HomeMy WebLinkAboutPermit Building 1992-2-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
I.CleATION Of PROPOSED WORI,: ~ '!
\'-i 0 '"J-- 3 ~'-: ~s
pL A <'I:, -d-
c::::
ASSESSORS MAP:
LOT:
C:>
BLOCK:
OliVNER: .__cl,' 110 V",J rf -F A y t. E <) L e" 1/
ADDn[~~s: . L~__9-L..___llj'::LI!Ltz.~.S---_._-~------
CITY: -~v---d:>-'- &./ 'c." 0 Y-t"", C:L2...c,t: 6 5- STATE:
J9B NUMBER 0/')/~~,
.
225 Fifth Street
Springfield, Oregon 97477
Re'L L
!--' tb9S'~ Jj>~~,F"7
TAX LOT: '-1& 0 0
SUBDIVISION: SP:t.\"'C~ k\J1j P_
c,L 7.s/ ~o ? / S~
PHONE:
'. ~. ,
___.~-i_______ --_._-~--- ---..,-
/- . '. .
o ~ E'" 36' V' ZIP: - 9 7 ~;L-o' :) '"
DESCRIBE WORK: /Vf'.-/V l-,':;'.~ -r:-
NEW V REMODEL ADDITION
...... .. ."10. ,'f'"
C 6" F..J 'i' r u Co /; ~"fi./" .
DEMOLISH
OT HER
,'. ..
"", CONST.
ADDRESS - ,', C6NTRACTOR # EXPIRES
->4-', q 5- !? A t? (J E ~:_, - & ~r ~ f c="5' LC" ~
~"" g s-- G.4I-71.o y cl"" c;'- .:'\
CONTRACTOR'S NAME . ">'
GENERAL:iv,L) ; I-- (Z, p )./d ~' 'v;''C
PLU'~~~~~:-' Cb SDf44! (pr~
MECHANICAL: C.~h1;;,;J -P f00 I
ELECTRICAL: 1; J2.ed' Q \~c\r-.~
C.l'-~S cj e:f f, "
OUAD AREA-:R~
1/ OF BLDGS:' \ - -
OCCY GRoup:E_j-r- JV\,
1/ OF STOFlIES: / -
WArEIl HEATER: ~")--
~ OFFICE USf -
LAND USE: - (\ \
{- .
\IN."-'
1/ OF UNITS:
CONSTR, TYPE:
HEAr SOURCE:~r..pI?
F/
RANGE:
PHONE
~y~o71,;-
7''12... ~ 2.'2.4 ~
FLOOD ,PLAIN: n
ZONING CODE: tU\:::--
110';; BDRMS: --.8 ' '
SECONDARY, HEAT: -a3(\--:C5\--
, SOUARE FOOTAGE: 0- i:::J'__\_
To request an inspection, you must call 726-3769, This is a 24 Ilour recording. All inspections requested before 7:00 a,m, will be
macle the same working clay, inspections requested after 7:00 a.m. will be macle the following work clay,
REQUIRED INSPECTIONS
1'v1'~ .
.l?">.I Temporary Elec,trlc _
~ Rough Mechanical '- ,Pri?r to
cover.
o
'Site Inspection ~ To be made
after excavation, but prior to
setting (orms,
,...., A Rough Electrical - P;i~>to\i\
~ cover.
o
~Electrical Service - Mu'st 'b~"'
)r'~ approved to obtain permane~t
electrical power. r,::"
Underslab Plumbing! Electrical!
Mechanical - Prior to cover,
~ Footing - After trenches are
excavated,
D
Fireplace - Prior to f~ti~g
materials and framinglnsp,
..0 M'asonry - Steel location, bond
beams, grouting,
~ F~aming - Prior to c~~er,
~ Foundation - After forms are
~'erected but prior to concrete '
placement.
, ,
d ' .\
LX....I Wall! Ceiling Insulati~n.,,:.r:'.rior to
, - cover., . ...
.~ Underground Plumbing ~ Prior
to fillinQ trench,
M Underlloorrrum~cha~
~ - Prior to'iflSufatlon Or decking.
~ "'.~.F, '"
f'v/I Drywall - Prior to ta,pi rig~ \
~ \ ~~
:\. ,....:' . .~. \ ,..
~ Wood Stove - Afi~r insiall'ation.
o
Post and Beam - Prior to floor
insulation or decldng,
o Insert - After fireplace approval
and installation of unit.
I':7'f Flobr Insulation '- Prior to
~ decking, ,
"
.'
\~ Curbcut & App'roach. - After
,p Jorrns are ,erected but'.p~i2ir, to
placement of concre.le:" ..
l'V1 Sanitary Sewer - Prior to filling
y.:::,.; trencll,
'1 'I_
i"':71" Sidewalk & Driveway - After '.
]./'I. excavation is complete,' forms
and sub-base material in place.
~
Storm Sewer - Prior to filling
trench,
,';
I'v1' Water Line 7""'" Prior to filling
~ trenctl. _ " '. ' '...
o Fence - 'Wh..en completed.
'~;'i \,1 ~
/r50',eel T,"es - Wh'(n,.:: ,~qU:,red
~rees are planted, ' ,\ :,:\ ',,'
IVI Rough Plumbing ,'-,- Prior to
~ cover, , ..
1\../r Final Plumbing - When all
~ plulllbirig worl, is cOlllplete.
l'cI( Final Electrical - When all
~ electrical worl, is complete,
f'vIr Final Mechanical - When all
~ mechanical work is complete,
J'v1' Final Building - Wilen all
~ required inspections have I)ccn
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - WI,en all
blocl<ing is complete,
o Plumbing Connections ,- Wilen
tlOme I,as been connected to
water and sewer,
~ ~.
-- ,
o Electrical ConnectiOn -When
t)locking, set-up, ancJ plllml)ing
inspections Ilave been approvocl
and the home is connecteel 10
the service panel.
o Final - After all reqllj'recJ
inspections are approved and
porches, skirting, cJecks, and
venting have been instal/eel.
Lot facl;s"...._.
,.""';&." '.._,
Lot s(J, ltg,
Lot coveraoe
Topow,aphy
. <<tAnn-f1 ., n,/
TOTaY~gh t n'
~(\ ~_~l fltr~\{l
BUILl1lNG PERMIT
ITEM
Lot Type
In te ri or
Corner
Panhandle
- ,
~- Cul-de-sac
Setbacks
P.L, , HSE GAR ACC
3 THE PFlOPOSED WOFlI< Ihl THE:
HISTORICAL DISTRICT, OR ON
THE HISTORICAL ,REGISTER?
N
S
w
E
Main
SO, FT. X $/SO: FT. VALUE
1'9~/.ft ~9.7O 7Stf?7.'Z'?
.
5..;;;Z!3> /c.;.ft7 Z~y.gC>
-, -
Garage _
Cmport
Ldt,8/P.
/
q~
Total Value
Building Permit Fee
St~lle Surcharge
Tolal I~ee
;;;?Po ~
(A)
I ~ r,Q;/~ .6er
/L)/.~~?orf
· So
-d-3.Z-
'$8
----~f,-
49i~!:.
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
' (B) i 2-o~1 s:z
PLUMBING PERMIT
ITEM
Fixtures
'Residential Bath(s)
Sanitary Sewer
Wate~:
Storm Sew.er
Mobile Home
1
I
r
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t F;:1fl
NO
'4
FT.
FT.
FT.
....'
(C)
NO 3
--,----- --..---,----
Dryer Vlmt
Wood Slove/lnsert/Fireplace Unit
/
Mecllanical Permi t
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State IS$uance
State Surch'arge
'Sidewalk Jl3~ ft
Curbcul 3a... ft
Demol i j i,on
Slate Surcllarge
Total Miscellaneous Permits (E)
FEE
--J~o~
eo<>
--~L~~ <!O
-0 0 ~__:
f~o
__9ov..__
/50E...
__3..'!!?__
_~7.S0
/0 ao '
J.~8
48.30
'.:3r;.ZO
/450
. I
__~6l2~".'!'!
~~~/_ 2.9
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, arid E Combined)
If yes, this application lTlust be si~lnecl
and approved by the Historical
Coo'rdinator prior to permit issuance,
APPROVED:
BUILDING VALUE, PLAN CHECK'
AND BUILDING PERMIT
This permit is granted on tile express condition tllalthe said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
8evelopment 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,
Plan Check Fee:
:2$'1.38
2 ,/Lj -4"7_
- ~~---,,-_/,.-
Date Paid:
Receipt Number:_~lf-7
Received . Y: /~ \-
-- ..~~~_._--
Pial s Ilcvicw;;T-~/'
~*f~ ~z.
D ,I (/-/-
Systorns DeveloplIlCnt Charge is due on all unclcvclopcd
p~operlies within the City limits which arc lJcinU ililproV(,~d,
ADDITIONAL COMMENTS
"-~ T (r~\J l. ..0':, \ ~\~Sl)
~Rffil~ \')(\tQ3' - \ CH '0.0-
(!I VJL1YidP ) riuimn on
"
,,1
By signature, I state anel agree, that I have carefully examined
the COml)lele';.I EijJplicalioil and do hereby certify that all
information hereon is true Elfld'correct, an'd I furlllcr certify
that any and all worl, performed shall be done in accorc!clllCC)
with the Ordinance~; of the City of Sprin~lfield, illld the L,IW:,>
01 the Stnte of OrcW)Il pertaining to the work de~;cril:wd
herein, arid, thEl1 NO OCCUPANCY will be 111;,1(18 01 any
structure withou't'permission 01 the Building Safety Divisi.on,
I further certify that only contractors and employees W~lO'
are in compliance with ORS 701.055 will IJe used on tllis
project.
I further agree 't'O 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 tlle front
. ~. . ,
of the property, and the approved set of plans will remain
on the site at all times during construction,
Xignature P~'f: ,: r1 CJ ~
." h 9 s '
Date 2 - -. ~ - L
'"
VALl DATIOr'J:
RECEIPT NUMBER ~,.=,".~"._~_e_~~g~___..... ,_0<" -- .
2.. ....2. ~- i' 2
_..--,.--
'27 t;. /, 2" __,._,______....___
tP~
'- ' -
DATE PAID_
AMOUNT IlECEIVI:D
RECEIVED BY
i:-
.,
JOB NO. 9 Z,D \ S (.,
CITY,OF
.INGFIELD SYSTEMS DEVELOP~ 1 CHARGE
"~ .
WORKSHEET I
. (COMMERCIAL & RESIDENTIAL)
.r-
NA~lE OR COMPANY: QL-\rF01Z-D I. F'AYE. ES1-t:12-
LOCATION:
(pq SD -e:,UJ€:~\...L-
\ 10'2"?? ~~ - y-(.,.OO
DEVELOPMENT TYPE: L-D~ - N.'t:::W S>fi2-
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. ~'-tlLt X $0.186 PER SQ. FT. $ {pLflo"~
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
LOT SIZE
,SQ. Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S \ ~ X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
$ Lo4?~."
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X '.06 S X $388.61
$ -:2..a" SS '
-../- ,b.,-
,r
X
X $388.61
$'
',:;:..,
,:.:.:,': ,>0'.' X""" :,;,~=.. X $388.61 , .. .
'(Se~ Attachment C To Determine Trip Rates)
'0, , SUBTOTAL (ADD ITEMS 1,2, & 3) $ ::, 1?c> ~
..
$
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X ~05
~ ' G I??;'
~ Df..o--
TOTAL-CiTY SDC ' S \ f?> '"1 '1.
5. SANITARY SEWER-MWMC
NO. OF PFU'S
18
x S13.25 PER PFU + S!O'MWf1C ADMIN. FEE S;"Z4e, -:>0
(Use PFUTotal From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
~.~~J.::_
\j Kip Burdick
SDC Coordinator
'2-/~4-/~ L-
s ~?~
TOTAL-MWMC SDC $ z..IL.\ l.~
TOTAL SDC S '2.D?1 ~
FIXTURE UNIT CALCULA T'ON TABLE: Number of New FiJo.1ures X 1''1it Equivaleht = FiJo.1ure Units (f-JOTE
For remodels, calculate only the NEl jilional fi>.1ures)
NUMBE~ OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
.FIXTURE TYPE
1-
2 --f
1
2
3
6
2 "2-
6
6
1
3
2
1/Head
2 <2-
2
1 -z.
6
4' 8
Batht ub................................. .....................................
Drinking Fountain..: ...:.......... .... .......... ..... .........---.....
Floor Drain...........:........:............................... .....~...:..
Interceptors For Grease/Oil/SolidsjEtc.................
Interceptors For Sand/ Auto WashjEtc..___.....~.......
La und ry Tub jClotheswasher....... .............. -- ............
Clotheswasher -3 Or More......................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator /Water StationjEtc........
Receptor For Commercial Sink/Dishwasher /Ete.:
Shower, Single StalL... ......-. .................... .................
S hov"er, Gang:.... ..................................... ................
Sink, Bar. COmmereial....................................._...... .
Urinal, Stall fWalL............... ..................... ........-......
Wash Basin/Lavatory, Single.........................._.~....
Water Closet, Publie Installation.............................
Water Closet, Private............................... ......---....
Miscellaneous:,
-z...
'1-
TOTAL FIXTURE UNITS
l~
r
CREDIT CALCUU\TlON TABLE: Bas€cd on assessed value. If improvements ~ed after annexation date in table.
calculate credits separates.
52.66
2.64
2.53
2.41
2.19
2.04
Year'
Annexed
1985
1986
1987
1988 .
1'989
1990
, Rate per Sl,OOO
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
Rate per $1,000
~VaJue
$1.69
1.35
1.15
0.92
0.59
0.23
~ '2-. "0_'
Credit for Parcel or land Only If Applicable ~ .l..l9 X $ rz..f I -..F.../
(Rate X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = s ~~~
""
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Res iQ ent ial.... ................ ..... ............................... 0.4
CommerciaL......... .......... __.. .............................. 0.9
I nd ustrial..... .........................m.......................... 0.45
G ove rnm entaL.......,. c..... ............ ~................--.. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT