HomeMy WebLinkAboutPermit Building 1994-8-4 (2)
OWNER' '" .OOItOZ./'
ADDRESS: . CJ [) \ R ~ ~ ~ 'xl ~ f\C\. ~~ 11
CITY: ,~\ ('{)It Q Q r') STATE: '
-, \ \.
/vCuJ
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
o fIIee: 726.3759
ASSESSORS MAP:
~c:2-
LOT' ,
DESCRIBE WORK'
NEW I~REMODEL
CONTRACTOR'S NAME
r!o.'-1
- I
I-I-a, do. h eM-
, /JJ.u..u. h 4.;/ r
;:?,1J~
GENERAl'
PLUMBIN'"
MECHANICAL:
ELECTRICAL:
QUAD AREA:4~~~
# OF BLDGS: ,
OCCY GROUP.' \("2?-\ fJ\
# OF STORIES:_8
~ff
WATER HEATER:
.
1)oDW"~D
I
BLOCK'
.5', F: D .
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER
9 ~og/c::>
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISI
PHONE: =t:tLR1 (
ZIP: 4l<1-1"!
\..,
CON ST.
CONTRACTOR # EXPIRES PHONE
. m41 In-\D9~ '1 '-I7.g7 [) t/
<rtl r~.2lr 7
Sf.u 45 '!i!J I Q.a3-q:J- ~ u 7 ~ l,/f../ S
17 ~ .,~~~.q<:; ~~-=?/353
- OFFICE USE -
LAND USE: \ (I , FLOOD PLAIN'
# OF UNIT'" '\ ZONING CODE:-1..[f---
CONSTR. TYPE: \J..,ALL.~~ OF BDRMS'
"..,.-- . , " -- .
HEAT SOURf'''' j':2<--, , ....-SECONDARY HEAT:
RANGF' f'./ - . - - - SOUAREFOOTAGE:OO'()(o
ADDRES~ ' '. {,
, ~~H/
{!I--'.,' , ,.R..
"
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 the following work dey.
REQUIRED INSPECTIONS
-r='f R~U9h Mechanlpal ...; Prior to
~cover. ZdW etA. r.,d,
,,-
l.2:$l1.omporary Electrl,C
'fV"( Site Inspecllon - To be made
~ after excavation, but prior to
,,' setting forms. 'JDI{. ~
O Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
I":/rFoollng - After trenches are
~ excavated.
o Masonry - Steeflocallon, bond
,beams, groutlng.
!817Foundatlon - After forms are
erected-but prior to'concrete
placement.
o Underground Plumbing - Prior
to filling trench. .
m'"underllo~mbl~Mechenlcal
~-.Prlor to rll~UI"""'''''' or decking.
rii?I Posl end Beem - Prior to 1I00r
~ Insulallon or decking.
'-
rv:r Floor Insulation - Prior to
~deckfng.
r;;::>1 Sanlla'ry Sewer - Prior to filling
~ trench.
.1f'V'l Slorm Sewer - Prior to filling
U::::..:>.l. trench. '
rN'l' Weier Line - Prior to filling
~ trench.
fi'\A.Rough Plumbing - Prior to
~cover.
'f;:7f Ro'U9h'Eh;~lrlcel ..., Prior to
;.0...( cover. .. ,
IV1 Electrical Service - Must be
~ approved to obtain Pl'rmanent
electrical power. !r ~:~~
o Fireplace - Prior to facing
meterlals and framing Insp.
~ Framing - Prior to cover.
r<v=rWeIl/C'elllng Insuletlon - Prior to
~ cover. .' .
~ Drywall - Prior to taping.
. '
o Wood Stove - Atter Installation.
o Insert - After fireplace epproval
. and Inslellatlon of unit.
~'Curbcut & Ap'proach - After
'~forms are erectedl but prior to
placement of conerol.e.
1);/f Sidewalk & Driveway - After
~ excavation Is completo, forms
and'sub.base'materlalln pface.
o Fence- When completed.
~treel Trees - When ~II required
~ees ere planted.
I'i;71 Final Plumbing - When all
~ ,plumbing work Is complete.
- , '
-, ,
~ Final, EI~ctrlcol - When all
~electrlcal work Is cor:nplete.'
'RA Final Mechanical - When'all
~ mechanical work Is complete.
t<:::7( Final Building - When all
~equlred Inspections have been
approved and building Is,
completed.
o Other
MOBilE HOME INSPECTIONS
o Blocking end Set.Up - When ell
blocking Is complete. '
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrlcel Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections ere epproved and
porches, skirting, decks, and
venting have been Installed.
,
, ~
Lot faces ---S- L~e.
Lot sq. ftg: ~ _ Interior
Lot coverage ,!110 Corner
Topography ~ Panhandle
Tolal height m- Cul.de.sac l
\ ",-.'
BVILDING PERMIT
:;1: \7'20(;)
Garage 4"1<
Carport
~S THE PROPOSED WORK IN THE, '
,....HISTOJ:\ICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I
1
..\~: ' ':
. i,;;.. j
.....;. .;~.;(- ',1 \:' '::<~~':'~::
" Setbacks '
Ip.L 'HSE' GAR' ACC I
'I N :3iS
,1$ Zi!:>
I~ ,~"
IE /3
XR;;lo a 91tbl
14...\D "~
Total Value
Building Permit Fee
State Surf~ar.g~ , \'
Total Fee
(A)
\ f):\ '1.161
' ...I /..? e-O
.. 2..2..10
j 3 ?~
I ,
d'7/J,'3,r"
(B)
SYST,EMS DEVELOPMENT CHARGE (SDC)
l.222o,S~
PLUMBING PERMIT
ITEM
Fixtures
~ Residential Bath(s) N' "<
..
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
......:.-..t1.-.;...:~ "$'9D ~,,-nl.u .
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
4.
Vent Fan NO
Wood Stove/ln~l)la~~ unIt--->
Dryer Vent
-.""
:'
FEE
_7'2 ~~
5.7&
9t.3
/.-07. '1/
6-fl!2
ct.ro
/2.. ~
js 6-0
3.6-()
.A'/l,5"tJ. 3- ~/.g;>
Mechanical Permit (U - - ""f'.: -
//'\,0-4>
Issuance r.:;.,.,/
;2..9'j~
State Surcharge ;Sf!> A!/71/'o. ;.::: ~ ~
.r f._.....
Total Permit (D) .5.5- 7..., !. ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk 1",,2-
Curbcut
fl
'3 ?.. It
Gf'D
Demolition
State Surcharge
-,'PLAD ~/ tit)
/~.30
-I-.4.~
.z~7_30
32i :1,0
Total Mlscelleneous Permits ' (E)
TOTAL AMOUNT DUE (excluding electrlc~I~'~
(A, B, C. D, and E Combined) 30 ~ '5'8
-. , ,
\ '\ .~.
APPROVEf" '
BUILDING VALUE, PLAN CHECK.
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall,ln 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: ,"2 8 7: :3,{)
'Date Paid:
Receipt Number'
Received ~
'/~
,Plans,l\leviewed By . :
,
I
-2~r9f .
.Systems Development ,Charge Is d,ue on all undeveloped
properties within the City IImlts,whlch are being Improved.
- - , .
(.. '.
ADDITIONAL COMMENTS
,,-5/_pf~ ~-~&-'L~ /
~ ci+-~I; /YH-?{Y) I
,~U\~.Llj,lY): ILl'}'/(
....
(w/.l'JfJUiL ,'\t rilu1J2D
....
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 Ordlnanc~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 cerllfy that only contractors and employees who
ere In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure th'at all required Inspections. are
requested at the proper time; that each eddress Is readable
from the streel, that the permit card Is locateg at the front
of the property, and the approved set of plans will remain
on Ihe, site at a~rlng construction.
Slgnaturp
/-, ~/3 -c;if
Date
VALIDATION:
RECEIPT NUMBER I. Lj 7-IJ5
DATE PAin, ~ - L( ...tj L)
AMOUNT RECE;VED ?E.-::":' , ..=t:) 3ficd I C5f
RECEIVED BY OvIJv n -
~
..
.
.
SPRINGFIELD.
The following proJeCl es submitted h.s the followln
zoning, and does not requIre specific land use
225 FIFTD STREET approvsl. ELECTRICAL PERMIT APPLICATION
SPRING~IELD, OREGON 97477 Zonlno LOt!-, nAI\OnJD
INSPECTION REQUEST: 726-017,69 K- 4-- 'jU 'Ci ty Job Number '1ll:.J C)
OPPICO: 726-3759,.e ~
Authorized Signature () r'fl.
1. I~O~\NN~T~_
\!!(Ob~~
R~e ~6g~~NQ.n~ ~
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
I
2. CONTRACTOR INSTALLATION ONLY
,
Electrical Contractor
BILLS
Address
3~tST 11TH ~NUE
City
1'1 U;I'NI' Phone --6.8..7 _ , R~ 1
Supervisor License Number 9805
Expiration Date
10/1/95
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Constr Contr. Number
"
......
21351
Expiration Date
4 (2B.L9..ll'
,S~oJ7~
Ovners -;:me f'rt ) 0 S\ 1 ) V'
AddressClo ~i)~ C'/) 9~ .
Ci ty _~ oi. Phone 111- 870f
o~ I~ALLATION
The, installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE: i - 4-:c;~t---
RECEIPT I: /4 U-'?
RECEIVED BY: ~
COKPLETE FEE SCHEDULE BELOV
A.
Nev Residential-Single or
Kulti-Family per dwelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
B. Services or Feeders
Installation, ~lterations
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
Items
Cost
Sum
Ef::>
~
I
$ 85.00
-3-
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
volts see "B"
40.(1)
above
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
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
3'1o~AJw.',,,,, ~e<--
\OlAL-
not included)
$
$
$
$
DD ,m
'1. e;p
&j.10
_to 3. tan
40.00
40.00
20.00
36.00
,
'Ho37a
. .
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
NAHE OR C0!1PANY:
LOCATION: ~ 1/0
DEVELOPHENT TYPE:
v~L/L
/?~~Ir1
I
SF/)
BUILDING SIZE:
-
LOT SiZE
SQ. Ft.
o'
r. STORM DRAINAGE
IMPERVIOUS SQ. FT. 20S-r.".
X $0.203 PER SQ. FT.
(" "f/ 1. 3 ;)
<...... -'
2. SANITARY SEWER-CITY
rw. OF PFU'S
_ (See R.everse)
23
X $42.03 PER PFU
(' Q("1:;;"1)
'- -----
3. TRANSPORTATlOIl
NO OF UNITS X TRIP RATE X COST PER TRIP
I
X /,0/ X 5424.31
X X $424.31
(" 4.2.1'.!>~
......... .......-
S
X
X $424.31
s
4. SANITARY SEWER-11WHC
NO. OF PFU'S 23 x S15.125 PER PFU + SID HWMC ADH FEE S 3S1.?'F
(Use PFU Total From Item 2 Above)
MWHC.CREQIT IF APPLlCAB.LE (SEE REVERSE) S S-'.lf"2.
TOTAL-MWMC SDC r:-;o/,(){,'1
'- --'"
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S ~II"", ~ 01-
5. ADMINISTRATIVE FEES
BASE ~GE ;S~)fIT ABOVE) X .05
~. /1.-. . ~-/~-r..y
/ ~ir E:t:r .
{Dc Coordin or
00~'0
TOTAL SDC S z.2.Z0.S'c.
r r ^ I \J I 11..- '" I 'II I _ ~ - - - - - . - - - - ~ - - - . - u_.
For remodels; (..1Icul~;e only. the "cr ,1\\,li:;'''':lII;\1\11''',)
FIXTURE TyPE . .
r,L'I.'.r:Efl OF .
1,:EW n.''1UGE",
[3athlub................,..,.......,...
Drinking FOullt;}il1....................
Floor Dr.lin....................."....,..""'.,... ............,
Interceplors For Grease/Oil/Solids/Etc.................
Inlerceplors For Sand/I,uto Wash/Etc...,..............
Laundry Tub/Ootheswasher.......,.........,......."..,.....
Ootheswa~er . 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Recep)or Fgr Refrigerator f\"Iater Station/Etc........
Receptor For Commerclal Sink/Dishwasher/Etc..
Shower, Single.StaIL.............................................,.
Shower, Gang..........................................................
Sink, Bar, Commercia!......................................:......
. Urinal, Slallf\\'all.......................................................
Wash Basin/La\'ator)o, Single..................................
Water Ooset.Publie Installation.............................
Water Ooset, Pri...ale.........................................,.....
Miscellaneous:
I
I
I
I
:?
"\
TOT.~.L FIXTUrlE Ut'lTS
L':\'lr
I:CL'I\';.LEIH
3
G
2
G
6
1
3
2
l/Head
2
2
1
6
.
~
=
fiXTURE
U1'~lr5
.2.
2..
z..
1.2.
;LJ
2.
3
Basej 0:1 assessed value. If improvemenls occurred aller annexation date in tabla.
CREDIT CALCULATION TABLE:
calculate cre:ihs separates.
r-
Rale per $1,0')0
Assessej Value
Year
Annexed
Year
Annexed
1979 or belore
1930
1981
1932
1983 .
1934
'1985.
$3.21
3.13
3.03
2.95
2.82
2,63
2.51
1985
1937
1988
1989
1m
1!?31
1!?32
..
O~,~ for Parcel or Land Only If Applicable
Improvement Crt after annexation date)
3..2/ X s /'1, T(7()
(Rale X Assessed Value)
X S
(Rate X Assessed Value)
CREDIT TOTAL
=
S'. i' Z
-----
=
= $ ,c,.7[2
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
: , Residential........................................~~:~..........~.. 0.4
COmmercial...................................................... 0.9
I nd USlrial... ............ ............................... ............. O. ~ 5
GovernmentaL.................,............................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Rate per 51,000
Assessed Value
S 2.24
1.93
1.57
1.18
0.79
0.44
0.28
1
I
J
r
.
o !!!m~!!!~!~!!!:;
.~
Job No. q~?')
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM81)u)&\\1 ./r~~,
ADDRESS: ID I\~ tD ~; ~
PHONE: f'f\f\. ~ 10t
. STATE:OO--zIP~
LOCATION OF IilROPOSED BUILDING SITE: ~J c _ _ .J\
Street Address if Known: ---LdJ 10 - "" ._~ ('CIX::j(,J
".ttN'~~l~~-b~ lnt Nom"," \1fJ?~11-rtJ?:Z{
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.!
A. Sinl!le Familv - Detached
I Single Family home
NO OF UNITS l
B. Sinl!le Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park ..4 N"\f'(l
X $400 PER UNIT _= $ C{tl 'P-".
X $370 PER UNIT =
. $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4fO~
,
$ YaJ
$ 4t() .
2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit!
~l(
Community rvices
City of Springfield
eJ
I
I
Date