HomeMy WebLinkAboutPermit Building 1994-5-19
CON ST.
.;ONTRACroR'S NAME ADDRESS.. CONTRACTOR' EXPIRES
;ENERAL _.,_._",SCL\J.I~1~,gUGV__u__B_lA-L~tt~___8&<tLL_- od q <t 7Cf'HQ( l"
I'LUMI3ING: {'u...I.;...tlM. 9\-uv...'o~"'3tLf{C: 11q,~
MECHANICAL:_,.\1tl\-'\.Z J:.~~~D~i ~Lj..1l.e....tt :rW-l~qt.{ 3<fS- .J...83%.
I 1-+' t-J\ ~te..~; ~ tll g ~'6 J'u.~p qcJ. 74-7 08"
To requesl an Inspection, you must call 726-3769. This Is a 24 hour recording, Alllnspecllons requested before 7:00 a.m. will be
milde the sarno working day. ln~;poctlons roquested after 7:00 a.m. will be made the (ollowlng work day.
;1., TempOr'ary Electric ~:~U~~:~~h~~c~~E:~~~t~S ~Inel Plumbing - When ~ii
l~ ~ cover. J ~ '~IUmblng work Is camplel.e.
,
D Silo Inspection - To be made rVrRough Electrical - Prior to ~ Final Eloctrlcal .;... When all
- .llIer excuvHllofl, but prior 10 ~cover
~otlinu forms. . . electrical, work Is compl~le. '.
o Uoidersl~b Plumbing/Electrical/ M Electrlcel Servlc'e _ Must be ~ Final Mechanical - When all
Mechanical - Prior to cover. / approved to obtain permenent ~ mechanical work Is complete,
~ . . electrical power. 6
I f ,Ill. ,
oot ng - A ler trenches ere Final Building - When all. ..-.
xcavalod. 0 Flreplac~' ~ Prior to facing , required Inspections have been
materials end lramlng Insp. approved and building Is
completed,
.,~
RFiSIDENTIAL
PlRMIT APPLICATION
I .
,,,pCClion,: 726.3769
Jllice: 726.3759
I
~OT:
?,o
::>WNER.
,ouel2..t=- i ('., w
IU-) l ~OOc.
"f"'; IUr., 1: J P_ L ()
I\DDRESS:
CITY:
:)ESCRIBE WOR/<'
-~EW _~ REMODEL
s ):. Q...
ADDITION
/
ELECTRICAL'
QUAD AREA:,l~ \\")\tJ
. OF BLDGS: -~..,l
OCCY GROUP: ~~~~
\
. OF STORIES: _,.
WATER HEATER:
~
o Masonry - Steol location, bond
beams, grouting.
~ Foundation - Altor forms are
erected but prIor to concrete
placement. '
o Underground Plumbing - Prior
to filling trench.
~ Underlloor Plumblng/Mechenlcal
~ - Prior to Insulation or decking.
r\7( Post an"d Beam - Prior to floor
~ i.nsulatlon or decking.
~. Floor I~sulalion - Prior to
'L\N decking. .
VI Sanitary Scwer - Prlor to filii no
~ tlUnch.
I~ Storm Sower - Prior 10 '1IIIno
~ trench.
~ Watcr L1no - Prior to (11I1nO
LA trench,' .
'~ROU9h Plumbing - Prior to
t, cover. \
. - .
W"-:-s:..,
BLOCK:
i?I.J...\ LOE'IL c::.
,STATE:
()~
DEMOLISH
OTHER
- OFFICE USE -
LAND USE:
\ \,\ \
\
'\/ tV
.:;==--&
E
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
.~ Framing :- p;lor to cover.
M' Wail/Calling Ins'UlatlOn - Prior to
L6I cover.
'96- DrYWall'~"prlor to toping.
o Wood Slove - After Installation.
o Insert - After lire place approval
~d Installation or unit.
, . ,
Curbcut & Approach - Alter
forms are erected but prior 10
placement of cencrulo.
J.. Sidewalk & Driveway _ Aller
~ oxcavallon Is complete, forms
and sub-base material In place.
o Fence - When completed.
I
o Street Trees - When all required
trees are planted.
)
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JOB NUMBER
,,~
9~OSZs
,
225 Flllh Slreel
SprI1l9f1eld. Oregon 97477
__~Pr;C\)J.r~J
, \'-n6'2,~
SUBDIVISION: (')aJ(tkl r: r:=
".~-- --
PHON~'
7'-N- Dq/~
:.i
ZIP: 97'+ 1'"\
PHONE
,..
,
"
FLOOD PLAIN'
ZONING CODE:
l4?C2-
.'
,
. OF BDRMS'
SECONDARY HEAT: ~. ~p,
SQUARE FOOTAGE: A 1'")0 n
,.
,
I
, '
o Other
MOBILE HOME INSPECTIONS
. _I::, .
o Blocking end Set.Up - When "ali '
blocking Is complete. "
:;
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel-up. and plumbing
Inspections havo boon approved
and tho homo Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
'ventlng have been. Installed. .
,
'; 'i
J
\
.
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Lot TYP_~I ck S4-0 .Ji.elbacks_ ___-.-" '-----&15 THE PROPOSED WORK IN J:~
\J P.L. HSE GAR I ACC "HISTORICAL DISTRICT. OR ON L \ D
-2>.._ tnlerlor - -: --,--- THE HISTORICAL REGISTER? N
Nits --:,"_'
-~-"------
_L_ 3~ If':; _oo---
_ V:L L2- If ~_ ___moo
_ S__ _'2-_ J _ _. .
;T
.
I
Lol faCC3 ~
Lot sq. fig. ~
Lol covcrag~
Topography llir
Tolal height ~
r4A' ')
Corner
Panhandle
x
Cul.do.sac
...
BUILDING PERMIT
ITEM SO. FT. X $/50. FT. a VALUE
/ ~73~_7iJ
\~ ~\ ~ S)f').r::J:)
'YJ.~ . ~$~r~
(A) ~~43
I
Main
2. 3:J If.
I
t.l-LfJ
Garage
Carport
Total Val ue
Building Permll Fee
State Surchargo
Total -Fec
/3L! 7~t.O
. __t.e.2.J~ I"'
SYSTEMS DEVELOPMENT CHARGE (SDC)
. . $;. ";2 1. 9a.B) ~ 1-~ ~.. ,-d
PLUMBING PERMIT
ITEM
T/.~9-. ~'.~
,.{j .03
~ 53
Fixtures IS-
Residential Bath(s) N' _-=3
Sanitary Sewer FT. 4t1-
Waler FT.
Storm Sower FT.
Mobile Home
Plumbing Permit -r- 5f18
Stale. Surcharge
Tolal Charge (C)
MECHANICAL PERMIT
Glt-5
...--/
r/4
Furnac~
Exhaust Hood
Vent F'an
N' J./-
Wood Slovellnsert/Flreplece ~."It
Dryor Vent I
Mechanical Permit
Issuance
State Surchargo
Total Permit
.'
(D)
MISCELLANEOUS PERMITS
Mobile Home ' ".~ ,
I..
. State Issuanco
State Surcharge n: i ': 11('"
.::..3' n-
Sidewalk It I;""'
Curbcul 30 q'l~ . ':
Demolition ~ ':'.
State Surcharge ..
...
"
, Totel Miscellaneous Permits (E) I
TOTAL AMOUNT DUE (excluding electrical) i
(A. B, C, 0, and E Combined) _
FEE
BRS"J
'.
/
~~
( Ol.CP
~UO
/0, .
.00
_"'2,. _,
I.
l~ill:5{
~
, II,
-.
If ye5, this application must be signed
and approved by tile Historical
Coordinator prior 10 pU'lInil Issuancu.
APPHOV(;J): _______.. _._
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perllllt i~~ {ll'anted on Iho express con<Jilion that the said
construction shall, in all respects. conform 10 the Ordinance
adopted by the City of Springfield, including tho
Development Code. regulallng the construction and use of
buildings, and may be suspended or revoked at any limo
upon violation of any provisions of said ordinances.
. ?77C>S
Plan Check Fee: __:s ~ /,
-_~"4/;.)AL
Recelpl Number:JlZ-- 7, 2. Co
~e By: ~~
Plans Reviewed By ~
Dale Paid:
l41fli
Systems Development Charge Is due on all undeveloped
properties within the Clly lImlls which are being Improved.
ADDITIONAL COMMENTS'
ulliA.bO\11LL~O 0 Q ~
~~L3JI-~~)
~d0f\O v. m't(L: \U\C\.'!:::-
:'
. .;n~
, "
. "
By slgnalure, 1 state and agree, that I have carolully ex~mlnod
the completed eppllcatlon and do' hereby certify that all
. Information hereon Is 'rue and correct, and I further certUy\
that any and all work performed shall be done In accordance
with the Ordl~ances o/lhe City of Sprlnglleld, a~d tti~ Laws
01 the Stnlo 01 OrOllon pertaining to tho work described
heroin, and thai. NO OCCUPANCY ";111 .be mado of' any
structure without pcrml~slon of the Building Safcty DivisIon.
I furihcr ccrllfy that (,"Iy cpnlractors and ornploycos who'
. . . I
are In compllanco with ORS 701.055 will be, u.~d on thl.
project.
I further agree to ensurQ that all required inspections' are
requested allhe proper time, that each address Is readable
. from the street, that the permit card Is located al nia' front
01 the property, and the approved set 01 plans will remain
C?,n the site at all II e~u~ c~~struc~l~n. ...1 .
__A:r~
, I
1?9~
Date.
jlloZ ,.
VALIDATION:
RECEIPT NUMBER
DATE PAID ~ ' t\
AMOUNT REC'tV~."' l.
RECEIV(;D BY M\~
,LiP)'
.
j
J
,
fi y!i!I~!.!!~!~!!!l!
.
Job No.
~w26
SYSTEMS DEVELOPMENT CHARGE
J.. A~RKS~EET
NAME:~l)pJlJj'CYYl L1fU)~ PHONE: ~
ADDRESS !j!3 LftJ 1M (')~J fP!J{rfJTATE ~p q1411
r:/JjA )'1 Y1J.A~~a -"
Tax Lot Number: _I fJhs 04 'dvQ tY'P:3~
LOCATION OF ~ROPOSED BUILPJ:'l}{~E:
Street Address if Known: '--1CJn
Platt Name: {fh It 0 L .
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.l
A. Sinl!le Familv - Detached
\
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached
NO OF UNITS
C. Mulli-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
cf)
$4LO, .
t
X $400 PER UNIT .F..
.
X $370 PER UNIT =
.$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$400~
$..ef
$ 4-n()~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
I "-
. , J.ffi J .' (
Community ServiceS-Divisi
City of Springfield
)
~1C0~
Date
JOB NO. 77 6~ 23
, -
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
LOCATlOtl: -7"-,-
DEVELOPMENT TYPE:
BUILDING SIZE:
I. STORt.! DRAINAGE
, SOVEi~ ElC/'I ~q/.t..D&-:S Q
.';~- c q~ ~('\ ll\lJ.::XtJ.4lP_ -/
5,c/( ~
NAME OR CQi'lPANY:
LOT SIZE
SQ. Ft.
IMPERVIOUS SQ. FT,
5/33
X $0,203 PER SQ, FT.
~G;, "} c,,::;
"-- -----
2. .SANITARY SEWER-CITY
IW, OF PFU'S
. (See Reverse)
).-5
~
X 542,08 PER PFU
105'2- ~
~.t-:J:-c.", ,~ .
'- .-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X /. 01 X 5424.31
, X
X $424.31
~ r2 8. ,?')
~
S
S
X X 5424.31
4, SANITARY SEWER-MWMC
NO. OF PFU' S ~ ~S-x $15.125 PER PFU + 510 MWMC ADt1 FEE
(Use PFU Total From Item 2 Above)
"?7s<g ~
S cf':'3.7~
MWMC CREDIT IF APPLICABLE (SEE REVERSE) s (jJ
~7.. 1"2-
TOTAL-MWMC SDC~ 407;' y<68
"- ..-/
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S ~rs.r~
:z.ot:>4. '" 1
5. ADMINISTRATIVE FEES
, . (
- . B?tSE CH #~BOVE)
/ pfBurdickL,J
S C Coordinator
X ,05
0::TdV l:z 5'.23
TOTAL SDC $ -' ':'3'::,2. /-
~2(' 21. 70
.
.
SPRINGFIELD~
The1followlng project es submitted hae the following
zon ng, and does not requ' if
225 .FIPTB STREET epproval. Ire spec Ie land use ELECTRICAL PERMIT ?t]f~~N
~~~~:fimg~~~ 9~~~~37fj9'ing LDe City Job Number L1~2.,~
OFFICE: 726-3759 D"to s-. \C,':'cu -
. i)~ 3. COKPLETE FEE SCHEDULE BELO"
1, ~ ~NST.AtrAfJ1iti Signa,tu " f\ 1'\. 'nA.
~~~~ )l New Resl~entia1-Single or
~ Multi~Family per dwelling unit.
; ~~ON. .. rJ . Service Included:
~~ ~ Items Cost Sum
~OB ~N _ If'\. \ 1000 sq.ft. or less $ 85 00
~ ~~~~ Each additional 500
Permits a e non~transferable and expi~ ~~~r~~for portion $ 15:00
if work is not started wi thin 180 days Each Kanuf'd Home or
.of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder $ 40.00
CONTRAcrOR INSTALLATION ONLY
/
/
City
"'"
Expiration Date
""
.'"
Explrat n Date
. 'ture of Supervising Electri~.
.~
owners
The installation is being made on
property I own.which is not intended
for sale, 'lease or rent. .
Owners Signature:
DATE:_ . . f=" ,~.qi 19Qd/~
RECEIPT, I. . . . ~. . ..... ..~ ~
RECEIVED BY: .., .. . .
-
Temporary Services or.Feeders
Installation, Alteration or Relocation
40
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
C.
200 amps or less
201 amps to 400 amps
Over 401 to.600 amps
Over 600 amps or 1000
D.. Branch Circui ts
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
\ $ 40.00
, $ 55.00
$ 80.00
volts see "B"
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
. Linii ted Energy/Comm
SUBToTAL OF'ABOVE
5X.State.Surcharge
TOTAL . .
E.
5..
"co',
+ :PIo .. M\'i\\{\ .~-e..
$ 40.00
$ 40.00
$ 20.00
$36.00
4t),~
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