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HomeMy WebLinkAboutPermit Building 1994-6-9 ~t?/C#{ RESIDENTIAL PERMIT APPLICATION 4?/o/ir /uJ?t(1),cJ>>tpfl . . 'SPRINGFIELD' Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT:' ~ BLOCK: O~NER: . /q~~ {/;:j~pt!!!:-/f;/.:s' ' ADDRESS: 2. t::::::T&:> ~~ ~~7 ~7" . ;- ~ ''. CITY: ~~~~/5 ~~ DESCRIBE WORK: ~F;z:t~, - " ( NEW REMODEL 'ADDITION ~.- ~. STATE: - /' JOB NUMBER 99'~~5 r DEMOLlS~ OTHER 225 Fifth Street Springfield, Oregon 97477 ,"~' 'r TAX LOT: SUBDIVISION: rf~.#//~' ~t-Ll ,", /1:~P 'P~ONE:L~) ~-7Y7;;- ZIP: q~'Yo>/ CON ST. CONTRACTOR'S NAME , AD~~.>/ ~NTRACTo.R # GENERAL:~~ ~~?--~ ~ /- ~.~/f'/~":'- 6:<6S'=?... PLUMBING:.l~~';> , , t"" JciC~ ' '7:5 y- ~' EXPIRES, J;>HONE /.:> '-~'r, '~.? ~~- " , MECHANICAL: ELECTRICAL:~~~i~~' ,.:....,,, ,....'.. ~) 1/ ;': '. 4~E. - OFFICE USE - QUAD AREA' LAND USE: \ \ \ , FLOOD PLAIN: # OF BLDGS: , R~i- }J\ # OF ,1,INITS: , ZONING CODE:" f D f(./ ~ OCCY GROUP: CONSTR. TYPE: \) f\' J # OF BDRMS: ~, # OF STORIES: \ HEAT SOURCE: : W l+ SECOND~RY HEA;'~ - WATER HEATER: ~ RANGE: S SQUAREFOOTAGE: <\([>5 ~ To request an Inspect.lon, you must call 7~6.3769. This Is a24 hour recording. All Inspections requested before 7:00 a.m. will be m~de th~ same working' daY. Inspections r~quested after 7:00 a.m. will be made the fbllowlng work day. ' t, ',:" .". . , '. O:.rempo.rar:y Ele,ctric f ~,. ~ 'r . ',;.. \ '.' l5<( Site Inspection - To be made _ "after excavation, but ~rjor to setting forms. St> ft.) O Underslab Plumbing/ Electrical/ Mechanical - Prior to cover. rv-1', Footing - After trenches are )6t excavated. " o Masonry - Steel location, bond beams, grouting.' , , K/(Foundatlon - After forms are ~ erected'but prior to concrete placement. o Underground Plumbing - Prior to filling trench. ~ Underlloor Plumbing/Mechanical. }A..J -,Prior to Insulation or decking. ~ Post and, Beam - Prior to floor }CS--Insulatlon or decking. 1l9rFloor Insulation - Prior to ~ decking, ~ Sanitary Sewer - Prior to filling ~ trench. I"Vf Storm Sewer - Prior to filling ~ trench. ' ~ Water Line - Prior to filling ~rench., , I"'\7f Rough Plumbing.,... Prior to ~ cover. " REaUI.REDINSPECTIONS ,g RoiJgh' Mechanical ~,p.rl~r .to ' , cover. " i~ : ~. ) . ~ RoughEle~trlcal ....,. Prior to t6l. cover. " '~ . ' Electrical Service - Must be approved to obtain permanent elect~lcal power. . o Fireplace - Prior to facing materials and framing Insp. 15(1 Framing - Prior to cover. , IV"1 Wall/c'eUlng Insulation - Prior to ~cover.' , ,[)('lDryWall.,- prl,or totaplng. ~WOOd Stove - After i~stallatlon. D Insert,"::' After fireplace approval and Installation of unit. ~Curbcut & AP~roach - After ~ forms are erected but prior to placement of concret~. D Sidewalk & Driveway - After , excavation Is complete, forms and'sub.base!'"aterlal In place. D Fence,-:- When co'mpleted. , ~,Street Trees- When all required (7 trees are, planted. ' ~Flnal Plumbing - When all plumbing w9rk Is complete. l'v'l Final Electrical,.... When all ~ electrical VoIork Is complete. 1S?l Final Mechanical - When all ~ mechanical work Is'complete. ~ Final Building - When all ~requlred inspections have been " 'approved and building Is, completed. D O,ther d~ . 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 Con~ection - 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. skirting, decks. and venting have been Installed., :('. ,;\,. Lot faces ~ Lot sq. Itg. ~/'1+ Lot coverage '33Pc. Topography -I-?o Total height 'l~1' ~~\ / ) BUILDI~ PERMIT Lot Type K Interior Corner Panhandle Cul-de-sac .' , , :::f{i": \' ,H' :;i"~r:':l;:~~'~ (;':: ':>..:&:~.t,' , P.L. N Is Iw IE Setbacks ' HSE GAR ACC 2.1,5 f /~f ZS' 5"1 .HE PROPOSED WORK tN THE. . . HISTORICAL DISTRICT. OR ON THE HISlORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. ITEM SQ. FT. X $/SQ. FT. VALUE Main /2. 3 > ,C;-G ,?,4 --61-.4dJ - Garage 4~ I,S- I c1,/(O " t:,~?,~ Carport 15113 ~3b/.60 /0.83 + J~,~r -;;:tp,q ,n Total Value Building Permit Fee State Surcharge Total Fee (A) (B) SYSTEMS DEVELOPMENT CHARGE (SDC) 'zOI' ,;2'i PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Z_ Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit FEE /~O ,00 State Surcharge ~r~-i-~cf:> -;::/~~O J '7f.,a" 0 Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO 2- Wood Stove/ll')sert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge "g, +/,+3 Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ;;2~ft Demolition State Surcharge h7/A,v ~lJVlav Total Miscellaneous Permits (E) 49,0 . o , (!7-0 / .c;,6-'O (5~ '/ ~ '5"10 - ~ , / ~ ,"0 ::- - 2..'>-" 40,7' \. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the City, of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances, Plan Check Fee: _"2..B <f. t:.S" Date Paid: Receipt Number' R~~ Plan~Revlewed B~ 5/;?//yd' / Dafe'T Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS ~~~tI$' '?2~" ~ " 0\+ T: i\ nr )().! (~ \ . , 1SJ\f\, r\ 0 Nt" 1 tit g~: 1 C{ (-CO ~ tV\llJ\f\rx- 'rJnOlnUl1 fp~ .u/L '~tl3' \'r)~~ v--fAf" ~ ~1 ~~-r ~#6E "~~i :;tr> 5'Pk21 ~ Sr~T-~ /{4fJ;/;lL ~n...,J/jL.~T /(" .k9g~/~ ~f 8, /Z-1 Re:~,U(?_ ~/<S I 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 01 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 rea,.dable 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 sltl'! at all times during construction. ~" '~ {',/- ", l /~/ ^_ / s atureC~ ~ :/1 - Date ~/5'/7~ ~_').,O t ( . ( 2*$"' TOTAL AMOUNT DUE (excluding electrical) 2~~g .~o (A, B, C. 0, and E Combined) VALIDATION: 1 RECEIPT NUMBER / w-Lf" ~ . Pi) DATE PAID AMOUNT REG~ /- \. - ~ RECEIVED By(J)~QJ 1'.., JUt; NU. 9iZO~3/ j CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE , ' WORKSHEET (COMMERCIAL & RESIDENTIAL) ":... '''g~ c'NAI-iE OR C011PANY: ;f~,.y A'~8.€R/.s LOCATION: ;to~< L:4h?6"~~/~ 57': DEVELOPI-1ENT TYPE: ~ES. BUILDING SIZE: LOT SIZE ,SQ. Ft. .'-"" 1. STORM DRAINAGE IMPERVIOUS SQ. FT. - ", 2 2.90 X $0.203 PER SQ. FT. (4,~ ;;-; '--- .-/' ' 2. SANITARY SEWER-CITY IW. OF PFU'S ':,,' (See Reverse) I? X $42.08 PER PFU ~1S1. ~ "- ~ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP / X /.0/ X X X 5424.31 X $424.31 ~421.;n "'-- ~ $' S J' If.~ '.' X $424.'31 4. SANITARY SEWER-I~WI"C NO. OF PFU'S /~ x $15.125 PER PFU + $10 MWMC ADH FEE S 216..2.'- (Use PFU Total From Item 2 Above) ,,:. SUBTOTAL s I-Z. '8'1- TOTAL - MWMC SDC ~ ~f. 4';), '-- ..;./ (ADD ITEMS 1,2,3 & 4) $/'f.2t:J.;t; MWL~C' CR~DIT IF APPLI~ABLE (SEE REYER$E) 5. ADMINISTRATIVE FEES , B~AE c~ (~tbAl ~B WE) /' .:H~,J~ ~ ' ,S Coordinator X .05 ~ 9~.~ 0 "- '/ TOTAL SDC $ :J-~/c...z r t'1^IUnCVI'I.....,r"'--~~_...~.- ...---."-'.' - For remo.1cJs; calculate only lhe /,JCT ;1ddilional fi",ur('~) :\'Li1.',5Ei, e'F FIXTURE TYPE NEW FI.\iUGES Balhtub....,........." , Drinking Founl3in..,. Floor Drain,...".....""..., "........,......,...., Intercepto~ For Grease/Oil/Solids/EIC.,....,...,..,.., jntercepto~ For Sand/Auto Wash/Elc,...",.......,., Laundry TubjOotheswasher,..... ",.".,.. ......' .......,.,.. aotheswa~er - 3 Or More.................................,... MobDe H6me Park Trap (1 Per Trailer).........,........ Recep!or F9r Refrigerator {Water StationjEtc......,. Receptor For CommercIal Sink/Dishwasher/Etc.. Shower, Single .Stall..., ...,.....,.....,...... ......... ....,..,..,. ,. Shower, Gang..,...........,........,.. ,.... ,............. ,..,.....'..., Sink, Bar, CommerciaL......... ...',..." ,......,...'.. ,..,....... . Urinal, Stallj\\'all......,.,. ....... ..,."......".,..... ........., ....... Wash Basin/Lavatory, Single,...........,..,.,..,............. Water Clpse~ Puqlic Installation..,...........,..,........... Water Ooset. P ri\'ate,... .........,."".', ..,..,..., ,.. ..... ......, Miscellaneous: A , ,', J' . . .. _ ~ . If ..... . . I '" ~ .. . - . . ~. TOTAL FIXTURE UNITS l<~;T E C:UI\' ;.L E I-,J T fT<1Ur-,[ urms 2 4 .... ......... ,"" 3 G 2 .2. 6 :. '6.'. 1 3 2 1/Head 2 2 1 6 2... 2... , ~ <t: fi Based on assessed value. If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: calculate credits separates. ~.. ,.' - ~. .: 'Year Annexed Rate per $1.000 Assessed Value Year '.', Annexed 1979 or before 1980 1981 1982 ,1983 .;-' 1934- '1985 $3.21 3.13 3.08 2.96 2.82 2,68 2,51 1986 1987 1988 1939 199::> 1991 1992 Rate per $1.000 Assessed Value S 2,24 1,93 1.57 1.18 0.79 0.44 0.28 ___,_a,_ , .. - -~." = I;t.. "?1 = = $ /2. E' 4 ..- ._..~- ., .. -. -_..'-- Credit for Parcel or Land Only If Applicable $.,2. I X $, 4. 0lJ'0 (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL ... .... ~, . Improvement [If after annexation date) RUNOFF COEFFICIENTS FOR STORM DRAINAGE R esid entia!......... ...... .... .............. ... ............'....... Q.4 Commercial..... ................"..... ,.......... .... ..... ...... 0, 9 I nd ustrial....,......,.",...........,.....",.."........."........ 0.45 G overnm ental",. ,..,....,......"",.,..,',.,............".... 0 ,5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT ,/. ~'-ya Willamalane' . 't'lJ' Pa,k & Rec<eat;on D;stdct Job No. CMl)~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: ~_Cl'{\, l!]:l~ PHONE: <unS1c~A+6 ADDRESS: aDO ~ AO t+moo.~,,<i)i\ ll~TATE: 6( ZIP q~ol LOCATION OF ~ROP;SED BUILDING SI1J\ . c~.,~ '\ Street Address if Known: n () 3 rA ,f.-l.1LL Platt Name: f!t1/Jtt1/1~.-' f(J/JLLr.ax Lot Number: J 1. DEVElOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the backJ ' A. SimIle Familv - Detached, ( Single Family home NO OF UNITS I B. SimIle Familv - Attached NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NOOF UNITS WPRD SDC ('I; ;, v :~\;~?:.~'t Manufactured home not in a park tiJ $ 4{j)\ X $400 PERU N IT _= X $370 PER UNIT = '$ X $277 PER UNIT = ,$ X $280 PER UNIT = $ $ 400iCD $ JJ \ $4ro (fJ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTALWPRD NIT sot ASSESSED (If SDC reduced for Credit) ~) ~~(\~eJ Community ServICes Divi . o~ ' City of Springfield , (p /91tf[ , Date