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Home My WebLink AboutPermit Building 1995-4-27 / ,~ RESIDENTIAL PERMIT APPLICATION InspectIOns 7263769 Office 726 3759 LOT DESCRIBE WORK NEW ............ REMODEL SPRINGFIELD BLOCK OTHER JOB NUMBER q~lH9) 225 Fifth Street Springfield, Oregon 97477 TAX LOT ~J SUBDIVISI~\ IN.f\ G,()J\"\.f\Cf:' \ _ '..l.IIU2> PHONE M4 lnC\lol.fJ ZIP q'\4fl91 CONTRACT~~_NAME ADDRESS GENERAI\ Q)('u \0. On f n1;--, PLUMBING 9~ ~ rt.. ~'rJ.lQ 1\ MECHANICA' , Q'\() 1 \r\ 0 n f 1'\:1-; ELECTRICAL , ~u ~ c;: ~~ CONST CONTRACTOR' q1 0 ()Cf~ S \\~\ Qt.W8 "lnRl"\-S EXPIRES I) 2.C\. 0..(0 0... \~ C\\n \o~3 SlHn 'l 2q Qf.p QZ30W02- C\ <\ C\s 4-lS I'J~9 PHONE CU.'3ln\dJL - OFFICE USE - QUAD AREA '-~0l\ _ LAND USE ---11 , I FLOOD PLAIN . OF BLDGS I # OF UNITS I ZONING CODE J.1J!2.- OCCY GROUP Q?-'+M CONSTR TYPE U;1J # OF BDRMS ,'j . OF STORIES I HEAT SOURCE (1)1-1 SECONDARY HEAT [;) WATER HEATER E~ RANGE f__ SQUARE FOOTAGE II o~ ~ To request an Inspection, you must call 7263769 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 D Temporary Electnc D Site Inspection - To be made after excavation, but pnor to setting forms o Underslab PlumbmgfElectncal1 Mechanical - Prior to cover ~ootmg - After trenches are excavated o Masonry - Steel rocatlon, bond beams, grouting ~undatlon - After forms are erected but prior to concrete placement D Underground Plumbing - Prior to filling trench c::g-underfloor Plumbing/Mechanical - Prior to InsulatIOn or decking ~ost,and Beam - Prior to floor Insulation or decking ~Ioor Insulation - Prior to decking ~nltary Sewer - Prior to filling trench ~torm Sewer - Prior to filling trench ~ater line - Prior to filling trench ~OU9h Plumbrng - Prior to cover REQUIRED INSPECTIONS ~ough Mechanical - Prior to cover ~ough Electrical - Prior to cover ~Iectrlcal Service - Must be approved to obtain permanent electrical power o Fireplace - Prior to facing materials and framing lnsp ~ramlng - Prior to cover ~all/cellrng Insulation - Pilar to cover Q-DrywalJ - Prior to taping D Wood Stove - After Installation o Insert - After fireplace approval and Installation of unit G-;:urbcut & Approach - After h forms are erected but prior to placement of concrete G'Sldewalk & Dnveway - After excavation Is complete, forms and sub base material In place D Fence- - When completed o Street Trees - When all required trees are planted ~lnal Plumbmg - When all plumbing work Is complete ~Inal Electncal - When all electrical work IS complete ~lnal Mechanical - When all mechanical work is complete [9;,lnal Bulldrng - When all required inspections have been approved and bUilding Is completed o Other MOBILE HOME INSPECTIONS o Blockln9 and Set Up - When all blocking is complete o PlumbJng Connections - When home has been connected to water and sewer D Electncal Connection - When blocking, set up, and plumbing InspectIons have been approved and the home is connected to the service panel o Frnal - After all required Inspections are approved and porches, sklrtlng, decks, and venting have been Installed '" " Lot faces Lot Type Setbacks Lot sq ftg V Interror I PL HSE GAR' ACC I IN I Lot coverage Corner Is I Topography Panhandle Total height n CuI de sac Iw I (l.oO' ) IE I BUILDING PERMIT ITEM SO FT \ \ ?J3 ~lnO X $/SO FT S\1J7D V\. \() Main Garage Carport Total Val ue Building Permit Fee State Surcharge -t- ~DID Total Fee (A) VALUE lo?:'~ '1 ~ C\tO ,\\~f')D ....~OO AI") C\~ ;:)f")\o q~ SYSTEMS DEVELOPMENT CHARGE (SDC) <<s (B) ~ \ .;,e B 04- PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO c9. Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + ~O/D Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Perm I t (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk '1 D Curbcut '2..Lo ft ft DemofJtlon State Surcharge J(~t>- \J\~_0_\l~\"'.lOO-0 Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) FEE \\ Dn cJ:) \ ~oD CO \~ro n~&J .; SrJ a..cD .?,c;(::) \ \ n SQ \\')CO \ ,~~ dj B'3 ~lJ 50 { ~ c:ro 4MCO 9~~-qq , . 'I ~ ,S THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTERQ._ h D If yes, this applIcatIon must be signed and approved by the Historical Coordinator prIor to permit Issuance APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said constructlOn 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 vlolatlon of any provisions of said ordinances Plan Check Fee Date Paid \ "-("'\.,)-/ Receipt Number .(? , ~ Received By ~ \\fiD \,\\~,\Il-.i Plans Reviewed By - . . Date Systems Development Charge Is due on all undeveloped propertIes wIthIn the City limits which are beIng Improved ADDITIONAL COMMENTS ,,'1.0\:;'0(\ r.X , ,,-~r\O Ll 'n~ '( 1),.; 04\. rtSPD ~fI\\~)[ ~ \ C\LoD - ~(\~ \ By signature, I state and agree, that I have carefully examIned the completed application and do hereby certify 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 contractors and employees who are In compliance with ORS 701055 will be used on this project t further agree to ensure that all required Inspectlons are requested at the proper time, that each address Is readable from the street, that the permit card Is located at the hont of the property, and the approved set of plans will remaIn on the site at all ~es during nstr 10 Signature M Date VALIDATION RECEIPT NUMBER DATE PAIr> ///'-/~ '7~2/.?~ ~~~_ - .\C1 /::1~~ - " AMOUNT RECEIVED RECEIVED BY . ~. ",- )8 NO. '1S"So'iS CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY W""'i'Of'-N El-i\E12--.P(2..j'7ES Tl-tC LOCATION. ""-?4-"?'2.. C...t+f~\C.Eot- DR... DEVELOPMENT TYPE LDl2- - USIA! <SFf2... \<60"2-DID'l-\ - 00"='00 BUILDING SIZE LOT SIZE SQ. Ft 1 STORM DRAINAGE IMPERVIOUS SQ FT f-..l A- X $0 209 PER SQ FT ~ 2 SANITARY SEWER-CITY NO OF PFU'S \~ X $43 26 PER PFU ~I~G,~ (See Reverse) -.......--. ..-/ 3 TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X \.0 , X $436 19 ~440~ X X $436 19 $ X X $436 19 $ 4 SANITARY SEWER-MWMC NO OF PFU'S \~ x $17 19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ '='\9 4-'2. TOTAL-MWMC SDC $ Zb~ c(;. cr'? Ii) ~. $ ''5 I '2. 4~ SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) k::. '_A ~Lc.-k- cj Kl P Burdlck SDC Coordmator X .05 Date: 4/24/0,(:, , f TOTAL SDC ( lSb~ $ \ 0~'Oo4 (NOTE: For remodels~ calc'ulat~ only th FIXTURE UNIT CALCULATION TABLE: Number of New F,xture< 'JOlt Equivalent = Rxturc Untts fI- I addttlonal fixtures) NUMBER OF NEW FIXTURES FIXTURE TYPE Bathtub __ Dnnkmg Fountain Floor Drain Interceptors For Grease/Oli/Sollds/Etc Interceptors For Sand/Auto Wash/Ete Laundry TublClotheswasher Clotheswasher - 3 Or More Mobile Home Park Trap (1 Per Trader) Receptor For Refngerator/Water Statlon/Etc Receptor For Commercial Slnk/Dlshwasher/Etc. Shower, Single Stall _ Shower, Gang _ __ __ Sink- Bar, Commercial, Residential Kitchen Unnal, Stall/Wall _ _ Wash Basin/Lavatory, Single T orlet, Publrc Installation T orlet , Pnvate Miscellaneous 7.. z.. 2- TO tAL 1'1> 1 URE UNI, S UNIT EQUIVALENT 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 FIXTURE UNITS 4- z.. z. '2- q, \<6 , ,- CREDIT CALCULATION TABLE Based on assessed value If .mprovements occurred after annexation date In table, calculate credIts separ3tcs I Year Annexed Flate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 1985 $346 338 332 321 306 292 273 Cred.t for Parcel or Land Only If Applrcable Improvement (If after annexation date) Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 3,4{, X $ '1S~ (Rate X Assessed Value) X $ (Rate X Assessed Value) Rate per $1,000 Assessed Va{ue $246 214 177 137 097 061 0.44 015 Zt" Z. 2. _ ..$ ....,,'Z~ CREDIT TOTAL - "--""- -I