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Home My WebLink AboutPermit Building 1995-5-18 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Oltlce: 726-3759 LOe -:f . BLOCt<' M&c~- (V\"Qu./Q( 0..;;';)&/ OWNER' LUc:,-/ ~ ADDRESS' 'fPo /5 UV CITY: ?,c, <........ Ct c;+:: e.v<3 ~ DESCRIBE WORK: NEW )( REMODEL STAT'" ~ . q 00 47g ADDITION DEMOLISH OTHER JOB NUMBER '. 225 Fifth Street Springfield, Oregon 97477 TAX LOT: l ~ trO-. SUBDIVISION: ---Ul:l1l0-4p~ PHONE: ~ 718"',3'';1 /'/ ZIP: 9-'7''7''",....:l. CONST, CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHONE GENERAL: (/.L'S~0r1 M>>--f_ f/o 4 ..v~~ ~-?ol So/f',y- ~,y77 /, .' ,-..-9 /5~~Z;',~,,/, ~ ~..,,""> PLUMBING: ~~1ifJ~Y~ra!l!::r ~~ ""7~~, /<p<C.~2. "(8._, ~,r"". ~-Z~4S MECHANICA" r:.Ie;/~ U4n-/' \ 010;1)' 1':\. \.g~ ?f\-5'~177 ELECTRICA" /'/l/W/J 1/4//<-1 ~/f:.. 'G\16c\'\() r 1O.C\ln l2.q,~\~ V ' , , ", \ ~~JlU - OFFICE USE - L QUAD AREA: LAND USE: \\ \ \ FLOOD PLAIN: # OF BLDGS: \ # OF UNITS' ZONING CODE: I ~)\2-l OCCY GROUP: ~~V\ CONSTR. TYPE: -'1/ }J # OF BDRMS: ~ # OF STORIES: )~ HEAT SOURCE: ~f..7 SECONDARY HEAT~ -0 WATER HEATER: RANG'" l(.-/ SQUARE FOOTAGE: \\Q\ cn,~ , , - , To request an Inspecllon, you must call 726.3769, This Is a 24 hour recording, Alllnspecllons requesled before 7:00 a,m, will be made the same working day. Inspectlons requested after 7:00 a.m. will be made the following work day. [K] Temporary Electric / D Site Inspection - To be mado after excavation, but prior to settIng forms. D Underslab Plumbing/Electrical/ MechanIcal - Prior to cover. ILl Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting, [Z] Foundation - After forms are erected but prior to concrete placement. I7l Underground Plumbing - Prior I4--l to filling trench. rTl Underlloor Plumbing/Mechanical ILLJ _ Prior to Insulation or decking, rKl Post and Beam - Prior to floor ~ Insulation or decking. IZJ Floor Insulation -. Prior to decking, D' Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. f171 Rough Plumbing - Prior to 4L-J cover. REQUIRED INSPECTIONS rYI Rough Mechanical - PrIor to ~ cover. IVl Rough Electrical - Prior to LpJ cover. fVI Electrical Service - Must be iA-J approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp, [Xl Framing - Prior to cover. [Z] Wail/Ceiling Insulation - Prior to cover. ~ Drywall - Prior to taping, D Wood Stovo - After Installation. D Insert - After fireplace approval and Installation of unit. ILl Curbcut & Approach - After forms are erected but prior to placemont of concrete. [Z] Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. D Fence - When completed.' lZl Street Trees - When all required trees are planted. C!J Final Plumbing - When nIl plumbing worl( Is complete. r:tl Final Electrical - Wtlen all ~ electrical work is complete. rN1 Final Mechanical - When all ~ mechanIcal work Is complete. r7l Final Building - When all wq-J required InspectIons have been approved and building 15 completed. DOthor MOBilE HOME INSPECTIONS D Blocking and Set.Up -'When all blocking Is complete. D PJumbing Connccllons - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, nnd plumbIng Inspections have been approved and the home Is connected to the service panel.' D Final - After all required Inspections are approved and porches, sklrttng, decks, and ventIng have been installed. " 'or',:;' .:9:\,r:~:\ LO;J'P. _,IS THE PROPOSED WORK IN THE. Lot faces .5- Setbacks ~ I P.L. HSE 'GAR'ACcl HISTORICAL DISTRICT, OR ON Lot sq, fig, Interior IN I THE HISTORICAL REGISTER? LOI coverage ~ Corner ~ If yes, this application must be sfgned ~~ Is 1-0 I and approved by the Historical Topography Panhandle ~5' Iw 7 ,'I1/Hi, I Coordinator prior to permit Issuance. Total height Cul.do.sac FrY' ~~ APPROVED: BUILDING PERMIT ITEM sg, FT., X $/SQ, FT., = VALUE Main i'?/'1~~.5'6.=<'~ 73111-'7$. i:l?:7bqJP "~~ Garage Carport Total Value Building Permit Fee State Surcharge TOlal Fcc (A) PLUMBING PERMIT :--- ITEM FEE Fixtures Residential Bath!s) N' 2- /4:!J. ~ Sanitary Sewer FT. Water FT, Storm Sewer FT. Mobile Home PlumbIng Permit /~.- State Surcharge ~ ~-~ Total Charge (C) I ?Z.8e> MECHANICAL PERMIT .", Furnace ~. Exhaust Hood 1-9> Vent Fan N' -;;; "'7.-= Wood Stove/lnsert/Flrcplace Unlt~. Dryer Vent --r. -- Mechanical Permit '22. ~ /;p. _2> "Z-- "3'7.,?/ Issuance State Surcharge Total Permit (D) MISCELL.~NEOUS PERMITS Mobile ,Home State Issuance State Surcharge Sidewalk 4Qo? ft Curbcut -::? Y ft I?~'t:::> J'3.c6o Demolition Slate Surcharge h ""~ ~P/ r. '::r; > &--,,-, ~"""" '&s>~Ji!?9-P - 27. 3e> :1.~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) ~.%.z:;./!!?"J IA. B, C, 0, and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT . This permit is granted on the express condition that the said construction shall. In all respects, conform to the Ordinance adopted 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: 7/11.7 () <;?-;<04'_ p ~. L{_I-;, .qc::, ~ tl~ ~~~f/.P Receipt Number '\ l{)I Rec~y: J)/i ~ /4!f'r4f"'-~~ ~-~ I t: ~Iyrjftcviewed By ~ '~"3 Dale Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved, Date Paid: ADDITIONAL COMMENTS \ 9\-\-T: ~~-5COO \()\l\I\Ok" l'Q.k', Rq 4 150't'7'B CloIrI.... lt~<d.s C\ p"'v,,f-L, --- -I " SAn;4-"'....;:! SLwt.... ea:L"Q..,+ '- By signature, I state and agree, that I have carefUlly examined the completed 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 Ordinanc~s 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 of 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 are requested at the proper time, that each address Is readable from the street, that the permit card Is located at the front of the property. and the approved set of plans will remain ont~~~lng?tr~ Slgnatu~ -4'::f ( ~.R' ~ DatP!~-?'J VALIDATION: RECEtPT NUMBER rJ4.2-- "'2-----' DATE PAin t:). \~ .Gf~ AMOUNT RECEt'lD _ Z:;~. ~ RECEIVED BY ~ . SP.tl.FIELD Zon;"" L..- 0 e... Dma<)---li-!;.( 97 tfihorlZed SIgnature ... \ 1\A 726-3769 ELECTRICAL PERMIT APPLICATION q~1R 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 City Job Number COMPLETE FEE SCHEDULE BELOY 3. . 1. \~~~Ol~~~~t'')_ 1&.GAli,.{JE"S.,CRIfTION "::2~ \~l)~N.'l\\ [)\~~J Nev Residential-Single or Multi-Family per dvelling unit. Service Included: A. Items Cost Sum ~ 3D - \\O\roD~ 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 C\ JOB D~CRIPT1~ ~.~_ O.h)\ 0 $ 15.00 Permits are non-transferable and expire if vork is not started vi thin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY $ 40.00 Services or Feeders Installation, Alterations or Relocation: '.B. Electrical Contractor(2111J ~11t'j r,,,~'c AddressP.O, &l< Q..'d'Jol Ci ty ~.Jo./?",e 07vo.:l Phone Gc:t3 -~ 3 \;l Supervisor License Number 3~d- 'i.5 Expiration Date IClcr5 Constr Contr. Number ~5~/l? Expiration Date 6/""I~ $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to' 1000 amps Over 1000 amps/volts Reconnect Only Temporary Services or Feeders Installation, Alteration or Relocation C. ... . $ 40.00 ~~ $ 55.00 $ 80.00 see "B" above ,,/ 200 amps' 'OT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Signature ,of Supervising Electrician ~)~A.~ O,om "., ~~ ~lItru: Addre9{,~.\~ .. . & ~ \ Ci ty ~ Phone.::Aro. 8\11 OYNER INSTALLATION volts Branch Circuits " Nev, Alteration or Extension Per Panel $ 35.00 One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 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 /~- 5% State Surcharge 7.~5 3% Adminis t ra t i ve Fee ,(.h-?- TOTAL /6? 4U' The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: ~ATE~----------------~~~C~------- RECEIPT II: \ ~ '-' ,4-" L.L- RECEIVED BY: ( . - -e e= , ~ o !!.'!ilti!o~,ll!l,\!!~ JObNO.q~1S " ' SYSTEMS DEVElOPMENT CHARGE WORKSHEET NAME: ~.~. \'\\rA ~ 1 \) OJ- ( ADDR~\)~~ a~\\yJ.~ Lq<:ATION OF PROPOSED BUILDING sr~: . ~ " Street Address if Known: -\. ~ ~ 'n.-. lD. ~A.Jf'CY\ f'\lf' ) .~ \ ~~~ Tax Lot Number: \lm~'\\ \ O\'~ PHONE: .9i\S. ~ rtl " STATE:~ZIP ~ Platt NaMe: ~L\~~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back.l ' . . A. Sinl!le Familv - Detached l. Single Family home L NO OF UNITS Manufactured home not in a park ci) X $400 PER UNIT .F.. $ 4[[') , '. B. SiOl!le Familv - Attached . NO OF UNITS X $370 PER UNIT = '$ C. Multi-Familv Aoartment NO OF UNITS X $777 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ ,$~sD $ . Id:- $ 4tfPJ ~ I~ q~ n~IP WPRD SOC 2. SDC CREDIT (If applicable> SDC-payer must furnish proof ofWPRD Credit approval. See SDC Credit Worksheet. ' 3. \ii\J r,......................:"', C:I'n,:,-n\- ~;"i(";""" . .B NO. CJ.:2.!L.4- 7 p., CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: C. t.l<;.-rOM Mo DUL.AlZ- LOCATION: \'2..';1;>"2. ,^-I. DL-YM'PIc.. 1,0 '7'2- 'l '? I - [-;:'00 DEVELOPMENT TYPE: LOR- "-IE:-w MA.t.Ju, t+OME BUILDING SIZE: LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 2A '2- 'l X $0.209 PER SQ. FT. (SO/~ 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) \""1 X $43.26 PER PFU C'67..\"I~ '-- ...-/ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X \ ,0 1 X $436. 19 X X $436.19 X $436.19 G 44Osi) --- ---- $ $ X 4. SANITARY SEWER-MWMC NO. OF PFU'S I~ x $17.19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) $ ??lo~ TOTAL-MWMC SDC SUBTOTAL (ADO ITEMS 1,2,3 & 4) $ t-.(. A. . ~ ---- ..-' $'2.\DI...~~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 ~' -r:<. .L....L (gip Burdick SOC Coordinator Date: 4-/-z.o /<=\5 , ' TOTAL SDC c'O?~ "- ...-/ $ '2."2- I \ ro~ l~i~~~~~~~~.tg~~r:t;;\~El~t~11~~~~F~::l~?~~;~t~:~:;,:~~:::'." ;.':':"'::'~'~':;; ;-,.\ . ," . 'FIXTUf{~il!.~n:r,~~g~.H~T~T ~BlE: Number of New Fixturesinit Equivalent =' Fixture Units (NOTE: Fo!' remoilels,:'calculate'only- th. addItIonal f,xtures) , ': ' . . " , NUMBER OF UNIT FIXTURE " FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS -'". .' :.Y", ," '." Bathtub............. ......................................................... Drinking Fountain.... ....... ............ .............. u"O' ....... ." 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........ Roceptor For Commercial SinklOishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang............................... ..... ..... ......... .:,. .... Sink: Bar, Commercial, Residential Kitchen........................ Urinal, StalllWall.................... .., .., ...,...... ............. :..... Wash Basin/Lavatory, Single,.......,...,....,................ Toilet, Public Installation..............................."....... Toilet, Private................................,.................:,... Miscellaneous: 7- 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 4 .' 1 2.- '2.. ,~ ? z.. e TOTAL FIXTURE UNITS \"'1 CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table, calculate credits separates, Year Rate per $1,000 Year Annexed Assessed Value Annexed 1979 or before $3.46 1985 1980 3.38 1986 1981 3.32 1987 1982 3.21 1988 1983 3.06 1989 1984 2.92 1990 1985 2.73 1991 1993 Credit for Parcel or Land Only If Applicable Improvement (if after annexation datel ) Rate per $1,000 Assessed Value $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 X $ (Rate X Assessed Value) X $ (Rate X Assessed Value) .A- = CREDIT TOTAL = $ f.J. A