HomeMy WebLinkAboutPermit Building 1992-7-27
RESIDENTIAL .
PERMIT APPLICATION
Inspections: '1:'6-3769
Office: 726,3759
LOCATION or' PROPOSED WOFlf(:
ASSESSOF'lS r.jlAP:_____/7 Q~
LOT: ..,_~
OWNER:
:J V'l--C i~
,1tt.1('/ ( I
?VI At tvJ s-r
ADDRESS: ____.2;,7: ~ 7
CITY:
~~) OVe5dV'
SPRINGFIELD
'!
5' 2 5 <:: <;. s c..<;;, Le-
~5
..~ :?
BLOCK:
STATE'
DESCf'lIBE WORK:
. NEW __2S_ IlEMODEL
S~ ~l'_9.:)
--. ADDITION
DEMOLISH
OTHER
JOB NUMF,3ER 7'~O$~~
225 FirHl Street
Springfield, Oregon 97477
TAX LOT:
'87ClO
. ~7?)A )
2. ..0 ()
SUBDIVISION:
PHONE:
7 ?. (;, ~ I \~9 '-I
ZIP:
'774'753
CONST
CONTRACTOFfS NAME ADDRESS CONTRACTOR 11
GENEF1AL: ____7/12 @__;.u___B:z.o~--'=L-- CY ~_f.________ ~2D /
PLUMBING: _ _f'rLJt-~__ f::~2~_______~_\o1 ~____--.:.. (Q<6lC\1
" loSS \0.,
---- ____6Dd ~
MECHANICAL:
i \.
I \
ELECTRICAL:
l.---~ d c. () ~,~ J&,\U
__n__-:-__ _ ______~~ ---
QUAI~1 AREA: 5~R~
II OF ElLDGS: ___~___\
OCCY GROUI'):____n~__:r..l" .----
Eh
E
II OF STORIE~;
WATER HEATE:R:
- OFFICE USE -
\..1..\\
~lJJ
FE
1=
LAND USE:
II OF UNITS:
CONSrR. TYPE:
HEAT SOURCE:__
RANG E: _
EXPIRES PHONE
g~Az 7.2 6-/ :;~!... "-I
1J 21 8'2-. _____.__________
-;f5}fj2- b~2LB~:
_1-. 'Q../(l ~_-----~----
FLOOD PLAIN:.. . ________
ZONING CODE:~_Q .-
'- q----------------
11 OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: c:Qj a. --::s..
To.request an inspection) you must call 726-3769. njl,s Is a 24 hour recording. All inspections requested before 7:00 a.m. will be
made tile sarne working day, inspections requested_'-"af.ter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
'1\:71' R~l:9h Mechanical - Prior to
~cover .
ft Tcmpor,JlY Electric
D Site Inspection - To be made
. after excavation, but prior 10
setting iorrns.
o
Underslab Plumbing/ Electricall
Mechanical - Prior to cover.
I':7f Footing - After.tre'nclles are
~ excavated. .
D Masonry ~. Steel location, bond
. beams, grouting.
K7f Foundation - After forms are
~ erecteel but prior 10 c6ncrete
placement.
o
Underground Plumbing - Prior
to filling trench.
"'K7( Underfloo<plumbiJm~cha.ni~
~- Prior to IIlSUlatlon'0-ru<ov.""lg.
t><:I Post and Beam:"" Prior to flo~r
,inSulation or decking.
,
I'XI Floor Insulation - Prior to
~decking. .
;jxf Sanitary Sewer - Prior to filling
~ ,trencrl.
I'\:::,:(Storm Sewer - Prior to filli,:"g
~ trench."
~Water Line - Prior to filling
~trench.
./
K I Rough Plumbing - Prior to
~ cover. . .
-lViRough Electrical -' Prior to
~ cover .
-
~ Electrical Service - Must be
~ approved 10 obtain permanent
electrical power
D Fireplace - Prior to facing
materials and framing Insp.
,
!XI Framing - Prior to cover
" ...
xC'wall/Ceiling Insulation - Prior to
.. .. cover.
~ Drywall - Prior to taping.
" .
D Wood Stove -.:. After installation.
D Insert - After fireplace approval
and installation of unit.
~ Curbcut & Approach .- After
forms are erected but prior to
placement of concrete.
'K7f Sidewalk &. Driveway - After
~excavation is complete, forms
and sub-base material in place.
D Fence - Wilen completed.
'::':':'~Street Trees - WI~en all req~ired
~ trees are planted. .
;
IY1 Final Plumbing --' WilCn all
~ plumbing worl( is cornplete.
1~'Final Electrical - Wilen all
~ electrical work is complete.
~'Final Mechanical - Wilen all
~ mectlanical. worl( is complete.
1"V1Final Building - Wilen all
~ required inspections have been
approved and building is
- completed.
D' Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocldng is complete.
o Plumbing. Connections - Wilen
home has IJeen connected to
water and sewer.
D
Electrical Connection - When
blocldng) set-up. and plumbing
inspections Ilave been approveel
and the home is connected to.
the service panel.
o
Final - After all required
inspections are approved and
porch~s. skirting. decks, and
venting have been installed.
i
0rol
,
Lot faces :"'""I Lot Type Setbacks S THE PROPOSED WORK IN THE
Lot sq. ftg. ~ '~terior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
IN 351 3S'I THE HISTORICAL REGISTER?
Lot coverage ~~ Corner If yes, this application must be signed
~% Is 'ZSI and approved by the Historical
Topography Panhandle
Total h~i9ht d~/ Iw /01 \ Coordinator prior to permit issuance.
Cul-de-sac
~ 5" ~ APPROVED:
B U I L DIN GPE RM IT
ITEM SO. FT. X $/so. FT. VALUE
Main -&05 3'9 "ZQ ~ .~h 3 )'
Garage '-;::;)t9C/ /4~ 705tJ
Carport
'7~7~
.3 -10.0'S>
/7;0
3~3 }I'O
SYSTEMS DEVELQPMENT CHARGE (SDC) ~.
. . . C (B) .ifn '=>~ ~
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM'
FEE
Fixtures
Residential Bath(s)
NO
2.
/ ~(') tHJ
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
~,6-C
I t:.,~.J~
Total Charge
(C)
MECHANICAL PERMIT
~ t'rO
450
~~
Furnace
Exhaust Hood
Vent Fan
NO
2-
Wood Stove/lnsertlFireplace Unit
Dryer Vent ..
.~ tf)~
Mechanical Permit
/9. ~,(;)
---I--tJ.~-t)
.?S
~€;
?,o,
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk -103 ft
Curbcut --.25' ft
2S,~5
~~7S
Demolition
State Surcharge
Total Miscellaneous Permits (E)
~ '7' . 2..0
2~~4-,13
I
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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 or
buildings, and may be suspended or revokecl at any time
upon violation of any provisions of said ordinances.
PI k F :') '2..... ./, 90
an Chec eEr ~ f
Date F?aid: ~h. .~ ~ 2-
, -/
Receipt Number:~S2' ~ 7
Re~
P.fa~s' Revi eW13d By/' .
7/~. .~L
I ~t; .
Systems Development Charge is due on all undeveloped
properties within the City limits which are being imp'roved.
ADDITIONAL COMMENTS ,
,.
,.
(~ljLrofu_; ~~.
\. cA.+"1 \c:..,,o2[J
4\J\Q~_): \~ Ce()
By signature, I stale and agree, thai I have carefully examined
the completed application and do hereby certify that aW
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 furth.er 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 requi.red inspections are
requested at the proper time, that each addressis readable
from the street, that tile permit card Is located at the front
of the property, and the app . ved set of plans will remain
~g~haJ~\al:LdU'~ con'~uc(;on
Date .(\:r~ '2.../. 1'l,Z-
. V
VALIDATION: J:::n^ t:::::
RECEIPT NUMBER U fA" J-.-J
DATE PAID. f{ .~f) _.....~ . ..
AMOUNT RECFlrLriJ _{... . OJ........ ~<fc)
RECEIVED BvC'7\ (,L.R---/
JOG tW - 4 '2-0 f>~J,>-
C I T Y 0 F S ('~d N G FIE LOS Y S T Et-1 S 0 EVE LOP ~1 E. . C H A R G E
WORKSHEET }
. (COMMERCIAL & RESIDENTIAL) _
NN1E OR COt'lPANY: :rAL--~ 1\ g.."'e- ~ L..L
LOCATION: 5-z..-C"::> C-~ c..A-t:>E::
DEVELOPI.1ENT TYPE: t....Og-tJt=.W 4f-l2-
BUILDING SIZE:
LOT SIZE
.SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.. 20!?>0 . X SO.186 PER SQ. FT. ~~:.~ ~
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is n
~~~~
3. TRANSPORTATION
NO OF UNITS X.TRIP RATE X COST PER TRIP
\ X I. o-a S X $388.61
x'
X $388.61
~
$
x X 5388.61
(Se~ Attachmen~ ~ To Determine Trip Rates)
.' , . . ., ,SUBTOTAL '{ADD ITEMS 1,2, &. 3)"1..: I~I.I ~~~ .
~.
~
:-,-~
4. ADMINISTRATIVE FEES
"BASE CHARGE {SUBTOTAL ABOVE} X .05
~l~ '?~()
-- -
TOTAL-CITY SDCS \'5>Y-a...\- ~
5. SANITARY SEWER-MWMC
NO. OF PFU'S
I~
x S13.25 PER PFU ,+ S10MWI1C ADMIN. FEE S z.-c.tf:> ~~
(Use PFU Total From Item 2 Above)
. s ?'1~
TOTAL-MWMC ~ 1,of> ~')
TOTAL SOC S \ -"1 ? ~ ~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
v' _ ~ LOlL- to /~'f 11-z.-
I~ Kip Burdick . I /
SOC Coordinator
FIXTURE UNIT CALCULA-, )N TABLE: Number of New Fi,,1uresX
For remodels. calculate only the NET addi,ioncl h1ures)
, Equivalent = i=iMure Units (I\!OlT
4
FIXTURE TYPE
NUMBEfl OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
I
2 +
1
2
3
6
2 2.-
6
6
1
3
2
1jHead
2 ~
2
1 z.,
6
4 8
Bath! u b..... .... ........ ..,........."'''' ...-... -- --.-. ---- -- -- - -.. -. -.. -...
Drinking F ountain......~... ............ -......... ....-- -.... - -....--..
Floor Orain.... .......:........:. ............. ....... ....-.. .--." .._m'"
Interceptors For GreasejOiljSolidsjEtc:................
Interceptors For'Sandl Auto WashjEtc.......__.:....__.
La undry Tub IClotheswasher...---.....---. -...... ..--..... -- -.
C10theswasher - 3 Or More~........___.....___.....__..__.__.._
Mobile Home Park Trap (1 Per Trailer)......._______....
Receptor For Refrigerator fWater Station/Ete..._____
Receptor For Commercial Sink/Dishvvasher /Ete.:
Shower, Singl e StalL.......:.. .............. ..... -----..... .,,--..
S hower, Gang..... ............................-. ........ ......... -....
Sink, Bar, COmmerciaL....................._........--_.......
Urinal, Stall fIN all... ........ ...... ............-.. ........-.. ..........
Wash Basinflavatory, Single._...._._______.........____.
Water Closet, Public InstaUation...-........-.---.------..
Water Closet. Private___..._................-..
MisceUaneous:.
Z--
I
,
~
'Z--
TOTAl FIXTURE UNITS. -
18
r
CREDIT CALCULATION TABLE:
calculate credits separates.
I
Based on assessed value. If,improvements occurred after annexation date in table,
-. - - .
1979 or before
1980
1981
1982
1983
1984.
Rate per $1.000
Assessed Value
$2.66
2.64
2.53'
2.41
2.19 .
2.04
Year'
Annexed
1985
1936
1987
1988 .
1989
1990
Rate per Sl,OOO,
Assessed Value
:Year
Anneietf
$1.69
1.35
1.15
0.92
0.59
0.23
Credit for Parcel or Land Only If Applicable 'Z- .lR (.. X S ~.;. 0 "2-- ~ 9..?
(Rate X A<:<:P<':<;ed Value)
Improvement (If after annexation date) · X S
(Rate X Assessed Value)
CREDIT TOTAL = S 7;f1~':;
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resident ie\...... .__.u__m...____u..... ......__ -- .__.u...__.... 0.4
COmmereicL...m... ...... ...__.__..__... ----.... u.........u. 0.9 '
IndustriaL----u ...__..._... ....___....__..__..__.............__.___ 0.45'
G overnment2.L--.... _.... u"__ u.". _. u ..__.. --...-.--------- 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT