HomeMy WebLinkAboutPermit Building 1992-9-24 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PI10POr:r30'A .~~ ~7r-S<rTh'-:7'
ASSESSORS MAP: ~ CI,. ()~. '
LOT: _I '7 BLOCI" A
OWNER. 1I/?? ,.(Y?7.~
ADDI1ESS' -::2 /<7e 7~~~ z;>
. - /
j'P?-/,.p/-
DESCI1IBE WORK: S~\.Jh ffi&) \ZQ l'\\(hlV\9--
NEW.~ REMODEL ~ ~ . AD~'ITION ~ DEMOLlSH- - OTHER
CiTY'
SPRINGFIELD
~,.,
STATE: _/'!??f .
.
9'2//Y'b ~
JOB NUMBER
225 Fifth St'eet.
Sp,'ngfleld, O,euon 97477
"
..
TAX LOT: Us.. V'J ,
SU BDIVISION: (!{uJ C!1J'Ip 1iQinfr {r S
1liS-t-
PHONF' -;;nl?.qb~7
ZIP:
"
CONST.
CONTRACTOR'S NAME' ADDRESS CONTRACTOR · EXPIRES PHONE
,..' /,/. -~. -::?L2f?~-:Jd?P ~..-..?-/ / /.?? //-,.~
GENERAL/}@/~LPg~# ( -;57'~;: 4/1'~--._/ /?"";'~ [/ -7 -" 77.......~~
PLUMBING: '-vI~/ /~~-:/"t:,.:>
MECHANICAL:~~P~ 6. -0...__
ELECTRICAl' Y V.b"~'" jLC~~,
QUAD AREA: L\;:QSV
. OF BLDGS: .,.
OCCY GROUP: _~)~ l\f\..
. OF STORIES:_
WATER HEATER: _ ,~Ct::: ~/
- OFFICE USE -
\ \ \ \
\
V.tJ
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE: Cc~ ~;z:"
RANGE: rctF~-
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS:
\f\\L
,~
':.
SECONOARY HEAT:
~ 4JlltL
SQUARE FOOTAGE:
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
m~dc the sarno working day, inspections requested after 7:00 a,m. will be made the following work day.
o Tcmpormy ElcClric
o
Site Inspection - To ba made
after excavation, but prior to
setting forms.
o
Undcrslab Plumbing/Electrical/
Mechanical - Prior to cover.
[AJ
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
IZl Foundation - After forms are
erected bu I prior to concrete
placement.
[E] Underground Plumbing - Prior
to filling trench.
00
Underfloor Plumbing/ Mechanical
- PrIor to insulation or decking.
C{]
Post and Beam - Prior to floor
insulation or decking.
[Xl Floor Insulation - Prior to
decking.
[l] Sanitary Sewer - Prior to filling
trenel1.
rn Storm Sewer - Prior to filling
trench.
rYl Water Line - ~rlor,t~ tilling. .
lLlJ trench, . ... -. .
~ Rough Plumbing - Prior to
cover. ..
. " - "......
REQUIRED INSPECTIONS
IVI Rough Mechanical - Prior to
,~ cover.
r-..
IIIl Rough ~le~lrlcal - PrIor to
L4-J cover:
[Xl Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
malorlHls and framIng Insp.
~ Framing - Prior 10 cover.
Grl Wall/Celling Insulation - Prior to
cover.
!::lJ] D,ywall - P,ior 10 taping.
[XJ
Wood Slove - Aller InBtallatlon.
o Insert - After tire place approval
and installation of unit.
IXJ
Curbcut & Approach - After
fOlms are erectocj but prior 10
placement of concrete.
1\....
I17f Sidewalk & Driveway - After
~ excavation Is complete, forms
and sub-base material in place.
o Fence - When completed.
rVl Street Trees - When all reQulre.d
ycJ trees are planted. .
[X] Final Plumbing - Wilen all
plumbing work Is complel,e.
rvl FInal Eloctrlcal - When all
~ electrical work Is complete.
rn Final Mechanical - When all
mechanIcal work is complete.
rvl Final Building - When all
l4J required Inspections have been
approved and building Is
completed.
DO'her
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blockIng, set.up, and plumbing
inspectIons t1aVC been approved
and the home Is connected to
the servIce panel.
o Final - After all requi,ed
inspectIons are approved and
porches, ski'tlng, decks, and
venting have been. Installed.
:;
Setbacks
I P.L. HSE 1 GAR ACC I
~ ~J~'-f'
Iw ~'AtC
I E /"I~ ---
Lot faces J-
Lot sq. Itg. '~1
Lot coverage ~
Topog,aphy ~
Total height tJ.551
L)ZYP.
Interior
Corner
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
-::>/:>?Lj~
t.}</-;>
..~~ g'i3'iZ2::<-'
/~./.c> _62~
Garage
emparl
Total Value /.?,,?~?7.~
Building Permit Fee f/~. ~r
State Surcha'ge "2r.~ /
Total Fcc (A) ~V. %6
SYSTEMS DEVELOPMENT CHARGE (SDC) $
, (B) -u.'Z'Z.1 ,€A
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
.
Sanitary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
L1~6]:>
Plumbing Pe~mlt
State Surcharge
19:? frO
-~.~
Ul~.../-~
Total Charge
(C)
MECHANICAL PERMIT
6P
~.
'1-62
/2 ..
/S."
:;:.-
Furnace
Exhaust Hood
Vent Fan
N'
o/"k'"
~OOd Sto~lnserllFlrePlace Unit
Dryer Vent
Mechanical Permll
-ij~.$'&>
/;-,p
'2 .d3
~2. 5'3
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home'
State Issuance
State Surchargo
Sidewaik
9-;:j
~~
;2 ~. 95'"
j~~
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
~~
TOTAL AMOUNT DUE (excluding elect,icai) ~ 1'6
(A, B, C, 0, and E Combined)
'.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.
'/
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition ttlat ttle said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating Ole constl'llction and use of
blllldirl~l~t, alld may be: sllspended or revoked ilt any time
upon violation of any provisions of 5:J.id ordinances.
Plan Check Fee: _21-'2. /C
Date Paid: ~&"?2-
Receipt Numbe,: C:;-i'5~
By: #...,...-?...~ ~
.~~~
. rrr:~-::>
eviewed B
_s~~ ;1-9:?-
Date
Systems Developl11ent ClwlUu is due on ,111 undeveloped
properties within tile City lirnils Wllicll ;Ire ueino i/llproved.
AD9!,TIONAL COMM.ENTS
~7/7 Z--~4 7~~~
<
-nIIffJ)2i1irL ) 0ti'J Q J J11f/.L
Cs:\+i; 1':),U~()
\ ~'- uaXu; '1410/)
By signalure, I state and agree, that I have carefully cx?mincd
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
Witll the Ordinances of Ihe City of Springfield, and the Laws
of the Stale of Orenon pertaining to the work described
llerein, and that NO OCCUPANCY will 'be: made of any
structure WitllOut permission of the Building S<lfety Division.
I further certify that only contractors and 1~ll1ployecs wllo
are In compliance with ORS 701.055 will be used on ttlis
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, th<:lt tile permit card is located at tho front
of the property, and the approved set of plans will remain
on the sito~es during construction.
Signatu,e '/~ C-..--.~
/
Date -r Q t.;"3 2.
VALIDATION:
RECEIPT NUMBEFI
t? ;;;: 99
'7-.20<97-
3/97. 'lib
~~
DATE PAIr>
AMOUNT RECEIVEf1
RECEIVED BY
SI-IIINGFIIZLO
, \nelO '
" on'" ou.e
.~'O",i\\e c~ic \ai'
"'I'IlI',oieY\~i{e'l'" ELECTRICAL
97477 "","IO\'O~~orlo~
726-376~~~~~, City Job Number
el'" ,
201"1'9
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
,-~ce IDWg~N Q Jl(U _ d40 lo \J
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Address
City Phone
OVNER INSTALLATION
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT 1I:
RECEIVED BY:
q-zy'.,,-.<
6~?" .'
~~."
SCHEDULE BELOV
New Residential-Single or
Multi-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 Dwelling
Service or Feeder
200 amps
201 amps
Over 401
Over 600
Items
Sum
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
\ Lr? ~ Installation, Alterations or
Electrical Contractor~~~ Relocation:
Address ~ ~ () 200 amps or less
On 201 amps to 400 amps'
City ~Cl..~hone_'/U-?'f;.,clr401 amps to 600 amps
- 601 amps to 1000 amps
Supervisor License Number :)SS ,?-S Over 1000 amps/volts
, ~ . Reconnect Only
Expiration Date J"( 1'2..-
c. Temporary Services qr Feeders ,
Constr contr. Number ~~J of Installation, Alteration or Relocation
Expiration Date /O/..,-z----
f
Signature of Supervising Electrician
~p~
1/
Owners Name
Cost
- $ 85.00
AS"
I./~
'1 $ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00,
$130.00
$300.00
$ 40.00
*
or less ' ~,$ 40.00
to 400 amps $ 55.00
to 600 amps $ 80.00
amps or 1000 volts see "B"
D.
Branch Circuits
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 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
TOTAL
/7~.-
s.~
/ 7A 5"0
. .OB NO. ""12/1 4 C"
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: Titvl HOL. Tc
LOCATION: iOfYi? r::ofZSy-ri-l-IA
DEVELOPMENT TYPE: L.D~ - f...\ E:W <7f'~
J'i{Oz,.OZ,2-2 - O??OO
,
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SIZE
SQ. Ft.
'2- I \ 2;,
X $0.192 PER SQ. FT.
C:"Y7-D 9~
'- ---
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
"2.'?
X $39.78 PER PFU
G9\y9~
-----------
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X I.OOS X $401.05
c: YtJ~00
-- --
X
X $401. 05
$
X
X $401.05 $
SUBTOTAL (ADO ITEMS 1,2, & 3) $ \€)?e>9~
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
c;- ~I~
~ ,..;
TOT AL - C!TY SDC $ \C'j?:>o e,'f.
5. SANTTARY SEWER-MWMC
NO. OF PFU'S t.:z;, x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ '?'2.:,?-z...ce
(Use PFU Total From Item 2 Above)
~ ~.L-&.-
() Ki P Burdi ck
SDC Coordinator
~ /'2-1 /q-z.
I
$ 4z~
TOTAL-MWMC SDC~f)~
~ ---
TOTAL SDC $ "2.'2' \ ~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCULAT!N TABLE: Number of New Fixtu'e~ X It Equivalent = Fixture Units (NOTE:
For ,emodels, calculate only the NET additional fixtures)
FIXTURE TYPE
Bat htubm.u u. .mm." um.' u. muU m' mu.: uu ..u uuu uu um
o rinking Fountain... u.. u... u u u............. u.. u" u u. ..u..u.
Floo' Drain.... u u......... u..... u u....... u..u. u.... u. u.. u.. u...
Interceptors For Grease/Oil/Solids/Etcu.uuu.u.u..
Interceptors For Sand/Auto Wash/Etcu...muuu..u
La und ry Tub /Clotheswasher............. u.... u. ..uu.... ...
Clotheswasher - 3 Or Moreu..uu.u.u..m..uu.uu...uu
Mobile Home Park Trap (1 Per Trailer).........u.......
Receptor For Ref,ige,ator ;Water Station/Etc...u.u
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Singie Stall........u...... ....... ............u.....u.uu
S hower, Gang................ u u...................... u.. u.... u....
Sink, Bar, Comme,cial.......................uu.....u.uu....u
Urinal, Stall ;Wall........ u....... u.........................u.u......
Wash Basin/Lavatory, Single.....u.u..u.u.u.u..u.......
Water Closet, Public installation..uu...uu.........u...u
Water Closet, Private....uu..........u.......u..u..uu..m.u
Miscellaneous:
NUMBER OF
NEW FIXTURES
7:>
?
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-
-z.
z
'2
?
\2
'Z?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
- --.- - -
-- -. ---"
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
Rate per $1,000
Assessed Vaiue
$2.83
2.76
2.71
2.60
2.46
2.33
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
Credit for Parcel or Land Only If Applicable
Improvement (if afte, annexation date)
2..~? _ X $ Ie;. 02
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
=
42. '=>-1,
\1
Rate per $1,000
Assessed Value
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
II
I
=
= $ 1..\-2 ~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaLu.u. uu..... U" u... u. u u... u.. u..u..u...... 0.4
Commercial. m .... uuu. u..... m' u... u..... u .......u U' u 0.9
IndustriaL.. u.... u... um m" u uU' u' u.. u. u... m......u u 0.45
GovernmentaL.m....u u u.u. m."" u..' UU u.. m u..... 05
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT