HomeMy WebLinkAboutPermit Building 1994-10-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
,I
JOB NUMBER
Gl4 \rjj'L3
225 Fifth Street
Springfield, Oregon 97477
. TAX LOT: ()6~D \
LOT: BLOCK: SUBDIVISION: \\J\Q ",q~
OWNER: 'tlli,n \ ~ · ~~!\~ C)~_ ...1 PHONE: <\?f,).&\C\'\-
ADDR~\?-'~a. ~,l'lOU ~ \'\U 1U
CITY: h~_~ -". . STATE:\\.\.\'~.J ZIP: q'l~~'
DESCR~E ~R~X'\'{\1\~. ,mJ\\\Q - \'\\)OTl1)H .R- <:\ ~()j\. ~:.
NEW "-V REMODEL AD I ON DEMOLISH 'H~
I . .
CONTRACTi~S NAME ..,rrv, V "- _~DRESS .
GENERAl'-.' N\ 1l.A....A--~)\} \.00 .
PLUMBING: ,'\ ,""" ~
MECHANICA~: ~.-~ ..
CONST.
\ CONTRA~:'( ~~PIRES
.~. ;'}U\_
..'Swt \ 'L,.
PHONE
~.qW1
ELECTRICAL:
- OFFICE USE -
QUAD AREA: ~~~ LAND USE: \\~ FLOOD PLAIN:
If OF BlOGS: \ If OF UNITS' \ " ZONING CODE: l/DQ ./
OCCY GROUP: I~?J CONSTR. TYPE: Vf\J # OF BDRMS: .'\
If OF STORIES: \ HEAT SOURCE: Fv SECONDARY HEAT:
WATER HEATER: f~ RANG 1=' t::.-. SQUARE FOOTAGE: J9PD
')
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
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior 1'9
setting 0 ms. V .-,
~nderSla' u I)ln Electrical r
I::f-l'Mechanlcal - Prior
rA Footing - After trenches are
\"" excavated. . ,:
o Masonry - Steel location, bond
beams, grouting.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must ':be
approved to obtain permanent
electrical power.
.'".: " ,
o Fireplace - Prlodo\facln'g ....
materials and framing.. Insp. , . .
'.
o Framing - Prior to cover.
o Foundation - After forms are . i
erected b~t 'f\~r ~~ffi~i1o /,,@all/celllnglnSJlatlon-prlorto
Placemen~ \.~~ co r.
o Underground PlumbIng - Prior 0 Drywall _ Prior to taping,
to filling trench.
,
o Underfloor PlumbIng/MechanIcal
. - PrIor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
~anltary Sewer - Prior to filling
trench.
torm Sewer - Prior to filling
trench.
~lIater LIne - Prior to filling
LJ:t';;ench.
o Rough PlumbIng - Prior to
cover.
o Wood Stove - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & DrIveway - After
excavation Is complete. forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. .
o FInal Plumbing - When all
plumbing w9rk Is complete.
o Filial Electrical - When all
elec'trJcal work Is complete. C
o Final Mechanical - When all
mechanical work Is complete.
o Flnal.',~.\.llidlng - Whe.nall
requlred"'lnjspectlons have, been
approved'"al'ldbulldlng Is' .
complete~; .
.:-'.
. 0 Other
MOBILE HOME INSPECTIONS
( rf]) Blocking and Set.Up - Whe[1 all
T_ blocking Is complete.
~PIUmblng Connections - Whe'n
home has been connected to .
water and sewer.
~'ectrlca' Connection - When
blocking, set-up. and plu~blng
Inspections have been approved
and the home Is connected to
the service panel.
~al - After all required
nspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
';, '::';\~:'r
Setbacks '
HSE GAR ACC'
BUILDI N G PE RMil.T,:,,;
'iTEM' "j:', SQ. FT;; ':.X
$/SO. FT,
"
. '" \
,..VALUE \,.,
S~JD(tl~'
,,.";,
Main
Gacage,
"
JfVt~
~
)
~
!~.~
..~.CA
4 1 .5Q
Total Value
Building Permit Fee
State Surcharge -t ~
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~ / ?~S.?!'
,
C$PLUMBING PERMIT
ITEM
Fixtures
,
Residential Bath(s) NO
Sanitary Sewer FT.
, Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
-- State Surcharge 4- 3'lu
.,
Total Charge (C)
MECHANICAL PERMIT
Furnace
FEE
c-fJ~.oO
AS ,0()
~S.OC)
'lS,CO
lo.OU
f)-I.CJU
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State :Surcharge
ff
(O~~O
~n.cf)
'\.~; 4S
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk 0 ft
Curbcut & ft
~~~~
State Surcharge
G,-lS
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~\ lp\ . ~'L.'
(A, B, C, D, and E Combined) -
" .S THEPROPOSED WORK,tN 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 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 ordinances.
PI~n Check Fee: ,) /
\eyr ,
Receipt Number: 'Y'"
Received By: ./
Date Paid:
Plans Reviewed By
DatE;l
Systems Development Charge Is due on all undeveloped
properties within tho City limits wtilch are being Improved.
ADDITIONAL COMMENTS
\ ~x\l'\\o-rQ.(
, )\ c),(\ \)
, \ td) LQ ./\(' i-Cl C
\)
uAlitil h'f)J\(U,c ~
~~-~pviY
ft+T,' IJI~rJ ,A-nne)C,' {qirf) ,
o
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 the City of Springfield, and the Laws
of the State of Oregon pertaining 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 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 at all times during construction.
Signature f"t..l.'5 rP01c:;e~^
Date I tJ- A ? - C( 1
VALIDATION:
RECEIPT ~~
DATE PAl
/e/~;Jq /. ,
C)CT Cj:.Lj
rl~\n\.~a
AMOUNJ-F-l;CEI
RECEIVED BY
.-
,
;~
~
*'
225 FIFTH STREET Zonina L",P L- ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 11 1+ "'4 ", C/ t::1' "'2-'
INSPE~ION REQUEST: 726-37@9IEi - -- '1 l: _ _ City Job Number - J -..jL', ~)
OFFICE. 726-3759, AUli1crized Signatuis ,,(Jhf'<--/ _ _
/,,' i ",~,' '", '.. _..~,_,,;~~!Y;;TE~F~E, 'CHEDULE BELOV '
1. , LocATION OF INSTALLATION ,
/f50} ~re.:J{l 5f-FI.)lr Dt'C.\ '~,.. fA. /New Resi,ia -Single or
/ ../, ~ul ti-Family 1I~fS.r dwelling uni t.
11LE~ ~.:S~PTION n2Tl'/,,\/) f" '''d~rv, ice Inclpded~ \ I ' / C
'?o~<?si&;;r10N I ~7~L J , lC}\lOOos<i. ft. or le~ 5'W 8:~~O ~1
AleLJ VZ1PjJ I Ho'vfJ 8 Each ciddi tional 500 fi \ 4
sq. ft 'or portion .. \, ~
Permi ts are non-transferable and expire thereof $ 15. (tj)1,l!:,P'
if work is not started within 180 days Each Manuf1d Home or I
of issuance or 'if work is suspended for Modular Dwelling', /}
180 days. .. .. ~rvic~ or Feeder -L- $ 40.00 TO..
~~ f\6te'k\'S.'\1~ ~\-\orol..~ermJlJ
B. S~Vlces or Feeders \) ~~~~.
Installation, Alterations ,\\ UJ
or Relocation: ' ..
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor sfeuelU5 8LE:crlfG1C
Address f,o,'lf,oX /43 ,
Ci ty , (}eJ(ree..Phone ((f.)7J",3,7L
Supervisor License Number 401 tf C;'
Expiration Date I?~
j ') '7() e.u:cr- ~ C.
Constr Contr. Number 9p~ ~ ~1hc.?7'3-e
\ q ,......,
Expiration Date, 7
, ,
Si~f~~ing Electrician
Owners Name t;L-U S fGNSSLJA.J
Address gr35, L-OSr CI< rf(.{?
Ci ty f)e'it-e/L Phone q~7~ 2494
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
----------------------'2t~,~--------,---
DATE: nJ('\~1
RECEIPT ~: WI f' ~ 153!9-6
RECEIVED By:C/lV( LX ../ ..
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
..
Temporary Services or Feeders
Installati6n, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see "B'" above
,.
New, Alteration or Extension Per, Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
,Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Admirii~trat{ve Fee
TOTAL
$ 35.00,.
$ 2.00
not included)
$ 40.00
,$ 40.00
$ 20.00
$ 36.00
iD'~
. 3021
, I z...a
~~ LL -iz. a
I
,JJ.'~ Willamalane
'(;\1' Pa,k & Rec,ea';on o;stdct
Job No. C~\()~
LOCATION OFfllROPOSED BUIL9INC;; SITE:
, Street Address if Known: ~c{)3
NAME: [_~,
ADDRESS:f> 13~ ~~(JS: J ~G ted
\ 9\:st9-X7 ~
Tax Lot Number: \ ~ O'L32-43 032D \
SYSTEMS DEVElOPMENT CHARGE
f) n V\s \\?~K~HE~
\-'UU I JLU1\ / . PHONE:!J::/7 -~1
STATE: f!)~ZIP Q'743 f.
platt Name:
up-=8 L\C\3
1. DEVELOPMENT TYPE (Check appropriate dwelling(s>. SDC Calculations and dwelling type
defjnitions are on the backJ
A. Single Family - Detached
Single Family home
NO OF UNITS \
B. Single Family - Attached
NO OF UNITS
C. Multi-Family Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
Manufactured home not in a park
$ 4bD,c0 ,
X $400 PER UNIT _=
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ ~D.cO
'ffi
$.
$'tDl).oO
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approyal. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
\o~~~seli~~? rJ .
r;h, ,...,(- C.-"'\,..;,.,,..,,+;ofrf
I
I
Date
ATTACHMENT B1
JOB NO~, q~/S-.2.3
0",1
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
, WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~ r~'
LOCATION: 15~3 A~ '5f.,'"
DEVELOPMENT TYPE: A~"# ~ ~-~~~4~'"
PAr....... HouSE , , " I
BUILDING SItE: (1'1;.(/2) r (.21)(48') - LOT SIZE"' SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. / s/~
2. SANITARY SFWER-CITY
NO. OF PFU'S ;?
"- (See Reverse)
3. TRANS PORT /l.T T ON
X $0.209 PER SQ. FT. ~/~.Ol)
'- ~
X $43.26 PER PFU . ~.
NO OF UNITS X TRIP RATE X COST PER TRIP
J
X /.01 X $436.19
X X $436.19
{44~
$
x
v '436 10
^ _ . J../
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $ /5$ S .;2<jf
4. ~ANTTARY SFWFR~MWMC
NO. OF PFU' S /? x $17 .,19 PER PFU + $10 MWMC ADMIN. FEE, $ 3/fJ. f.2
(Use PFU Total From Item 2 Above) ,
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
'. " TOTAl -MWMC SOC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
.$ 3'1,S ~
ez ~ 9. rf-~
$J8"IS.oY
5.., ~MTNTSTATTVF FFF~
BASE CHARGE ( SUBTOTAL ABOVE) X . 05 ' ,
~/~C
/ Mary HOrriig, P.E. ')
SDC Coordi nator vi
('Ja.10
Date: /0 -~/- '1~
TOTAL SDC
$ J 70S". 8"3.
B2 . SDC .
~ X Unit Equivalent = Fixture Units
FIXTURE UNIT CALCULA .uN TABLE: Number of New Fixtu.
(NOTE: For remodels, calculate only the Nfl additio'nal fixtures)
NUMBER OF
FIXTURE TYPE NEW FIXTURES
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 Per Trailer)..................
Receptor For RefrigeratorNJater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall. ...... ........................ ........ ..;.......
Shower, Gang.............................. ............. ...............
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, StaI\AfVall..:........................ ............................
Wash Basin/Lavatory, Single.... .......... ...... .... ... .......
Toilet, Public Installation........................................
Toilet, Private.. .....................................................
Miscellaneous: ,TANI iCR'.s 5.I.-.tK
FIXTURE
UNITS
UNIT
EOUIV ALENT
2
2
,
2
3
6
2
6
6
,
3
2
1/Head
2
2
1
6
4
~
4-
2.
J....
:z
.2,
2.
<;(
TOTAL FlXTUP,E UNITS
/'t'
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in tabie,
calculate credits separates.
Year
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
1938
1989
1990
'991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
J
Credit for Parcel or land Only If Applicable
=
39, SF
..----
'3 ,-1~ X $ II, 1--10
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Improvement (if after annexation datel
=
CREDIT TOTAL = $ 31,s-ff