HomeMy WebLinkAboutPermit Building 1993-4-8 (2)
..
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Ollice: 726.3759
LOCATION OF PROPOSED WORK: ~(g'i:17
/ ~CJ 2.. tf;> 2..
ASSESSORS MAP'
\fJ
Lor:
OWNER: _l2-o~("
, v
ADDRESS' '~? (:J
-
CITY: !_::_.I/ 1iJ" Vl.R -
SPRINGFIELD
.HY"'} 1fk,'-7--
2-2-.
BLOCK: _fS
cl-- i\ ( f1 /I) tl-r< r vis ()Y')
Mfi,~ L~,
.<:c..r:- ~8
DESCRIBE WORV'
NEW /- IlEMODEL
ADDITION
STATE"
~
.
'f-~,..
SPZ1"
DEMOLISH
OTHER
,lOB NUMBER
'9 3034~
225 Fi Ith Slreet
Springlield. Oregon 97477
,
TAX LOT' c:;-z.~
, '8t
SUBDIVISION: fu ['{'D..nQ..~; I
PHONE: 4-1' 6 -1i..o.JR.../
ZIP: 7'74ffl
CON ST.
ADDRESS CONTRACTOR H ~},l~%~
42tjJ:SINc..et2.,--BOX_~621. f.u7jfll-,DLiLl.t&!
PLUMBING: __L:1Y.IT t'lr3 PtJ.!.fjRL^,;:"
MECHANICAL: H.fJ,rz<:;.{./Al L'('~fIN 6
ELECTRICAl' '[:)1 J( /')/1 / ~(_~ C7/C1 C
CONTIlACTOR'S NAME
CENERAL:~USJ:(-
QUAD IIREA: 4R~.
.. OF 8LDGS: \.
OCCY GROUP: _8.."3 +M
" OF STORIES: ~ -
VVAT~R HEATER: L-
- OFF!CE USE -
LAND USE \ Il \
. OF L:NI"S:_ \ I
CONSTR, TYPE: Y;.../
HEAT SOURCE: _~(...
U
r-~ANGE:
PHONE
6~{.lil6
~..lt'lt1'i?(,)
FLOOD PLAIN'
ZONING CODE: J n~
# OF BDIlMS' -4 ~
SECONDARY HEAT:- (f
SQUARE FOOTAGE:,"-~~lU_
To f.;quest an ;r.spe~tion, you must call 726-3769, This is a 24 hour recording. All inspections requested before 7:00 a,m. will be
rn<1cJ0 the sam..; working day. inspections requc'sted after 7:00 a.m. will be made the following work day.
% TC01p"rary Electric
~Sitr,: Inspt:'ction - To bo made
)6C "ftel excavation. but prior to
settinu ionns. (ScQ II..)
o Ulldl.~rslab Plumbing/Electrical/
Mcch.:mical - Prior to cover.
I'9f Footing - After trenches f:.re
~ cxcava:p.d.
o Masonr'j - ~tee: location. I)ond
beams, groutll1g.
!";?1 Foundation - After forms me
~ erecled but prior to concrete
placement.
o
Underground Plumbing - PriQr
10 fiiling tmnch.
KAu ndertloo'.-Plu mb;nfl,.!.lK"cchanic{!.i)
~ _ Prior to Jnsulallo,', or deCI<tnU.
';,. Q1' ~ost a,:d Beam -. Prior to floor
~ ln$u!at:Gn or dp.ckmg.
r\:7f F~CO,I" lll~ulation - Prior.to
~ cJEc~.lng.
~Sanitary SeWN - Prior io fi!ling
~ trenCh.
i':?f Storm S~wcr - Prior to filiing
~ trench.
RA"'\Vater Line - P:,:or to filling
~trt1nGh.
r'1 Hough Plumbing - Prior to
I,.l:S. CO'JAr,
REQUIRED INSPECTIONS
~~ough Mechanical - Prior to
)6J <?ovc:". .
~.A' Rough Electrical - Prior TO
~ cover.
cg[ Electrical Service -- Must be
- approved 10 obtai n perm::t:1enl
electrical power.
o Fireplace - Prior to facing
materials and :raming Insp.
~ Framing - Prier to cover.
R71" Wall/Ceiling Insulation ~ Prior to
~cover.
.r&l Drywall - Prior to t3pjng.
~ Wood SIov9 ~ After lr.~;tallatlon.
~ ~. ry,J,
I l'n~;er' -_ J\ft,~r lirf~plac'~ ar:pro\':l.1
r:.nd lnst~i!~:io', 01 ur.it.
1'Vr Gt:rocut & J\ll(::-oac!= -- Atter
~~ iQnn5 ;:Hi) .;recled but. ;J~iO' to
p!:>i;crnent QI :;')ncre;e.
~ Sidewalk & Driveway - ~\ftCI
~Xc,wuUO!\ Is cO:;~;J10'.t:. ll'lrnl.::
and 3L!1)-ba~;e mak.:al in ple-lee.
il Fence - V.Jhen con',ple:ad.
'--'
~ Stwei Trc'1s 0.- \~,.IIi8'''' all rcqulrt-,j
~ tl~f-:;~ i.'.~~; pLtol!!':-"':. \.
~ Final Plumbing - When all
~ plumbing work is complel,co
~Final Electrical - When all
electrical work is complete.
~Final Mechanical - When all
mechanical work is complete.
FV1 Final Building - When all
~reQuired inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
l~ Olocldng ;Jnd Sel'Up - Wilcn all
L- blocking is com~:J:cie.
r~ ?Iumbing Connections ,- When
. heme l1a5 o(;cn connl~Glcd to
water and sewer.
[J Electrical Connection - When
blo:-.cking, set.up. and r1umblng
inspections have teen approved
and the home is ..::onnected to
the service panel.
,",
L.....J
Final - After a:1 required
irt$pflctlons are aool.:.vod and
jJor(;:"1l~S, :kirtir,G,"dr.ckz, aN1
v0nting have been installed.
j
-tL .
Lot faces Lot Type
Lot sq, ltg, mO _ Interior
Lot coverage 3U% -'t Corner
Topography 8>% N. Panhandle
;g:)J
Total height Cul.dc.sac
BUILDING PERMIT
ITEM
SQ, FT,
'2 S.TS-
..:92L2-
X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
"
Stale Surcharge
Total Fee
(A)
Setback:.;
,---
I P.L ! HSE GAR ACC
~-----
N I I~
Is /0
W
.
--
IS THE PROPOSED WORK IN THE
HISTOIlICAL DISTIlICT, 011 ON
THE HISTOIlICAL REGISTER?
-.
SYSTEMS DEVELOPMENT CHARGE (SDC) $
(B) ~ 2"'80 I;
PLUMBING PERMIT
ITEM
Fixtures
~ N' ~
Residential l3a(~(s)
Sanitary Sewer FT,
\ FT,
Water
Storm Sewer FT,
Mobile Home /
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO 4- .
Wood Stove/lnsert~
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
--I-~ It
~5 It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (ex~ludjng e!ectrical)
(A, B, C, D, and E Combined)
17
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
E i/Q____
API'1l0VED:
VALUE
/.~1 S'7r
....! 3 r; 77
L1-~"2%
Sf--3'_zS
'? +1. (p
570, -fl
FEE
_j(;;;.Ll.~
~.oe
u10f~_~
~_&-4'
4.5"0
12,0-0
/ S (}-[)
3.00
4D.'SO
-/0. dO
"2 .e;'
5' 2. /53
-3Z~~_
/~:!.!..
53.? 5/'
, ,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
T11is pcrrni~ is granteeJ on tile express condilion that ttle said
construction shull, in all respects, conform to the Ordinance
adopted by t~le City of Springfield, including the
Development CoeJe, 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 Clleck Fee: '=5 5'3,/1
Date Paid __,$/.{~h 3
Receipt Numbcr:___~~~
--4P~
. ~~ ~h:l
PIa Rev:cwcd By / ~te" -
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~__~~ \q(dJ
~Si f1}:\f)()
Mbs.R1o ;;;i(~ 00 U~ --
-#47U-:l
~~_~)uLf~'X1 ~
~-~-~~m~~
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 Ordinances of tile City of Springfield, and the Laws
of the Slate ?f Oregon pertaining to the work described
herein, and...tl1at NO OCCUPANCY will be maae of any
structure Without permission of the 8uilding Safety Oivisi.on.
I further certify that only contractors and employees who
are in compliance with OAS 701.055 will be used on this
project.
I further agree to ensure that all requirerJ inspections arc
requested at the proper time, ttlat cach addlcss is readable
frOJn,1I1e street, thaI the permit card is located at the front
of the property, and the approved set of plans will remain
><.o"~::"::" "~((,g'""'~O
, D"~e _u~ik-l- f3'
VALIDATION: _ _ _r\
REC8PTNUMBER ~
DATE PA'D 4-. ~ .q ~
AMOUNT IlEC~ ^t~':::~r()f)_\(
RECEIVED BY ~ )
.<
...
.
. ..JOB NO. ")'7,0" <-f S
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
,
(COMMERCIAL & RESIDENTIAL)
,
NAME OR COMPANY: f(o&c.1Z ~ NA1<J IJIY~/$()N
LOCATION: t,g<j7 t=:()~-rHI,4
DEVELOPHENT TYPE: 'LOt<. - NEE-v-! Sr~
BUILDING SIZE:
I. STORM DRAINAGE
1'60"].0 "Z-?--7- - 5 "2-00
LOT SIZE
SQ. Ft.
IMPERVIOUS SQ. FT.
2;,5>0'"
X $0.192 PER SQ. FT.
(f~OI0
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'2-'-1
X $39.78 PER PFU
GqS<-f;Y
---- ---
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I X I. ooS X $401. 05
Ctfo-;~)
-- ---
X
X $401.05
$
X
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ 2. 0 Is '6 S.z
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
G/o'-f+3)
-- .-
TOTAL-CITY SDC $"2.I"lL.'i~
5. SANITARY SEWER-MWMC
9'iJ
NO. OF PFU'S 2';' x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ;?lo -
(Use PFU Total From Item 2 Above)
!~~LvL
, d Kip Burdick
SDC Coordinator
->::'/7-</-/1':>
$ '/'i n
TOTAL.MWMC sDcG1 ~
--- .--
.t 17-
TOTAL SDC $ 1-..., %0-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE UNIT CALCULA TIO,," ABLE: Number of New Fixtures X uni6ivalent = Fixture Units (NOT~
For remodels, calculate only the NET additional fixtures)
~
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
."
2 2-
1
2
3
6
2 2-
6
6
1
3
2 Z.
l/Head
2 L
2
1 4-
6
4 t7.
Bathtu b..,......, ............... ........... ...... ........ ............ ........
Drinking Fountain..... .....,......,.............,....,......."......,
Floor Drain.,...."...,...................,...............................,.
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc...........,......
Laund ry Tub /Clotheswasher.,..,.."....,.,."...,... ....,..,.
Clotheswasher - 3 Or More................:...........,.......,
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator jWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
, '
Shower, SIngle StalL..........,..,.............,.,........,...,....
Shower, Gang..,..............,.......,..,..,..,..,......,.....,...,..,
Sink, Bar, eommercial,......,.:......,..,.....,.,....,..,...,..".
Urinal, StalljWaIL..,.;...,....,.,..,....."."." ".,.".,..,...,...,..
Wash Basin/Lavatory, Single.,.,...,..,.".,.,.,..".",."..,
Water Closet, Public Installation,..................,........,
Water Closet, Private..,..",."."."."..,.".""".".",.",."
Miscellaneous:
t./-
TOTAL FIXTURE UNITS
_7,4
CREDIT CALeULATION TABLE: Based on assessed value.
calculate credits separates,
I
If improvements occurred after annexation date in table,
Rate per-$~~
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
$2,83
2,76
2.71
2,60
2.46
2.33
1985
1986
1987
1988
1989
1990
1991
$2,16
1.90
1.60
0,25
0.87
0.50
0.16
1-83 X $ 17,':;'1 L/-q7=
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ '-1-'173;
eredtt for Parcel or Land Only If Applicable
Improvement (n after annexation date)
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL..................................................... 0.4
CommerciaL......................,.............,............... 0,9
IndustriaL... ............... .......................,........ ........ 0.45
GovernmentaL...,.............,.......,..,..:................ 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
, . ":,.0'" > ,.v.- *'
.,_", _.J' .
'0110'" ~ \,ov' . {) ~
'1,,-0 ' .,f< L> ;;.-- "
225 FIFTH STREET "",\:;.,1 -c^ ~--- r'~RtEcTIuCAL PERKIT' APPLICATION '
SPRINGFIELD, OREGON 974n ,.or,;.-- \'\1 (),~ {] 3-'-""'0 AC
INSPECTION JtEOUES'I': 726-3769 A \J.. - - ~ Ci ty Job Number - \ {J ( -) \ "- )
OFFICE: 726-3759 ,.w__________ ' r.I>I\l'. --
\> 'oil1..0 51" '- , 3. COMPLETE FEE SCHEDULE BELOll
'~~~=r'
-~f1) -'~)
:,~~:~~'~,~~ \:i.
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
~
.
-i-
CONTRACTOR IN: :TALLATION ONLY /'
Electr'cal Contra.:tor /'"
/'
Address
City
Supervisor
Expiration
..
"""::
'<
~
Expiratio Date
Sign~ re of Supervising Electrici~
~~ fll\ '11 rt-..h,,^ J D.
'~L:' :\Q...e \.' ~ \ nDl,\ llix. 'l:.li' !lOil
AddresLD (Q .~ ~J.rrtL
Ci ty PdQ( Xl_o Phone..J.Zfl.Jm. ~
~NSTALl.ATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~-----~-~~-~<:7~-------------
RECEIPT I: ;~ ~ ~
RECEIVED BY':L.L1 f~ ,
.
New Residential-Single or
Multi-Family per'dwelling unit.
Service Included:
Items
Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
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
$ 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 l s 40.00 '4/)
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
'Over 600 amps or 1000 voHs see "B" above
Branch Circuits
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
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$ 40.00
$ 40.00
$ 20.00
4t:OO
~ :f1J
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '