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Home My WebLink AboutPermit Building 1995-10-17 RESIDENTIAL PERMIT APPLICATION SPRINGFIELD , , .t:A ~q1 E: 2'l>{' JOB NUMBER 9~~4'9<- kti;t LOCATION OF PROPOSED WORK "22:::? i- ::?~ ~ ~:'=';;~ '':17 / ,4~~ ><ASSESSORS MAP /_7-/-I2'~--::S---::C: I TAX LOT 7'~/ r '(LOT ?AlA;' ~ t:.? BLOCK SUBDIVISION /7?? /~~-=? OWNER --.~'ifrJ/ i..pv~~~ ~ ADDRESS -:7 ~"/"3> ij ~ ~ A 5.7--' CITY ?7Fl--P /" _. . . STATE /-?/.:? . DESCRIBE WORK ~.K/~~P.e=.T p--',?~ ~~' /~ NEW / r 'REMODEL ADDITION DEMOLISH _ \ OTHER Inspections 7263769 Office 7263759 225 Flflh Slreet- Springfield, Oregon 97477 PHONE ,- -;Jij').J9 2r-:: '2 - - - ZIP ~~~ ~~"""'~ ~><- , CONST ~~~ '?~S/ '-"'-.>.;;s- CONTRACTOR'S NAME ADDRESS ;y ~ CONTRACTOR' rl"/df,'RES PHONE ,- . GENE_RAL~.N"...s~"""0~/ ~~.;~~ >~~2~ ~-~-:JC;- 7~7-9?L'? PLUMBING~?:,""~ ~,..,..-,.r~..c-~_ r",If~?_I#/ji:$ MECHANICAL --m'~38R. ELECTRICAL #~ -7 t QUAD AREA' !{ ~n)C!J ( 8?>+ JA . OF BLDGS OCCY GROUP . OF STORIES WATER HEATER >-=, - , . ~- - OFFICE USE - LAND USE { I ~ () . OF UNITS~ VA..! HEAT SOURCE ?/~.~c<-.. FJ CONSTR TYPE RANGE ,LOOD PLAIN ZONING CODE \oJ f)f2- . OF BDRMS rlJ +;L;{ _ SECONDARY HEAT --0" SQUARE FOOTAGE cfl4A~ . To request an Inspection, you must call 7263769 ThIs Is a 24 hour recording All Inspections requested before 700 a m will be made Ihe same working day, Inspectfons requested after 700 a m will be made the following work day [lJ Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms ~ UnderslaJir"1'llJm~.!.!l..gLlJectncal/ ~Mechanl~- Prior to cover VfFootlng - Atter trenches are ~excavated o Masonry - Steel location, bond beams, groutlng ~oundatlon - After forms are ~rected but prior to concrete placement D Underground Plumbing - Prior to fllJlng trench o Underlloor Plumbing/Mechanical - Prior to Insulation or decking o Post and Beam - Prior to troor Insulation or deckIng 'K7I Floor Insulation - PrIor to ~ decking ~ Sanitary Sewer - Prior to filling ~trench ~ Storm Sewer - Prior to filling I.6.l trench rs<1 Water Line - Prior to frlllng ~rench rc:('Rough Plumbing - Prior 10 ~over REQUIRED INSPECTIONS ~ Rough Mechanical - Prior 10 ~over r\:?r"Rough Electrical - Prior to ~cover Ts;1' Electrical Service - Must be ~ approved to obtain permanent electrical power o Fireplace - Prior to facing materials and framIng Insp ~Framlng - Prior to cover K:AWall/Celllng Insulation - Prior to ~ cover t8l Drywall - Prior to taping o Wood Stovo - After Ins lallation o Insert - After fireplace approval and Installation of unit o Curbcut & Approach - After forms are erected bul prior to placement of concrete o Sidewalk & Driveway - After excavation Is complete, forms and sub base materia! In place o Fence - When completed ~treet Trees - When all required ~rees are planted ~ Final Plumbmg - When dll ~Plumblng worl~ Is complete K71"" Final Electrical - When all J6J electrical work Is complete ~Final MechanIcal - When all ~mechanlcal work Is complete I'\:/r'Flnal Building - When all ~equlred Inspections have been approved and building rs completed D Other MOBILE HOME INSPECTIONS o Blocking and Set Up - When all blocking Is complcte D Plumbrng Connections - When home has been connected to waler and sewer o Electrical Connection - When blocking, set up and plumbing Inspections have been approvcd and the home Is connected to the service panel o Final - After all requrred Inspections are approved and porches, skirting, decks and venting have been Installed lot laces ..e..- l'?t sq Itg ~ Lot coverage ~..:l ~ Topography ..c.z.i). fQ" Total height ..iLL n3~ Lol Ty ~Intertor Corner Panhandle " Cui de sac , " BUILDING PERM)T 12ICr' xS0.25 .~ l4 '() ITEM Main Garage Carport Tolal Value BuildIng Permit Fee Slate Surcharge -+ ~9Q' Total Fc~e (A) Setbacks HSEIGAR 9' I ~ I $'" I Iw 12.01 I ~ BUILDING VALUE, PLAN CHECK '_ AND BUILDING PERMIT I Pl IN Is cg~{~O~ '_lint -, \D~,UI 444.2S ~'5 5t ~lq -U , . " IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT. OR ON THE HISTORICAL REGISTER? Accl I I J I If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance APPROVED. -- This permllls granted on the express conditlon that the said construction shall, In all respects, conform to the Ordinance adopled by the City of Sprlnglleld, 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 Date Paid u ~~~ 1'Odo ~O. OK:> Recel pi Number '. Re~elved y - - ~~~-' Pia ReViewed By ~ , . S~ s-h..r 7' D.k /, SYSTEMS DEVELOPMENT CHARGE (SDC)1f::> (B) ~I?Z~ PLUMBING PERMIT ITEM Fixtures Resldenllal Balh(s) N' \ t I Sanitary Sewer FT Water FT Storm Sewer FT . Mobile Home PlumbIng Permit \ State Surcharge t3r?o Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent MechanIcal Permit Issuance Slate Surcharge /,05 ~ ,~.3 Total Permll (D) MISCELLANEOUS PERMITS Mobile Home State Issuance Slate Surcharge Sidewalk It Curbcul It DemolItion ~~rG~OQ)~ no;) Total Miscellaneous Permits (E) TOTAL ~ MOUNT DUE (excluding electr'cal) (A, B, C, D, and E Combined) FEE ~1-(.) lliQ'1O ~4~ I q (0 qc q,QJ (n CXJ -.0 In cD 2/. o-v / D 00 /. c.e ~'2,~e ~ -if- ~ .Gl:> ."S~t;.r Systems Development Charge Is duo on all undeveloped propertles within the City limits which are being Improved ADDITIONAL COMMENTS : .~~~ 9~e>1g'2l(f~~~r,t ~~ #.-;7?1?~s/c;,- _ . ~ - A-\. 8.QC\() - MX. \.'n1 0, \Y( oC) By slgnature,l state and agree, that I have carefully examined the completed appllcallon and do hereby certify that all InformatIon hereon Is true and correct, and I further certHy that any and all work performed shall be done In accordance with the Ordinances of the City of Sprlngfleld, and the Laws of the State of Oregon pertaining to tho work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safely DIvIsIon I further certIfy that only contractors and employees who are In compliance with ORS 701055 will be used on this project I further agree to ensure that all required Inspections are requested at the proper Ume, that each address Is readable from the street, that the permit card Is located at the Iront of the property, and the approved set of plans will remain on the site at all tfmes during construction SlgnaturX~ _.c r ,J./ Dale VALIDATION lfl 'JTlQ RECEIPT NUMBfJt-, ~1{~.JU DATE PAID l U /7 l:t...~ AMOUNT RE~I 0 4-Z!:>O:S 8 f RECEIVED BY II Y1 ) - ~ n,." \'. ~ , , 1 l NO. CJ504--95 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET' (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY 13/ZIAN LOUAlSBUIZY LOCATION "Z'2..2- ~ 'L'Z-4 Ct-J.APNlAN LANE. /70?-?">:>">:>1-4-e,0/ DEVELOPMENT TYPE N1 D/Z... - N e.W DUPL-[;.)( BUILDING SIZE. LOT SIZF SQ. Ft 1 STORM DRAINAGE IMPERVIOUS SQ FT '7:>2--0'2-- X $0 209 PER SQ FT ~~f:) 2 SANITARY SEWER-CITY NO OF PFU'S 2-?.- X $43 26 PER PFU ~51~Z:) (See Reverse) -....... ~ 3 TRANS PORT A TI ON NO OF UNITS X TRIP RATE X COST PER TRIP z.. X (0 / X X X $436 19 X $436 19 X $436 19 0~110 $ $ 4 SANITARY SEWER-MWMC NO OF PFU'S ~~ x $17 19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) $ ,?f:,8 (~ \ TOTAL-MWMC SDC $ ?/ ~ ~ '----- ...-- $ ~111O'5 MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 y:' (~ ~. ..Q.....J...- \J kip Burdi ck SDC Coordinator Date 4-/24 JqS , TOTAL SDC cl'4-?~V $ ?O I ? '2-..2 , .,. - ~";:" ~ ~ ~-:.r _ ~_ ~~ "'i~ ~~ < 1 ~h~, ~ ~~ ~ - _ ~ FIXTURE UNIT CALCULATION TABLE: Number of New fixture' v Unit EquIvalent -:fixture 4nits ' '," 'c (NOTE For remodels. calculate only tt :r. additIOnal fixtures) - - NUMBER OF UNIT FIXTURE ,- FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub_ _ . Drinking Fountain Floor OralO _ Interceptors For Grease/OlllSoltds/Etc Interceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More _ MobIle Home Park Trap (1 Per Trailer) Receptor For Refngerator/Water Statlon/Etc Receptor For CommercIal Sink/DIshwasher/Etc. Shower, Single Stall . ..... ... .. Shower, Gang Smk: Bar, Commercial. ResIdentIal KItchen ....... ....... . Unnal, Stall/Wall. ..... Wash Basin/lavatory, Single TOIlet, Public InstallatIon Toilet, Pnvate MIscellaneous 7- 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 7... 'Z- 2- '2- TOTAL rlXTURE UNll S 4 4 .a.. 'Z- '6 '2.2. CREDIT CALCULATION TABLE Based on assessed value If Improvements occurred alter annexatIon date to table, calculate credits separates 1 I II 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 $346 338 332 321 306 2_92 273 1985 1986 1987 1988 1989 1990 1991 1993 Cred,t for Parcel or land Only If Applicable ? ,4(, X $ ~. q" (Rate X Assessed Value) X $ (Rate X Assessed Value) Improvement hf after annexation date) $246 214 177 137 097 061 0.44 0_15 _I ,,:;(0.. CREDIT TOTAL = $ "" I ~ '<;,,4iP';l~'il-l\" ~}~"~ >tr.. The foJ1ov.lng IJ" " '~~... i>" zoning a~rd d' J}c-:.t 8.s sub~ r1t I "<)~,; /oJ ~'i"l, J approvJ.! I A00t> fI(,t roqlJjrt:/~,'J~r, !:,a;s the f0;/Ow,nfl.__ ~"iz257~FIFTH STREET -ol.C IeI'd lS'ELEGTlUCAL PERMIT APPLICATION ~~:Sl'~NGFIJ;:LD. OREGON 97477 Zcnlng_ m 12 C ..~:"I~SPECTrON REQUEST: 726"-'3769//0- 12-(;;"" - ~~~~OFFICE: 726-3759 A ') ,..',.', ~ " ' LIfnonz&(j S N roA COMPLETE FEE SCHEDULE BELOY '!~";~ii"~i;t.AGAPON OMN~~~T~N 19nature;jT:' . ':L ,<~,~""~a.'""i (1tt\"' C1\[)._ Llli'\. A. "'li-'tt '.# i~ "- ':. ~;:,i~ -LE~~~CRIITW..N,..... "~~';\lL')0-\)\ (~)\ B< ~l:-"~~< t - . ..,;;~,~ JOB DESCRIPTION f\ (\N r\ 0 l, ;;~".'~ , ['It VI <::::>\- T \U\f\ ~ nr':I~_ ~I'~~ ""''''~~' . J '\ - ~~:~~,p~~ml,ts are non-transferab e and expIre :~>~~.t/~f~work lS not started wlthln 180 days 1\,;.,~~t.'o'fJ,l.ssuance or If work lS suspended for ~.&<~.,.. : -180' days :~:''j..( ~tv") ':( , -~ l1~&r 1..(' ~"r~:;'" , i !!i~")<,f"!" ~:2 .~,: .C,oNTRACTOR INSTALLATION ONLY ~*-~,;) .Pot.k ';'1 'l' ::.. "v i >,..t~ -'"tb......,. ;>~"" n C ..'~,<'~"Electncal Contractor 'KnSe .or-D. > """i.,;J.> ,f >. ~ ~ ~i;:~i:i~~~e~s B;q q '1 b ))l1M LmlHo ~/,\"j~......."r,1.-< U ~~~';;;:, _'Cl,t~;;t=l 19- OR Phone t,S(,,- OClCl'3 ~i~~i~X:..~~{p~ivlsor LIcense Number 15C:,flC ~~ 'J:'. ,.,~ IaJ ~~1'i':'~~-"";\'?" JbYI./a,r::' ,;'!" -i.-<;'Explra tlon Date 'J':1 ~~.~;);tf-.Jt~... ~i\"" '1t~: ~xlft;.?". J"t, ~ ~ ~~~~' ,p~Constr Contr Number ryr <, "~..,, ~j '- ~ -t"'~"~l.u<..;;;l ~ 0)~~.\ \~~ ' 't ' If'"... "'Explra tlon Date 1 ((::' ~~,I 'Tr ,- p '.. ,,"~ >- ,~~ r >ft1 ~.... ~ ' , . ~:-. :,,;~ -:'Slgnatu~e 0 perVlS1n~ctrlClan ~J/go';i; ,""t'" -'1'J' / .K y~- >-'t~ ~~~"~~,,>Al _ 1/ --A A ~il..~~i"'" ..' '-""0. "-=-- ~qJ...r. if..,,~"ii/!;~',6'Wn~'rs Nama. Jl"'1\ 1 h f\ LIlt ~l""i~ ~:t.:c '" ;;~~"'~;A~dressA~tj~ ~?f\: l-t- ~ t~_ t~'" " ~~~i..;~~ ;C'l ty "-~ Phone l"\1 qzloL.- ~"t;1t~4.. <~ ~i ~~ \ -- - ~}".;\-> I ~~ .Ji";:.-:fi:"'....,' OI/NER STALLATION 1lr~t.~1 t~'\^ ...'~ ~ .~" I.... ...~ ~%-..~t~ f,}Thet/lnstallatlon IS beIng made on , "';~7' 1'" ~f .. h h d d ~'._*,-,: -~prop'erty I own w lC lS not Inten e ~'H:""-i}..t f'Y,...;l' 1 1 .~ 1-- ~.""'I~ or.lsa e, ease or rent 4.~~'" .' ;;""'t:. J~<;,\'~\ I t..... '>.\-<-~'t ~<'.t<i ~ of 1-"~;"'1!!~~"'" S t r "l'I ~. "'~ ~r"i-,~..vwuers 19na u e: ~ {""",<{.,.\"~,, /.- 7f,;~ t"~(~~' . ",," ~ ,..- .. ~ "'1~1"..!'..... ',,~,: " ~ DATE~----------m-TT y ~----------- <_~ ,j ':'~RE~EI1>-l 1I:. U r \~ ;. ,:~~EIVED BY. c"IJ~ . - ~ ..J;i~ q/30/q5' C. ~o-~ 5.3 ~ '..... .,....,............1 .. -r'" -~~- ~ ~~ , J t 1 ~ .... , " t . ... "",..:l'. .... .. '<\, t"~l. '0" .,,-,, '" ., I. HI;"}>""'").''''' (' 1~"'~,~ 1. ~J:~~~~i~~,,~~~\~~~~;J~, " ~ M ,.." r::- ,;.~~ ~ :)' v.-'t>....~~..!>.~..'.:s:;iVrf........~~:::., ,..l: CIty Job Number Q5rJ1MCS New Restdentlal-Slngle or Multl-Famlly per dwelllng Servlce Included: unlt. Items Cost Sum 1000 sq ft. or less Each addltlonal 500 sq. ft or portIon thereof Each Manuf'd Home or Modular DwellIng Servlce or Feeder ~ 11Q $ 85.00 ~ $ 15.00 ~ $ 40.00 B. SerVIces or Feeders Installatlon, Alteratlons or Reloca tl on. 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Temporary ServIces or Feeders InstallatIon, Alteratlon or RelocatIon 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 , ~ $ 40.00 $ 55.00 $ 80.00 see "B" above volts D. Branch CIrCUIts New, AlteratIon or Extenslon Per Panel One Cl rcult Each Addl tlonal Clrcult or Wlth ServIce or Feeder PermIt $ 35.00 $ 2.00 E. MIscellaneous (Servlce/feeder -Each InstallatIon Pump or lrrlgatlon Slgn/Outllne Llghtlng Llmlted Energy/Res Llmlted Energy/Comm no t Included) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Admlnlstratlve Fee TOTAL $ $ $ $ d40 ,ciJ /2.00 7_'"0 ~6 Y ,20 40.00 40.00 20 00 36 00 ~?..... Willamalane 'tg' Park & Recreation DIstrict . ~ JobNO.q~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: l ~ ~lJ\~llli PHON;r4l Q1.lol- - ) ADDRESS: t1CC:{\~.J'\ ?f\:~_~~_ STATE:OC- ZIP fLf4.l1 LOCATION OF P'ROPOSED BUILDING SITE: l J . '") -Street Address if Known: oA Q + C!)~ 4 C' J\n ~{b i\ rI::::}J Tax Lot Number. \q~12t\ ~~ Platt Name. 1. DEVELOPMENT TYPE (Check appropriate dwellmg(s). SDC Calculations and dwelltng type definttlons are on the back.} A. SinQle Familv - Detached Smgle Family home NO OF UNITS B. SinQle Familv. Attached NO OF UNITS ~ C. Multi-Famllv Aoartment NO OF UNITS D. Manufactured Home Park. NO OF UNITS WPRD SDC '-- Manufactured home not in a park X $400 PER UNIT .= $ . X $370 PER UNIT = $~ X $277 PER UNIT = $ X $280 PER UNIT = $ $ 1)1{) /f) $kf $tJ1D (j) 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 CrechO \lm A JP I \1 ,05