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Home My WebLink AboutPermit Building 1995-4-17 , RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 SPRINGFIELD LOCATION OF PROPOSED WORK %_t.f1 \50~ao'rl-. \ 1)y- ASSESSORS MAP ~O LOT BLOCK ~OB NUMBER CfGOWt! 225 Fifth Street Springfield, Oregon 97477 . TAX LOT O~/OO SUBDIVISlcI"m \ IF G,f)J\~ PHONE r'f:\:4 [nQ.l0(11 ZIP q,'l4fl9> OWNE~Ur\U\ F'(\toy-(j\~ J,~(\ ADDRESS 9:>~ Do ~~~nr\ ,J~U&..{ . . CITY .... ~1\ \ s\~ 42 Q ~ N. STATE I ~}. Q~ rJ(\ DESCRIBE WORK ~\ f\l'IJ'\ G , k(\ f'f\ I ~ I '" ~~lQ~ (\~ NEW .....---- REMODEL ~ADDITION DE~IS~ OTHER CONTRACl~\S~ NAME GENERAI\ QX'u \c10nrf\t, PLUMBING y~ ~ ft \.yilla l \ MECHANICA' '_ [\C'11 l,{\ j) II f Jfl+, ELECTRICAL' AU ~ t ~ CONST CONTRACTOR · QtJ00x S \\ ~\ q t.:2DR " lnhl"\-S EXPIRES ~ La.. a.ll) C\ \0\ C\\() f) 2q cito C\ '\ C\S PHONE q 1.3loldJ2. \O~~ Sl\ 1rJ Qi3fotIft <\-lS ?J~q ADDRESS - OFFICE USE - QUAD AREA \.. jR <"-.C' _ LAND USE ---.11/ I FLOOD PLAIN . OF BLDGS I . OF UNITS f ZONING CODE ~ OCCY GROUP Q?-'+M CONSTR TYPE UJJ . OF BDRMS ,'j . OF STORI ES I HEAT SOURCE uHf SECONDARY HEAT [2 WATER HEATER p, RANGE r__ SQUARE FOOTAGE II O~ ~ To request an Inspection, you must call 7263769 This 15 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 Electric D Site Inspection - To be made after excavatIon, but pnor to setting forms o Underslab Plumbing/Electrical/ Mechanical - Prior to cover ~ootlng - 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 Insulatlon or decking ~ost and Beam - PrIor to floor Insulation or decking ~Ioor Insulation - Prior to decking ~nttary Sewer - Prior to filling trench ~torm Sewer - Prior to fdllng trench ~ater Line - Prior to frlling trench ~ough Plumbln9 - Prior to cover " REQUIRED INSPECTIONS ~ough Mechanical - Prior to cover ~OU9h Electrical - Prior to cover @:Iectrlcal Service - Must be approved to obtain permanent electrical power D Fireplace - Prior to facing materials and framing Insp Q-Pramang - Prior to cover ~all/Celllng Insulation - Prior to cover Q-DrywalJ - Prior to taping D Wood Stove - After Installation D Insert - After fireplace approval and Installation of unit ~urbcut & Approach - After forms are erected but prior to placement of concrete [3"Sldewalk & Driveway - After excavatlon Is complete, forms and sub base material In place D Fence - When completed D Street Trees - When all required trees are planted &Inal Plumbing - When ail plumbing work Is complete ~Inal Electrical - When all electrical work Is complete ~anal Mechanical - When all mechanical work Is complete CD:.'nal BUilding - When ail 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 D Electncal Connection - When blocking, set UP. and plumbing Inspections have been approved and the home is connected to the service panel D Fmal - After ail required Inspectlons are approved and porches, skirting, decks, and ventIng have been installed Lot faces Lot Typ, Setbacks IS THE PROPOSED WORK IN THE Lot sq ftg ~nterlor I PL I HSE I GAR I ACC I HISTORICAL DISTRICT, OR ON n IN I THE HISTORICAL REGISTERQ _ D Lot coverage Corner Is I If yes, this application must be signed and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit Issuance Total height (~~) CuI de sac IE I APPROVED BUILDING PERMIT ITEM sa FT \ \ ?l3 .5\.QO X $/sa FT 5~7D \'\. $) VALUE 102>Lcf'A- '1 y,C\ to Main Garage Carport Total Value '\\~'1D "m 00 A.i")~R 2/1\0 q~ Building Permit Fee State Surcharge -t- ~ 010 Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) ,1:1 ~ 04- ('P (B) I <:>es- PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' 6l Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing PermIt State Surcharge +3.% Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' FEE \\ ol) cf:) \ UlDCO \ :4. ro \I~ 7';D .c, S[) 0.., cD Wood StovellnsertlFlreplace Unit Dryer Vent .?,CO Mechanical Permit \\n SO \l>[;D \ ,~?J dj 63 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk '1n Curbcut &..la- It r:::Qr ) .'::;D 15Lf) It Demolition State Surcharge \~. ~\~ f\ \\~ 4$cO Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excludln9 elect"c~ffi1 <-t1' (A, 8, C, D, and E Com blned) 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 01 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 \ ~~ ~ Receipt Number .() ,'V"'" Received By ~ t\fiI\ \'\\~, \ ll;\ Plans Reviewed By Date Systems Development Charge is due on all undeveloped properties WIthin the City limits which are being Improved ADDITIONAL COMMENTS "fto b'oC\ fI X , ~ ~r\ 0 u n ~ Y J::v l...A+\, ~{\\\~}[ fl~ \ C\ lDD 0J r\l-h \ By signature, I stale 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 01 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 certl fy 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 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 plans will remain j;.n the slte~t 131 times d ~In~ns tlon S nature. c:./~ - ~ - Date 1-1 ~;/rJ VALIDATION I ( fO~ RECEIPT NUMBER _ \ \[J-'\ ( \ . DATE PAID 411l~ , AMOUNT RECEIi::T~ H RECEIVED BY (J)(M ) : NO. 9<:>0444 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY +-I....yDf:.I-J E:t-.lIE:!2-f'P--ISc.S LOCATION: ~~41 c..!-\-f:.l2..DlLE-E- 'bP- DEVELOPMENT TYPE LO~- NE'-iN 'SF~ BUILDING SIZE: 1 STORM DRAINAGE (cnO'2-0~'2-1 - 0'2-100 LOT SIZE SQ Ft IMPERVIOUS SQ FT N A x $0 209 PER SQ FT ~e) "-- ----- 2 SANITARY SEWER-CITY NO OF PFU' S (See Reverse) \'6 X $43 26 PER PFU G=,78 b~ '-- .---/ 3 TRANSPORTATION NO OF UNITS X TIRIP R~IE X COST PER TRIP G 440"'~ X I 0 \ X $436 19 '-- --- X X $436 19 $ X X $436 19 $ 4 SANITARY SEWER-MWMC NO OF PFU'S } <6 x $17 19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ?194"L TOTAL-MWMC SDC SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ 'Z-(.'l-:' ~ .-- .---/ $1'5>\'2.1\::2: 5 ADMINISTRATIVE FEES TOTAL SDC G (S~~ '-- .---/ $ \ Se,2> 04- BASE CHARGE (SUBTOTAL ABOVE) ~ ~~J..~ \) K1P Burdlclc SDC Coord1nator X ,05 Date: 4-/, /q,S Unit EqUIvalent = Fixture Units FIXTURE UNIT CALCULAT"lN TABLE: Number of New Ftxture . , (NOTE For remodels, calculate only tl ..I addItIOnal foxtures) NUMBER OF FIXTURE TYPE NEW FIXTURES Bathtub __ . __ Orin king Fountain Floor DralO Interceptors For Grease/OdlSollds/Etc Interceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More MobIle Home Park Trap (1 Per Trailer) Receptor For Refrlgerator/Watcr Statlon/Etc Receptor For CommercIal Slnk/Olshwasher/Etc Shower, SIngle Stall. . --. . u_____ Shower, Gang.. ... u . . . -- ... .u SInk' Bar, CommercIal, ReSidentIal KItchen ..... ......--..-- Urinal, Stall/Wall Wash BaSin/Lavatory. Single Toilet, Public InstallatIOn Toilet, Private Miscellaneous '2 '2- 'Z- TOTAL FIXTURE UNITS UNIT EQUIVALENT 2 1 2 3 6 2 6 6 1 3 2 lIHead 2 2 1 6 4 FIXTURE UNITS 4- '/.. 'Z- ~ ~ If<, CREDIT CALCULATION TABLE' Based on assessed value If Improvements occurred after annexation date In table. calculate credIts separates Rate per $1,000 l Assessed Value 'j Year Annexed Year Annexed 1979 or before 1980 1981 1982 1983 1984 1985 $346 338 332 321 306 292 273 1985 1986 1987 1988 1989 1990 1991 1993 Rate per $1,000 Assessed Value $246 214 177 137 097 061 044 0.15 I I \ '2..-G.z.~ CredIt for Parcel or Land Only If Appltcable ~ 4-", X $( S B (Rate X Assessed Value) X $ (Rate X Assessed Value) Improvement (If after annexation datel = CREDIT TOTAL = $ 2-"'z.~