HomeMy WebLinkAboutPermit Building 1992-8-12
OWNER: _~.fDh~ j~+i- .~I e,l!lh1~(('r' tlo.rD. ~'J .
ADDRESS: _:7,OD~ l1.t.JJ~.Ld{4-~~ 10't
r' . ;~.f\i ,
1!J\~~~~
10 1?vilo{ Ci. 'lAew' ~Oille
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
CITY:
DESCRIBE WORK:
NEW /- FlEMODEL
S,'-nINGFII:;LI:>
BLOCK:
.-
<'
-.-'
:J08 NUM8EA~
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
O~.~rD
,-i.
If+lt'.. f1~-
STATE:
DR
TAX LOT:
PHONE:
ZIP:
q 74 7 7
- lJvrf~,:,J\f(A ~er(j'v1d .{lMt
DEMOLISH OTHER
ADDITION
CONST.
CONTRACTOFl'S NAME T/lr .J'DDRES~ CONTRACTOB II
. -/I<....~75'S7.'.........~~~ 7//6'lf,
GENERAL:./it:::-"f L .Ct2,os.t:- ';;:':;"~~..J!u;_.T."~l. ' ,<;f.;,t'Q7
'. .',' . . /~~r a 9'7~JT,
PLUMBING:... ..__.. ...... __....00.._. ................._. .........._.__..._oo_......._..,.._...........__......._._...
MECHANICAL:
ELECTRICM.:
QUAD AREA: --4: R..Sf ..J
II OF BLDGS: - \
OCCY GROUP ~. "\-:t....LfVJ...._-~
II OF STORIES: d
_9 ../
- OFFICE USE -
l ~ \ \
LAND USE:
II OF UNITS: __l ~
CONSTR. TYPE: -V .. ---~:..-
HEAT SOURCE:' V
U
EXPIRES
_-~j7.(9~
PHONE
.-2..S~ ~.f!f?
"
.!'i"
FLOOD PLAIN:
L() yz)
ZONING CODE:
:::O::::~>IE;; F~--
SQUARE FocirAGE:~~Z:..1
v
To request an inspection, you must call 726.3769. This is a 24 hour recording. All inspections requested belore 7:00 a.m. willl)e
made tl'10 same worl<ing day, inspections requesteej after 7:00 a.m. will be made the lollowing worl< day.
WATER HEATI::R:
~ Tempormy Electric
D
Site Inspection - To be made
after excavation, but prior to
selting lorms.
D
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
r...........r'Footing - After trenches are
~ ~xcavated.
D Masonry - Steel location, bond
beams, wouting.
""
!Xl Foundation - Alter forms are
.. erecteej but prior to concrete
placement.
D
Underground Plumbing - Prior
to lillina trencl1. I
'D<'T Underlloo~mbinfilMechani~
~ - Prior to In!;UIClIIOn VI Ut;Ll\lng.
f'...../I. Post and Beam - Prior' to floor
~ insulation or decl<ing.
M'Floor Insulation - Prior to
~ejecl<ing.
K/f Sanitary Sewer - Prior to lilling
~ trench.
J')<["'Storm Sewer - Prior to filling
~rench.
i'9l' Waler Line - Prior to filling
~ trench. _
"'K71' Rough Plumbing - Prior'to
~covel.
RANGE:
REQUIRED INSPECTIONS
f'\:;:1 Rough Mechanical - Prior to
~ cover. .
, . ,
I'VI Rough Electrical - Prior to'
~cover. .
lC7f Electrical Service - ~"lust be
~ approved to obtain permanent
electrical power,
D
Fireplace - Prior to lacing
materials and framing Insp,
~ Framing - Prior to cover.
~ Wall/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taping.
1VT Wood Stove - After installation.
~ ZQeO ~, 'F,p.
o Insert - After fireplace approval
and installation 01 unit.
\.
15<f Curbcut & Approach - After
, " lorms are erected but 'prior to
placement ol'concrete. '
IxrSidewalk & Driveway - After
..-K~excavation is complete, forms
and sub.base material in place.
o
:. >~ .
Fence - When completed.
@ Street Trees - Wilen' a;1 required
trees are planted:"':\ , '._
. -
I"\::/f Final Plumbing - When all
~ plumbing worl< is complete.
~I Final Electrical - Wilen all
,'" ...... electrical work is complete.
15<1 Final Mechanical - Wilen all
; ,mechanical worl< is complete.
, ,
1><1 Final Building - When all
,.. '" required inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and' Set-Up - When all
1)locl<irig is complete.
D Plumbing Connections - Wilen
home has been connected to
water and sewer.
o
Electrical Connection - When
blocl<ing, set.up, and plumbinu
inspections have been approved
and the home. is connected to
the service panel. .
-\
o Final - After all required
inspections are approved and
porches. sl<irting. decl<s, and
venting have been installed.
Lot faces ~ Lot Type Setbacks
Lot sq. Itg. 18-5(;, ~ Interior' I P.L. HSE GAR ACC
Lot coverage ~ Corner IN '2/~
Topography _irP~ Panhandle S /~' ';2.01
Total height .~5', Cul.de-sac W /SI IS-I
~ 1!'1. 'J__.~._.
BUILDING PERMIT
ITEM
SO. FT. X
:"/' '.'.
.Lt2GJ~ '"~'>
53'7
'!fb7'7
$/SQ. FT. =
h6...:-,o_
1'1/0
22, S""1..
Main
Garage
~~"s~
~A...[
VALUE
':~~I'~?O
'7~OO
/ Cj 7SfJ
Total Value ~tf"q.tZO
, :d 42.,d:J.' ~
Building Permit Fee ~C/';IiJ-
State Surcharge ,E., "
Total Fee (A) '"i.~1 t-t!!--.
SYSTEMS DEVELOPMENT CHARGE (SDC) .,..
. . (B). iP.Z:Z.DC;~
PLUMBING PERMIT
ITEM
Fixtures'
Residential Bat~l(s)
NO :5
Sanitary Sewer
FT.
Wate~ ~
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical. Permit;,
Issuance
Slate Surc~:arge
To'tal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State 'Issuance
State Surcharge
Sidewalk /20 It
Curbcut 22- It
Demolition
State Surcharge
........
....... -;;:=:---....:""-~~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D, ond E Combined)
FEE
-8..? So
963
2L?2 ~ 3
IO~O
+.~o,
/5. ~:eJ
---3.. tn:J
2-f!3;J f'o
-LO.tOC)
J.~
.-:sCJ ~q3
~.gt)
./ ,~.3t)
-t--zjpn2~
HE PROPOSED WORI<. IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permil ic;suance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects. conlormto Ille Ordinance
adopted by the City 01 Springfield, including the
Development Code, regulating the construction and use of
buildinns, and may be suspended or revoked at any time
upon violation Ohl'~~iO~~ said ordina,n~~s..
Plan Check Fee:' A.. (k. )..
f\~D :C\~',. ',.
,.~~4 ~-
/
"
Date Paid:
:.....
~~
~~~
r~te
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
-(\1 ~)I- f\c;t NO, ~n rl n Qi'~
__ .' ou . '.ll.l.Y- __o.______ . ~
~':'c:!-+ T : \ Q~llD
'c~c;&{\ (\Q)(, 'f ~: I q &:)
PRn7/. :1.
, r" __
By signature, I,state and agree, that I have carefully examined
the completed application and do hereby certify that all
inlormation 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 lhe work described
herein, and that NO OCCUPANCY will be made of any
structure willlout permission of the Building Safely 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 atthe proper time, that each address is readabl~
from .the street, that the permit card is located at the front
of the property, rJc;2he appro d set of plans will remain
~~g~:~rSHem ;; ,"cOon
/ f)-V
Date . /'1-
VALIDATION:
RECEIPT NUMBER
DATE PAID
-S-~ 7 S
~//b/5"?
.~~~=-.._--
AMOUNT RECEIVED
FIECEIVED BY.__
__ . _JOB NO. 9"Z-o~Co
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WQRKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: "Ro~~12- '\ ~ -S~...HF-e~ Mo~~l,...E..~
LOCATION: Co"Z..."1 CA~c...~t>E:. l"'107.. '7::7'??'? - O?'UJO
DEVELOPMENT TYPE: Lof2. ~ NE:.W ~f-':'"
'.
BUILDING SIZE:
,LOT SIZE
SQ. Ft.
1. 'STORM DRAINAGE
IMPERVIOUS SQ. FT.
-z..\--z,o
. X $0.192 PER SQ. FT.
cGo,oV
2. SANITARY SEWER~CITY
NO. OF PFU'S ~~
(See Reverse)
. X $39.78 PER PFU
~9~~
'--- ....---
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
lX' ,DoS, X $401.05
~c~o0
-........ --
X
X
X $401.05 $
X $401.05 $
SUBTOTAL (ADD ITEMS 1,2, & 3) $ \cocL4-'='.2
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
c;- C;O~~
----- ...-----
TOTAL-CITY SDC $ \'O~t4-e.E-
5. SANITARY SEWER-MWMC
NO. OF PFU'S --ZS; . x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ?~D~
(Use PFU Total From Item 2 Above)
, ,
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
~---~L~ (/2" /17..-
\ --~ Kip Burdick . I
SDC Coordinator
$ ~ 1? c:r!-
TOTAL-MWMC SDCGL\~'
---- ------
TOTAL SDC $?..209 ~~
, . " ..
FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X u5uivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
Bat ht u b......................................................................
D rin king F ounta i n.................,......................:............
Floor Drain................................................................
Interceptors For Grease/Oil/Solids/Etc.................
I nterceptors 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....... .'........:.... .......................
Urinal, Stall /Wall... ..........,... .................. .,..................
Wash Basin/Lavatory, Single.........,........................
Water Closet, Public Installation..........................,..
Water Closet, Private.............. ..............,.. ,.. .............
Miscellaneous:
2
1
2
3
6
2
6'
6
1
3
2
1 jHead
2
2
1
6
4
2.
-.;
~
TOTAL FIXTURE UNITS
FIXTURE
UNITS
"Z
2.
'-\
2.
~
\"l..
Zt;
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
19&1
'1982
1983
';', 1984
$2.83
2.76
2.71
2.60
2.46
2.33
1985
1986
1987
1988
1989
1990
1991
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
Cr'edit for 'Parcel or Land Only If Applicable '2, CQ? X $ \-z...-" ~? c;.J.
(Rate X Assessed Value)
Improvement (if after annexation date) X $.
(Rate X Assessed Value)
CREDIT TOTAL = $ 3t;~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential,...,............................. ...................... 0.4
Commercial,............... .:...................... ............... 0.9
I nd ustrial........................................,.................. 0.45 '
Governmental.......... ........ ..,...... ............... ......... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT