HomeMy WebLinkAboutPermit Building 1994-9-27 (2)
SPRINGFIELD
WiLt@
LOCATlONOFPROP~E9....WORK: 33~l 0 ("\r\ \\~ \J.J'(-.
ASSESSO.RS~. .'0. \'Cl)'ri.O\o(';() . .. . TAX LOT:\J1o ~rr:)
LOT' ry~.. BLOCt<.. . SUBDIVISION'_full~~
OWt:JE\>._Q\~ Q.i\ r f\to '(\')'\\1 !:\() J) ';~'(\~HONE: t \~ . \~ LoCo
ADDRE~~: ~~ r ;~J ~\3~ fY1 y, ~\J\ 0 0 j-' ,
CITY< 01\\ l\ l ri I ~. V (\I . . - STATE: ll\ 0 rz~f\ ZIP: 01-'\ -, ~
DESCRIBE WORK: ~f\r'\^Q., ~QN\1.VL, \~QJ:\\c1.Qf\C'L
NEW-Y REMODEL . ~ADDITION . "OEM ~ISH OTHER
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
.- '
JOB NUMBER~
225 Fifth Street
Springfield, Oregon 97477
CONTRACT~'~ NAM~ C J ADDRESS.
GENERA0J'\"Ll;,( \ Qi\ eJ\t,l.. .,
PLUMBING: ~}[C\ Q It \ "p. \ ~\o Q \,
MECHANICA-- . ,~_..t, _-\.(1 0 (\ Tf\1-:.
ELEcTRICA'\' ~\ \ Q A f] ~ '\U ~ )
CONST.
CONTRACTOR .
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5 \"\ ?{l
B\. '\C\~
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QUAD AREA:
· OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER: ~9 ~
- OFFICE USE -
LAND USE: \ \ \,\
· OF UNITS: . \ . \
CONSTR. TYPE: V TV
HEAT SOURCE'
f-
RANGE:
EXPIRES
'1.\';\. .
q. \.4.
'1:\ Q..
Q4
FLOOD PLAIN'
ZONING CODE:..ille-
· OF BDRMS: -,.3
SECONDARY HEAT:
SQUARE FOOTAGE:
/ lJf-K_~
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
mede the same working day, Inspections requested alter 7:00 a.m. will be made the following work day.
. , .
REQUIRED INSPECTIONS
~ R~ugh M.echanlcal ..:. Prior to
LA{ cover.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
r'Vl Footing - Alter trenches are
~ excavated. .
o Masonry - Steel location, bond
.beams, grouting.
~FoundatJon - After forms are
erected.but- prior to'concrete
placament.
o Underground Plumbing - Prior
to filling trench.
rc71 Underlloor Plumbing/Mechanical
Ll:ol. -Prior to Insulation or decking.
~ Post and Beam - Prior to 1I00r
~ Insulation or decking.
r&I Floor Insulation - Prior to
decking.
IVl Sanitary Sewer - Prior to filling
L..O.l trench.
rg] Storm Sewer - Prior to filling
trench. .
f"V1 Water Line - Prior to filling
~ trench.
~ Rough Plumbing - Prior to
~ cover.
I'Vl Roug.hElectrlcal - Prior. to
L.,..Or.t cover.
1::21. Elactrlcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
&DryWall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
C29 Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
excavation Is complete, forms
and'sub.base material In place.
o Fence - When completed.
o Slreet Trees - When all required
trees are planted.
~ Final Plumbing - When all
- plumbing Work Is complet,e.
~ Final Electrical - When all
~electrlcal work Is complete.
@Flnal Mechanical - When all
mechanical work Is complete.
C11 Final Building - When all
~equlred Inspections have been
approved and bUilding Is
completed.
o Other
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 have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
-j"
Lot faces
Lol Type.
.K Interior
Lot SQ. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
~
Cul-de.sac
BUILDING PERMIT
::I~ Jt~~T:
~lcO
X $/SQ~
&.OJ
14./0
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
<.,' "
"
>'0) . -1" ~',. .::..... '~..1J1'~..:~:Gf
:.:ti:.:: \ :-,.:, . I .. I ~,:.',_I.'- ;;':.l1:'''l' ,'-.'
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SYSTEMS DEVELOPMENT CHARGE F;5C.14
(B) <:YO 'J
(115'/0
~q~
1041+ ~
(A) 3')lo.qIJ-'
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT,
Water FT.
Storm Sewer FT.
Mobile Home
FEE
HOO.CD
Plumbing Permit
State Surcharge
Total Charge
/Jpo.oo
+80 + a ,W
(C) /72..RU
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N' ?,
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
.50\
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sldawalk 70 It
Curbcul at (J
It
Demolition
~~S~\)~~~
4.<fO
q.t()
.r~.OO
/ (0 .'SU
/0,00
.f3~
~
cOO. 15
I~ ,q()
<\-Uq?
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlc~.J3?3'1'
(A, B, Co 0, and E Combined) ,
Setbecks '
HSE GAR ACC'
:. THE.PROPOSED WORK.tN THE. .
. ".HISTOI;lICAL 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 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
I upon violation of any provisions of said ordinances.
Plan Check Fea: 'L\.f'-\.J ./
Date Paid: oJ ~
Receipt Numbe~ y
Received BY:~-
~S:>S~lLti
f).~.%
Date
Systems Development Charge Is due on all undeveloped
proparlles wllhln the Clly limits which are being Improved.
ADDITIONAL COMMENTS
_~')9 try\ r-Y __~.d O...u..Yl ~
lA",'" \QJjD (~1 )
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By slgnalure,l state and agrae, 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 the City of Springfield, and the Laws
of lha State of Oregon partalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure 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 thai all required Inspections are
requested at the proper lime; that each address Is reada~le
from the street, that the permit card Is located at the front
of the property. and the approvedf}jJet of pi will remain
\0"/,"\ site at al times durin ~uc ,
~re ~,
['ate 7k/
\ // /7
VALIDATION: lri ~
RECEIPT NUMBER
DATE PAIr> U .1: ' .
AMouNTREc~d~1 ~ I .~q.
RECEIVED BY _ I ^~
ATTACHMENT B1 -,
. ' JOB NO. 9"/-/.er/c"
CITY OF SPRINGFIELD SYSTEMS'DEVELOPME~GE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
N~~ OR COMPANY: I!a-,~ ~
, /
LOCATION: 33 $f, G~ 4-v<.
DEVELOPMENT TYPE: c,;:- 0
BUILDING SIZE:
tOT SIZF
SQ. Ft.
1. STORM nRAINAGE
IMPERVIOUS SQ. FT. 23 0 ~
X $0.209 PER SQ. FT. e2..3 0
2. SAMlIARY SFWFR-CITY
NO. OF PFU'S .
(See Reverse)
3. TRANSPORTATT~
NO OF UNITS X TRIP RATE X COST PER TRIP
/ X I. 0 I X $436.19
/'t
X $43.26 PER PFU
'~11F,~
X
X $436.19
((4-~O. 5~
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $ / ;0/'(;, V
X X $436.19
4. SAMlIARY SFWFR-MWMC
NO. OF PFU'S /'ir x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 1/9',-12
(Use PFU Total From Item 2 Above)
"
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
IQIAI -MWMr. Sl1C
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ 3~ tJ
( 2.'8"'1. y~~
$ / f ?~. "7 2
5. AnMTNTSTATTVF FFF)
BAS .CHARGE (;~BrL ABOVE) X .05
~~ . Date:
- rnig, R.E. I
oDrdinatoV
~~~~
~-
9-2:2-'1~
IQIAI snr.
$ 20'PC_7~
B2.SDC
, . '1-':' '
FIXTURE UNIT CALCUlATION TABLE: Number of New Fixt s X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the liE! additional fixtures)
NUMBER OF
NEW FIXTURES
~
FIXTURE TYPE
Bathtub..................................................................... .
Drinking Fountain.... .................................................
Floor Drain...................... ..........................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher .................... ...............
Clothes washer .3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
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 BasinlLavatory, Single..........,.......................
Toilet. Public Installation........................................
Toilet, Private.......................................................
Miscellaneous: ,...iI,VIlTO"'',s SINK
UNIT
EQUIVALENT
FIXTURE
UNITS
:2
4-
2
1
. 2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
..l.
'1r
J
~
:z.
r
"
/
J.2..
2
2-
z
TOTAL FIXTURE UNITS
/::;(
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
I
Year
Annexed
Rate per $1,000
Assessed Value
L
1979 or before
1980
1981
1982
1983
1984
1985.
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Year
Annexed
Rate per $1 ,000
Assessed Value
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
3, -1" X $ /tJ, cff)
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Credit for' Parcel or Land Only If Applicable
Improvement (if after annexation date)
34. 6 ()
-----
=
=
CREDIT TOTAL = $ 3~ G 0
"
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~
The following project as oubmltted'i'Ias the follow
zoning, and does not require opociflc land use
opproval.
225 FIFTH STREET n
SPRINGFIELD, OREGON 97477 Zoni"" L-D'L-
INSPECTION REQUEST: 726-ciYJi9 q -Z.?-~I(
OFFICE: 726-3759 '
Authortzed Slgnatu"'_/oHV"- ';OHP' "..." "KE SCHEDULE
1. LOCATION OF INSTALLATION
,.'2,5?!-. '-:;;"J#ZJ)~AJ DAf>!.
Jenm~PTIO~ -:ufo
.
\ w:l.~8'
, JO)l DESCRIPTION
/11 Ji'iu~ ~f2..~/ 7')&.u U!>
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor \.\\\'711.\ (:\pri-R;c
\ :4. s;u..~ ~ yt <;.J-e H+
Ci tY..Lr{\MP"C, Phone l..\'\S-d.J<,C)
Supervisor License Number I n(J(n~
Expiration Date I Cl-I-qS'
to~llj5
q-4- ~5
Address
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
~. ~--~--
Owners ~~Ent
Add~..ess .' JJd
Ci ty ~ Phone "114-.lcfildo
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Owners Signature:
.'
ELECTRICAL PERKIT APPLICATION
Ci ty Job Number
~.-?
,
BELOV
A.
New Residential-Single or
Multi-Family per dwelling ~nit.
Service Included:
Items Cost Sum
1000 sq.ft. or less \ $ 85.00 8S
Each additional 500
sq. ft or portion & ,'<.0
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 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
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D.
Branch Circui ts
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
$ 36.00
n~~
,"").'~
lQI~:~lL
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL