HomeMy WebLinkAboutPermit Building 1994-7-26
ASSESSORS MAP:
.5
OWNER: ~ ~W\ \\~J)~ ~. ..,
ADD~S~.:, ,d()Q \JlQ~, _0<\,_ r
CITY'~' f\ ~\ ~ ~.\~O
DESCRIBE WORK' ~. \. \<. ~ ~\ (\ (J f\:0 2-
NEW ~
I
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
LOT:
REMODEL
ADDITION
~
/ \
\J'"
BLOCK' '
STATE:
\\~
,,' DEMOLISH
OTHER
I'~
~
,.,-~
U
C\L\D (\~D
, JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
PHONE:~ ~~.~\'\=5
ZIP'
CONT~~cr:~S NAME. . ,,' ",ADDR.E~S
GENERAL: \~~ {\ f\ L[, \t1i\\ \ 'l'f\ ,"
PLUMBIN~: \~N\tt ~(J::J_ )
CONST.
CONTRACTOR #
l nfl-\(>1-2
EXPIRES nt--'AHO~t... \.
\l. \ \ 'Cf\-\~, .~\l)1
MECHANIC/> I. ,
ELECT'RICAL:\_ro~ \ t~--,{~S'\\\'\\~ U
"'''"\ \. WATER HEATER:
./-....::::",
To request an Inspection, you must call 126.3769. This Is a24 hour recording. Alllrispectlons requested before 7:00 a,m. will be
made the same working day,'lnspectlons req'uested after 7:00 a.m. will be made the following work day.
~R~S
\
\R~T~
\
6.7
QU~D AREA'
# OF BLDGS:
OCCY GROUP:
,# OF STORIES:
~ Temporary Elec~rlc
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
rn Footing - After trenches are'
L..P' excavated. ' '
o Masonry - Steel location, bond
beams, grouting. '
rVl Foundation - After forms are
~ erected but prior to concrete
, placement.
o Underground Plumbing - Prior
, ,to filling trench.
r'V1. Underlloo(Plumbln~han~l)
~ - Prior ~L;Sulatlo~;-~~cKTng.
m Post and Beam - Prior to floor
L...PJ Insulation or decking.
rvl Floor Insulation - Prior to
'-f:\:l decking. "
rf1 Sanitary Sewer - Prior to filling
L..AJ trench. ,
m Storm Sewer - Prior to fll'llng
LpJ trench. '
f'11 Water Line - Prior to filling
~ trench. '.
nf1 Rough Plumbing - Prior ~o
LfJ cover.
- OFFICE USE -
\ \ \ \
\
Vf'J
'CONSTR. TYPE:
HEAT SOURCE: ' \ 0 \-1
f~
LAND USF'
# OF UNITS:
RANGE:
REQU IRED I NS PECTIO NS
It1 Rough Mech~'nl~al '~Prlor to
~ cover. 26eO ~. 'r~A,'
, '
f'tI, Ro'UghEle6trlcal -,. Prior to
~ cove~ , ,
I'll Electrical Service - Must' be
L...pJ approved to obtain .permanent
electrical po~er. " "'i':'~
o Fireplace - prior to facing
materials and framing Insp.
CfJ Framing - ~rlor to ~ov,er.
. .
r'\1\ Wall/C'e,lIIng Insulation' - ,Prior to
L.f>J cover. ,
[j Dryw~lI-,. Prior to t'ap~ng:
, ,
o Wood Stove - After Installation.
rVllnsert - After fireplace approval
~ and Installation 01 unit. '
. '
~ '.
,Curbcut & Approach';'" After
, forms are erected but prior to
placement of concret.e. :
CJ Sidewalk & Driveway - After
excavation Is complete, forms
andsub.base material In place.
o Fence- When completed.
mStreet Tr~es - Wh~n.~1I ~equlred
L.4l trees are planted. ',. "
FLOOD PLAIN:
ZONING CODE:'
# OF BDRMS:
u,)fJ
2>
,-: -lJ )
\ ~V) ~
SECONDARY HEAT:
SQUARE FOOTAG E:
~ Final Plumbing - When all '
L+1Jplumblng w9rk Is complete. "
Ltl FI~al EI~ctrlcal .,... When all
electrical work Is complete.
rdt'Flnal Mechanical - When all
4 mechanical work Is complete.
M Final Building - When all
~ required Inspections have been
approved and building Is
completed.
O'Olher
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
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.
P",-
Lot faces
Lot sq~ ftg.
, ,
, Lot. coverage
Topography'
Total helght~\C\:::;
\ 42> '.t--)
, '-;/
BUILDING PERMIT
'ITEM SQ. FT.
M~ln n~~\,
Garage 4 ~
Carport '
Total Value
Building Permit Fee
State Surcharge
Total Fee
'i
i"~.~.(", ':~ \, ':',',:r ':iT,i-.\\t1;..:~ ',~.: .
r
I
( ..; THEPROPOSED WORK IN THE -
"HISTORICAL DISTRICT, OR ON 'i', "
THE HISTORICAL REGISTER?
If yes. this application must be sl,gned
and approved by the Historical
Coordinator ,prior to permit Issuance.
Lot Type '
~ Interior
J P.L.
- .\'N
Setbacks '
HSE GAR ACC
Corner
Panhan~lIe '
Cul.de'sac
S
W
IE
x ~~&;-Q()lD~~iQ3
\L1. \0., to 3"5
I "
l~,fl~
3 '--\D 0Si
-,,()I ./\ ~~ \ 7.~. ' .'
'0'0' II~ . ,\G......,.,
"6b 1. :l.~L
(A)
SYSTEMS DEVELOPMENT CHARGE (SOC)
$ .2000.-I~
PLUMBING PERMIT,
ITEM
Fixtures
Residential Bath{s) NO
Sanitary Sewer FT.
Water ' FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood '
Vent Fan
(B)
~;~,,~
:'
FEE
l~~~
,~~~'
(C)
\Cq~ :
~ tL~'
\ ~'tf6:;"
NO ~
4..~
C9~~
(J:Q
'5.,-
~~,
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
\
'Mecha'nlcal Permit
Issuance
State Surcharge
Total Permit
r3~---.sf!)
tZi!l,-, "I
ttJ.~
~~~, J,,-13
'r 7Mr
; "..//;-" I
(D) -~c ~1-l-Z7:'
MISCELLANEOUS' PERMITS
Mobile Home
.
State Issuance
State Surcharge
,Sidewalk .!) 3 .It
.Curbcul &~
ft
Demolition
State Surcharge
\ 1 ;lli
l~'~
I
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.
DevelopmentCode, regulating the constructl9n and use of
buildings. and may be suspended or revoked at any time
upon violation of an'yprovlslons of said ordinances.'
Plan Check Fee:,
Date Paid:
Receipt Number'
R~~~_,/~..
Plan(Revle~:d "Bt' ,~' 0
7/m~
~r I;(ate/
Syst,ems QevelopmentCharge Is due on all undeveloped
, pr9perU!3swlthln the City limits which are being Improved.
.' f ' ..
ADDITIONAL COMMENTS
'18:3J -If) - I/o (P.icf.(tJ1hJ10
\YJ.f),~t'rt #0~,_) "
'l '
, , '
, ,
\~,>rT:41~go-V~~\
\_~~ \ -.5 \q \00
'~f~<:;~/- CJ")~~) tQf1'/~
'/(cc.cr/Ti?! /':>) 2..J '
,/
\~
....:.{..
,".J ,.
". M" ',.
By signature, I state and awee, that .1 h~ve c;:arefuUy examined
thecop1pletedappllcallon and do hereby ,certtfythat all
Information hereon Is. true and correct, an,d I further certify
that any and ali work 'performed shall be done In acc9rdance
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 Dlvisl<.m.
I further certify that only contractors and employees who
are In compliance with ORS701.055 will be used on this
project. '
, .
I further agree to ensure that all required Inspections are
, requested at the proper tlrT)e;that each address Is read~b,le
from the street, that the permit-card Is ,Io'cated at, the. front,
of the property, and th - et of plans will remain
on the site at all structlon:
'{'gnature ;'/'
/Sll ~ c7~-
Date 7 - z te, -<7J
./
VALIDATION:
Total Miscellaneous 'Permits '(E) 6~.li
TOTAL AMOUNT 'DUE (excluding ~lectrICal) L~)'?->'ft?J-
(A,B, C, 0, and E Combined)
.I tjlfPo//
DATE PAID ?-?~-9Y' ,i'
AMOUNT RECEIVED ,d{:a137V1.
/2~-P
. ",/ j-
,.
RECEIPT NUMBER
RECEIVED BY
, ,",
'. ' ''l908~o
." " ,.'
... >:.-'.t
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'~.'::~, '
g , " ", '. "... "
. CITY 'OF SPRINGF:tELD SYSTEMS DEVELOPME~T CHARGE,
'~
.".' ,
, ,WORKSHEET
,(CO~ME~~)^l&,RES1D~~TJAl1
'. -.
.' .. :'~.' .
. -, I'
o ~. ~ .
, NN1[ OR ~or1PANY :".'k ,....f~ ,
..' LOCAUON~ ?!b#6~~ d5~-' ' .
... .. - ,..' ", :;
~ .. ~
..'.DEVELOPl.IENT riPE: '5,c ~":"c"" .
<ii,
",," \~~ .,;. .
,..f'
., '_.i .
. "BUILDING 'SIZE-: -,
1. " STORl1 ORA I NAG{ ..'
, '~'l
.....,
lOF'-S'fZE':)' ',;
;., ,
',' SQ. Ft.
"
XSO~203 ';ERSQ,:;FT ;', .' rH9~ 4'?'; ,
.' " .'. ;'...;: , '--.,.. ~,'
INPERVIOUS SQ~ FT.. ;22/.6"'.9-$'
2'. SANITARY SEWER~CITY '..
. ..:. ~ .
f..,
.. :H51.#~:" ,.
.'--. '.~
'", NO. OF. PFU':S .. "
~ ." (See R,everse:) ,', ,
, .'..t.
30, ' TRANSPORTATION ' ..
IV'.
'X $4~,.08 PER PFU '..., ,: '
; '.... .'
.,ti,
. :,.... ;<I..
. -'.
NO OF UNITS x' TRIP. ,RATE X COST 'PER TRIP,
,.... -,,.-
/,'"
x /,.0 /
X
X $424'.31
X $424.31
" .f '~~.)?,s?>
, ,--. :...-.?"
S ," '
i..... .
;.. .
'.".,
X
4.'~.. SAN ITARY' SEWER-'11WI1C '
, ,X' S 4 24 . 31
'" S
d.<
. NO. OF PFU'S, [f';' x 515.125 PERPFU + JI0 MWMC AON FEE' s202,2 ~
. (U~e PFU Total From Item' 2 Above)' Y , .
i<".MWl1C. CREDIT,J:FAPPL.rtAB'LE .(SEE REVERSE) __ '" ,'," S 1;2.,.1?'~
," . '.:'~TOTAL~HWMC SDc'k~rd7)
, .' ,'. '~.'~
'': SUBTOTAL (Aob.ITEM~ 1,,2,3'&:4-)- S !trlJ'S'",'~o'
:.. ~., ~ '.i .
. ." ;" <, -' .
5., ADllINISTRATIVE FEES,
. , . 0
: ~\;~ARABTOT: ABO;Jt:S/?f?"
/ 'ct-p ;;UI Ji\. I / '"
, )C Coordina or "',
" , ,'. ..,,';,..':.: ~ll' 9!r,j.~,
". './
"I 1,.'" '. .~
-. :-"
iTOTAL ,.SOC S ;2.,(JOO..p:C;
. .}-..~
. '
.-,.w'
" '
, .<"
r
, FIXTU BEl) N.IT ,CALC U LA 11(.) N 1 Alj'Ll:: r....\lmL'('I 01 New Fi'llH('s X Unit Equlv:11cnl = "l>.llJrC vnll::i \I"V' "'.
For icrnoqcls. ("~ltc'lll~IIC onlylhc r..:r- '1ddi;iOl\;\t li'dllll':')
, '
FIXTunE TYPE ", '
Bathtub..........,..........,.,.... "...."" ,:, ., "., ....."."...,......,
. Drinking F6unl:1ill...:........,..,..,....;, ',....,..,.......,.,...,.
Floor Drain, ..,........... .'..... ,.........~...,. ":.,..."...,..,...,.,' ,.,.
Inlerceptors For Greasc/Oil/Solids/Etc.,...............
Inlerceptors For Sand//\uto ,Wash/Etc..................
Laundry Tub /Oolhes~...a sher.........;.........................
aotheswa~~er. 3 'Or More..-~.~.;,...........~.~....~...;........':.~~~. ""
Mobile Home Park Trap (1 Per Trailer)..................'
Recep!orF{>r Refrigerator fWaler Station/Elc........
Receptor For .Commerclal Sinl</DishwasherIElc..
Sho\ver,., Single 'Stall.. ..... ......'... ..,........ ..... ..................
Shower.. Gang.....:'. ..... ..,.... ......... ;..... ....... ..... .......,'.....
Sink, Bar, Commercial:.....;.......:......,....:......:........... '
. Urinal" Stall (l\'all......; ....:';......;.. .'.........~ .,............. ..:....
Wash Basin/lavai6ry, Singl e :.,...... ....'...... ..:. ...........
V.,'ater Ooser. Public'lnstallation........_....~................
Water Ooset;. Privat e... ,'... ............ ...'.. ........... ....,.........
Miscellaneous:
..- (,'
l':.m' ,
E Ol'iV/\L E IH,
fiXTURE
i." ,..
U:JITS .'
r..:ur.'.[3EII OF '
NEN ';IX1UI\ES .
. ~~-
2-
4
~
...
1
3
6
2.
'6 "
6'
l'
3
i
1/Head
"
2 '
2
. 1
6
~
<g
~
. .~
I
'2.
2
"'2.
2.
TOT /-.L FIXTURE UNITS
/7
CREPIT CALCULATION TABLE: Sased on assessed value. If improvements occurred after annexation date in table,
calculate credh~-'sep2.rates.
,Year
Annexed
Rate per $1,;000
Assessed Value
I
I
I
Year,
Annexed
p.ate per $1,000
Assessed Value
......:.:
1979 or before.
1930
1981
~, 1932::
,', '1983
'1934
, '1985
$3.21
3.13
3.08
2.96
2.82
2.63
2.51
..
Cred)tfqr \ar,cel or Land o~ylf'Al?plicabla
Improvement (rt aft!;r annexation date) ,
1935
1987
1~S8
1939
1990
1991
1992
$ 2.24
L93
L57
1.18
0.79
0.44
0.28
,3,..2. J X $ 4-0-rr0
(Rate X Assess~ Value)
X"$ ,
(Rate X AssessedVa)ue)
CREDIT TOTAL
/2. ?' 4-
=
---
=
= $ /;1..?'"
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R,esid ent iaf...u....~.........:~......~ ..........;'... ............... ,0.4 I. .
Commercial...............................:....................... 0.9 t~ '.
Ind uslriat.... .......... ...:.... ...... ......... ......... .... ......:.. 0.45
G overnmen\al........... ..... .... .:..: ...........~.............. 0:5
'I'~ .
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
... ~,.,. Willamalan~
. 't-g' pa'k&Re~'~atiOn D;stdct
Job No. C4D~)
SYSTEMS DEVELOPMENT CHA~GE'.
WORKSHEET
NAME: \:.~. \~!hJ!t-~ PH6NE:~OS'~'f{~-L\\\~
ADDRESS:&tD~,~\l\,~~ \uill AD- STATE:tl ZIP q,)4f\\
LOCATION OF IiROPOSED BUILDING SITE:
Str'eet Address if Known: :, ry.n4D
Platt ~ame:0nl)~-
~(\n\tQlj _ U) ,
. ,
. TaxlotNumber..,f\rn?D23 ~/o.D?\OO
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calcuhltions and dwelling type
definitions are on the back'> ' . , '
- '
,A. Single Familv - betached
\ Single Family'home
t . '..'.
Manufactured home not in a park
NO OF UNITS
r
X $400 PER UNIT _=
$ L\tlJ.tg
B. Single Familv -Attached
NO OF UNITS
X $370 PER UNIT' ==
'$
. C. Multi-Familv Aoartment;'
~
NO OF,UNITS
X ~277PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PE,R UNIT =
$
$ L\\'D .cD
$ 0
'Af:\ CO
,$:nJ~. .
WPRD Soc:'
2. ' SDC CREDIT (If applicaQle) SDC-payer must furnish proof of WPRD Credit
. approval. See SDC CrediiWorksheet . .' '. ' " '
3. TOTAL WPRD NET sO<: ASSESSED (If SDC reduced forCreditJ,
~.~\\\~,~ ...
Community service;~on .,', ;'
City ofSpringfjeld '. c,' . .
Da~ I t ~<<f