HomeMy WebLinkAboutPermit Building 1994-6-9
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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
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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
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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/
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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