HomeMy WebLinkAboutPermit Building 1994-8-22 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oltlce: 726.3759
.
SPRINGFIELD
LOCA~ION OF PROPlf!Mr )~() ~
, f'\
ASSESSORS MAP: rl
LOT' .f;:) BLOCK' . s.,
/OA'cf,/.,(",',:z
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OWNER: .~~- fA /L C,4,f)~,{~;-<
ADDRESS' . 2/30 fJ#/ aJood .,a... ,
CITY' #/ ..4,,<j
STATE: _/'JAi'
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JOB NUMBER
qL\s5'~()'\
225 Fifth Street
Springfield, Oregon 97477
""GO O?Arr)
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SUBDIVISION: C?A.sc;.:r;,!< &7.(# i
I~
PHONF'
ZIP:!J-7 5"'~ V
DESCRIBE WORK:A.JAV..>/;<....~.c 4..A?~''{~
NEW)< REMO'DEL ADDITION
I
>_v" ~,'c'? d.,d" L-,t.~.
J
DEMOLISH OTHER
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES
GENERAL' /2~,fe<:. ~Ab( ~..,..../ th /z.g'~<d4~ tb~t:k) ~
PLUMBING: ~ /'J~~. L.pc.--'.~c ~u."'/>~~ 1..'3~ lo . \1}qs
MECHANICAl' -~'L ~O< ..; PJ _ <~.M.C\S
ELECTRICAl' d.., c r-:-L .!'c.4.r C to tXlOd-. \
PHONE
?V7-;;/YO
(,,<;;c/, - ('('1;(
'..rCJfi- 71~~
t/J.~')..71/
~~E -, OFFICE ,\SE -
QUAD AREA: LAND USF' \ \ \ FLOOD PLAIN'
# OF BLDGS' ,{ # OF ,UNIT'" \ ZONING CODE: -.ll)~
OCCY GROUP: ~r ~-\ f\J\ CONSTR. TYP'" \J{\J # OF BDRMS: ~q,
# OF STORIES: ~ HEAT SOURCE: fG SECONDARY HEAT: ~.{J
WATER HEATER: ?~ RANGF' F~ SQUARE FOOTAGEdl df I
,
To request an Inspection, you must call 726.3769, Th!s.ls a24 hour recording. All Inspections requested belore 7:00 a,m. will be
. made the same working day, Inspectlons-requested,after 7:00 a.m, will be made the following work day,
" ','.,.., REQUIRED INSPECTIONS
D Temporary Electric
r9J Site Inspection - To be made
,sfter excavation, but prior to
~~lillLIormr--)'~ C~~.
?~I' ET1 r~' , '
D Underslab Plumblng/Electrlcall
Mechanical - Prior to cover,
fVI Footing - After trenches are
L...f'-l excavated.
D Masonry - Steel location, bond
.beams, grouting,
~ Foundation - After forms are
~ erected but prior to 'concrete
placement.
o Underground Plumbing - Prior
to filling trench,
I"'ll Underfl"'<;lu:~;;;'g/ Mechan~
L-...fJ - Prlo~nsuuulull Ut-OA"'ld:~~J
r:::::?1 Post and Beam. - Prior to floor
L-P:lnsulatlon or decking,
- ,'. . .
F5<l Floor Insulation - Prior to
'f-"'decklng,
r=::::::7f Sanitary Sewer - Prior to filling
L.,.L::::f- trench.
[";21 Storm Sewer - Prior to filling
l...{-::l trench. .
~ Water Line - Prior to filling
l,C::I trench, .
-, .. ..'~ Ro'ugh piumblr:'g ~. Prior to
L..f?i cover.
fQf R~ugh Mech~nlcal ~ Prior to
~ cover,
~ Rough' Electrical....,. Prior to
~ cover. '
IYl Electrical Service - Must be
Lf-=I approved to obtain permanent
electrical, power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Fra~lng - PriOr to cover.
~ Well/Ceiling Insulallon - Prior to
~ cover,
IjU Drywall ~ Prl,or to taping,
D Wood Stove - After Installation,
D Insert ;..... After fireplace approval
and In5~allatlon of unit.
l"tI Curbcut & Approach - After
Lp forms are erected but prior to
placement of concret.e.
Nl Sidewalk & Driveway - After
I exc~vatlon Is complete, forms
and sub-base material In place.
D Fen~e. - When completed,
D ,Street Trees -. When all required
trees are planted, .
IVl Final Plumbing - When all
~ plumbing w9rk Is complet,e,
r:::JI Final Electrical - When all
'-? electrical work Is complete,
R71 Final Mechanical - When all
Lf::;J. mechanical work Is complete.
, .
I'll Flnel Building - When all
~reQulred Inspections have been
approved and building Is,
completed.
D'Olher
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete. '
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been 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.
'L~t'~;pe.
Interior
;L
Corne r
Panhandle
Cul-de-sac
ITEM
Main
Garage
Carport
Tolal Value
Building Permil Fee
jif liS +- vl/1/
State Surcharge
Tolal Fee
(Al
PLUMBING ,PERMIT
ITEM
Fixtures
Residential Bath(s) N' :'3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
>.7~ +'1,(]
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
If
Wood Stove/lnser~i"lreplace Unit .'
.... .,......
Dryer Vent
GAs (JIP"ur + l? 1~,fJ. '.v.II,S
Mechanical Permll
Issuance
State Surcharge
1,1f) +--1$3
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharg~
Sidewalk ~O It
Curbcul ; i l? 11<
Demolition
"l'.1:';::
1. .
.:... ", ~ \' I .> I i'., i ': ;',
;;:.:~ ..,.,}' ~I ~d 'J4!f'.; ,'t-t '
'. ~ .~.: ' "~;,,\~ ;',<'CI/,~:~" ;.
..FP.L.
'IN
Is
Iw
IE
Setbacks,
, .
'.S THE PROPOSED WORKIN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. CoordInator prior to permit Issuance.
Lol faces ~
Lot sq. ltg, ~
Lot coverage ~
Topography 8, 7:'70 '
Total height ,!.)~ ,I::)
(4f);t-)
BUILDING PERMIT
j~ : ~rg :~~;~\.
HSE GAR ACC
5
1.1J
I
'l~&\O
.2$
3'?,8t
57,'0-1'
SYSTEMS D~VELOPMENT CHARGE (SDq
'(B) 1.2.5.22.,f'2.
FEE
/ 92r$ 0
J:..'1.7..r5 ~
J 5; If!
ur 7.9/
-.1.fJO
't,t;o
n,.()o
3,~ 6
I j,iJlJ
,3&.5'0
J 6,00
7-93
'1....9 . 'f3
.1.'/,66
f') no
,
cZ1d1r~e~\rt (l~\
'37-3.8; - 30 3. 3~
Tolal Miscellaneous Permits (E)
TOTAL AMOUI'jT DUE (excluding electrlcC! 33 {J,G,f
(A. B, C, D, and E Combined)
'UJ,'f7
'17,,0
10
t~
, APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall. In all respects, conform 10 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 p.)~s.i5ns of ld ordInances.
Plan Check Fee: ,'j( P
Date Paid: (0 '
n~celpt Numberl,;::;;/_/f}jO
Received By: ~ J
, .1:,~
Plans Reviewed By
7 r?t1-9t/
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMM;NTS
"l'J1J1..tDn Q ) 8,uj g 1l Xl U D
(cl+ \ ~O) J. W l1J()
~ 1 mo "/ ,1!iJ d)
frdJt i
5'"&~ ~.~/r /f_~) .
. ".~ .'. . '. .
By signature, I stale and agree, that I have carefully exa";lned
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 the City of Springfield, and the Laws
of the'State of Oregon pertaining to the work described
herein, and thaI NO OCCUPANCY will be made of any
stru~ture without permission of the BuildIng Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701,055 will be used on this
proJect.
I further agree to ensure 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 a2urln~.4trUction,
~gnature.~. ......J~~~~..L~
, -( - . -r
Date
VALIDATION:
/v~/o
DATE PAID .;2 -;2 '< &7~'
AMOUNT RECEIVED _~:.. .:.. :71. -?~.."
......---::;:7~.
RECEIPT NUMBER
RECEIVED BY
//./
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SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
J(\~~
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~
M," N,~ 0Il~ . ~~ ld N,mbec
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.
o YY}n~m~!~.m;
NAME:,~ '/ '
ADDRESS: A ~ ,
LOCATION OF_Ii'ROPOSED BfJIlPJ.ll\~1l;
, Street Address if Known: _ \Q L\ U ~
.
JObNO'~
PHONE:
STATE:~ZIP Ql~
D'f&-
~lQ )
P<)A~QA rrncO
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back,)
A. Sim!le Familv - Detached
l Single Family home
(
NO OF UNITS
B. Sin\!le Familv - Attached
NOOF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
$ 4OO.W
X $400 PER UNIT _=
.
X $370 PER UNIT =
, $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4DD <D
, flcJ
$1f::0 '
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
SED (If SDC reduced for CreditJ
/ /
Date
.
.
I~~i~~I08~1~~ project 89 '~bm~ted hes the foil
Bpprov~1. cas not requIre spec;tlc land use
225 FIFTH STREET L
SPRINGFIELD, OREGON 97477 Zoning. D~
INSPECTION REQUEST: 726-l1.6.9:>r-)?..;.q4:
OFFICE: 726-3759
AL~ho~l9d SIgnature 11m. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
':;9~::3 ~:;If .;.....-rAc"/-A
LEGAL DESCRIPTION
--.dl ~;:>~-.::?~. 9 ~ Yp--o
/
...&B DESCRIPTION
/~~ ~.;c>.
r '
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if,work is suspenaed for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
~:~~~f. ~on trac tor .72tg~, Z/~'p:;:.'
Address-L2~? W- T:> 'f?/'-.
City ~ Phone ?,?,7'-::?0c:-
Supervisor License Number
#:/.#,
Expiration Date
Constr Contr. Number e:; "')P~
Expiration Date ~~~.~
Signature of Supervising Electrician
.
,
Owners Name 5~./c::: ~ -r;l!'"~/..3?
Address
City Phone
01lNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owner~~
~~~~~
DATE: g.,:;Z "<,'5' Y'
RECEIPT #: / 'Yz;:..;:;
RECEIVED BY: ::....----::.,.:... ~ ..
AYLY- .
ELECTRICAL PERMIT APPLICATION
City Job Number
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
~Y~~6l,/
uni t.
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
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
$ 85.00
S 15.00
$ 40.00
S 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 Y'P
$ 55.00
$ 80.00
see "B" 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 S 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
~~. #,
-;z..-
I-~
'(j, ?,t"!;>
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"
.
,.JOB NO. '1,?~ f'~-/
,.
'~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
. (COMMERCIAL & RESIDENTIAL)
NANE OR COMPANY: -d.. <)__h/ ~
~_ L .//
! LOCATION: (;,'103 O~~
/
DEVELOPMENT TYPE: 5;= /)
.'
-
BUILDING SIZE: LOT SIZE sQ. Ft.
l. STORM DRAINAGE
IMPERVIOUS SQ. FT. "30 5"40 X 50.203 PER SQ. FT. ~Y:/O.r;,'?)
'- .-"
2 . SANITARY SEWER-CITY
NO. OF PFU'S .2.3 X $42.08 PER PFU ~9f:, 1. F'M
(See R,everse) '--- ...;/. .
3. TRANSPORTATIor~
NO OF ,UNITS X TRIP RATE X COST PER TRIP
I
X 1,01 X 5424.31
X X 5424.31
~.2'K:5"~
'- .-" -
S
X
X 5424.31
s
4. SANITARY SEWER-MWMC
NO. OF PFU'S :2-3 x S15.125 PER PFU + SIO MWMC ADM FEE S 35"t: Fr~
(Use PFU Total From Item 2 Above)
MW11C CREDIT IF APPLICABLE (SEE REVERSE) S -:(0,-'17
TOTAL-MWMC SDC ~
, '- ..-/
SUBTOTAL (ADD ITEMS 1.2.3 & 4) S 2-f-<:;2, 1'-0
5. ' ADMINIS1RATIVE FEES
BASE dHARGE ~ysT9{A~ ABOVE) X .05
?, A"-r- /f.rz.4 '1-/5-?7-
ip Btlldi k .
Jc coordi1Jr
.'
~:zo./~
~.
TOTAL SDC S 25"'22..>1!.
, ,/
'" . FIxTuRE UNIT,CALC~TION TABLE: NlImbN 01 New Fi.S X Unit Equi\'alcnt = Fix1urc Units (NOli
For rcmodt'ls. c.llcul~tc only Ih~ additional li'1"',,:.) 1
r,UI.WEn OF L'NIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUI\',"LENT UNITS
"
Bathtub........."..,..........,.. "..,..""" ",,'.. ,....,..,..,.., ...' ,..
Drinking Fountain..,......""....,..",." ",..,..""....,..'"..,...
Floor Drain,...........,..,."..,..,.,.., ',..,"'" ,'..' ,." "".'",...,..
Interceptors For Grt'asc/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..,............,..
Laundry Tub /Clotheswasher......... ..... ...........,..... .,...
C1olheswa~her . 3 Or More.....................................
'" MobITe Home Park Trap (1 Per Trailer)..................
Recep!or F(>r RerrigeratorfWater Station/Etc........
Receptor For Commercial Sink/Oishwasher/Etc..
Shower, Single' Stall................ ...... ...........................
Shower, Gang....................................................,......
Sink, Bar, COmmercial.............................................
. Urinal, Slallj\'-Iall.......................................................
Wash Basin/Lavatory, Single..................................
Water CloseL Public Installation.............................
Water Close!, Private...............................................
Miscellaneous:
/
.,
2.
~
"
,/
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
2.
I
I
3.'
'3
'2.
2.
'3
12.
TOTAL FIXTURE UNITS
=
23
CREDIT CALCULATION TABLE:
calculate credits separates.
Ir---- Year
I Annexed
Sased on assessed value. If improvements occurred after annexation dale in lable,
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1934
'1985
$.3.21
3.13
3.08
2.96
2.82
2.68
2.51
.'
"
Ctedil for Parcel or Land Only If Applicable
Improve~enl [If after annexation dale)
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
,
.,
R esid ent ial................................:......'...... .......:... 0.4
CommerciaL.................................................... 0.9
I nd ustrial......... ......................... ,....... ...... ,.......... 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT