HomeMy WebLinkAboutPermit Building 1994-7-12
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SPRINGFIELD
i .
RESIDENTIAL
PERMIT APPLICATION
9y.o/?:<\
JOB NUMBER
Inspections: 726.3769
Office: 726-3759
225 Fi fth Street .
Springfield, Oregon 97477
TAX LOT: I~ 5'&-'~
ASSESSORS MAP:
LOT:
SUBDIVISION'
BLOCK'
OWNER' S ck L-e/:J {1'J IJ\Qh
ADDRESS: . -'21.j/J'O ~ ?"r= .
0?rt:-, /.
CITY: " ~
DESCRIBE WORK: ~~;~~C,7
PHONE:- .?c;i~;,..~":>-=3
p ,
qr?p
'&::f77'" /' ..>
STATi='
ZIP:
,
I
--fA ~~'5 ~ /47~~ ~ ~~~,-
.,c-l /,. -= ,,>;....., / //--- lj. -:- ~/"-t'~ ;~-''7- ~ ".
DEMOLISH Ol'HER
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y
REMODEL
ADDITION
NEW
CONST.
CONTRACTOR'S NAME' , ADDRESS . qOt'JTRACTOR /;
GENERAL:'~E~L~A", :2,7"~ ~ 5/: 4..p~_ ..::f>'2'::>2t y
. - ' " r" .,./ - ./.','
. > " ~ o. 'I
PLUMBING: ' .
MECHANICAL:
ELECTRICAL: M:.!45' ~~
, . ' .' ~
EXPIRES PHONE
~ '}I""""!7Y 7 Y6-eT;>':?'
/'
/-1'Z~qlf r)4~'-{&7TO
(~Cio51
. - OFFICE US.'1-
" ,:'-, .~~ND US~~ . ,.1 ( l j
. \'. ~
; F^/'
CONSTR. TYPE: _ V I\,
, .c;s.Eq,~ ~
HEAT SOURCE:(~' / ~ -
RANGE: . ~- '
QUAD'A~E'A:rOf< rl)CU
I
L)'..'-l.... -fA A
OCCY GROUP: n) 1\../'-
." \
'8\
FLOOD PLAIN: p
ZONING CODE: U-J ~
9J
/; OF SLOGS:
/; OF UNITS:
/; OF BDRMS:
/; OF STORIES:
SECONDARY HEAT:
SQUARE FOOTAGE: ~~
WATER HEATER:
, .
To request an inspection, you must call 726<3,769. Th,is Is 'a 24 hour recording. All inspections requested before 7:00 a,m, will be
made. the same working..d<;iY, ins,pecti,ons r,e.quested ~ft~r 7:00 a.m. will be made the following work day,
. . . ? ,. .~. ~. . .. .,~ '. ...... -
. . REQUIRED INSPECTIONS
I's?1 Rough Mechanical -:-f" P~i,or to
~cover, " .
rV'l Final Plumbing - When all
~ plumbing work is complete.
D Temporary Electric
.. '
-.-.,/;,
D<f Rough Electrical - prio:r t~ "
.I' 'fover. ..
D Site Inspection - To be made
after excavation, but prior to
setting forms.
rV"l Final Electrical - When all
~Iectrical work is complete,
K?1 Unrl"Y<:I"'b~\JmbinQ]:j:lectrical/
~~ch~ni~- I-'nor to cover.
f'.;7f Final Mechanical - When all
~ mechanical work is complete.
-----------
I><l' Electrical Service - Must be
... ) approved to obtain perm'anent
electrical power. '
"
j",' 0 '
'f';:7f Final Building - When all
~equired inspections have been
approved and building is
completed.
IV! Footing - After trenches are
~ excavated,
D Fireplace - Prior to facing
materials and framing Insp.,
D Masonry' - Steel location, bond
beams, grouting.
~raming -, Prior to cover.
D Other
M Foundation - After forms are
~ erected but prior to concrete
placemer:t.
1'71 Wall/Ceiling Insulation"": ':'rior to
~cover., - "
j:8[Drywall - Prior to ta~i~g,
D
Underground Plumbing - Prior
to filling trench.
MOBILE HOME INSPECTIONS
D
Underfloor Plumbing/ Mechanical
- Prior to insulation or decking,
D Wood Stove - After installation,
D Blocking and Set-Up - When all
blocking is complete,
D
Post and Beam - Prior to floor
insulation or decking.
D Insert - After fireplace approval
and installation of unit.
D Floor Insulation - Prior to
, decking,
o Plumbing Connections - When
home has been connected to
water and sewer.' .
'f'7( Curbcut & Approach - After
J.L4orms are erected but prior to
placement of concrete.
fX1 Sanitary Sewer - Prior to filling
~trench,
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service. panel.
-.c7T Sidewalk & Driveway - After
~excavation is complete, forms
and sub,base material in place.
IS7f Storm Sewer - Prior to filling
~trench,
D Fence - When completed,
M Water Line - Prior to filling
~ trench.
D Final - After all required
inspections are approved and
porches, skirting, decks, and ,t'
venting have been,installed.
".
. I"
~Street Trees - When all re~'uired
~trees are planted, . . .
1><'( Rough Plum'bing :....:. Prior to
~over.
Lot faces
I
JL
"~~O
1
3.tPD
L2}'a
ar
IZJ
~^/,
\.. 1 J '
Cul-de-sac
Lot Type
~ Interior
Corner
I P.L.
IN
Is
Iw
IE
Setbacks
'HSE'GAR'ACCI
4-0 I
4- / 1-1
lP
~....IS "1E 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.
Lot sq. ftg.
Lot coverage
Panhandle
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT. VALUE
Main .~ ,~2t> ~/74!U"O
Garage ~22.. Io/~ /~ f~~e:>~
s/~ /0/0 ,~5'~ -e..
Carport
Total Value
~4<:>
-#2-.CJO
2:2/D
401./0
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
" (B) *2?D~ ~
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO 2-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
/~o
Plumbing Permit
State Surcharge
~oo
_/fn]~O
Total Charge
(C)
MECHANICAL PERMIT
tO~
4.50
-.tb .00
Furnace
Exhaust Hood
Vent Fan
NO
;z.
Wood Stove/lnsert/Fireplace Unit,'
, ,
_~.oO
Dryer Vent
Mechanical Permit
/ q ,5'0
/t).CJO
.q~
30~
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
-LI,~
/Z.7tJ
Sidewalk
/2- ft
.
/9? ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
~4- .50
2190,5:0
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
5
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee: '2:it /,.?d>
Da'te Paid: 2-R-'l'7
Receipt Number:--"/~$ /'
Received By: d~~
//
~/^^-<. :'.
S ReviewecV'!3y-
'.3/?h?
( .Date'
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS ~
~~c?t~ _-S-~~~~
\ cl-+-T'. !' ) Of oU. .
cb{nllQj(: t_>>.Lo__ \.~\.dl
~7H 1-
_~~~ ~r: ~&/wI..T ~ a-
fI(J O(!L}d~A>rJ~ LI"(J)7/ //??4Lf'.JaY2C7r)(
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certi fy 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 contradors 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 '1 all~'Y7\es du' co tructio,
~Ignaturp.~. ;;( ;
. "
Date 7 t:-/2- ~'
, (
VALIDATION:
RECEIPT NUMBER
1'~~7?
7 -/2--')'4-
<?/?(]('3~
/!p~
.,
DATE PAID
AMOUNT'RECEIVED
RECEIVED BY
, 1
: :!t
JOB NO. qL{o ( 35'
CITY OF SPRINGFIELD S~STEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: S' ci-f L.. EY. 'L Y Ai c.1-I:
LOCATION: gS? CrE-NTE:.NNfAL.. /7()?/7-043 - /3QDO
DEVELOPMENT TYPE: LOr<.. - N6W. 5FR
"BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SlZE
SQ. Ft.
~ -, c.f Of
X $0.203 PER SQ. FT.
~<Ol o~
'--- ~
2. SANITARY SEWER-CITY
NO. OF PFU' S '
(See Reverse)
1'6
X $42.08 PER PFU
0",:!!)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X $424.31
~Zg~
'-- ~
$
$
('
X ' I ' D I ' X $424. 31
X X $424.31
SUBTOTAL
.'. $ 35 60
TOTAL-MWMC SDC ~4(P "1 ~
. ''---, /'
(ADD ITEMS 1,2,3 & 4) $ 2-tCr~.~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~LvL "2/'\ /4Y-
(j Kip Burdick I !
SDCCoord;nator
4:,", .
~O'1~~
'- ~
TOTAL SDC $ '2-?';>o?:> I../-,!.
FIXTURE UNIT,CALCULATI,-.J TABLE: Number of New Fixtures X L :Quivalent = Fixture Units (NOTE:
For remodels, c:;alcul~te only the NET additional fixtures)
Bathtub,.,.., ,.,.."",.., ,.""".".."""""""""",""',...,',..,"
Drinking Fountain....,......,..,.. ......,..,.,: ,'.., , ........... ,.....:
Roor Drain, ..,. ...." ......",..""..,...".,"""""",., ,..'",...' ,.
Interceptors For Grease/Oil/Sollds/Etc.................
Interceptors For Sandi Auto Wash/Etc...............,..
laundry Tub jClotheswasher. ......, .... ....,. ............ .....
C1otheswa~er - 3 Or More.....................................
Mob~e Hdme Park Trap (1 Per Trailer)..................
Receptor F9r Refrigerator fWater StationjEtc........
Receptor For Commercial Sink/Dishwasher fEte..
Shower, Single 'StalL............... .........., ..... .... ............
Shower, Gang............................."... .............. ...........
Sink, Bar, Commercial.. ......... .... ..... ....... ....... ...........
Urinal, StallfWall......................... ..... ....... ,... ..............
Wash Basin/lavatory, Single.........,...,....................
Water Closet, Public Installation:......,................,....
Water Closet, Private..............., ,...,.. .... .......,......,.....
Miscellaneous:
FIXTURE TYpE
NUMBER OF .
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
I
2 .2-
1
2
3
6
2 2-
6
6
1
3
2 -z...
l/Head
2 ?-
2
1 2..-
6
4 ~
I
:. I
I
2-
"l-
TOTAL FIXTURE UNITS
('it
If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE: Based' on assessed value.
calculate credits separates.
I
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
'1985
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
1986
1987
1988
1989
1990
1991
1992
$ 2.24
1.93
1.57
.1.18
0.79
0.44
0.28
'\
Credit for Parcel or Land Only If Applicable
3 .-,( I' '2.. r::, ~
, ~ . X $ /,.0 fa --;../?
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $ 3~r;o
Improvement {If after annexation date)
RUNOFF COEFFICIENTS FORSTORM DRAINAGE
Resid ential......... ............; ....... .... ... .......... ... ........ 0.4
CommerciaL........ ....... ............ ...................,...... 0.9
I nd ustrial.... ............ ...... :..... ........................ ....... 0.45
Governmental................................................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
fi y!ill.!!!!!!~!!!
Job No.
qqfJffi
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: ~~\\\o~.c~\~~~
ADDRESS: ~.~CD G. & P_ 0 J-, S
PHON E: ~4\n-- () ~ ~ 0"
STATE: QtLzlP itI1Jl
LOCATION OF PROPOSED BUILDIN~ SITEQ 11. ~ 0
Street Address if Known: 6 ~ -( ') \. ' 0'- n t 0 1'\ n 1 (l
- - -- - -.
Tax Lot Number: \~l53alo4'3{5qcO
Platt Name:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Single Familv -: Detached
{
Single Family home
Manufactured home not in a park
$4tD~
NO OF UNITS
r
X $400 PER UNIT =
B. Sim!le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
C Multi-Familv Aoartment
NO OF UNITS
X $277PERUNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$iff). CD
$Rf
$ mn ie{:)
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SOC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~~fy~~rl~~
City of Springfield ~Vi,iO
-,7//Z./~
Date