HomeMy WebLinkAboutPermit Building 1994-1-26
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
sp ~6"l-
JOB NUMBER
9~ov2/
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WO'RK: 5(? .!-)' (';78- .;- I o'7n~ Ltt:~ aBd-C
::IFJ7-c?2- 7?" - /JY _ 00 v.(:;J~'7
ASSESSORS MAP: -- 7 . a '/. . TAX LOT'
SUBDIVISIO~pJilG7';v}'" . )..!/f./C/0
LOT: /0.
OWNER' ~jJ &~fAij .
ADDR~~~'.;?&& c/(g)r~~ fll?
CITy:SJl ~ ~ {/~( ~7J:~5 / ~/fCJ
. ADDRESS gg~f~ACTOR #t2tf'~E;:PIRES / ;;-?f PHONE 7'17-~~ '7(-
1U/? '"' .... .n- ,., .4 . ' IJ i qA ~H-tl- ]. )(, ?
/////V/&I/24 87f/T' VJ/v4YG')f/IPd". .. "'./ ~ J' ,- \ "
17/v~Vl, .'. "',8?O/to Lo'lO.Q'1' (0% ./Q'11
B~2'~ Q.S.Df-'M4\\lrn
.......... " -.
DESCRi"BE W0RK:
y.
NE~.~~ REMODEL
CONTRACTOR'S NAME
rf'J"EJ//lIi(
/,F/.,v//"S
GENERAL:
PLUMBING:
~
MECHANICAL:
BLOCK:
STATE: 0/; ,
.~-~.. ~).LMfUJ?
ADDITION
DEMOLISH
OTHER
)J;4P~ rJ-/lAJ/J?/J?~/f"
ELECTRICAL'
QUAD AREA:
~GF:
I "
A3rJJ\
~)
T/
It OF BLDGS:
OCCY GROUP:
It OF STORIES:
WATER HEATER:
"~ OFFICE USE .;....
LAND USE: -w a CJ
# OF UNITS:' ~
CONSTR. TYPE: j,Lf\)
HEAT SOURCE: \.D\-\
V .
RANGE:
PHON~'
ZIP: tj',? tJo J
FLOOD PLAIN:
. ZONING CODE:
LJ)t2-
'4.
It OF BDRMS:
SECONDARY HEAT:
. SQUARE FOOTAGE:~ It>:
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.
D Temporary Electric
~Site Inspection - To be made
,lAI ~fter excavation, but prior to
) setting forms.
o Underslab Plumbing! Electrical!
. Mechanical - Prior to cover.
,.
1\../1 Footing - After trenches are
I6J excavated. ~-" "
,Masonry .,... Steel location, bond
':learns, grouti ng.
~1' Foundation- After fOrms are
~erected but prior to concrete
placement.
KX Underground Plumbing - Prior
~o filling trench.
~.' , Underfloor. Plumbing! Mechanical
~.,.... Prior to insulation or decking.
d Post and Beam ~ Prior to Heor
~sulation or decking. _
/.
I')<:...L Floor Insulation - Prior to
~ecklng.
~sanitary Sewer - Prior to, fill'ing .
~nch.
rVStorm Sewer - Prior to filling
lL..J'1}e n c h.
,
~' Water Line - Prior to filling
_ V~ench.
,..... /,"'ROU9h Plumbing - Prior to
~ cove~ '
REQUIRED INSPECTIONS
01 Rough Mechanical - Prior to
~ver.
~ Rough Electrical - Prior to
~cover. "
rl Electrical Service - Must be
~ approved to obtain permanent
electrical power. '
DC Fireplace - Prior to facing
_ , rnaterlalsand framing Insp.
~raming - Prior to cover.
'Ql.' '. Wall/Ceiling Insulation - Prior to
~ cover. .
~rYWall -- Prior to taping.
D Wood Stove - After i~stallation.'
...Ql Sidewalk & Driveway - After
~xcavatlon is complete, forms
and sub,base material in place.
o Fence"':":' When completed. "
J5] Street Trees - When all required
trees are planted.
~
I=~al Plumbing - When all
plumbing work is complete.
VI Final Electrical -When all
~ electrical work is complete.
..{7l Final Mechanical - When all
~ mechanical work is complete,
f7i Final Building - When aU
~ required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
- 0 Plumbing Connections - When
home has been connected to
water and sewer. "
D Elect~ical 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,ski rtl ng, decks, a"nd
venting have been installed,
l.
...
Lot faces Lot Type Setbacks
Lot sq. ftg. . Interior I P.L. HSE 'GAR'ACCI
Lot coverage L Corner IN I
Is
Topography Panhandle
Total height & J '" Cul.de-sac Iw
IE
BUILDING PERMIT
{~iAT. X $/SQ.,W = jX,AWnV1
WD a o. D _d D'10']
JaIL A4.i" ,~..
ITEM
Main
Garage
Carport
, [14~/,0J.4
-~6\O,'5
,I, %-.321.1
~( ) ,r51
SYSTEMS DEVELOPMENT CHARGE (SDC) ffb
. (B) 1'30/7'1-
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
. Fixtures
Nd'+~
~~n
Residential Bath(s)
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
6f[j{}5
~3-loV
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood & q.CO
Vent Fan NO 4 \~CO
Wood Stovellnsert/Fireplace Unit (olD
Dryer Vent ~
Mechanical Permit d').oO
Issuance 1(),cO
State Surcharge '7.35
Total Permit (D) 8f).~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surch~e
Sidewalk k:Jq ft
Curbcut 42- ft
5).86
If o.2L)
Demolition
~surCharge
\.J(\~ f\
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) 4-5-1.ZW
(A, B, C, D, and E Combined)
.'-' THE PROPOSED WORK IN 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 ~ances.
Plan Check Fee: t!f)//,~, ~~
Date Paid: /jJI/q4
//z, s4'
'~/Y:Z-v\.
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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el1RJJDlr1Q)~ r=)r4.l0hL~lrL
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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 t apl=l v f lans will remain
on the site at all tion.
:~:::ONN~M,?~P, ']WJf)~.
DATE PAID . -_.,1::.& b-Cj4---
AMOUNT REC. ~V.~ J ' ~=AQ
RECEIVED BY 'F:f'\\fj~
"
QCJ
po
.,
JOB NO. '1,-/00'2..,,/
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: RoN BBefZ- -r s
LOCATION: 3/7 '5. t:, 7 t!J -1 to 70 c::, B ~ u €:.l6e L-L
DEVELOPMENT TYPE: !-D!Z - N€:-W [)UPt-f:;.x
/7 () ?- 3~ t...( if ~ C>08'6 7
BUILDING SIZE: LOT SIZE SQ. Ft.
l. STORM DRAINAGE
IMPERVIOUS SQ. FT. '?;; 0 Cf t.-- X $0.203 PER SQ. FT. ~b~7~
'-.. ~ .
2. SANITARY SEWER-CITY
NO. OF PFU'S 30 X $42.08 PER PFU 0'cf~~
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S 3f::, x $15.125 PER PFU + $10 MWMC ADM FEE $ 5Stf 50
(Use PFU Total From Item 2 Above)
$ r"/" <l
MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~
TOTAL -MWMC SDC ~o '2- li'9
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ :''50'2- ~
X $424.31
68?7~
"'-- ~
$ -
$
2-
X I.t:> I X $424.31
X X $424.31
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~K~L~k /Jif/tff
Kip Burdick (
SDC Coordinator
~7s/i)
"- ----'
~(
TOTAL SDC $ 3'='77 -
FIXTURE UNIT,CALCULA. IN TABLE: Number of New Fixtures;
For remodels. calculflte only the NET additional fixtures)
it Equivalent = Fixture Units CNOTE~
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
2-
t../-
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
Sl
Bathtub..... ... ,.............,...,."....".".,..,.,......,....,.,.,.....,..
Drinking Fountain.... ........., ............,.,......, ..:........., ..,.
Floor Drain,.............. ......,...............".....,..,....,......,....
Interceptors For Grease/Oil/Sollds/Etc.....,...........
Interceptors For Sand/Auto Wash/Etc..................
Laund ry Tub / CI othesVfasher...................................
C1oth~swa~er - 3 Or More...:...:............................. ,
Mobile HdmePark Trap (1 Per Trailer).................. .
Receptor F9r Refrigerator jWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single .Stall..................... ...... ....... .......... .....
Shower, Gang.....:,.........................., ,................ .c.....
Sink, Bar, CommerciaL........... ...c.. ......... ... ...... .......
Urinal, Stall jWall................ ..................... ,... ...... ..:.....
Wash Basin/Lavatory. Single..................................
Water Closet, Public Installation.............................
. Water Closet, Private................................,...........,..
Miscellaneous:
t/-
. ?;. .
'If
+
L/-
I./-
It::.
TOTAL FIXTURE UNITS
3~
CREDIT CALCUU\TION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
1979 or before
1980
198.1
1982
1983
1984
'1985
Rate per $1,000
Assessed Value
Year
Annexed
Hate per $1,000
Assessed Value
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
1986
1987
1988
1989
1990
1991
1992
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
Improvement [If after annexation date)
"3,1,-/ X $ /~" I S I ~~
(Rate X Assessed Value)
X $
(Rate X Assessed Value) g
CREDIT TOTAL' = $ 5/ ~
Credit for Parcel or land Only If Applicable
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential. ...... ............ ........... ..... .......... ........... 0.4
Commercial...................................................... 0.9
I nd ustrial................ ............... ......... ... ...... ........... 0.45
Governmental................................................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
i,');
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a, ..
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q.. L1\AnC
Job No. \LJ L.:-
. ,
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
~ ~)terts
ADDRESS:M~e~~\)~J, STATE:CA ZIP C~3'-.61
SF\{\' lUJ:S (9%5\ ~m
LOCATION OF PROPOSED BUILDING SITE: \ ~ fD..\ \ " ....
Street Address if Known: ~\'l~DLo'l~f'\ lQ'lD(n\ ~l.i~~
PlattNanie:~rot~t1:kTaXLotNumber:. \'\D~l::w\~
NAME:
PHONE:
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back,)
A. Simlle Familv - Detached
Single Family home
NO OF UNITS
B. SinQle Familv - Attached c9
NO OF UNITS
C. Multi-Familv Aoartment
Manufactured home not in a,park
X $400 PER UNIT =
$
X $370 PER UNIT =
$ f't().cD
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$14n~
$ C!f '.
$ f{4{)r;D
/ ()~It2J Q1.
\
2. SDC CREDIT (If applicable) SDC-payer must furnish.proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
\ iliClx J~~nop )
Community Services Divis on\
City of Springfield
Date