HomeMy WebLinkAboutPermit Building 1995-5-24 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
-.
?
A- ASSESSORS MAP'
).,LOT: q
LOCATION OF PROPOSED 'WORK' (",q 2,~CIJR. <;..;,-1-1 I A
-. .-- . I
/9j,,.Q 2-. c:> 2...
::2- 2..:
.4
- BLOCK'
OWNER'
ADDRESS.
CITY:
~~' fM""-IT'lJN
4 D 1--~1 ' i frfl ~Ii
h{N1 f)
I Jj Y1P/
STATE' '
urf.-
NEW
x.
1-/.0//<;'<:::- ,--..,A I--<rQ./...-. T/~
DESCRIBE WORK'
REMODEL
ADDITION
DEMOLISH
OTHER
:5f'~'1"
,....--
_.
~5as?cf
JOB NUMBER
/
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: C> 59c::ro
,P/-<'TT ""~N17d";
SUBDIVISION: a1S'~~~ ,"'e;~WT
PHONE:
7<1t. -1704
ZIP:
Ci1r.,{1f
CONST,
CONTRACTOR'S NAME ADDRESS' CONTRACTOR' EXPIRES
GENERAL: _17/cK. .#.4..~ Of - f'$'hL~?if: ..-. "'"'. 58372. J;j77('4'6
PLUMBING: A.I?/::>~ 1'7L,hA1"'u/J: rc::4. I\\)O~\D7_ct_ \lJJ\nm... (C~t~)
MECHANICA" ;-I1:J/p.d}I.~t/ 1- :s",J l/a7/~ . / - ~ rtb J
ELECTRICAL: . lY1y ..r::-/?..... '7:If2~/A. j :r~.
1
/)y t2-t7 f1./
. OF BLoGS: I
,I. \i t'J II.. l/,,^
OCCY GROUP:'. "".'1" II \.
. OF STORIES: '],...
WATER HEATER:_Y;
QUAD AREA:
- OFFICE USE -
111\
I
CONSTR. TYPE: V N
HEAT SOURCE: _r;. (:,.
-g
LAND USE:
· OF UNITS'
RANGF'
PHONE
~SZS7- /<lS~
9S~-377S"
FLOOD PLAIN:
ZONING CODE: --.J!()l.-
/);
SECONDARY HEAT: f:P
SQUARE FOOTAGE: jC{lR1
. OF BDRMS.
,-
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections requested belore 7:00 a.m, will be
made the same working day, Inspections requested alter 7:00 a.m. will be made the following work dey,
REQUIRED INSPECTIONS
~empOr8ry Electric
D Site Inspection - To be mado
after excavation, but prIor to
setting forms,
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
rvrFootlng - After trenches are
~ excavated.
D Masonry - Steel location, bond
.beams, grouting.
~oundatlon - After forms are
~rected but prior to concrete
placement.
I\:7I'Rough Mechanical - Prior t.o
~ cover.
~ Rough Electrical - Prior to
~cover.
F=::7f'-Electrfcal Servlc~ - Must'be
~pproved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framlng - Prior to cover,
"""" Wall/C'elllng Insulation - Prior to
~over.
D Underground Plumbing - Prior Q Drywell _ Prior to taping.
to filling trench, )"""-l.
'Nl"'u nderflCl!lt.Plu m bl ~ ec han Ieee)
~ -.Prlor ~V,()'''''''''Q._~tfecK,"g, D Wood Stovo - After Installation.
'.
'rv1 Post 'and Beam - Prior to floor
~ In'sulatlon or deckIng. .
K71' Floor Insulation..... Prior to
.IC>ol. decking.
lv1 Sanitary Sewer - Prior to filling
~ trench.
I
'R7f fStorm Sewer - Prior to filling
~ trench.
M Wster Line - Prior to filling
~trench.
~ Rough P~umblng - Prior 10
LAlCover,
D Insert - After fireplace approval
and Installetlon 01 unit.
fV'1' Curbcut & Approach - After
~ forms are erected but prIor to
placemont of concrete.
'fV7T Sidewalk & Driveway - After
~ excavation Is compiete, forms
and sub-base material In place.
D Fen~e - When completed:
~treet Troes - Wh~n all required
~ees are planted. .
k:;( Final Plumbing _ When all
.J6l plumbing worl( Is complete.
, .
"f::71 Final Electrical - When atl
~ electrical work Is complete.
M Final Mechanical - When all
mechanical work Is complete.
~Flnal Building - When all
~requlred Inspections have been
approved and buildIng Is
completod.
DOthor
MOBILE HOME INSPECTIONS
D Blocking snd Sel.Up - When all
blockIng Is complete.
D PJumbing Connections - When
homo has been connected 10
water and sewer.
o 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
porchos, skirting, decks, and
venllng have been Installed.
la-0.eq..,
A9.7s-
<~/e
~7~p13
SYSTEMS DEVELOPMENT CHARGE (SDC) .J.b
, ~~\~
(B) or 2.<;"1"1-
lot faces
...J::L..
Wi
lot TY.
~I~terlor
lot sq, ftg,
lot coverage ZS;.J,~
Corner
Topography ~
I}QI
Total height ~
( q')
~
BUILDING PERMIT
ITEM SO. FT,
/f27.
5~CJ
Panhandle
Cul.de.sac
x $/so, FT ~
..~,,:; ~"
^ ,
/9:~ "
Main
Garage
Carport
"~If)ISIfC{J
/~ """A
.
'1,1'1
37.+7
Total Value
Building Permit Fee
State Surcharge '2.1,f'J r- /3/ OS
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' _'2,
Sanitary Sewer FT
.~.-":--....... Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
Q.~':' ..L C",7f ,
State Surcharge {, T" l,};
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
1-
Wood Stove/lnsertJ Flroplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge ,/:J. 'I> -f- . 7?
Total Permit (D)
MISCELL,ANEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
95 ft
3~ft
Curbcut
Demolition
State Surcharge
PLAll)~~) ,AW
.
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
IA. B, C, 0, and E C\,mblned)
I Pl. HSE GAR ACC'
IN
Is
lw 2-D
~~ 15 _
BUILDING VALUE, PLAN CHECK'
AND BUILDING PERMIT
'..;'
VALUE
~.".,I C; 7
7~/cf
L4~?~
FEE
I'/~~O
J S:~/
;2..D7...!!
" ~o
/',."
4.5'0
)200
~ c?O
2~.S"O
-LO.OO
_ 2,oS
~7. S-f
A2..S' '
Z<r
/5_~O
2'7.7'
~7,f1-
,
11 (!7~~
<3 S.
/7 W
...,.,.:.:~.; :~._~:J'~:\Hl;'
_ IS THE PROPOSED WORK IN THE,
.'.HISTOI:IICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks .
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said Otdlnances, f
Plan Check Fee: 2. '5 g .0 S Z$s-i ~J"
Date Paid: 4/2::'- ~~r - 2.- , ,
'/" )ti c ;;Z 7. 7'J
Receipt Number: /7115)'
RecABY;. ~~-,
P14~
s~\
/ a)l'te
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAl: COMMENTS
fl.n; rA6,410,
Il f/JUfJJi! nt dw ~ I q~oj
(111 A1lJ?ntlf hT/ialJtaf..e/ "
PA-rlI- /
'SjJ~~ Ha.,r ///k?A1/T ~d-#~
By signature, I state and agree, that I have carefully examined
the completed app"lIcatlon and do hereby eartHy 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 lews
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be mede of any
structure without permission of the Building Safety Division,
I further cert!fy 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 tlme~ tha"t 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 wlli remain
on the. site aa~1.durlng~o structlon.
'>f-gnature ->
,/~' . I
Oat.' '
VALIDATION: '(\/\nQ
RECEIPT NUMBER I - ~. .11:'-\.'-- )
DATE PAIr> ,':v~4.<-<i) '.
AMOUNT RECt~~ #,~';-4S",~S'i6.bt
RECEIVED B; Ir\l.~
.'
,,-':- '-,-,
. f _ .
-":~ ,:,'.,:-.~.~::!r\<J.8:.-b~}i_~i:W():i-;~~~~~~ ..~(~;:',
.GITY OF SPRINGFIELD.SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: '8e-r,y 1?f2-AYttJN
LOCATION: l.,q?u", r=:o~Sy-n.llA
DEVELOPMENT TYPE: LOtz - IJE.-w'5FP.
BUILDING SIZE:
1<60'2.02'2-"2. - OS"tOCl
LOT SIZF
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
'2-04-0
X $0.209 PER SQ. FT. ~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'2'?
X $43.26 PER P\U
Eq4 9~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1.0 I X $436.19
X
X
X $436.19
X $436.19
G 4-4-0 ~
------------
$
$
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
V....-=R., .L..k
U Ki P Burdi cl<
SDC Coordinator
TOTAL SDC
(1141~
$ '2. >:!>91 '!!.
X .05
Date: 4/Z8h9
.. . ...
~I~~~~~~c~i c?r~~~~n~* a~~i~n~~f~x~~r:~~r of ~e~ Fi~t~r~.~i~EqU;:~le~t';~~xt~(e ljnits'i,';;.;;';
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
?
2
1
2
3
,6
2
6
6.
1
;,
2
l/Head
2
2
1
6
4
4-
Bathtub........... ...........................................................
Drinking Fountain........ ... ............ ........ ............ ..........
Floor Drain....... ..-........... ...........................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors.For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher...................................
Clotheswasher - 3 Or More._...................................
Mobile Home Park Trap (1 pe'r trail~r)_.........:..:.....
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang............................. ..... .,. ...... ........;,.....
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall............... :...... ................... ........ :'.....
Wash Basin/Layatory" Si{lgle.... c.............................
Toilet, Public lnstallati'on................... .....................
Toilet, Private.................... ,.... ... ...-. ....... ...... ....:....
Miscellaneous:
'2.
...,.
.1..
2.
'2.
?
?
\'-
TOTAL FIXTURE UNITS
~
'Z.'?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
I
Yea.r
Annexed
Rate per $1.000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984.
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
Improvement (if ~fter annexation date)
3.f-b X $ "25.4-7
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
~
';l'iS I~
Credit for Parcel or Land Only If Applicable
~
CREDIT TOTAL
~ $ "i5<6 I~
.
.
, ~
o l!.':till~,!!~!~.'!.!;;
Job No.4t; /]6?4-
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:
g~,ga1~, '
LtO'l/(7 'I trVV~CG l {ULt..-
u
PHONE: -'14&/ l10tr
STATE: .JJ/k-ZIP 41th ( .
ADDRESS:
L~CATION OF PROPOSED BUILDING SITE: ,..rz .. .
Street Address if Known: loll ~I p :n/Yt?~ n1fua_~
Platt Name: I q (J ~o 't-1.I2r Tax Lot Number: [)q)CJ OZJ
1.. DEVELOPMENT TYPE (Check appropriate dwellirig(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. Multi-Familv Aoartment '
NO OF UNITS
D. ManufactUred Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
, "/A,A ,to
X $400 PER UNIT _=, $'1lJU
.
X $370 PER UNIT =
'$
X $777 PER UNIT =
$
X $280 PER UNIT =
$
$ t.M!J. tsO
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 Creditl
$
$ t/IJ(j ,() ~
'Jdy.
/ '
. .. . -
r"........."..":h' <:f\n,:,..",l" ni"i('inn{ I
tit 1//1/ ttc{
n~,p I
. I
The following project b
zoning, and doe. not ~:.~ mltted ~.. tho follo\
approval. qu ro specific land use
Zoning-L--OC
oet05-(CJ -'j-(
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
97477\c1horiZOd Signature j-J i'^
729-3769
1. LOCATION OF INSTALLATION
~'93c., 1~1f7:h'/4r
LEGAL DESCRIPTION
I <A-A 2... C> 2.. 2- 2. 6 S '98 i?
JOB DESCRIftION /7 ~/
~, ~~iM~d'7/
Permits are non-transferable and expire
if ~ork is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
O",ners Name~~--n., ~<J/I':rA J
,. ( - - ----rr ~
Address ~~/ r'*77f L/~'
Ci ty :"ill /"i'l Phone 7~ 7 - ? d-/ <:;
;j', (- 17~1t. r T<
01lNER INSTALLAtION
The installation is being made on
property I o"'n ",hich is not intended
for sale, lease or rent.
O~ers Signature:
l?1l5L~ 0>~~
------~----%-;;-:=~----------------
DATE: _'::;//7''}I95
RECEIPT #: c/ //'74:4/
RECEIVED BY:
///~-'ff; I
ELECTRICAL PERMIT APPLICATION
I:i t)' Job Number C)'SD 534-
3. COMPLETE FEE SCHEDULE BELOII
A. Ne~ Residential-Single or
Multi-Family per d",elling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'D~elling
Service or Feeder
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
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 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
D.
Branch Circuits
.....- $ 40.00 44,#04
S 55.00
$ 80.00
volts see "B" above
..
Ne~, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or ~ith Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
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% Administrative Fee
TOTAL
$
$
$
$
~eJ.-
"2 boO
J ..:2.0
4J.2..0
r -..,.
40.00
40.00
20.00
36.00