HomeMy WebLinkAboutPermit Building 1992-6-4
RESIDENTIAL
PERMIT AF'PLlCATION
Inspi;,:tion';: ,''lG.37G'J
Of/It I.:: 7:?n<ii:'~)
ASSI:.ssorl~'; i:1AP; __
LOT: _ __
y{\\C.,"VtcL. "'S."~i\-'"
OWNER: _,. __ _ ._,_ . ----
ADDRESS, 9D /]Q~-r-' oR. ~.obl:.
CITY __~.r~~~_ .___
DESCRIBE WORK: _ _flOO\"Il'" ~
NEW
REMODEL _ _ ADDITION
CONrRACH!I'S NAME
,~.
GENERAl.:
PLU/v1HIN(.:
~E~IIANI(~;/d . --~ r /--
[:.lI:.CrRIC,d ,-'if ---.
OLJM1MIIA
,c9ffiW_ _
J
,\{3
-\.
" OF DLDC::-'
OCCY Cine lUI-.
" OF SlOrur:,'
WAlEn HEAI!.n: _ _
.
SPRIN,.FIELD
I
NUMBER _1..2-D7_C!3
Avt.
BLOCK: ___
(jow,""s
AU't.
STATE:~ ~1rl,,",
~ \"~.<. ~ ~O~ "'"
x... DEMOLISH OTHER
JOB
::?2~; rlflll DIII:..I
Spdllgllcl<.J, OltJotln 97'1/"1
TAX LOT -6-W-9:z.- 2---
SUBDIVISION:
PHONE: 7,;;JIa-JfcO \ j;W\ (s;~fr~ ~c
z,P:37'f77
ADDRIo:,;S
CON ST.
CONTRACTOR'
I"I'IONI:
- OFFICE USE -
LAND USE, Jj' I
. OF UNITS - j tV
CONSTR. TYI'I,: _\.1_
HEAT SOURCE:_
flANGE: ___
EXPIRES
FLOOD ,PLAIN:, ;--f"\ I? - )
ZONING CODE:_~
"OF DORMS: _._
SECONDARY HEAT: _,. __ \
SOUARE FOOTAGE: ,. ..3~
To req~JCSI an in!:>pcction, yOll IIlLl~t call '126-3769. This Is a 24 hOllr recording. All Inspections requested before 7:00 ~l.In. will he
rnaclc !tIC :.,11110 wOII.;iIlO (lay. in:;pcctions n~QlIestecl after 7:00 a.m. will be made the following work di'lY.
[]
Tempol :Iry Electdc:
CI
Site In~.pectioll - To be made
allel .~.:!:avalion. /lut priOI to
$cltill~J lonns.
[]
Undt}I~I;lb PIUlnllillg/Electlical1
Mechallical - Plior to covel.
K7f FOOlill~1 - A(\cl trenches arc
~ exc:lv:l[..cl.
CI Mil501l11 - ~101:1 location, boml
I)CClI11:J ljIOullll{l.
rv1 FoulI{l:llion - Aflur (OrlllS are
~ crccH.:o Uut pllOr 10 concretc
plac.:llll.nl.
o Undclf/lOund Phllubing - Prior
to Ijtllll~J trenctl.
"r'V1 Undt}lllt,~ILJl1lluPfl/Me(;hanicnl
P - Prien 10 insurcllion 01' dcckintj.
KAPosI nlld BCZIIll - Prior to floor
~insulalfun or (lccldng.
r\:./f Floor 11I,~allntion -- Prior to
~ dccl<.in~1
o
SanilillY Sewer - Prior to filling
Irendl.
Cl
Stalin Sewer - Prior to lilling
lIcndl
LI
W<.tlt:1 l. illc - PIIIH 10 lilllllU
Ilun,;tl
~ROllUh
~Ct)\IC'I.
PlulllbinU - Plio, to
REQUIRED INSPECTIONS
Iv( Rough Mechanicnl - Prior'to
)L--""cover.
)'7'f Rough Electrical - Prior to'
~cover.
D
Electrical Service - Must be
approved to oblain permanent
electrical power.
D Fireplace - Prior to facing
materials and frallllng Insp.
~Fr'lming - Plior to cover.
t\J(Wall/Ceilino Insulation -
~ cover. . ....
Prior to
~ Drywall - Prior to taping.
o Wood Stove - After Installation.
[J
Insert - After fireplace approval
and instalJalion of unit.
o
Curbcut & Appl'Onch - After
lorms ale (~n~clcd but prior to
placement of concrete.
[J
Sidewalk & Driveway - After
excavation is complete. (orms
and sub-t';lse lllaterlal in place.
1.=1 FCllce - \Nllcll t:ompldt~d.
I~ Street Trees - When all required
---' trees are planted. .
~ Final Plumbing - Wlllm all
J6lplulllbing wad, Is co"'ph~le.
15<1' Finnl Electric.11 - Wlll)1l all
~ ....lectrical wo,,( is COlllptde.
~ Finnl Mechanical - WIl.m all
~lIlcclwnical work is cOlllplelC.
'JV1' Final Buildin{) - Wilen all
~reqllired inspectlon:. 1J:IV'~ bl~l:ll
approved and buildino i:~
completed.
DOthcr
MOBILE HOME INSPECTIONS
D
Blocking Dnd Set.Up - WI'Jt:n <.ill
blocking is complete.
o
Plumbing ConnCcliolls - When
Ilomc has been conn,~cl(:d 10
water and sewer.
o
Eleclrical Connectioll - Wlll:ll
blocking, sot-up, ami ptlllllbill~1
inspections have been apPIIWll(l
and tile hOl1w is connt;ctcll hI
the ~ervicu pallel.
o
Final - After all required
inspections arc apPluvu(! anrl
porches, skirting, dccl(s. and
vCllIing havc l)Con in~;lallu(1.
10 DW.tV
'&0,'5"0
--#3
fif.53
SYSTEM~DEVELOP~ENT CHAR~
~ ~"I~ ~ (B) ~
PLUMBING PERMIT
ITEM
LOI races
Lol Type
,
LOI sq. IIg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
l1!
Cul-de,sac
BUILDING PERMIT
ITEM SQ. FT, X $/SQ, FT.
MaIn
Garage
Carport
Total Val uc
Building Permit Fee
Stale Surcharge
Total Fec
(A)
Fixtures
4-
I
Residential Bath(s) NO
San! tary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
I
Wood Stovellnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
1>11,(/,
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sldowalk
II
Curbeut
II
Demolition
Slate Surcharge
'.
Setbacks
I P.L. HSE GAR
IN
Is
Iw
LL-_
VALUE
FEE
40.&0
4iJ dO
28'0
4-2.. Q?)
/ej po
//').~
,75
.-;2S 7S'
Tolal Miscellaneous Permits (E)
~ '-~
TOTAL AMOUNT DUE (excluding electrical) ~;;, ' -
(A, B, C, D, and E Combined) ;2;1/.9;z...
ACC I
I
I
I
I
6HE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISmRICAL 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 permit Is granted on the express condition that Ole said
construction shall, In all respects. conform to the Ordinance
adopled 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.
Plan Check Fee: --4-7.. ~
0-1~ --1'Z-
tf~~Cj
f).~
, ~
Pia Reviewed 'By
Date Paid:
Receipt Number'
_~~2-
Systems Development Charge Is due on all undeveloped
propertles within the City limits which are being improved.
ADDITIONAL COMMENTS
~/u AVee dJ".,71' .1
By signature, I state and agree, that I have carefully examined
the completed application and do hereby cerli ry that all
Information hereon Is true and correct, and I furltlcr certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield. and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permisSion of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on thIs
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, that the permit card Is located at \ he front
of the property. and the approved set of plan~; will remain
~. the site at ar7Je~~nJ constru~tlon.
~ature -JY' If' ?\!
I Datp 0: '-/. Cj ;).~
VALIDATION:
RECEIPT NUMBER Lfq 1/
DATE PAin h-tf-q7/
AMOUNT RECE;VE~ .'79:1, J7
RECEIVED BY (FA;;",9
" :;.":<:<"~,-"t\'~:;~';.Y~i<~~I~'""c',, " ~~
, .: , . ~oos ,.,;,~ 1It<'l""~ \.,,>,",'ELECTRICAL 'PERMIT APPLICATION
~O~":t~,,=_!':jty Job Number 92.rJ,7'I'9eC;
_ ; :;'C'~~~' WHPLETE FEE ~CHEDULE BELOY
~~~, A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
LOCATION OF INSTALLATION
q~-? ~(1-IJ)/.(Jd;:
,
LEGAL DESCRIPTION
/103 2t::. /2-
(n-t- ~ '2 '2..
JOB DESCRIPTION
,
A7W J 77J M.' ~
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
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name /vf/~ 6f1J1V/iUS
Address CjF; 7 /:f.t'.M~~ ~
Ci ty 4f:iJ . Phon<tQ.1'2/__c;;t/""""l/
(W)~~ --:Z3~
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners
~~;o;-t'----::-:1i'~--:-"c-------------
RECEIPT liP it! /I
RECEIVED BY: '[JIIA.v--<-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
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
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ~
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
~ $ 35.00 ~o
$' 2.00 /060
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
45.0'0
. 2.;1.>
47.}..s
. I JOB liO. ,:,!'l:~:J.Q5_
CITY OF SPRINGFIELD SYSTE~lS DEVELOPNENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAHE OR COI'lPANY: """WA:E:.L tl. SUSAt-l GOWltoJS
LOCATION: '1S, NOR.IHR..lD6F_ AVE:,
\'10-:>,261'2. - oy.~'2-':2-
DEVELOP~lENT TYPE: Lbe... - b.b't> ,-TlO ~
BUILDING SIZE:
n -1..7-1
LOT SIZE
SQ, Ft.
1, STORM DRAINAGE
IMPERVIOUS SQ. FT. Lf,?q X $0.186 PER SQ. FT, b '3<;"""3-
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. OF PFU'S ., X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
~*
~
3, TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $388.61
Is
X $388.61
s
1
I'
I'.
,
X X $388.61
(See Attachment C To Determine Trip Rates)
SUBTOTAL '(ADO ITEMS 1,2,
s -
& 3) s~'"6S~~
4. ADllINISTRATIVE FEES
'BASE CHARGE (SUBTOTAL ABOVE) X ;05
TOTAL-CiTY SDC
2.'7
Is ~ t.f--
'''; _ _~_ l--fLJ
s~<?'i -rI
5. SANITARY SEWER-MWMC
NO. OF PFU'S
-
x 513.25 PER PFU + S!!lMWIiC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
S
TOTAL-MWMC SDC Is -f}- I
TOT AL SOC S ~ ~'i '::i -#
,
~'~~A~,)!. S/ISt/e;7-
'--cr Kip8urdick
sac Coordinator
'I .
FIXTURE UNIT CALCULATION TABLE: "limber 01 New Fi,"UICS X unau'''"lenl = Fi'lure Un;ls (hiOTE,
For remodels. calculate only the NET 2ddii.iO!l21 li\.lWCS)
NUMBEf OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTUliE
UI~ITS
FIXTURE TYPE
Bathtub.... ....... ..,........... .......... ..,...,...............,.......,....
Drinking Fountain..,....:......... ..... ,.. ,.....,.....",....' ..,..,..,
Aoor Orain....,......:........:,..,....,..... ......... ,.., ,.. ,. ,..........
Interceptors For Grease/Oil/Solids/Etc....,..,..,......
Interceptors FOf'Sand/Auto Wash/Elc,......,..,..,....
Laundry Tub/Ootheswasher..........'....,..........'......,.
Ootheswasher - 3 Or More................,..--................
Mobile Home Pari< Trap (1 Per Trailer).................,
Receptor For Refrigerator fWater Stalion/Etc,.......
Receptor For Commercial Sink/Dishwasher/Etc.:
Shower. Single StalL........:.............................'.....'..
Shower. Gang,..............,....,..,..,....".."....,..,.,.,......,"
Sink. Bar. COmmerciaL......,....,...-......,............,.,',..
Urinal. StallfWaIL"......,."....:....,.....-.,....,-.........."..'
Wash BasinfLavatory. Single,...._.,_..........,...........,
Water Ooset, Public InstaIl3tion......,.,.....-.............
Water Ooset, Private_...............-....----'-....
Miscellaneous:,
\
2
1
2
3
G
2
G
G
1
3
2
l/Head
2
2
1
6
4
~
04-
TOTAL FIXTURE UNITS
..,
Based onasse$SP<'l value. If.lmprovements occurred after annexation dale in.table,
CREDIT CALCULATION TABLE:
calculate credits separates.
'1\ Year"
Annexed
$1.69
1.35
1.15
'0.92
0,59
, 0,23
I
\
1979 or before
1980
1981
, 1982
1983
1984'
Rate per $1,000
AssesSed Value
$2.66
2.64
2.53
2.41
2.19
2.04
Year
Annexed
1985
1986
1987
1988
1989
1990
Rate per $1.000,
Assessed Value
. - - - . - - --'
------ - -
---'-
I
.'1
Improvement (ri after annexation date)
x $ ~
(Rate X Assessed Value)
X $ ~
(Rale X Assessed Value)
CREDIT TOTAL = $
Credit for Parcel or Land Only Ii Applicable
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resident izL.. ....,....,.......,.. ............' ..',., ..,.....-,.., 0,4
COmmerci2I.....,.......,...,..,.,..................,...,....,... 0,9
I ndustri2I....... ...'." ........,..,......., .....".,..,.."....... ,. 0,45
Government2l. .._......_.. __.....___.. _ _ u." .._. ............... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT