HomeMy WebLinkAboutPermit Building 1994-5-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
ASSESSORS MAP:
LOT' -\'1"'3'1
LOCATION OF PROPOSED WORt<. 10. t; \
n-o~-3s-34-
\)<l"S" 5i,
BLOCK' .
OWNER' c"~V'\tt Ma.,,~e TvD'Je,<
. . , , .
ADDRESS" 1~:lL) \ Cololo\e. S-\-o""-e..
CITY: A o'h <,,' (' ""- ,
DESCRIBE WORK' 5\"" \c..
I
NEW -X- REMODEL
ADDITION
STATE:
C"'- \~~
.... 3111(
.
~ z..o5'
1=",,,,,,', \'\1
I
DEMOLISH
OTHER
JOB NUMBER
t?) U 0 l{:Jh
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: '< ~rl{)
SUBDIVISION: Me,K",,,,...:.C \..L\\<:, $",-'0.
PHONE: ~O~- 4,,)5-7.;)4:l.
ZIP:32f'lO~
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
GENERAL: J--a..",,"c \) ..\\,..d""..... Co",~, l\'l C S 4.J~ <,+ s~n, '# ~ g'tl 7inJ.:L<+: 7 ;)(,,- 9ole4-
PLUMBING: -.ffiL~ ;c."",-",,,\ ~\ ~- \,,-. > - W4 c.1...",-vl\.~ .'i"Jc ~ C- !1.~,) _ l:J~.~1!tf344 -').02:1.
MECHANICAL:rI\C'A"'~\''''-\\'' D',\ ~ \\"'~"r - 411.LE':>t- S<?-\-\~ ~n l,q.f13Bj147- 1~
ELECTRICAL~'u, ~~ -fk,':\v', ('1v.i 4.1:3d.1.Mc.k,~..~c \ol-~) ~A~ ~I);~~ 1I.\2=lCl\- '3% -3'14.;:),
'-'- OFFICE USE -
QUAD AREA: 4Q.~ LAND USE: \\ \ \ FLOOD PLAIN'
\ r .' \ U"JIL
, OF BLDGS: "OF UNITS' ZONING CODE:
OCCY GROUP: \=<.'6-\ V\ CdNSTR: i'vP~' V tV. , OF BDRMS' bl-
, OF STORIES: A HEAT SOURC0 yf~ SECONDARY HEAT: ~p
y/ I' SQUARE FOOTAGE:c9.W~
WATER HEATER: RANGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 ~.m. will be'
made the same workIng day. Inspections requested after 7:00 a.m. will be made the following work day.
~
~TempOrary Electri~
~ Site Inspection - To be made
~ after excavation, !?"yt pri9r to
setting forms. ?I!ll '-
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
rt::r Footing - After trenches are
~ excavated,
o Masonry - Steel location, bond
beams, groutl ng.
r\'YFoundatlon - After forms are
/:rected'but- prior to concrete
placemer:t.
o Underground Plumbing - Prior
to filling trench.
'K/('Underfloor Plumbing/Mechanical
~- Prior to Insulation or decking.
f\/rpost and Beam - Prior to floor
~Insulatlon or decking,
"r'v'( Floor Insulation - Prior to
~ decking. .
b1 Sanitary Sewer - Prior to filling
F trench.
NStorm Sewer - Prior to filling.
7Ll'trench: .
1'5?1 Water Line - Prior to filling
( trench, .
r'V! Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~ough Mechanical - Prior to
~over, ~.i:.U. r.!'.'
~ Rough Electrical"": Prior to
~cover,
IVl""Electrlcal Service - Must be
~approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
r;;;:;rWalllCelllng Insulation - Prior to
~ cover. '
~ Drywall - Prior to t~Plng.
o Wood Stove - Afte~ I~s~allatllon.
D'lnsert - After fireplace approval
and Installation of unit.
'fV'(Curbcut & Approach - After
r-~orms are erected but prior to
placement of concrete. '.
~Idewalk & Driveway - After
xcavatlon Is compiete, forms
and s.ub-base material In place.
o Fence - When completed.
~ Street Trees - When "all required
c:;:::; trees are planted. ...'
rv1" Final Plumbing - When all
~ plumbing work Is complet.e.
~Flnal Electrical - When all
pelectrlcal work Is complete.
l5?1 Final Mechanical - When all
~ mechanical work Is complete.
!'VtFlnal Building - When all
~requlred Inspections hav~ been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
o 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.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been. Installed.
Lot faces Lot Type .. Setbacks (.THE PROPOSED WORK IN THE
Lot sq. Itg. .x Interior I PL. I HSE GAR I ACC I -"HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prIor to permit Issuance.
Total height ~
Cul,de:sac
-- ~' IE I APPROVED'
BUILDING PERMIT-:
ITEM SO, FT. X
I c:, "i< r
1-/(.";:),,
$/SO. FT. =
. c:.. (,., "'l>
ILt'()
Main
Garage
Carport
IA~~"",:2:t;eA 'L<l?D
IL-f'O
Total Value
Building Permit Fee
State Surcharge,
Total Fee
(A)
VALUE
!R9. gc, ':l
(~,S 1--=1-
-::>.,CiY-5?
.
'9.9 ?,JL{
4<; ~ a'-c
, ?/"s
1-C:1,6S
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 of Sprlngflel.d, 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:
~'i<I.:-!:'~
?'};;z,llt)1.{
I) ILl"}
Date Paid:
Receipt Number:
Recelved)lJ Da.
/f"/~ .
Plan.r:Revlewed By
'~~/5'<f
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
217,0,(,5.
__ Systems' Development Charge Is due on all undeveloped
properties wlt~ln the City limits which are being Improved,
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' "2
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
'1
Wood Stove/lnSe~lrePlace U~
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ It
, Curbcut 2.? It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
/~6-a
~_60
/~f?~
,
c., a ()
1-S0
9.afJ
/, <:; ,tHO
. ? cl'-D
<'7 ptJ
/..0,&00
/,Z)'O
4"7,:18
/r.c.90
/4,or
2'A '7?.. 7J
ADDITIONAL COMMENTS
\..-\\4 "" r!){ )} J ()n
,c:A{\~H/~;oh,~ 1(:1 4~
\l~~" h !l\D-kk, ~ ~ ri Q U ~Jl b
/~~
. SJl'AM?E ~ ~~/T~.J;_
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 cert!fy 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 pro~:~ and the approved set of plans will remain
~:::u:~:;,rl:fll times ~It :~tlon.
Date (0 N\e.... ~4--
, '
'----
VALIDATION: /~' .A /l
RECEIPT NUMBER Ii frr-,. I
DATE PAID ,c::;, ((1' 4
AMOUNT RECEI~trJ ~ ~ ,'73- t517S. ~)
RECEIVED BY c-J) ( ~
.
.OB NO. ,9.{()~...<t;
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: GENE ; J/IARt~E J;.O'lE'ft: ~.2S1 [)AISV C;T~&'$r
LOCATION: 17.0,J.'3':'-'34/Proo Lor.#3f I1)F!l/dEN.?/ff~.u..s .r1l~[)IJ/I.5/<r-I
DEVELOPMENT TYPE: /'IE/tl S//V6,t,F rAA7d- Y PE90c,<tC-€
BUILDING SIZE: -
I. .sTORM DRAINAGF,
IMPERVIOUS SQ. FT. ;z.cm.z
2. SANITARY SEWER-CITY
NO. OF PFU'S /q
(See Reverse)
3. TRANSPORTATION
LOT SIZE -
SQ. Ft.
X $0.203 PER SQ. FT.
~t10.J"?J
'-- -----
X $42.08 PER PFU
~'1 j~ S' '?)
'-- .-/
NO OF UNITS X TRIP RATE X COST PER TRIP
I
X /..01 X $424.31
X X $424.31
(4~F..>;:;
'-- ----
$
X
4. SANITARY SEWER-MWM(
NO. OF PFU'S Iq x $15.125 PER PFU + $10 MWMC ADM FEE $ ;z.f"1..p)f
(Use PFU Total From Item 2 Above)
X $424.31
$
SUBTOTAL (ADD
$ (;,'1..5"2
TOTAL-MWMC SOC ~
ITEMS 1,2,3 & 4) $ ZOc, 'T,2f
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
SU~) , .OS
urdick U
oordinator
-f!-f- ?7Z-
~O)IJV
TOTAL SOC $ 2/70,05-
..~...-
FIXTURE UNIT ,CALCU ~N TABLE: Number of New Fixtures .it Equivalent = Fixture Units (NOTE:
For remodels. calculate only the NET additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub..,........ ........,........
Drinking Fountain..,..,.. .................
Roor Drain..,........................,..... ..........."'..,.........,..'
Interceptors For Grease/OiI/Solids/Etc......'..'..'''..
Interceplors For Sand/Auto Wash/Etc..,........,......
Laundry Tub /Ootheswasher......,......... ..,.......,........
Ootheswaliher . 3 Or More,.........,......,..................,
Mobile Hdme Park Trap (1 Per Trailer).................,
Receptor Fgr Refrigerator /Water Station/Etc..,.....
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single.StaIL..,....,"'......,...........,....,.........."
Shower, Gang.. ...., .......' ....,......,...".... ..,..,.....' ....."'. ,.
Sink, Bar, CommerciaL..,....,"',..,......,...........,....,....
Urinal, Stall/Wall...,.,"'..,.."........"...,...,.............,.......
Wash Basin/Lavatory, Single......,......,...........,........
Water Ooset, Public Installation..,..........,"'.........,..
Water Ooset, Private......"....,...,...".,..........,...,........
Miscellaneous:
.'
2
I
2
3
6
2
6
6
1
3
2
t /Head
2
2
1
6
4
"
/
/
-\"1,
:2.
TOTAL FIXTURE UNITS
2.
'2
-'2..
'2..
'3
'il
Jq
Based on assessed value, If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates,
r--
Rate per $1,0001
Assessed Value 1
S 2,24 I
1.93
1.57
1.18
0.79
0.44
0,28
Rate per $1,000
Assessed Value
Year
Annexed
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
1985
$3,21
3.13
3,08
2.96
2.82
2,68
2,51
1986
1987
1988
1989
1990
1991
1992
~<21
Credit for Parcel or Land Only If Applicable ,9.-.,:' t X $ ;2..0./0-0
(Rate X Assessed Value)
Improvement (If after annexation date) X $ .
(Rate X Assessed Value)
CREDIT TOTAL
=
c;, f',s 2
=
= $ 6 1~ >2.
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential...... ,.... ..........' :..,.:........:..,..... .........., 0,4
CommerciaL,..,........,..,__,..,.,..,..........,.,.............. 0,9
I nd ustriaL,...."'. "'.. ......' ....,.. ,..................... ..,.... 0,45
GovernmentaL...,....,......,.........,....................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT