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Home My WebLink AboutPermit Building 1991-11-12 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 . LOT ELECTRICAL: -: QUAD AREA: 4Q~ ~<?y -\"' !-1\ ~\ ~ # OF BLDGS: OCCY GROUP: # OF STORIES: WATER HEATER' SPRINGFIELD ADDITION DEMOLISH OTH ER JOB NUMBER Cf( ~)/ Co 225 Fifth Street Springfield, Oregon 97477 ' ZIP~ Lj \ CONST. yONTRACTOR # lO~~ -' OFFICE USE - \ \ \ \ # OF UNITS: \ CONSTR. TYPE: V N HEAT SOURCE: -.-f G G LAND USE:' RANGF' \ 9JblCt PHONE FLOOD PLAIN: ZONING CODE: I .f) \C-J . # OF BDRMS: ~ / ) . SECONDARY HEAT .~~ SQUARE F,OOTAGE: (- -9 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. rn Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. . D Underslab Plumbing/Electrical/ Mech.anicaf .:.... Prior to cover. ~ Footing - After trenches are excavated. . D Masonry - Steel location, bond . beams, grouting. IVl Foundation - After forms are I,.L.J erected but prior to concrete placement. [ZI Underground Plumbing - Prior to filling trench. [Z] Underfloor Plumbing/Mechanical : .,..... Prior to i nsu lation or decki ng. [L] Post and Beam - Prior to floor insulation or decking. [Z] Floor Insulation - Prior to , decking. [2] Sanitary Sewer - Prior to filling trench. G Storm Sewer - Prior to filling trench. ' I:\7l Water Line - Prior to filling L"LJ trench. [Z] Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS IYl Rough !",echanical - Prior to l"LlJ cover. ' r\7I Rough Electrical - Prior to t.pJ cover. Ii7l Electrical Service - Must be L,LLJ approved to obtain permanent electrical power. D F.ireplace :...- Prior to facing materials and framing, Insp. [LI Framing - Prior to c~ver. I7l Wall/Ceiling Insulation - Prior to. W cover. ~ Drywall - Prior to taping. D' Wood Stove - After i~stall~tion:' D Insert""": After fireplace approval and installation of unit. Ii7l Curbcut & Approach - After .LA-J forms are erected but prior to placement of concrete. ~ Sidewalk & Driveway - After ~ excavation is complete, forms and sub-base material in place, D Fence - When completed. . ., rvl Street Trees -When all required IjLLJ trees are planted. . . I )II Final Plumbing - When all plumbing work is complete. F)(\ Final Electrical ~ When all L,L::J electrical, work is complete, ~~ Final Mechanical - When all mechanical work is complete. ~ Final Building - When all required inspections have been approved and building is completed. D Other 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 C~nnection - When . blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. D Final...,. After all required i nspectioris are approved and . .. p'orches, skirting, decks, and venting have been installed. Lot faces or:;' Lot Type Setbacks THE PROPOSED WORK IN THE Lot sq. ftg. "7$" Interior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON IN THE HISTORICAL REGISTER? Lot coverage <~ X Corner /~2 If yes, this application must be signed S-~60 Is '2.~ and approved by the Historical Topography Panhandle Iw Coordinator prior to permit issuance. Total height j~ I Cul-de-sac lit> IE ~ APPROVED: BUILDING PERMIT ~~.~ x3ctib ~;\Cb 4~q. \4.\Ulol~ ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee (A) PLUMBING PERMIT ITEM FEE Fixtu res Residential Bath(s) NO :2 Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home /tb??,~ Plumbing Permit /~o~~ g~ c:oc> Lb8. -=> State Su rcharge Total Charge (C) MECHANICAL PERMIT ----.6. -c> 0/. Se:> ? iPr? Furnace Exhaust Hood Vent Fan NO ~ Wood Stove/lnsert/Fireplace Unit Dryer Vent "3'.. ~ Mechanical Permit ':2 '2 - :>~ /~, C#C> : - .t, ~ )1 '$ --."/1-:::::> ~-r'f ../ Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Su rcharge Sidewalk Ib L/' ft ~ c.j. .~.!> /'1. :20 Curbcut "7 a ft Demolition State Su rcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) --::<::;-/2. L(7 (A, B, C, D, and E Combined) 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' prov~ns of said ordinances. Plan Check Fee: r\)()' / .8..~ Date Paid: ~~5 . q T Receipt Numbe(ci~ Received By: _. ./ . r .. d~~~-~7 p(~ Reviewed By , g-/6-<7/ Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS ~l)\~JiQ ~ A~ T (9\~Qcl VbS)~~ 8) ()()(j. ~(\ft(y\. ~to~! lctlo') 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 nng CO.rul.tr"r..ti~ Slgoatu," l-vl (j ~ ///iL/7/ ( r Date VALIDATION: RECEIPT NUMBER ~~C(5 3 J/~/2 -7/ Z{O 7~. '7 4- ~ DATE PAID AMOUNT RECEIVED RECEIVED BY I CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE:itq \09 \ b ';"' ~ .WORKSHEET ", NAME OR COMPANY: C;'Eotz.G"E c.o~ WAY L OCA TI ON : lO f?"'l. 'e::L.U-E:. ~t:: LLE:. W A<.( DEVELOPMENT TYPE: L-Oe. l, o"27:,S~Y - 00€)CC> . BUILDING SIZE: 1. STORM DRAINAGE IMPERVIOUS SQ. ~T. "Z<2>-, ( X SO.186 PER SQ. FT. S S?t..t6~ . (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) . LOT SIZE SQ. Ft. .2.. SANlTARY SEWER-CITY NO. OF PFU'S l~ X $38.55 PER PFU (See Reverse To Determine Total PFU'S) <10 S .0Cf~- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X I.o-O? X $388.61 X X $388.61 X . - X; $388.61. . (See Attachment C ToDetermin~ Trip Rates) -- -. __H_"" .-.' . '.'--., -_.. -.- SUBTOTAL (ADD ITEMS 1 2 h... h._........_.. ._'..0... Oh. ..._..... . __." .. ..... '.. .' , , S ~qo ~ . $ $ & 3) S \b'S~ 4.' ADMINISTRATIVE' FEES' -.. BASE CHARGE (SUBTOTAL ABOVE) X .05 s f>o ~ TOTAL-CITY SDC $ tb"q~.2 5. CREDITS IF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL: TOTAL-CITY SDC X (5~%) = ADJUSTED CITY SDC $ f...J /4 6. SANITARY SEWER-MWMC NO. OF PFU'S lej t;;" x $13.25 PER PFU + S10 MWMC ADMIN. FEE $.-z.tf~- (Use PFU Total From Item 2 Above) HWMCCREDIT IF APPLICABLE (SEE REVERSE) 1.--<0 s ~2. f - 22- TOTAL-HWMC SDC $ -Z Z 7 - TOTAL SDC S \92..6 ~'t 1<.~~jJ.'.k '( Icthl . ~ O' Kip'Burdick.. . SOC Coordinator FIXTIJRE UNIT CALCULAl\~ON TABLE: Number of New Fixtu~es Y' ''"lit Equivalent = Fixtur~ Units (NOTE: For remodels, calculate only the NET''' "'\fJitional fixtures) __ . NUMBER OF UNIT' FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS 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 Refrigerator /Water Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single StalL.......................... ........... ......... Shower, Gang........................................... ...... ......... Sink, Bar, Commercial.... ........,...... .... .... .................. Urinal, StalljWaIL................:......... .......................... Wash Basin/Lavatory, Single........................~..:...... Water Closet. Public Installation....:.................,...... Water Closet, Private....... ........ ........... ......... ............ Miscellaneous: -~ 2 1 2 .3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 "2. -z.. TOTAL FIXTURE UNITS Lf 7-' "2, 'L -----B (€, CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred affer a~nexation date in table, . . calculate credits separates. Year .A.nnexed Rate per $1,000 Assessed Value Year Annexed ~ .- - - _..:.- - : .-, .. - . - _. -'.- '- - - -- -- - S:2.Cc ".-.- - . --- - -"-'- 1980 lS3i 19t:2 19-83. 2.64 2.53 2.41 2.19 2.04 1986 1987 1988 1989 1990 1904 Rate per $1,000' Assessed Value S1.~;:. 1.35 1.15 0.92 0.59 0.23 Credit for Parcel or Land Only If Applicable '2. .,,~ X $. ~.o (Rate X AsseSsed Value) X '$ (Rate X Assessed Value) CREDIT TOTAL ?- I ."2..- <;' Improvement (if after annexation date) = $ Z/,)..~ RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential. ......... ............... ...:'...... .... ........ ....... C.~ Commercial............................................ .:...... .0.9 ,I nd ustrial... ........ ................ .... ........... ........... ...... 0.45 Governmental. .......:......................................... _ 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT