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Home My WebLink AboutPermit Building 1995-4-13 *' LOCATION OF PROPOSED WORK: / 77 Z 0~~/~ c=:- ,/-i,./,"L-. ~,...., , 1I)(),~~Sal', ", ".,TAXLOT !1AOqYOJ 'SUBDIVISION: e::::.;~.r~<~r~"P~;:- OWNER: XA'-N;?'Y~,~A"""49'~-:A-:'-1/~4 PHON" 75/?~6&>~2s ADDRESS:'/:?.:?~ 'N~ ~~;:~,~ r" ~ ' ~ . ?~L~ STATE: q~~, ZIP: 9/y"':>~ DESCRIBE WORK: ~~/X~ ~~ ~ ~~' ./' - -- - , ./,.. ~ CONST, ^ nr\l:lI:;SS "_ _"_ .:- _.,.. _ GObll]=lACTOR 1/ 5''';)'-; PINE a" C/fi!SltJ#tL /t!)';"S3 ~ r . -. -- '--, 1'l~'JU_ _ __ , , PLUMBING' MECHANICAL:4Ar""'5~~~~~ ~ ~ ,. r , . .... ,/;/ .. EL~CTRICAL: / ~~~~. ...' ,4 '1 RESIDENTIAL . PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 ASSESSORS MAP: 3 LOT: CITY' NEW x REMODEL / CONTRACTOR,c"-"NA.MS, , ~ G EN ERAL~~__ ACXL{M1E cQtXT, Co, QUAD AREA: :J Q t00 1/ OF BLDGS' ., \_, OCCY GROUP' ~-T tJ\ ~ f/ 1/ OF STORIES: WATER HEATER: ,~ BLOCK:, ADDITION DEMOLISH OTHER , . .,#,/ ~~ YS- \' - OFFICE USE - \ \ \ \ 1/ OF UNITS: \ CONSTR.'TYPE: V!\J ~E" RANGF' ,,___ _&_~ ___. __~- LAND USE: HEAT SOURCE: JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 ~~?~~ / EXPIRES ,-- - i'f A4Wclf 'f PHONE 8'S'-'I~71"- , {' -", I , FL:.OOD PLAIN: ZONING CODE: 1/ OF BDRMS: LD{L -~ SECONDARY HEAT: SQUARE FOOTAGE: ~ ~2J ~ 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, Inspe~tlon~ r~quested after 7:00 a.m. will be made, the following work day. REQUIRED INSPECTIONS ~ R~ugh'Mechanlcal ...:. Prior to' ~cover. )KI~T~mpOrary ,~Iectrl~ . . D Site Inspection - To be made after excavation, but prior to setting forms. O Underslab Plumblngl Electrlcall Mechanical - Prior to cover. M Footing - After trenches are ~ excavated. ' o Masonry - Steel location, bond beams, grouting. ~ Foundation - After forms are ~rected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. tx1 Underfloo(Plumblil])>/~echanlC1l1) " ~- Prior to to ."'.... ;",flo,; <:k a9clll rtg':'"' -r--..A Post and .Beam - Prior ~_~ floor ~Insulatlon ,or,d_~cklng. , '-- _ ~ " '. " - I ~ Floor'lnsulallon -, Prior:. to'". J.L.-.1"deckl ng. ~ Sanitary Sewer - Prior to filling 1./"01 trench. ' fVIStorm Sewer - Prior to filling ~ trench. ' !'XI Wate~,\L1ne -prlorto filling ~ trenc'}! . I , 15<f Roug'h Plumbing - Prior to , ~over. 'I><( Rough Electrical - Prior to 'fover. ~ Electrical Service - Must be ~approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. ~ 1><\ FramIng - Prior. to cover. 1><"1 Wall/Celilng InsJlatlon - Prl~r to ~ cove~ ' ,15<1 Drywall - Prlor'to taping. ~ D Wood Stove - Afti3r Installation., D Insert - After fireplace approvtil ' , and Installation of unit. . "~Cui:bcut & Approach - After, ~forms are erected but prior to placement' of concrete. ~Sldewalk & Driveway - After ~excavatlon Is complete, forms and sub.base material In place, o Fence - When 60mpleted. ~treet Trees - When a'lI r~q~'red ~ees are planted. ' , , M Final Plumbing - When all ~plumblng w9rk Is complete. ~Flnal Electrical - \t\I.hen all ~electrlcal work Is complete. C R::VFlnal Mechanical - When all ~ mechanical work Is complete. IXl Final Building - When al/ , ..... required Inspections have been approved and building Is completed. [Xl Other }16t.D ~Ce. fI PANe. y ttl::I.1l( f~T IS ACt:...!3P reD , (5 - '8'1 ? ) MOBILE HOME INSPECTIONS D Bloc~lng and Set.Up - Whe[l all b.locklng Is complete. ' o Plumbing Connections""': When home has been connected to ' water andsewrrr, o Electrical Connection - When blocking, set.up, and plurvblng Inspections have been approved and the home Is connected to tne service panel. o FInal - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. '. IS THE PROPOSED WORK.tN THE - f HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. ..';~- ~i:~".;'\1', " Lot faces S Lot Typ Setbacks ' - Lot sq, ftg. ,~ ~ Interior I' P.L. HSE GAR ACC Lot coverage f2.7 Corner IN 31~ Topography Li~, Panhandle .' Is /3!!./iSAm) Total ~elght ~~, Cul-de.sac Iw /'J/ 'I E s Plan Check Fee: ~ ~ y. ,/ Date Paid: I-/?-~ /.0..8 ~~";S- ~ ' 4..5"2,,2.;5" Receipt Number: ~~ ~'t'o .2. ~ RecelvedAJY: //. &'~~, #~/~ '~9, ~ I Plans 'aevlewed By ? SYSTEMS DEVELOPMENT CHARGE (SDC) , zs-re.O.:J~ \_~+- --r: , \qq4 ' ,,-192[0 \~nQ}(.lY)h>-> lrA9fl (Q~ ./JAjtf 1 -~ ~~~ ~ ,4'~Af'/?r (I C:;;5:~-1 -./8 _pbf"/~61 ' , c, . /W;~, 6v~tJJJ /lent h~be ""267 ~ ~&.P~ IS ~~ '.3~ ~~/.uEiX'/.()i:; ( BUILDING P5RMIT ITEM sa. FT. X ,$/SO. FT. = VALUE ~:?~, ~'2".:>. ~~- L!6./0 " ?7~ Main /? 7'2- 5~~ Gatage Carport Total Value Building Permit Fee , State Surcharge ~'2.. ~Cp+ /~,~o Total, Fee (A) (B) PLUMBING PERMIT ITEM FEE Fixtures , .3 Reslde!ltial Bath(s) NO Sanitary Sewer FT. Water FT. Storm Sewer FT, Mobile Home Plumbing Permit 9"3 +- 5",18 State Surcharge 4-/ Total, Charge (C) MECHANICAL PERMIT ~~ 4~C) /20D Furnace Exhaust Hood Vent Fan NO 4- Wood Stovellnsert/Flreplace Unit Dryer Vent ~ .&>&> , Mechanical Permit , $'0 "-%$1 ,', /t:J. a-o '?. ~ s , ss ,3.2 Issuahce ' 1.~ - 1 State Surcharge I. + I '7 , Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance 1'- State Surcharge Sidewalk ?~ ~4 2/ .'-S" /5/0 Curbcut ft ft Demolition State Surcharge ..., ~/ _.3"> Total Miscellaneous Permits (E) ~ , TOTAL AMOUNT DUE (excluding' electrical), j~3! ffp~ . (A, B, C, 0, and E Combined) ,:,' APPROVED: ' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT r ~ 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. ':i/!l)?J 5" /Date/ Systems Development Charge Is due on all undeveloped properties within tho City limits which are being Improved. ADDITIONAL COMMENTS By signature, I ~tate and agree, that I have c,?refully 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 the approved set of plans will remain ,~ on the site at~ ~ c~~ ~aturr~~~ ~~' --, o /' 'T-/j~.i~ ~ 'l t" ./ VALIDATION: RECEIPT NUMBER /69 VC:;;; Y-n..95:"- , AMOUNT RECEIVED .3 7a11 ~b RECEIVED BY'" /2~_____ ~' /' /.' - tv, DATE PAID '>, , . i r ATTACHMENT 81 )8 NO. 9 soo.;. s:- CITY OF SPRINGFIELD SYSTEMS DEVELOH1ENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: -Lf j I. /Itu;f~ LOCATION: / 172 &~" jJ~ / DEVELOPMENT TYPE: 5? /) BUILDING SIZE: 1. STORM nRAINAGE IMPERVIOUS SQ. FT. I~OT SIZE" SQ. Ft. .2.. ,~ '.'" 5" X $0.209 PER SQ. FT. p7~ , 2. SANTTARY SFWFR-CITY NO. OF PFU'S . (See Reverse) :24 X $43.26 PER PFU , ,------ ~ , $/7c;3~ ( , 3. TRANSPORTATTON NO OF UNITS X TRIP RATE X COST PER TRIP x X $436.19 ~ SS>; l ---- $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 20/:;-,?7 / X IrOI X $436.19 X X $436.19 4. SANITARY SFWFR-MWMC NO. OF PFU'S .:2-4 x $17.19 PER PFU + $10 MW11C ADMIN.FEE (Use PFU Total From Item 2 Above) $ 122.55 MWMC CREDIT IF APPLICABLE (SEE REVERSE> . TOT~-MWMC~ SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ ~ - y-- -I-22..;'-~~~ ..... $ 7-43F,-tZ-r 5. AnMTNTSTATTVF FFFS BASE ~ (SUBTOT~VE) X .05 ~ 4- Date: / Mary ~omig. Ip.E. , "\ /' SDC Co'bi"di nator ~ ~/:~~ /-2C,-1S TOTAl SDC $ 2 ~c"O.J f - B2.SDC . FIXTURE UNIT CAlCUl :ION TABLE: Number of New Filt"Aes X Unit Equivalent = Fixture Units ';, ' (NOTE: For remodels, calculate only the ME! ad.ditional fixtures) , " NUMBER OF NEW FIXTURES FIXTURE TYPE Bathtub...... .:.'..........,......... ............ ............... ..,..... ......... Drinking Fountain....,... ...,~:. ............ ..,......................... Floor Drain....... .......... ......... ... ...... ........ .............. ....... Inlerceptors 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, Commer~ial; Residential Kitchen........................ Urinal, Stall/Wall. .:,.,..~. ~:....:........................................ Wash. Basin/Lavatory, Single. :........ ......................... Toilet, Public Installation............... ......................... Toilet, Private.. ~.................................................... Miscellaneous: ", ,TANI TC~'.s SI/</K I ' , . ' 'V.,. ~ l 4 z, 't \, UNIT' EOUIV ALENT FIXTURE UNITS 2 1 2 3 6 2' 6 6 1 3 2 1/Head 2 2 1 6 4' -<- 2.. 2- 2.. 2-. 4 /2. TOTAL FIXTURE UNITS . = 24 CREDIT CALCU~TION TABLE: Based on assessed value. If improvements occurred after annexation date in table, , calculate credit's s'epcfrates. , , 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 Credit'for:Parcel or land Only If Applicable Improvement (if after annexation date) Year Annexed Rate per $1,000 Assessed Value $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 = ,AM / = ,; , ; .A .,' . )'; fIl" ,..' I/8JI!I ...-~ Willamalane 't'W' Pa,k & Recceat;on D;st,;ct . ,.!l ~ I.'~' Job No. qtfD10 SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME:~b'l 2J~ }~NAC PHONE: ~4(j .lDD~ ADDRESS: ~A Q l'f\ 3'fH1& ~~() STATE:~ ZIP rI-11..~. - - I , ' LJI....IQ- LOCATION OF IllROPOSED BUILDING SITE: 11 '^. J A ^ lit. _ ' Street Address if Known: WI) _ UlI f) ~ L,. J..1LCJL- Platt Name: ~D_~~J Tax Lot Number: \f1[)~fj,S~\ \\~Cfb) 1. DEVELOPMENT TYPE (Check appropriate dwellingCs>. SDC Calculations and dwelling type definitions are on the back'> A. Single Familv - Detached \ Single Family home NOOF UNITS \ B. Single 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 $ 4dJO . ex) X $400 PER UNIT _= ~ X $370 PER UNIT = '$ X $277 PER UNIT = $ X $280 PER UNIT = $ $ 4DD,cO $0 $4. )l). oU 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) C~~i~~~ Date I r;..~. ,,! ("""""':rl...,..t;o'r1 I