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Home My WebLink AboutPermit Building 1995-2-28 RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 ASSESSORS MAP ---- I , LOT --' SPRINGFIELD BLOCK JOB NUMBER C\5r; \9{) 225 Fifth Street Springfield, Ore90n 97477 PHONE ZIP NEW OTHER CONST CONTRACT~ME ADDRESS CONTRACTOR # EXPIRES PHONE GENERAI\ ~onfnt-, q1 'lD<K '\ 1.0.. o,lo Q?'3la\d')2... PLUMBING yJ'\\.Q 0 rl ~'rlllQ [ \ S \17" C\ \C\ 0..\0 to~3 51\ \0 MECHANICAL' ~(1 ~ 1) n f il-r, q t:2DR ') 2q qto Q23fof.oOZ ELECTRICAL f AU 'T L~.J I ()31"\-S C\ '\ C\S <\-l S 2.L~q - OFFICE USE - QUAD AREA \,. ~,,,r _ LAND USE (ll I FLOOD PLAIN . OF BLDGS I # OF UNITS I ZONING CODE --1iJf2- OCCY GROUP Q ?'+fI\ CONSTR TYPE VAJ # OF BDRMS ,'j # OF STORIES I HEAT SOURCE Ii) /-I SECONDARY HEAT 0 WATER HEATER S RANGE f--, SQUARE FOOTAGE I{(J~~ 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, Inspections requested after 700 a m will be made the following work day o Temporary Electnc o Site Inspection - To be made after excavation, but pnor to setting forms o Underslab Plumblng/Electncal! Mechanical - Prior to cover ~ootmg - After trenches are excavated o Masonry - Steel location, bond beams, grouting ~undatlon - After forms are erected but prIor to concrete placement D Underground Plumbing - Prior to filling trench @-Underfloor Plumbing/Mechanical - Prior to Insulation or decking ~ost and Beam - Prior to floor Insulation or decking Q.-:loor Insulation - Prior to \ decking ~n1tary Sewer - Prior to fIlling trench ~torm Sewer - Prior to filling trench , ~ater Line - Prior to filling trench lli1.0ugh Plumbmg - Prior to cover REQUIRED INSPECTIONS @:'ough Mechanical - Prior to cover ~ough Electrical - Prior to cover ffi"Electncal Service - Must be approved to obtaln permanent electrical power o Fireplace - Prior to facing materIals and framing lnsp ~ramlng - PrIor to cover ~all/Cellmg Insulation - Prior to cover Q-DrywaJJ - Prior to taping o Wood Stove - After Installation o Insert - After fireplace approval and Installation of unit G';:urbcut & Approach - After forms are erected but prIor to placement of concrete ~Sldewalk & DrIVeway - After excavation Is complete, forms and sub base material In place D Fence - When completed o Street Trees - When all required trees are planted ~mal Plumbmg - When all plumbing work Is complete ~Inal Electrical - When all electrlcal work is complete Q-:mal Mechanical - When all mechanical work IS complete ~mal Building - When all requIred Inspections have been approved and bUIlding IS completed rvl Other /loti J)~ ,- ... 7./ L6..J f < r:rd ~ A-~ MOBILE HOME INSPECTIONS o Blockmg and Set Up - When all blocking Is complete o Plumbing Connections - When home has been connected to water and sewer o Electncal Connection - When blocking, set.up. and plumbing Inspections have been approved and the home Is connected to the servIce panel o Fmal - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed LO/P. Setbacks IS THE PROPOSED WORK IN THE , , \. I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON _ Intenor IN I THE HISTORICAL REGISTER<L. t\ n ~1 S ,<:)'7:5 Corner If yes, this application must be sIgned Panhandle S 18 '2..lo I and approved by the HIstorical ,::; I Coordinator prior to permit Issuance Cui de sac W IE S I APPROVED Lot faces ~ 'tbbO Lot sq ftg Lot coverage Topography _ Total hel!jPt ~ lt o~ 5') - . BUILDING PERMIT ITEM sa FT \ \ ?J3 ~I.nO X $/so FT 5\si?D V\. \[)_ Main Garage Carport Total Value BuildIng Permit Fee State Surcharge T ~O;O Total Fee (A) VALUE lo'2>Vfr '1 <6<:\ to Yj\~f)D ,,'Jf>A 00 AI") C\~ 2ll\o.q~ (B) SYSTEMS DEVELOPMENT CHARGE (SDC) $; 5"(;'6-.04 PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' 6l. Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home PlumbIng PermIt State Surcharge + 3.0/D Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk '70 Curbeut l)(jJ ft ft Demolltlon State Surcharge '-~_ \J\t\(\ ~O\~O~ FEE n or) 0J ~ ,"--oDC:O \~?:O \l~~ l\ Sf) q.cD ,':l.,cD \\n 5Q \DCO \ ,'l,~ ~ f) 6.3 dO '2:D I~C\O 4;t)cO Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding eleetrlcal),4,!}QY Gt9 (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 of buildIngs, and may be suspended or revoked at any time upon violation of any provisions of said ordinances Plan Check Fee Date Paid \ "r'\ .,)-/ Receipt Number ..(,/ ,~ Received By ~ t\tlC\ \'\\~~ \ I )...J Plans Reviewed By - " , cY /E'q:s Date Systems Development Charge Is due on all undeveloped properties Within the City limits which are being Improved ADDITIONAL COMMENTS ",!jD b\j('\ {\ r , '" ~A 0 .'.1. 'Y1\. ~ V D./ t.A+\. ~{\\\~}.[ f1~ \ C\ LoO - '--'1 (\ t-D. \ By signature, I state and agree, that I have carefully examined the completed applIcatIOn and do hereby certlfy 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 cerllfy 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 tlme, 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 all ~_es during c"e4 ~ Signature _~a /' {/ /~/p~.-/ Date ~~_~. '- . VALIDATION RECEIPT NUMBER DATE PAIr> fA fL-z:? 2~~7~ ~~ltA.\C\ .~/~v' AMOUNT RECEIVED RECEIVED BY ,/ JOB NO :? 5'0/ Fd CITY OF SPRINGFIELD SYSTE~lS DEVELOPMEh, CHARGE \40RKSHEET (COMMERCIAL & RESIDENTIAL) AIIALHMl:.N J lJl NAME OR COMPANY /-!"j~~ ~~;~ LOCATION '5 -14'8 ~ })/7 DEVELOPMENT TYPE C;;:.:/) BUILDING SIZE 1 STORM DRATNAGF: IMPERVIOUS SO FT M4 / 2 SANTTARY SFWFR-CTTY NO OF PFU'S ;? (See Reverse) 3 TRANSPORTf;TTOli lOT SrzF SO Ft X $0 209 PER SO FT $((7' , . ) '-... / ..,/ X $43 26 PER PFU r~ NO OF UNITS X TRIP RATE X COST PER TRIP ) X j, () / X $436 19 X X $436 19 X X'S43619 rHt1~ $ . '$ SUBTOTAL (ADD ITEMS 1. 2 & 3) $ I 2/ '1 2 :s , < , 4 SANTTARY SFWFR-HWMr, NO. OF PFU'S /i x $17 19 PER PFU ... $10 MWMC ADMIN FEE $ "3/,??-< (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $. ~~ IQIAI -MWMC sac .~ :2 '13./9") SUBTOTAL (ADO ITEMS 1.2 3 & 4) $ / ~/.2. 4 2 5. ADMTNTSTATTVF FFFS ;;J? ':?T,El x 05 ~ary H-ornlg, P E.U / SDC COONllnator Cr:s-~c;~ Date ,.- 2--;z..~-? 5" IQIAI snc s/S-y;:; o~ ----- B2 SDC FIXTURE UNIT CALCULATION TABLE: Number of New F,,' "es X UOI\ EQuIvalent = F,xture Unlt- " " INOTE. For remodels. calculate onl e tlEI nddlllonal f"lUres) NUM13EH OF NEW f1\ TUf1ES FIXTURE TYPE Bathtub Dronkmg Fountam Floor Dram Interceptors For Grease/Oll/Sollds/Etc Interceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Mobile Home Park Trap (1 Per Traderl Receptor For RefngeratorNVater Statlon/ftc Receptor For CommercIal Smk/Dlshwasher/Etc . Shower, Smgle Stall Shower, Gang Smk Bar, Commerclal, Resldentlal K,tchen Unnal, StallNVall. . Wash BasmlLavatory, Smgle TOilet, Public InstallatIon Toolet , Pnvate M,scellaneous ,T.4HI roP'.s S/HJ:- z I / z. 2.. TOT" L FIXTURE UNITS UNIT EQUIVALENT 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 .< = FIXTURE UNITS , , <1 z z ~ ~ /'ii CREDIT CALCULATION TABLE Based on assessed value It lmprovements occurred after annexation date m table, calculate credits separates 'I Year Annexed Year Annexed , Rate per $1,000 Assessed Value L 1979 or before 1980 1981 1982 1983 1984 1985 1985 1986 1987 1988 1989 1990 1991 1993 $346 338 332 321 306 292 273 Rate per $1,000 Assessed Value $246 214 177 1 37 097 061 044 015 CredIt for Parcel or Land Only It Applicable 2023 Improvement hf atter annexatIon date) 3,"1e:, X $ "{,scd (Rate X Assessed Value) X $ (Rate X Assessed Valuel = = CREDIT TOTAL = $ .2(;; 23