HomeMy WebLinkAboutPermit Building 1994-3-30
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LOCATION OF PROPOSED WORK: ?~~, 2;,.:.~~V/..IC ~
ASSESSORS MAP: / 7~ ~"2:-?-k' (\, V
LOT: MP ~ -~ -4i:'9 BLOCK; ,-;:,?:!~~ ":5
. ' ' , 4""::1-../-"\
/ ',.1; ".<L" i...c::' ~o ,
OWNER' {-M>L? ~'~~/~~~?,~r ~7"
ADDRESS: p2? ~~ f~' V;p ,
CITY' C::;"14./A44~ A
DESCRIBE WORK', .0:~d;~:2'V\4/~~~~~-~7 ~~;:-
NEW ~ REMODE'L . ' .. ADDITION DEMOLISH, OTHER
..
'I
~
, 1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
:T:A
SPRINGFIELD
STATE:
a:/-f
~l"a , c.5'
.,..
<:..q,~,l>t
JOB NUMBER
q4/d=3'Z~
, .
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
'-/ /".,c:::>
SUBDIVISION:
PHONE:
":'7 Y"2 -.7/;;>$
. ~. ..
ZIP'
<9' '7 t,.// 2.
CONST.
CONTRACTOR'S NAME ~P8E~_ CONTRACTOR'
-. ' ~~:5?!K
GENERAL:d='"-f'/"""~ ~ ~:-J':~ -.'~/~ ..,?"'.:>? 6f/~, ~-"3-S:
. . . ~$'7~#""'~ M/ ""
PLUMBING' -:k"B5~~ _~~ ,7~,y<.~_.5..'.J!'::~ L'.:_ f'7Y.;:$' &:S',6C;> 4/-'3'7"
/:'c - - r II' ....,; , ,r ,. .",
MECHANICAl'
ELECTRICA" he. 'R~7:'
QUAD AREA:
\ R...~"1u
~
\-\21 + tv'\
l
V
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
EXPIRES
PHONE
~4:::: ~ .,../~.~--
<99~-Y1!ii'<.t;;;
(-y;( rfJ ~
\ 9./ \ ~O.C\1 -A-\ .~
'C- OFFICE USE -
LAND USE: "\ \ cc-D
. OF UNITS: \
CONSTR. TYPE: -1/ ~ )
HEAT SOURCE: F:'v
C.
C..-/
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
,~cover. ~~
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framIng Insp.
~ Framln~W-
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
o Sidewalk & Driveway - After
. excavation is complete, forms
and s.ub-base materIal in pla.ce.
o Fence - Whe.n co'mpleted.
fi'7'if Streel Trees - When 'all required
~ trees are planted.
FLOOD PLAIN'
ZONiNG CODE:
\f)V
2J
. OF BDRMS:
SECONDARY HEAT: ,0
SQUARE FOOTAGE:JQ.F\ I.L
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 7:00 a.m. will be made the following work day.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
I"fi Underslab Plumbi-~eclrlcal~
~ Mechanical - Prl~~.ov
-d Footing - After trenches are
~xcavated.
o Masonry ~ Steel location, bond
.beams. grouttng.
o Foundation - After forms are
, erected.but"prlor to concrete
placeme~t.
o Underground Plumbing - Prior
to fIlling trench.
o Underftoor Plumbing/Mechanical
-.Prior to insulatton or deckIng.
o Post and Beam - Prior to floor
Insulation or deckIng,
o Floor Insulation - Prior to
decking,
R'7"i Sanitary Sewer - Prior to fIllIng
~trench. .
d-"Iorm Sewer - Prior to filling
l.L]t;.ench. .
~'R,rWater Line - Prior to flJllng
~ trench.
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
plumbing work is complete.
rv-l Final Electrical - When all
~ electrical work is complete.
o Final Mechanical - When all
mechanIcal work Is complete.
I'Jf'Flnal Building - When all
~equired Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
i\:7l' Blocking and Set-Up - w~en all
~ blocking Is complete.
~ Plumbing Connections - Wh~n
jL..."} home has been connected to
water.and sewer.
.
rvr. Electrical Connection - When
r blocking, set-up, and plumbing
, I nspections have been approved
and the home Is connected to
the service panel.
~Final - After all required
~;nspections are approved and
porches, skirting, decks, and
venting have been. installed.
Lot faces
Lot Type-
Lot sq. ftg,
_ Interior
Lo't coverage
_ Corner
X Panhandle
Topography
Total height
Cul-de-sac
~~in ~.
'-'d~eP- '5 2... )>
Carport ~'5S~
&~~ 1:7//~,
Total Value
Building Permit Fee
State Surcharge
Tolal' Fee
...
(A)
"s-
.
\'
~'. ~ ..i;..~ I
I
-....
_ THE PROPOSED WORK IN THE
""'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
\,If yes, this application must be signed
.knd approved by the Historical
. C<?ordlnator prior to permit issuance.
Setbacks
'HSE'GAR'ACC!
I
I
-:74/4:'
<j'/ ~
?- s-'?.,po
, '9~<;/~~
<PhS)
~-03
r34..5.~
SYSTEMS DEVELOPMENT CHARGE (SDC)#
(B) {\.?o() p,~
I P.L.
IN
Is
Iw,
IE
BUILDING PERMIT : #a.~~.::sd:3!G-g) :;1
ITEM SQ. FT, X $/SQ, FT VALUE
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
nJ),OO/
FT.)1CO '
FT;) cb .
Water
Storm Sewer
Mobile Home
PlumbIng Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk .0
&
It
It
Curbcut
Demolition
FEE
.~"')oO
C::-SCU
-.:).
.5 5 C;U
Ho5~
.~.,$
\ 113 .~S
Cf
\D5,CO
cQ()a5
;). ~,~
~te Surcharg~ -+
(; Q 0(\0 ;.:/1:. ,t::{'[)- f)_ex..J
\'
To j;MlsCelianeous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcal)q401 .tCJ
(A, B, C, D, and E Combined) ,
".....
,,~. :
;:::- .
APPROVED:
"BUltOif\J~ VALUE, PLAN CHECK
AN,~ B~I~DING P.~RMIT .),...... ,
Thl.s\permit'l_s:granfed!.;m~!he express cOl)d_ltlo'l,.that the said
construction snail, In all respects, conform:fo the Ordinance
adopted "by th'e"City'f'6f~ ,Springfielif, i~cludlng the
Development Code, regula1.!_.Q9 the c~:>nstructl?n and use of
buildings, and may be suspended- or revoked'at any time
upon violation of any provisions of said ordinances.
" Plan Check'F~e: ':'. '~<':~"'=3
'?-~-~'7
Receipt Number' //93"'=5
Recelv~:g'BY:.l.. /2~~_:--- .
". .~.",...1 ~- -_,-.
.. ~"
Date Paid:
Plans Reviewed By
--
",
Date
Systems Development Charge Is due on all undeveloped
properties within the CI!y limits which are being Improved,
,', " '.
ADDITIONAL COMMENTS
, d\+-T: 4;/~)
"-=..rA\\ f\i,1( L ')frto y \(..\,1 'C\
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\ cAOlia-:imo Q . l'P YoJl}Ji)M 0
~ \L*1'V' J' h {.J:Y '-- J\ Q -'jJ 11 A 0 AJ,
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 '=-aws
of the State of Oregon pertainlr'!g 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 701.055 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 proper~, and the approved set of plans will remain
on the site ~t'alf times during construction.
Signature (.~ ~~t
Date Y/S0'Y:
VALIDATION:
J2//t:.
DATE PAID "!: /:10/'14-
AMOUNT RECEIVED 4'fO)~ 1J1
RECEIVED BY ._~.,
RECEIPT NUMBER
-
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
FAX (503) 726,3689
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that with the approval of the attached
manufactured homes will be placed at
Springfield, Oregon, City Job Number
)(
Development Code, I understand and agree
p~B~,~e ll-tf\the following ,() )
<,-")'-\0\ ~\LO...n)1 UL...0J 1\..., ,
q{)-;-<,.L.J, ,~ .
Type I Manufactured Home. A multi-sectional (double wide or wider)
unit with an enclosed floor area of not less than 1,000 square feet,
that,has a nominal roof pitch of 3 feet in height for each 12 feet in
width, that has ilO bare metal siding or roofing, and that has been
certified by the manufacturer to have an exterior thermal envelope
meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family
dwellings constructed under the State Specialty Codes.
Ty~e II Manufactured Home. A unit of not less than 12 feet in width
wi th an enclosed floor area. of not less than 500 square feet, that has
a nominal roof pitch of 2 feet in height for each 12 feet in width and
that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided with the
following in~ormation:
Manufactured Home blocking
- Water line connection
- Street tree standards
Sanitary sewer connection
- Electrical connection
- Minimum requirements for permanent steps
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the perimeter with stone, brick or other' masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade.
, :\ .
~ \\tp~1
SigTlatu01 -v [)
bate
.
.
@ y!i!I!!!!!!~!!~
.
Job No.
Cf4~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME~ G\ \i1of\ctto -6 . rlLG, PHONE C(4AJlj!fL
ADDRESGQ\C') ~,~ j(\' 'It\() Q;j STATE:.B('GZIP~
LOCATION OF PROPOSED BU,lt9l,N,.G?FE: n (\ , ~f ^
StreetAddressifKnown:d~ \'\1. Q n"i\. ~)~ l 0 I-"i I nv
\\ ct) Tax Lot Number: Ifjf)M'IIQffi\C:O
- qxit606-)
Plan Name:
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculalions and dwelling type
definilions are on Ihe back,)
A. Sim!le Familv - Detached
Single Family home
~ Manufadured home not in a park
NO OF UNITS
i
X $400 PER UNIT =
$ 4ft)
B. Single Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufadured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$4f'i)~
$ ef
$ 4{f)~O
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credill
\Un
f)
?J / 9iJ /0\1'
Date
Community Services Divi\io
. Cily of Springfield
-
_JOB NO. '1'-1o"?'l.S
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: JOE: 4 WeNDY SPADY
LOCATION:, 2. "?<-I-CJ Ll--F::A Ii:. \/uF- lA-N E: J 70:' 2. 71 2.- - ''''/100
DEVELOPMENT TYPE: L bIZ.. - J-Jr:':.N, MA-t-IV 0, i--!-DMF'-
Jfo,vu: CA~DE-r \,). \I'll A..V...u..HM (..-
BUILDING SIZE: 27",<I~ 1\I..n \~,,~O <"" ~ LOT SIZE
,. '
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT,
21--'::>("
X $0.203 PER SQ. FT.
~Slq.:!)
'-- ..-/' '
2. SANITARY SEWER-CITY
NO, OF PFU'S
(See Reverse)
\9,
X $42.08 PER PFU
(';'=> 1 '-f~
"--- ....-/'
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1,0 \ X $424.31
X X $424.31
X
X $424,31
~'-42.-~ '?~
------- ..-/
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S ("b x $15.125 PER PFU + $10 MWMC ADM FEE $ 'ZB7.::Z
(Use PFU Total From Item 2 Above)
$ \'2.. '?B
MWMC CREDIT IF APPLICABLE (SEE REVERSE) '~
TOTAL-MWMC SDC 0<08 {,0
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ \ 9 \ 7. ,,?>
5. ADMINISTRATIVF FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~~L0-__ "zJ!18/C;4
, Q Kip Burdick '
SDCCoordinator
~
'l.b
TOTAL SDC $ LOa B -
F1~URE UNIT,CALCU.N TABLE: Number 01 New Fixture_it Equivalent = Fixture Units (NO~E':
For remodels, calculale only the NET ndditional fixtures) .
NUMBEf1 OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub................ ...."......... '
Drinking Fountain .................. ............'
Floor Drain...........,..,........... .................
Inlerceptors For Grease/Oil/Sollds/Etc,................
Interceptors For Sand/Auto Wash/Etc...............,..
LAundry Tub jClolheswasher.,.......,."",.....,..,.."".,.,
C1otheswa:,\her - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor F9r RefrigeratorjWaler Station/Etc.......,
Receptor For Commercial Sink/Dishwasher jEtc..
Shower, Single 'Stall............."......."",.,...,., ........."...
Shower, Gang..............,..............., .,........".,.......,....,.
Sink, Bar, CommerciaL....,..........,...,.........,..........,..
Urinal, SlalljWall..................."..." ".....' "'" ,.."..,...",..
Wash BasinjLAvatory, Single.................................,
Water Close\, Public Installalion.............................
Water Closel. Private.............................................
Miscellaneous:
7_
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
7.
-z..
TOTAL FIXTURE UNITS
'A,.
z..
~
-z.
'Ii
\'15
Based on assessed value. If improvements occurred after annexation date in lable,
Rale per $1,000 I
Assessed Value I
S 2.24 ,
1.93
1.57
1.16
0.79
0.44
0,26
CREDIT CALCULATION TABLE:
calculate credits separates.
I
Rale per $1,000
Assessed Value
Year
Annexed
Year
Annexed
1979 or before
1960
1961
1962
1983
1984
'1935
$3.21
3,13
3.06
2.96
2,62
2.68
2,51
1986
19B7
1963
1989
1990
1991
1992
"
Credit for Parcel or Land Only If Applicable
?7-1 X $ Y :Z_:, \ ?;.'7.!.
(Rale X Assessed Value)
X S
(Rate X Assessed Value)
CREDITTOTAl = $ \'7:,';.!...
Improvement (if alter annexalion date)
i
,
,
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R esid enlial............,... .............................. .......... 0.4
Commercial...................................,..........,.".... 0,9
I nd ustrial... ...... ......' ,......... ........... _..........."" _," 0.45
GovernmenlaL......,.......,.......,.."",........."""".. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT