HomeMy WebLinkAboutPermit Building 1992-5-18
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.,
LOCATION OF PROPOfED l)~.: .""l 0/\ :Is Lu.p j.;, O.Q
'J . . ---...J,. ~ ~~L . ,
ASSESSORS MAP: . I < ) t:J"':-l -
'i? 0 V\ --;<o""hsu-~
7-00 C/'t:....~ ~('.
CITY: ~...^ L.~.' O:h~ ~?D
-So F,. k.~cQev..,-~
LOT:
L
OWNER:
ADDRESS:
DESCRIBE WORI<'
NEW ,./ REMODEL
Wo
BLOCI<:
STAT 1=.
1
Q..JLi..t
..;
JO~ NUMBER ~~2~~~
225 Fifth Street .
Springfield, o.regon 97477
TAX LOT: f) f.tJ W)&J
SUBDIVISION: M c-1}.A.u..{'~ c.v-.,
o
. PHONEf.~o~~ ~ 5.- '\ \ \ .,---
ZIP:
9 ~ l{~(
ADDITION
DEMOLISH
OTHER
.: ,'CONST.
. CONTRACTOR It
EXPIRES
PHONE
CONTRACTOR'S NAME . _ .,', ADDRESS
, 1-lli" '- .
: EN ERi\;_'O M:,~ .. .'~:Sl=-C" J."'::L~"-~'.'i.:h-:~~" _ll3fr~ -- _:_-z,:,,\~.. .. "7 ~~ii.~!
I LU MBI NG. _J2DY-..~--,--._-------- _~,___ .._590ul..1____.c9 ~~_.-.---- ~
Q~AD AREA: ~~_~f' -/
It OF BLDGS: . \
OCCY GROUP: R~~ M
\'C.-/
It OF STORIES:
WATER HEATER:
,5'3tdD) ~. '23 ~~ ~'.- ~
- OFFICE USE -
\ \ \ \:
, . I
/I OF UNITS: \.;.
CONSTR. TYPE: . 'V AJ'
HEAT SOU~CE: 1//.4LL ~rq
/:5" ,
RANGF' . 't'../ I ,
LAND USE:
FLOOD PLAIN:
lJ,)[u
.~
MECHANICAL:
ELECTRICAL: We.: l~,.o 'FQ<:,.,.J;-.r.~c.
ZONING CODE:
/I OF BDRMS:
SECONDARY HEAT:
I I} '2.,rJ
SQUARE FOOTAG E: ~ (. ) CZ)
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.
REQlllRED INSpECTIONS
M Temporary Electric
K::71' Site Inspection - To bernacle
~ after excavation, I)ut prior to
setting forms. S87""7.3~
D
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
15<1' Footing - After trenches are
, . .excavated.
o Masonry -:-. Steel location, bond
beams, grouting. .
"'R1 Foundation - After forms are
~rected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
~ Under.llo~umbin~'echanical
~ - Pri?r to ins~JIi.ll1on or decking.
~ Post and. Beam - Prior to fl.oor
)L-J'-;nsulation or decking. 1'"". ,. .
. (
.-
l:><1 Floor Insulation
~ecking,
l' t.,~.
Pri or 'to -'. -'..
"c'7( Sanitary Sewer - Prior to filling
~rencrL '
15<( Storm Sewer - Prior to filling
, . ,trench. '.
.,
'Ix"(water Line - Prior to f!H;n,g~
~rench. . ~
'"1':7( Rough Plu~bin9 ':':"Priorto
~ ~over. _ ~.,: '. . " _
..
'I>(I' ROl.19h Mecha~ical ~ Prior to
r~~over. .,
~ROU9h Elcclrifal -' Prior '.0 ..~.
. cover. ;.
; ,
~l>(r Electrical Service':' Must be
/ ~pproved to obtain permanent
electrical power. . I
Fireplace - Prior to faCi-ng
materials and,framing ~nsp.
j2s[,Framing ---. Prior to' cover.
~ Wall/Ceiling I~sulation :....: ~~';r to
cover. I,
I
o
M Drywall - Pri~r to :aPing.
.;11"" ). ~ ,.
. V1 Wood Stove - Afte'r installation.
~ zao ct.~ F~P; -
o Insert - Af!er !irep:lace approval
> . and installatiqn of unit. '
,
"'t'v( Curbcut & Approach - After
,'V~orms are erected but prior to.
placement of poncrete,.
, '..
't'x~,'fSidewalk & Driveway - After
~xcavation is complete, forms
and sub-1Jase ,mater,ial in place,
i
o Fence - Wilen completed.:
0treet Trees ! When all [CqUi;ed
~ees are planted.. <_"'. -'.
".
'I .
.1'x1 Final Plumbing - Wilen all
~Iumbing worl, is complete.
. f~jllal Eleclrical -.Wllen cJII.
Y-~Iectrical work is complete.
~inal Mechanical - When all
~nechanical worl, is complete,
~Final Building - When all .
~required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking is complete.
o Plumbing Connections - Wilen
home has been connected to
water and sewer.
o Electrical Connectio'o - 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.
Lot faces UP--~ v,pe
Lot sq.ftg. ). f).1' :$9S ' .Int~rior
Lot coverage :;??!;;/fc Corner
Topography <:: :2. ~t> Panhandle
Total height fJD' Cul-de-sac
BUILDING PERMIT
ITEM
SO. FT
X $/SO. FT
Main
12'~ ~">
er9?;. -;;-
Garage
Carport
Total Value
Building Permit Fee
".State Surcharge
Total Fee
(A)
Setbacks
.P.L HSE GAR ACC
N /t/
S It) l'
W -Y!.11. ,. ..J~ "__
E 51
VA LU E
~~s-
6201.~
. '. . t
~.~~
. '2,od2?
--/5?'O
3L--tq ,2D
SYSTEMS ~EVELOPMENT CHARGE (SDC) tt..
~- . (B)~ 1~c=:t1... ~
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
2
Sanitary Sewer
FT
Water ~
FT
Storm Sewer FT
Mobile Home
I.. Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove,! Insert/Fireplace Unit
Dryer Vent
Mechani.cal, Perrnit
. Issuance
State SurcharQ.e
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home '.
.State Issuance
State Surcharge
Sidewalk ?,fl!;; ft
~2
Curbcut.
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/hIJPO
-
-
'.
., .
'.,;. ~.~.-
-,
/?:)()O
_169:J~O
,
,
dG'O
(, -I.
-LS.tJ 0
____3_,q_9~
Z2- ,5 D
/0,00
/. /~
.33,~3
20.20
/3,:310
. 3_B~!..'S~
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4
,S THE PROPOSED WORK IN THE
HISTORI~AL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by lhe Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING 'PERMIT
This permit is granted on the expre.ss condition lhatthe said
construction shall, in all respects,confbrm. to.the Ordinance
adopted. by the City of Springfield, including the
Development Code, regulating tbe construction and use of
buildings, and may be suspended. or revoked at any time
upon violalion of any provisions ot" said ordinances.
Plan Check Fee: ~/ 97. tE,o
</-29-92.
Receipt Number' ~y e7 .
Rece~'ve ,,Y://~ ~
~~.~~ .
~(~eview~:f:/.,.
Date Paid:
'"
~51L~4~
I'-D~e"
Systems [)evelopment Cllarge is due on all undeveloped
properties within the City Iin:its :-vhich arf;) bei.n9 improved.
ADDITIONAL COMMENTS
~;p~~z:>.~~~,.
r{t[fi1Y~Ll ONt~
~!\9)C~)" gloO
~'+\"~ \O/\CO
\Jt~nl \.)J0~~
'4'~~iCA*~d:D j
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify thai all
information hereon is true and correct, and I furttle~ certify
that any and all work performed shall be do.ne in accordance
with ttJe Ordinances of the Ci.ty of Springfield, and the Laws
of the Stale of 01e9011' pertaining to. the worl< described
herein, and tr~9t NO?CCUPANCY will be made of any
structure Witll0Ut permission of the Building Safety Division.
I further certi fy.that only contractors and enlployees who
are in compliance with ORS 701.055 will be used on this
project.
'..;,;
.-' .
I further agree t6 ensure that all re.Quired inspections are
requested at ~hepr~per time, that each address is.readable
. fr~.rn the street, ttia~ the permit card is located at the front
of -the property, and the approvea set of plans will remain
. Xg:::u:~e ~;:w;nSI'UCllon . ....
I 'Date $-<.x--9,....
VALIDATION: /~:.~
RECEIPT NUMBER ___,._~_7<'~9'/ _________....
DATE PA I D ~~f!? ~ "':::2.______.. __.. _,___~_,.,..
AMOUNT REQEIVED . ~C .~. ~~~_____.:-
RECEIVED BY ~~ . --- ' -
/.4/-
"'v.
. J;
I .
, JOB NO _ Cf').,O (p? B
,.
CITY OF
. . '
Sr"iNGFIELO SYS\JEMS OEVELOPMl
WORKSHEET
(COMHERCI~L & RESIDENTIAL)
" :',. 'J
, t!
CHARGE
..
NN1EOR cor'1PANY: . -:RoN -Ro~~'s
LOCATION:~OI-' ~'.,.;..u'l?-.1?E;..u.... vJp.y
DEVELOPMENT TYPE: l-D~ - 'NE:.W SF-I'-
BUILDING SIZE:,
1. STORM DRAINAG~. j
IMPERVIOUS SQ. FT. 'Z1?.B , X SO.186 PERSQ- FT.b ?O,'il
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
lOT SIZE
SQ. Ft.
2. SANITARY SEWER-CITY.
NO. OF PFU'S I f;J X $38.55 'PER PFU
(See Reverse To Determine Total PFU'S)
$ (,:;,q? ~~ I
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIp.
X \ .oot:?X $388.61
Is- ::ljqO?~ l
X' , ' ,X $388.61
$
X X $388'. ()! $ -
(See Attachment C To Determine Trip Rates)
. SUBTOTAL '(ADO ITEM,S 1,2, & 3) $ I? ~ ( ~
..
4. ADMINISTRATIVE FEE~
'BASE CHARGE' (SUBTOTAL, ABOVE) X ~05'
Is7q'~1
TOTAL -C lTY SDC.S \(0'" 1'+.2-.
5. SANITARY SEWER-MWMC
NO. OF PFU'S
,/6
x 513.25 PER PFU ,+ 510 'MWHC ADMIN~ FEE s'ZL/B So
(Use PFU Total From Item 2 Above)
NWNC CREDIT IF APPLICABLE (SEE REVERSE)
,y" .?~'L.<k'
\\ Ki p Burdi ck .
SDC Coordinator
S/~/Cfv .
, ,
. s 'Z 1 (.,,~
TOTAl-MWMC SDcIs 220 ~ I
TOTAL SDC S; I E:>41... "2-~_L
FIXTURE UNIT CALCULATION TABLE: Number 01 New Fi:-."1ureSA Unit eQu{valent '" Fix"1ure Units (h!OTE
. .:
For remodels. calculate only the NET jj,ionallix1ure:;)
NUMBEfI OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTURE TYPE
1.-
2
1
2
3
G
2
6
6
1
3
2
ljHead
2
2
1
6
4
Batht ub..... ....__.. .___..____._. .__u__ u .-.... --.-..- ...--......-.... ....-.
Drinking founta in._:_..:...---.--.- -.-. .---' .--.----... -.... -. ...-....
Roor 0 rain__..:._ -...:-..-..--:-.-... -- ...-.----------.-----....- -'--"'--
Interceptors For GreasejOil/Solids/Etc...-....-.........
Interceptors For.SandjAuto Wash/Etc----..-...:-.....-
La und ry Tub / Ootheswasher.-...u---.------u--.... -. .....-..
Ootheswasher - 3 Or More.........__...___m_.....-___._._._.
Mobile Home Park Trap (1 Per Trailer)_.....____._._....
Receptor For RefrigeratorjWater Station/Etc....-..-
Receptor For Commercial Sink/Oismvasher jEtc_:
Shower. Single Stall.._.......:.......m.-...-.-------------.-....-
S hOVJ e r. Gang ........._..._ ..;....-. .--..-.,-- u.._._______.._....
Sink. Bar. COmmerciaL.-....--------.--m.-.
Urinal. Stall jWaIL.............. .~...__...-------------m......
Wash BasinfLavatory. Single____________n-.--....
Water Ooset, Public Installation....-----------.---.----
Water Ooset, Private_.....__....___..____---n
Miscellaneous:.
r
1.-
1--
TOTAL AXfURE UNITS
FIXTURE
UNITS
c..f
2-
2,
'],.-
8
16
,.
Based on assessed value.. If.improvements occurred after annexation date in .table,
CREDIT CALCULATION TABLE:
calc::u1ate credits separates.
I
Year
Annexed
1985
1986
1987
1988
1989
1990
Rate per $1.000
AssesSed Value
$2.66
2.64
2.53
2.41
2.19
2.04
- - - - - ..- -
- - - - -'. - -
Year
Annexed
1979 or before
1980
1981
1982
1983
1984.
...
Credit for Parcel or Land Only Ii Applicable
'2-.Corp X SIb....,. '-1 Co~
(Rate X Assessed Value)
X S.
(Rate X Assessed Value)
CREDIT TOTAL = S 2/ ~
Improvement (If after annexation date)
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R esid enticL_._______.._..________ __________._.___.._.._._u_n._ 0 - 4
COmmerci<ol-n----.--..-------.--------. ......-- n" ________.nn_ 0.9
I nd ustrial__n.__ n"__" ___.u__ _.' .n.___.._ ___.... -'- __..__..__n_ 0 - 45
Government2l. __..__.' ,_____.__.__u__ _ _ __ _ _ _ ._.___._._n___ .-.. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Rate per Sl.0oo.
Assessed Value
S1.69
1.35
1_15
0_92
0.59
0.23
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