HomeMy WebLinkAboutPermit Building 1995-4-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
.
SPRINGFIELD
v-
.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: /.0 ~t?t::>
ASSESSORS MAP' / 7-P"?- ,.~- 2~
BLOCK'
~ #,E /~'~rn/..e;. 5-
Co ~ ;} 7? ??'- .
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DESCRIBEWORK:C~~ ~~,.,.,..,:-; ~
NEW RE~LP"X AD~N DEMOLISH
LOT'
OWNER'
ADDRFC:C:'
CITY'
STAT~'
,C?/=? ,
SUBDIVISION'
PHONE:?..y/- 4/~h
ZIP'
"7:/<;/'77
m.-.z;b~~ ~,71~~~?-
OTHER
CONST,
CONTRACTOR'S NAME ADDRESS ~~ CONTRACTOR #
I.:C.._ . - 7. ~v-.n ....?.......;>...::1;
GENERAL:~~--~'-./~ _ _~~_~~~h~2'9 tt:J9~ ?t.//-~y'~
PLUMBING~~"':~.I;Z~>:-:- _/{ _~~--.;r:;~ ~y~ ~_~ r ?~-~'3'"2
MECHANICAl'
ELECTRICAl ,~~/. '1".-' ~ ~ -:-
QUAD AREA:
I f-lliJ
I.
/.j~
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER: _,::",
- OFFICE USE -
LAND USE:
II~()
.~
VN
EXPIRES
PHONE
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE: __t::,
FLOOD PLAIN'
ZONING CODE: WlI2t2....
Z-
# OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE:
-
F)/).8-.
To request an Inspection, you mu&t calt 726.3769,.Thls Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Insp~cllons requested after 7:00 a,m. will be made the following work day.
o Temporary ,Electric
D Site Inspection - To be made
after excavatlon, but prior to
setting forms.
o Underslab Plumblng/Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to (lllIng trench.
D
Underfloor Plumblngl Mechanical
- Prior to Insulatlon or decking.
D
Post and Beam - Prior to floor
insulation or decking.
"'F:::71" Floor Insulation - Prior to
~ decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to (lllIng
trench.
D Water Line - Prior to tilting
trench.
"t9f Rough Plumbing -:- Prior to
~over. .'
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~cover.
~ Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
~pproved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
~cover.
~ Drywall - Prior to taping,
o Wood Stovo - After Installation.
D Insert - After fireplace approv41
and Installation of unit.
o
Curbcut & 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 sl) required
trees are planted. .. . .
"TV'f Final Plumbing - When 011
~ plumbing w9rk Is complet.e.
f"VT Final Elcclrlcal - When all
~ electrical work Is complete.
-;:::71 Final Mechanical - When all
~ mechanical work Is complete.
l\7l Final Building - When all
~ required InspectIons have been
approved and buildIng Is
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have beon approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot TYP.
Interior
Lot sq. ltg,
~
Lot coverage
v
Corner
Topography
It' Y"''J.,'~~.._
Total height 'T ~
( 11')
BUILDING PERMIT
SQ, FT,
Panhandle
Cul.de.sac
ITEM
X $/SQ. FT
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge 5~3 'T 3:$1OJ
Total Fee
(A),
,-....
'I:; '.
_'S 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.
Setbacks
I P.L. I HSE I GAR I ACC
I N I I I
I S I I I
Iw I I
IE I~
VALUE
/h.~
,
"
J//.....,5P <..'
LJ1>,5"a
9,33
J2S,133
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~~So'2..~ta
PLUMBING PERMIT
ITEM
Fixtures
q
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT,
FT,
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge 15'0-1- ~;!O
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
'Z
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
175"" +, -15
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Tolal Miscellaneous Perml.ts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
qt:J,(X)
7-2.0
77~O
7,40
0,0-0
/c:;oo
/n()O
/20
~20
.?5/<::J3
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This per~lt is granted on the express condition that the 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 al any lime
upon violation of any provisions of said ordinances.
Plan Check Fee: 75' '73"
Date Paid: J.:O'9~
Receipt Number:-/L ~6
Recel~~ - - ."'_-
Plan~~ed By
4/7s--
// t;ate
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify thaI all
Information hereon Is Irue and correct, and I further certHy
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 of any
structure without permission of the Building Safely Division.
I further certify ttlat only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensuro 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
on the site at all times during construction.
V<: ';>.J ~ .
gfg'/tatureA- -::.. ') <:.1. -\, ~ _'
Date -f";'iyl\
VALIDATION:
/1'", '757
DATE PAID 4/' 3/'5')
. I ..ea NOr I/..)C/".
AMOUNT RECEiVED -'1217 ",t='.'lt;."l
RECEIVED BY ~..
\
RECEIPT NUMBER
...
.
The following projoct as submmod has the foil ~
zoning, an'f\Jfr->'lt:. require spccllic land use
225 FIFTH STREET approval. ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoain<f> t 9~ I
INSPECTION REQUEST: 726-3769 .j <-v - Ci ty Job Number q 5 n g/ if'
OFFICE: 726-3759 o.t~
t-J . p.".
Authorizod Signature 3.
1. ft'~~Tp'ON. OF INST4J,LATION
I .l1'rY\~dl1-.> p(l~
LEGAL DESCRIFTIO,N
11 0 ~S;) ~~ InttfV) .
JOB DESCRIPTION J
0U \\.i" fI. h c\ 1I P bo )"
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 B.
Electrical Contractor ('r.:) }lOOOt.n"t~ 'j ~1M..
Address Po O. ~ t49.L
City~~ Phone.24l -~1,3h
Supervisor L~ense Number I b 8 b ~
Expiration Date 10- I -'15
Constr Contr. Number t).~'Z~'1
Expiration Date
If-i-as
Signature of Supervising Electrician
~A~'-?~
'"-'- T
Owners Name ...g4tL..~ ~~.s
,
Address ~7~ ~.
s:,,/'7)
City
<iT
Phone2~J~~
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
-------------v- -----~----------------
DATE: s-; J-}- / ,..r
RECEIPT 1I:_ ' '71'-7/
RECEIVED BY: . _~p ~
COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
uni t.
Items
Cost
Sum
1000 sq.ft. or less Y $ 85,00 ~OO
Each additional 500
sq. ft or portion
thereof $ 15,00
Each Manuf'd Home or
Modular. 'Dwelling
Service or Feeder $ 40.00
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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "BIl above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35,00
$2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40,00
$ 20.00
$ 36.00
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9SZ0454
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COVENANT
IS "'<'1-1:: ~ ' R. ~7" INi:;.r "h? L.YNN P<-f.......f..e.J
record owners(s) of all of the following described property
of Springfield, in the County of Lane, State of Oregon:
being the
located in.the City
Lots 5 and 6 of Block 26, Extended Survey of Spfd. as recorded 'April 5th, 1872
on Volume 1 Page 1 of Deeds in the County Clerk's Office at Eugene, Lane .County
Oregon.
<:~
C
In consideration for the issuance of a Building Permit by the City of
Springfield which allows the owner(s) to convert a single family residence to
a duplex, the two lots described above must be joined in order to meet the
Medium Density Residential (MDR) zoning density of 10 to 20 dwelling units per
developable acre. The record owner(s) do hereby make the following covenant
(for the good and safety of the public, in compliance with the building
regulations of the City of Springfield), covering the above described real
property, specifying that this covenant shall constitute a limitation to run
with the land and shall be binding on all persons claiming under them, and that
the covenant shall be for the benefit of present and future owner(s) of said
real property.
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22~PR.13'95"06REC
~2~!APR.13'95"06PFUND
5.00
10.00
Be it hereafter known and agreed that:
1, The two lots as described above must either hereafter be sold together as a
single unit of land so long as the MDR zoning applies to these lots; or
2. Prior to the sale of the lots individually, approval of a lot line
adjustment application is obtained from the City as long as the modified
lots meet the minimum zoning density requirements in effect at the time of
approval.
IN WITNESS WHEREOF,
this 1"2.. -I::. day of
the undersigned
4p~: / ,
have caused this
19ts=.
instrument to be executed
-Ie <:,~ ~?
;?r, ~O--4-~
Owner<J V
STATE OF OREGON)
) ss.
County of Lane )
On this j.;z<f"'/ day of
before me, a Notary Public, the
ffrJv-, oj
with:l:h named
19 q 5'. personally appeared
and acknowledged the foregoing to be their voluntary act and deed.
WITNESS my hand and seal this day and
year last written above.
/ L YM.~ ~'-L ~
Nobary Public
.-=,., OFFICIAL SEAL
~""l~-e. AN~JE MAP-IE CORDON
.~.~.....~~ft,~ NOTARY PliS:""C - OREGON
\\f?.J?(;:'i COM;'Jl:SS;ON NO. 028492
'Ifu' MY C(jMY;S~ION EXPlP.ES OCT 4, 1997
for Oregon
1'0/1..( /0( 7
My Commission Expires:
'.
3676
9520454
.
Slale of Oregon,
County of Lane-ss.
I, the County Clerk, in ~nd for the said
County. do hereby certify that the within
instrument was received for record at
c.c
~,
N
O'
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"',
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13 APR S5 11: 1,5
Reel 2055R
Lane County OFFICIAL Records.
Lane County Clerk
A -.-t./
L.~ty Lferkl
By:
.
-.
AlTACHMENT 131
..~
JOB NO. . 9 '50 ? 14
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
--
NAME OR COI.\PANY: 1?LAIC.E D Ao~:"'T I f-J &S
LOCATION: 4 \? "PI 01-1 e::e:..~ ?~R-~\NA:'< \/JE:b'T
DEVELOPMENT TYPE: Mt>e. - R~,,^6t>12..L
\\o?~s'Z? - \0400
BUILDING SIZE:
1. ~ nRATN~
IMPERVIOUS SQ. FT.
I_OT SIZF
5Q. Ft.
X $0.209 PER SQ. FT.
c
'--
)
---
2. SAN!IARY SFWFR-rTTY
NO. OF PFU'S '"
(See Reverse)
X $43.26 PER PFU
C~e,,,,.;)
'- --'
3. IBANSPORT.IIJ.l.(lli
NO OF UNITS X TRIP RATE X COST PER TRIP
(-z.}(D."''6) - \.0\ :-0.\<;'
\ X 0.1<;' X $436.19
X X $436.19
G (,,'S42)
-- --'
$
X
X $436.19
$
SUBTOTAL (ADO ITEMS 1.2. & 3) $ 4?4-'.l
4. SAN!IARY SFWFR-MWMk
NO. OF PFU'S ~ x $17.19 PER PFU + $10 MWMC ADMIN. FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
IQIAI -M\4Mr snr
SUBTOTAL (ADO ITEMS 1.2.3 & 4)
$ \(",4-"1...!..
$ 14-0 ~
( $ 'Z ,?"'I~ )
$ 41f,i.!::,
5. ADMINISTATTVF FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
C ~? q0
"-- --
~~ '
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- - - - . -.;j' - . =-~
SDC Coordinator
Date: ;;, / ,-, /4 C;
IQIAI sot:
.$ ':::>0"2.."~
B2.SDC .
. 4t.
FIXTURE UNIT CALCULA tON TABLE: Number of New Fixtures X Unit Equivalent =. Fixture Units
'. .....
(NOTE: For remodels, calculate only the w:I additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
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:
TOTAL FIXTURE UNITS
UNIT
EQUIVALENT
2
1
2
3
6
2
6
6
',1
3
2
l/Head
2
2
1
6
4
=
FIXTURE "
UNITS
2-
"2-
4-
9
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
r
Year
Annexed
Rate per $1 ,000
Assessed Value
1979 or before
1980
~1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Credit lor Parcel or land Only If Applicable ~. 4-<a X $ 4-tl ,"'1
(Rate X Assessed Valuel
Improvement (if after annexation date) X $
(Rate X Assessed Value)
, ....
=
=
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
\4C'.:!.
CREDIT TOTAL = $ 14D'-z.
.
.
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Job No.$-;50~L+
SYSTEMS DEVElOPMENT CHARGE
WORKSHEET
NAME: ~~ p fh4:o:; T/A.J4 ~
fo37 r,8 r
-::>/
PHONE: 7+1 -- ~7~
STATE:Q&. ZIP 911'-'7"7'
"
ADDRESS:
- '
Platt Name: Tax Lot Number:
. *' 51~a Th"1' A~~~ ~,ljt-'~ 7b
LOCATION OF PROPOSED BUILDING SITE:, .
Street Address if Known: 4-/'2. P/CiD~'~~A'U I.AJEs r
. , ('
, '
17tl3 5~ 2S/I2~
])ti~
1. DEVELOPMENT TYPJ,; (Check appropriate dwelling(sl. SDC calculations and dwelling type
definitions are on the back.l ' " '
A. Sinl!le Family - Detached
Single Family home
NO OF UNITS
B. Sinl!le Family - Attached
NO OF UNITS /
C. Multi-Family Aoartment .
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
X $400 PER UNIT .P..
, .
$'
"
.
X $370 PER UNIT =
. $.~70~
X $777 PER UNIT =
$
X $280 PER UNIT =
$
. $ S70.~
2. SDC CREDIT (If applicablel SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. '
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
$
$ -:s"1/?OO
I I
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