractors and employees who are In compliance wllh ORS 701,055 will be used on this project. I further agree to ensure that all requIred Inspections are requested at the proper time, that each address Is readable from the street, that the permll card Is located at the front of the property, and Ihe approved set of plans will remain on the site at all times ~urln onstructlon. gnatur:~.n--_lf , ] Date Zj -,), '/ - &75 VALiDATION: I Vl fl c:. RECEIPT NUMBER _ . J ~~ DATE PAiD q.~6IA- ' ..~ AMOUNT REC~ -J .3t~, 75' RECEIVED BY\. .7) U ~\ ,~ . SPRlaELD The loilowlng project a. submitted has the loll 225 PIFTH STREET ~~~ir~~a~nd doe. not require spacmc laUrnICAL PERMIT APPLICATION SPRINGPIELD, OREGON 97477 L. ()/7 qc:!.lVIT"'O-- INSPECTION REQUEST: 726-3769 Zonlna 0'" 1"-- Ci ty Job Number <...XJi 1)( J OPPICE: 726-3759 Dot,,!~kLt.\ -'i '"'> J~_~OHPLETE PEE SCHEDULE BELOV 1.\ L0!f.\110,",OP ,Iti,~ST~IQ!trthOrl%ed Signature N TV\ _\O~( ) \ H('nrl,j,I--L"} A. New Residential-Single or Multi-Family per dwelling unit. Service Included: LEGAL.J1~CAUPJ+ON . llf'l:""6IH. I'n-.. (")I?{)Ln ~~~I".\~N\D \glo3.ccP Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY "- 'Electrical Contractor ','J Pn.v','~ f. \e.tp.~c.. Address ILltlo C.,...~ieL~k\ b~ 4\-11\ ./ . e . City LlA.ltrw~, Phone l;9'S'3()10 Supervisor Licen.se Number ~o;;> 1'1 5 Expiration Date 10' I - 'IS ".- Constr Contr. Number X ''1'1 ~r(' Expira tion Da te ~ - 11 . "I "\ ., Signature of Supervising Electrician \J- ~ ~Wr~Kfi\() i\C\ ttO.v0~O.cr Address <~~~ ~ c\-\mO~Ll~ Ci ty ~ X'.y Phone (J1 'tJ .1..3..l.b1 ~~ ~TAL~ION The installation is beirig made on property I own which is not intended for sale, lease or rent. Owners Signature: ---------------~-Jt-~l .. -------- DATE: . "T'bH'~ RECEIFT I: \ 4.., . IIrTI~ RECEIVED BY: (_')\.1 Y'x _.,' , - Items Cost Sum 1000 sq.ft. or less \ $ 85.00 P>~ Each additional 500 sq. ft or portion .9- !!:f) thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 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 118" 40 above Branch Circui ts New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.0Q $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 $ 40.00 $ 20.00 $ 36.00 l\~~ ~~ \~~~ its SUBTOTAL OP ABOVE 5% State Surcharge -wrp. ?!=Pu . .B NO. qSo'k; c?,. CITY OF SPRINGFIELD, SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR' COMPANY: CI+M2.ItC. -r13:.1Z I-Ia M e:s LOCATION: fL>6o A.heJ-loLA-":> /7 "~'2-7-f2- - IJ /,,;?ofL> DEVELOPMENT TYPE: LDR - .<y~~ BUILDING SIZE: LOT SIZE SQ. Ft. I. STORM DRAINAGE IMPERVIOUS SQ. FT. 7:7 -(? X $0.209 PER SQ. FT. ~51<f5~ 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) /'6 X $43.26 PER PFU 07~~0 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x X X $436. 19 X $436.19 G 44-<J si) ---- --- $ ! X I .01 X $436.19 $ 4. SANITARY SEWER-MWMC NO. OF PFU'S 1'6 x $17 .19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~/CJ ..p. TOTAL-MWMC SDC $ N.A. ~ ..... --- $ '2-lIi 2-1 SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 kd:.n ~cL~ Date: "3;:>/-;, /qr; U Ki P Burdick ' I TOTAL SDC SDC Coordinator GJOSq!:) ----- ./ $ 'Z 224 '!:.. . 1':"_. ...... '". .' ..... FIXTURE UNIT, C~LCULA T~ TABLE: Number of New Rxture.nit Equiv~lent = Rxt~~e Units (NOTE: For remodels, calc\ilate only th~ additional fixturesl . NUMBER OF UNIT FIXTURE " FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. Bathtub..................................................................... . Drinking Fountain.........._... n.................... ..... ............ Floor Drain........................ .................................... .... Interceptors For Grease/Oil/Solids/Etc................. Interceptors'For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher.............. ............ ......... Clothes washer - 3 Or More..................................... Mobife Home Park Trap (1 Per Tr~iler(..;.:........:.:.:. Receptor ForRefrigerator/Water StationfEtc........ Receptor For Commercial Sink/DishwasherfEtc.. Shower, Single Stall................................................. Shower, Gang...................................................;....... Sink: Bar, Commercial, Residential Kitchen......................... Urinal, StalUW all................................................ .:..... Wash BasinfLavata'Y, Single.....'............................. Toilet; Public Installation...................................._.. Toilet, Private..................................................:.... Miscellaneous: Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 19.83 1984 . 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 - I '2- . ,\ 2 1 2 3 6 2 6 '.:.:. ".'6\ ':' 10 1 3 2 lIHead 2 2 1 6 4 <;[ ,", 1- ( '2.. I '2. z '2. z. TOTAL FIXTURE UNITS /'iI = 'I I Year Annexed Rate per $1,000 Assessed Value 1985 1986 1987 1988 1989 1990 1991 1993 $ 2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 Credit for Parcel or Land Only If Applicable -6- Improvement (if .after annexation datel , X $ (Rate X Assessed Valuel X $ (Rate X Assessed Value I = CREDIT TOTAL = $ N. A . . , ~,... Willamalane '-tg' Park & Recreatio~ District lob No. q~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAM~ ~t\t1Q.l\9\b\'ro^ ADDRBS:~~~ ~O Lq<:ATION OF PROPOSED ~UI':!?,I'iQ.. SITE:J\ . fr\ ,.-.J . ~ 1'\ . _ ' Street Address if Known: l O~ ) '- ~ (\ ~ \\. l\ () ~ J\. A..1r . PlattNa~l~t<\~d()Wr~TaxLotNUmber. \\.~~~ %t PHONE: ~S'l3l61 STATE: ~ ,ZIP Ql4()( , '. - ' 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back.) , A. Sinl!le Family - Detached \ Single Family home NO OF UNITS l Manufactured home not in a park , $'4f(Lffi. X $400 PER UNIT .F.. '. B. Sinl!le Family - Attached . NO OF UNITS X $370 PER UNIT = '$ C. Multi-Family Aoartment ' NO OF UNITS X $~77 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SOC , $4W,C1J fJ $ uJ $4(1) 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. . 3. TOTAL WPRD NET SOC ASSBSED (If SDC reduced for Credit> ~)\_. r.........~........:h.<:"'....:.-..... n. ,;,. ... 4 (~ I~' n;lt~