HomeMy WebLinkAboutPermit Building 1996-3-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: . ,on
II () Z ?;;0 17?;
ASSESSORS MAP:
~
OWNER:~...' \)(\ \~t~f\~
ADDRE&\'~ ) .~\ ~tjf\~
CITY: '- '\l.\\ \ UJJJ ~~\~
" -, - {
DESCRIBE WORK: ~ .~" \{ \l k:\\.c,-o. f\~ Q .i
LOT:
NEW V REMODEL
BLOCK:
STATE:
w
ADDITION
DEMOLISH
OTHER
JOB NUMBER
C\t(Dlroct
,
'225 Fifth Street
Springfield, Oregon 97477
TAX LOT:, ()~
SUBDIVISION: ~JJj\~MD' \(Nil
~D5 ~A-~" \o\).I~
, PHONE: ~ "::) -0
ZIP:
C\3'\O\
CONTRACT~,"SS N NAAIV~E " ADDRESS
GENERAL~q~.~_\f\..\\)rt) ,
PLUMBING: ~'"'\C\. ~t~
.. --'\
MECHANICAL~~ f\. Q\~\,\\\(\\\)fY\
ELECTRICAL: ~~~ \.~~D:\a'("'
CON ST.
\~~t;~~R #
a~lll/
.~~
VL-\r~~ ~~l~q5
\00 \\j.(f; w~~. \t\3\
\?-.\\.q(n =14~
~.~.C\\..o '~~\\r5
"
- OFFICE USE - '\:,
QUAD AREA:' l\ ~"f> l\\ ,
LAND USE: FLOOD PLAIN:
# OF BLDGS: \ # OF UNITS: \" , ZONING CODE: \Dr
OCCY GROUP~~ ~ CONSTR. TYPE: VtJ # OF BDRMS: ~ n _
# OF STORIES: , HEAT SOURCE: \ctl SECONDARY HEAT: ~v
~ t:.. h2- '1 ' I
WATER HEATER: RANGE: _ SQUARE FOOTAGE:
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,
~ Temporary Electric
M Site Inspection - To be made
~ after excavaliqn, but prior to
setting forms,
D Underslab Plumbing/ Electrical/
Mechanical"';' Prior to cover.
rvJ Fo'otlng - After trenches are
L.,L:::l excavated, "
D Masonry - Steel location, bond
beams, grouting. '
r\7'l Foundation - After forms are
~ erected but prior to concrete
placement. ,
D Underground Plumbing - Prior
to filling trench,
rvr Underlloor Plumbing/Mechanical
T - Prior to Insulation or decking.
rYl Post and Beam' - P, rior to floor
r insulation or decking.
m Floor Insulation - Prior to
~ decking,
IV! Sanitary Sewer - Prior to filling
t...pJ. trench. .
I'vl Storm Sewer - Prior to filling
LpoJ trench.
r"Y1 Water Line - Prior to filling
LL::J trench.
~ Rough Plumbi,ng ,- Prio;r. to
~ cover.
,
~
REQUIRED INSPECTIONS
IY1 Rough Mechanical -' Prior to
LAJ cover. ,
r'Vi Rough Electrical - Prior to
L..p1 cover.
rvI Electrical Service - Must 'be
, Lf=:1 approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
, materials and framing Insp.
[fJ Fra~ing - Prior to c~ver.
r)(J Wall/Ceiling Insulatior:J - Prior to
rcover. '
CfJ. Drywall - Prior to taping.
D Wood Stovo - After instal/at/on.
m Insert - After fireplace approvlll
r and installation of unit.
I Xl Curbcut & Approach ~ After
(forms are erected but prior to
placement of concrete,
rY1 Sidewalk & Driveway - After
F excavation is complete, forms
and sub-base material in' place.
o Fence - When co~p~eted.
D Street Trees '- When al/ required
trees are planted. '"
m Final' Plumbing -- When all
t.p plumbing work is complete.
rYI Final Electrical - When all
~ electrical work is complete,
m Final Mechanical - When all
~ mechanical work Is complete.
rYl Final Building - When all
~ required Inspections have been
approved and building is'
completed.
D O;her
MOBILE HOME INSPECTIONS
, ,
o Blocking and Set-Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set,up, and plumbing
Inspe<;:tionshave been approved
and tlie f10me 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 ':1\
Lot sq. ftg. 1-\ ll-\'l
Lot coverage Sb'2,
Lot Type
V Interior
Corner
Topography
Total heightr: \6:
'~\ 44',
"
B;UILDJNG PERMIT
Panhandle
Cul.de-sac
"
;';-' ::",
,"-
I P.L.
IN
Is
Iw
IE
Setbacks'
'HSE'GAR'ACCI
I
I
I
I
1,S
l.S
'-ITEM sa. FT. X~~1OT. VALUE
Main \ ?rD. \\dQ
Garage 4tC1 \~ ,\D " ~o (;r
I
Carport
Total Value
Building Permit Fee
State Surcharge
l \j,bS -t \u,\
Total Fee
(1\)
1C\ \ \CB'
~ 73. ~
~<;. 8~
.l.\O~ .81-{
SYSTEMS DEVELOPMENT CHARG~ (SDC) rf!>
, (B) {I 2. fil '.1
PLUMBING PERMIT
ITEM
Plumbing Permit
State Surcharge 8.ct? + L\,. <<60
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
~
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical. Permit
Issuance
State ,Surcharge
\.'-, '3. + .l:SCo
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su~charge
Sidewalk
50
~B
ft
ft
Curbcut
Demolition
~?~
~t<> .c::1lj:El-,-,.,.. >>oj
t> \ IA.'^- . t1-.~~ b~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
\ CoO,~
\60.SQ
\ ~, So
\1~.a,g
4.~
Cs,.td2
V;. 02
'~.~
d.-B. SO
\C) ~~
:J. ~
~a.12
\1.~
\l...\-~
\ (0 1. ~
~t-t~, ~s.
~ J..\ \. SS
~ \ C:. '1 ;\~~',
\t)
..:3 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.
H~
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
Developmen't 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:
Date Paid:
Receipt Number:
Received By:
PI3~~ed 'gy-
s/ ~llls
I Dcl'te
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
A~IT~NAL ~OMMENT, S
, '_'~~ \:Jrn:\_ \\_0 '\'\"\-~
\_A'\ V. \CS[90
\~ ~<L: \~\rl)
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
str'ucture 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)rhat'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, the approved set of plans will remain
, on the site all ti es ~uri . nstruction.
\L ~_
~tu __, ,-",-
Date
VALIDATION: ~ nC/I
RECEIPT NUMBER" f v 0 11'\k7
DATE PAID . ~ tQ~ ~ ~Q
AMOUNT RECEt'E.p I. ~ S" <1:\ 1 S -~,-
RECEIVED BY -tl\\I)(}. ),.,
...
"1J"T '1
~ Y.'LiU~crnt~!g!!;~
> >
Job No. g.$1~1
SYSTEMS DEVELOPMENT CHARGE
\VORKSHEET
NAME:~ ~ ... PHONE: <(fb %,4;~ \d)-fl(
ADDRESS: 2.r{) ~ ~\t~ATE:Ot ZIP $S4D[.
,-
"
lqCATION OF filROPOSED BUI~DING SI~ \. \\ ~ :-'
Street Address if Known: \ rl' ~ \ ~DJ'{\~ ~
platt Name:
~~~\Z\\{\\\
Tax Lot Number:
tl()Th~.:\ D~OC}
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling type
definitions are on the back.) , " ' ' ,
A. Singie Familv - Detached
\ ' Single Fa~i1y home
, NO OF UNITS ,
B. Sin21e Familv - Attached
\
NO OF UNITS
C. Multi-Familv Aoartment .
NO OF UNITS
D. ManufactUred Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
'.. AW\ 00
X $400 PER UNIT _=., , $ "~ J. _.
e'
X $370 PER UNIT =
"$
X$~77 PER UNIT =
$
X $280 PER UNIT =
$
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 (or Credit)
. $ 4f'{)~
.,J
. KJ
$ ,
. It N'\ (f)
$~).
?J I ()~ I ~ \0 '
n;lfP
,..OB NO. Q6ot/:,54
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: <f(df..! ~1313,e.-r5
LOCATION: /~z.. ~ C!t-m/E.u-/4
DEVELOPMENT TYPE: LOI< - tJew SF-I<
BUILDING SIZE:
1. STORM DRAINAGE
/707. ??~? - 05009
LOT SIZE
SQ. Ft .
IMPERVIOUS SQ. FT.
Z':SO<6
~$ S"L/1"\
X $O~209 PER SQ. FT. ~~~ ~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
f<6
X $43.26 PER PFU
(778 ~
3. TRANSPORTATION
. NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $436.19
(( 440 5i)
'-- ~
$ ,.-
$
I
X / . () I X $436.19
X X $436;19
4. SANITARY SEWER-MWMC
NO. OF PFU'S, (cg x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ 3 19 ~
TOTAL-MWMC SDC
$ 52.. ~
((;~'7V!')
~ ---
$ 20 10 '-'4
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
, 5. ADMINISTRATIVE FEES, '.
BASE CHARGE (SUBTOTAL ABOVE) X .05
eff~"--'~ Date: 5/17 /qt;,
U Kip Burdick 'TOTAL SDC
SDC Coordinator
<C /DO~~
$ "'21""
.. .~ ..- . .
. i=IXTURElJ~IT~,G/:\LCULA T''""'N TABLE: Number of New Fixtures X Unit Equivalent =, Fixture Units
(NOTE: For remodels, caic:ulate only tht. , J additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
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, Residential Kitchen........................
Urinal, Stall/WaIL........ .....,..........,.... ......... ...... ....;.....
Wash Basin/Lavatory" Single, ,..,....... ,.... .................
Toilet, Public Installation.. ,.., ....,....',.,. ,...... ........ '-"
Toilet, Private...............,...."", ,.. ,...,..""".....,.,......
Miscellaneous:
UNIT
EQUIVALENT
2
1
2
3
6
2
6
6
1
,3
/ 2
1/Head
I 2
2
,2- 1
6
'1- 4
TOTAL FIXTUHE UNITS
FIXTURE "
UNITS
-z..
'2-
'2.-
'J...
"2-
~
l~
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates,
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
Credit for P;;lrcel or land Only If Applicable
'5 'Z- / !-
Improvement (if after annexation date)
'...."t,
-
3.4-<e. X $ /5.0'6
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
-
= $ ~..., t.!
CREDIT TOTAL ::> L.-