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Home My WebLink AboutPermit Building 1995-12-4 RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 LOCATION OF PROPOSED WORK \.~ 8LP Lo \ 50~ao~ \ OWNE~t1r\..u1 F'ntoy-O\~ J.~(\" ADDRESS 9)~ 0\\ :~ f) nA ,"'itA OOJ_. . CITY "h~1\ \s\~ ~ Q ~ ~. STATE ~\ O^ 0' DESCRIBE WORK ~\ f\l\ \ () , Kc'\ f'r\ I ~ l ~ \..~Llc\_l:l.?\UL----- NEW 1...../ REMODEL ~ADDITION DE~IS~ OTHER ASSESSO,nS ~AP LOT '-Q BLOCK JOB NUMBER Q50{og / 225 Fifth Street Springfield, Oregon 97477 ~ TAX LOT .--LUloer) SUBDIVISI~' \~ Gnl\~ , PHONE Il44 lnYln 1/1 ZIP Q,'\4'19J CONST CONTRACT~ME ADDRESS CONTRACTOR # EXPIRES PHONE GENERAI\ ~onfnt) q1'1[)~ '\2.a.. 0..(0 Q7.3lalcOL PLUMBING 9 ~ r\. \..llii~ l \ cs \l~\ C\ \0\ ~\() to~3 Sl\ \n MECHANICA' , St\r, '..! 0 n fitX-, q 'LWR f) 2q Q{o Q23foWOZ. ELECTRICAL' AU Q.. 'T Li.~ (nRl-tS C\ '\ qc; ~lS 7J~q - OFFICE USE - QUAD AREA ,,3R s,,0 _ LAND USE --.11/ , FLOOD PLAIN # OF BLDGS I # OF UNITS I ZONING CODE .i1JJ2-- OCCY GROUP Q~+M CONSTR TYPE [/ftJ # OF BDRMS ,'-3 # OF STORIES I HEAT SOURCE ..-! ,) I-J SECONDARY HEAT 0 WATER HEATER F~ RANGE f.-/ SQUARE FOOTAGE J.iLL~ '" To reqUElst an Inspection, you must call 7263769 This Is a 24 hour recording All Inspections requested before 700 a m will be made the same workJnQ day, Inspections requested after 700 am will be made the following work day D Temporary Electnc D Site Inspection - To be made after excavation, but prior to setting forms D Underslab Plumblngl Electncall Mechanical - Prior to cover ~ootmg - After trenches are excavated o Masonry - Steel 10catJon, bond beams, grouting ~undatlon - After forms are erected but prior to concrete placement o Underground Plumbing - Prior to filling trench ffi"Underfloor PlumbIng/Mechanical - Prior to InsulatIon or decking ~ost and Beam - Prlor to floor Insulation or decking ~Ioor lnsulatlo~ ..:... Prior to deckln9 ~l1ltary Sewer - Prior to filling trench ~torm Sewer - Prior to fdllng trench ~ater Line - PrIor to filling trench ~OUgh Plumbln9 - Prlo~ to cover REQUIRED INSPECTIONS ~Ough Mechamcal - Prior to cover ~ough Electrical - Prlor to cover @:Iectncal Service - Must be approved to obtain permanent electrical power o Fireplace - Prior to facing materials and framing Insp ~ammg - PrIor to cover ~all/Celllng Insulation - Prior to COVer Q-Drywau - Prior to taping D Wood Stove - After Installation D 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 o Fence - When completed o Street Trees - When all required trees are planted G::lnal Plumbing - When all plumbing work Is complete ~Inal Electrical - When all electrical work is complete Q-::mal Mechanical - When all mechanIcal work is complete ~Inal Building - When all required Inspections have been approved and building Is completed DOther MOBILE HOME INSPECTIONS D Blocking and Set Up - When all blocking Is complete D Plumbing Connections - When home has been connected to water and sewer o Electrical Connection - When blocking, set up, and plumbing Inspections have been approved and the home Is connected to the service panel D Final - After all required inspectIons are approved and porches, skirting, decks, and venting have been Installed Lot faces Lot Type Setbacks Lot sq ftg 1/ Intenor I PL I HSE I GAR I ACC I IN I I Lot coverage Corner Is Topography Panhandle Total helghtfn CuI de sac W 44') E / BUILDING PERMIT ITEM SO FT \\~3 ~~QO X $/50 FT 5\021) V\. \[) VALUE 1o'3\.1ft f')~C\1o Main Garage Carport Total Val ue '1\~f)D ,-m 00 AfJ C\~ 2-/llo.q~ Building Permit Fee State Surcharge -\- ~OID Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) ~ (B) #16~'6o.1: "W PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' 6{ Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + 3.DID Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' FEE J\ 00 P=> \ \c2l) CD \ :4. '?:O \I~ 7!D A. Sf) 0.., cD Wood Stove! Insert/Fireplace Unit Dryer Vent 2> CO Mechanical Permit \\n SO \0 (X) \ L~~ dj B3 lssuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surc~~ Sidewalk ~ ft Curbcut c\) L.fl ft - c\l D :D \?) ~D Demolition State Surcharge \~. 'Y\t\ f\ \lO\:lM ~cD Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrtcal) ~~l\ 4C\ (A, B, C, D, and E Combined) " S THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON '" THE HISTORICAL REGISTER(? _ 1\ f"'>_ 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 condltlon 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 yv ~,~ r Receipt Number Received By ~CJ(\ \\\~.\I W Plans Reviewed By - " . Date Systems Development Charge Is due on all undeveloped properties wIthin the CIty limits which are being Improved ADDITIONAL COMMENTS ,,"tQ b'o(\f\ r , "'- ~A 0 11 'h ~ Y 1.).J ~\, fl~ v.\.{\ \'Ie ~}.[ , \ C\ LaO JJ(\~h \ 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 certlfy 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 I further agree to ensure that all required Inspections are requested at the proper tlme, that each address Is readable from e street, that the permit card Is located at the front of t e property, and the approved s~t of pi ns will remain the site at, tImes dunn~tru gna eJ~r~~ VALIDATION (,A RECEIPT NUIf'j\ER' ~. ~'r DATE PAID c!::X 4- ~ ~ AMOUNT REc!EIVOD <4.~~ ~ RECEIVED BYt1:~ "iB NO. Q506<6/ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY I-IAY'OE:.N Et-JiEJ?J"!<-./SE-":::> Lie LOCATION '??~0 CH-efZo~eE / ~ CI ~ 0 Co, Z- I - 00 Coo 0 DEVELOPMENT TYPE L-/)f?- - tJE::-fN SFR. BUILDING SIZE LOT SIZE SQ. Ft I STORM DRAINAGE IMPERVIOUS SQ FT NA 2 SANITARY SEWER-CITY NO OF PFU'S /'if (See Revene) 3 TRANSPORTATION X $0 209 PER SQ FT c~~ X $43 26 PER PFU ((778"J.) '-- ~ NO OF UNITS X TRIP RATE X COST PER TRIP X I 0' X $436 19 c: 44oS~) ~ X X $436 19 $ X X $436 19 $ 4 SANITARY SEWER-MWMC NO OF PFU'S I~ x $17 19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~/q 4-3.. TOTAL-MWMC SDC $ Z!"Z'!> ~ ~ l.J '5 1'2- 4-2. SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) \~~~ \j Ki p Burdlck SDC Coordinator X .05 Date' 5/1-; /qS , , TOTAL SDC c; 75 "2.) ~ $ 156604- , ' FIXTURE UNIT GALCULA TV'N TABLE: Number of New FIxtures X UOlt EqUIvalent = F,xture Units ~ r ~ , (NOTE: For rcmodC(S4 calculate only the .L additIOnal fixtures) NUMBER OF NEW FIXTURES ^, ~' UNIT EQUIVALENT FIXTURE TYPE z. 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 Bathtub uu" no. Drlnkmg Fountain Floor Oram4 Interceptors For Grcasc/Od/Soltds/Etc Interceptors For Sand/Auto Wash/Ete Lau"dl'f Tub/Clotl1eswasl1er Ctothcswasher - 3 Or More Mobile Home Park Trap (1 Per Trader) Receptor For Refngerator/Water StatlO,,/Etc Receptor For Commercial Slnk/Dlsl1washer/Etc. Shower, Smgle Stall Shower, Gang Sink Bar. Commercial, Residential Kltche" Urinal, Stall/Wall Wash Basm/Lavatory, Single Todet, Public Installation T odet , Private MIscellaneous z. z.. lOTALfl;lUC U"ITS FIXTURE UNITS 4- 2 z. 2-- B \8 CRE01T CALCULATION TABLE Based on asscssed valuc If tmprovcmcn,s occurred aftcr anncxatlon date III table, calcul~tc credits s:::paraLcs Yc~r {{dte per $1,000 !I..S ,csscd Value YC2" Ratc pcr $1,000 Assc~::.cd Value I I I An,l:;^-cd Anne ,2<.-1 1979 or beforc 1980 1981 1982 1983 1984 1985 $346 338 332 321 306 292 2,73 193:) 1986 1987 1988 1989 1990 1991 1993 $246 214 177 1 37 097 061 044 015 '2.l:,2.~ Credit for Parcel or Land O"ly If Applicable ~ 4'" X $ /,<;,8 (Rate X Assessed Value) X $ (Rate X Assessed Value) Improvement (If after annexatIOn datel CREDIT TOTAL = $ 2'" 'Z.~ "