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Home My WebLink AboutPermit Building 1995-2-7 ~~ LOCATION OF PROPOSED WORK C ~ (AJiIlPDf1J.Q_ f>>Lu ~ , \ 50~ a o'rl-.. \ TAX LOT r)/A,fYJ SUBDIVISI~\ \~ G,r\J\~~ PHONE ~ InCllo.l/J ZIP q,,4Jl~ RESIDENTIAL PERMIT APPLICATION InspectIOns 7263769 Office 7263759 SPRINGFIELD JOB NUMBER 95{)//() 225 Fifth Street Springfield, Oregon 97477 ASSESSORS MAP I~ ~ , OWNE~Ufu1\ f'f\t.o'{m~ J~(\' ADDRESS 'P:,q's:{ Qo ...~? rv\ \..J)JU&J. CITY "'~1\ \s\~~ Q ~ N. STATE ~\.~l'J'\\ DESCRIBE WORK ~\ f\T\\() > Kc'\ f\\ I ~ I l, ,.}2Q...t\lc\ ~ Dc~ NEW \.-/" REMODEL ~ADDITION DE~_JSH OTHER LOT BLOCK CONTRACTGf~~NAME ADDRESS GENERA' \ <DC'u \0. G n f rvh PLUMBING y~ ~ rl \..'h.li~ t \ MECHANICAl' Q'\() I \r\ D (\ filL ELECTRICAL f ALt~ C( ~ CONST CONTRACTOR # q~ 'l1)~ S\l'?,\ q ~!.:2DR !o61<l-S PHONE q 1 '3lo\,{)L \0 ~3 S\\ ill Qi30(0()2- 4-lS 2J~q EXPIRES '\ 2.0,.0,(1) C\ \C\ C\\() I) 2q Q(o a.. '\ C\s - OFFICE USE - QUAD AREA "-~0.C' _ LAND USE -111 J FLOOD PLAIN . OF BLDGS I # OF UNITS I ZONING CODE Lflf2- OCCY GROUP Q?,+}J\ CONSTR TYPE lJ}J . OF BDRMS ,'1 # OF STORIES I HEAT SOURCE 11) /-I SECONDARY HEAT 0 WATER HEATER E~ RANGE ~.-/ SQUARE FOOTAGE {I {JCi--.~ To request an Inspection, you must carl 726-3769 This Is a 24 hour recordIng All Inspections requested before 700 a m will be made the same workIng day. InspectIOns requested after 7 00 a m will be made the following work day D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms o Underslab Plumbing I Electrical I Mechanscal - Prior to cover ~ootmg - After trenches are excavated D Masonry - Steel locatIon, bond beams, grouting ~undatlon - After forms are erected but prior to concrete placement D Underground Plumbmg - Prior to filling trench @-Underfloor Plumbing/Mechanical - PrIor to insulation or decking ~ost and Beam - PrIor to floor Insulation or deckIng g:loor Insulation - Prior to decking ~nltary Sewer - Prior to filling trench ~torm Sewer - Prior to filling trench r-l--Water line - PrIor to filling L.k::::r trench ~OU9h Plumbing - Prior to cover REQUIRED INSPECTIONS ~ough Mechamcal - Prior to cover ~ough Electrical - Prior to cover cg.--Electncal Service - Must be approved to obtaIn permanent electrical power o Fireplace - PrIor to facIng materIals and framing Insp ~ammg - PrIor to cover ~all/Celhn9 Insulation - PrIor to cover Q-Drywau - 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 G"S'dewalk & 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 ~mal Plumbing - When all plumbing work Is complete ~Inal Electrical - When all electrical work Is complete ~lnal Mechanical - When all mechanical work Is complete ~lnal Buildmg - When all required Inspections have been approved and bUilding IS completed o Other MOBILE HOME INSPECTIONS o 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 I nspectlons have been approved and the home Is connected to the service panel o Final - After all required Inspectlons are approved and porches, skirting, decks, and ventlng have been Installed Lot faces Lot TYPl Setb.cks I PL , GAR' ACC I Lot sq ftg L/ Interior HSE IN I Lot coverage Corner Is I Topography Panhandle Total height J:{ Cui de sac Iw I ( ~tJ~ IE I BUILDING PERMIT sa FT \\~3 .5\.0.0 X $/so FT 5\.0 ill \6..., \[) ITEM MaIn Garage Carport Total Value Building Permit Fee State Surcharge -t- ~C>ID Total Fee (A) VALUE \..o'3Lo'ft '1 <f,cl.lo 1\\~1JD ....mOO AfJ C\.~ 2/1\0 q~ (B) SYSTEMS DEVELOPMENT CHARGE (SDC) $/S-88,o~ PLUMBING PERMIT ITEM FIxtures Residential Bath(s) N' cQ. Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + 3?/D Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surch,{~ Sidewalk T.J fl Curbcut ,!J( () ft DemolWon State Surcharge \~_ \l\t\<' \l~~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE \\ 00 cO \. \..nDCO \~crD \I~ &:> t\ Sr) q,e;D ~co \\n SO \DCO \ L3?J d.j 53 \\215 \ r.\ OJ') 4\)CO ~,[(~ 0 ?j\ IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON l'\ THE HISTORICAL REGISTERL 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 condltlon that the said construction shall, In all respects, conform to the Ordinance adopted by the Clly 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 \\tl0 \\\~~\I t-l Plans ReViewed By -. Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved ADDITIONAL COMMENTS "f-w b\Jr\ fI r , "" ~r\ 0 u 'n CJ.I( 1:v LM"\ . fl;:.f?O ~\\ \\~ N. " \ ~ LoD - ~"-.:x;,, \ ,-SC-l:: , By signature, I state and agree, that 1 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 GRS 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 of pJa7?wlll remaIn on the site at a times dUrlng~OnS "~ / Signature .4, - ......-.- Date VALIDATION '111 RECEIPT NUMBER ~ \P LA DATE PAin ):4 '\ L15 ' AMOUNT RECEI~Ef~ /1 ~ I rl) 4:t RECEIVED BY LJ\~ ATTACHMENT 81 JOB NO 95'0//0 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE \40RKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY ;I~.L ~f LOCATION ~.:: j).""7( i4~ '32S-0 ~ ~ p DEVELOPMENT TYPE <;;:/) BUILDING SIZE 1. STORM ORATN~ IMPERVIOUS SQ FT 2 SANTTARY SFWFR-r.TTY NO OF PFU'S liT (See Reverse) 3 Tt<ANSP(lqT fiTTON lOT SIZE SQ Ft x SO 209 PER SQ FT S h0 ~ / X $43 26 PER PFU . ~-:fo__~ NO OF UNITS X TRIP RATE X COST PER TRIP / X /,() / X $436 19 a?'eJ.s5) X X X S436 19 X S436 19 S S SUBTOTAL (ADD ITEMS 1 2 & 3) S /2/q,Z :3 4 SfiNTTARY SFWFR-MWMr. NO OF PFU' S / 6" x $17 19 PER PFU T $10 MWt1C ADMIN FEE S ~/'1, -7" 2- (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 2(" 23 MAl -MWM[ SOr. $rV-i3,/1i) ~ - SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ / 5'/2, 1'2. 5 AOMTNTSTATTVF FFFS BAS~HARGE (SUBTOT~ABOVE) X 05 ~~~. / Mary Hdrn,g. P EU SDC COordlnator <:is :0 Date 2 -.2-75- TOTAl SOr. $ /56f:o-'1- B2 SDC ;f 5~C~/rtr~-".' '::' FIXTURE UNIT CALCUL .ION TABLE: Number of New Fixtures X UOI\ EquIvalent = Fixture Units (NOTE For remodels, C~lclll.:HC only the tiEl nodltlonal fixtures) NUMBER OF NEW FIXTURES nXTURE nTE UNIT EOUIVALENT Balhlub f)nnk.lng Fount3m Floor Drain Interceptors For Grease/Oil/Solrds/Etc Interceptors For Sand/Auto Wash/Elc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Mobile Home Park Trap (1 Per Trader) Receptor For Refngerator!Water Statlon/ftc Receptor For Commercial Sink/Dishwasher /Etc . Shower, Single Stall Shower, Gang Sink Bar, Commercial, Residential Kitchen Unnal, StallNvall - Wash Basin/Lavatory, Single TOilet, Publtc Installation TOilet, Pnvate wlscellaneous ,TAHI T"OR'.s S/.'/K 2- 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 ..( -z. ~ TOTAL FIXTURE UNITS = FIXTURE UNITS I-- :z.. 2. 2.. Sf /'if CREDIT CALCULATION TABLE Based on assessed value calculate credits separates I If Improvements occurred after annexation date In table, Rate per $1,000 l- Assessed Value $246 214 1 77 1 37 097 061 0.44 015 = 20.23 ----- = Year Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1280 1981 1932 1933 1984 1985 $346 333 332 3.21 306 292 273 1985 1986 1987 1988 1989 1990 1991 1993 CredIt for Parcel or Land Only If Appltcable Improvement (If after annexation date) 3,"/' X $ "1,5"?CJ (Rate X Assessed Value) X $ (Rate X Assessed Value I CREDIT TOTAL = $ ;z.t..23