HomeMy WebLinkAboutPermit Building 1993-3-4
RESIDENTIAL .
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/'7t'J ~
ASSESSORS MAP'
LOT'
SPRINGFIELD
4 H.- ~ Pt.j3IA.-(..
~S 2/
~,?c, ])Ef1t1~
JOB NUMBER
9'2- / 4- 'ltJ
225 Fifth Street
Springfield, Oregon 97477
BLOCK'
TAX LOT:
SUBDIVISION:
~Z/r7J
:t;2.. 72..
f) JI.~ fJh I '" ..
Ct?i^ 1''''-+4..'__ ""-
Ct,
OWNER'
S1~v<'''t
ADDRESS:
CITY: s:....<.re ~l-<-
STATF'
t'tI'~
PHONF'
qr/4
4~~70 2-.
ZIP:
tf7 'II? S-
DESCRIBE WORK: }.jet-.; . :') '-IF: ,#J?,;/~W.c5
NEW ~ REMODEL ADDITION DEMOLISH
~1/1~~ V/.4f)(J
~ , ./
OTHER
CONTRACTOR'S NAME
GENERAl' Cft--t-V( VI
PLUMBING: .Oev_(., '-.
MECHANICA" S-f." (/<.{ l.1
ELECTRICAl'
CONST.
ADDRESS CONTRACTOR #
o I-J.rJl1/rr',,<. 2272~""'1f1.r.,~",,-
P/k~ ~/"'" '"
}') )./olDh,'.....1
OUAD AREA:_I
J( JIJI./
I
# OF BLDGS:
OCCY GROUP:,,Q ~ "t.J1,t:1
-z...
C:.
# OF STORIES'
WATER HEATER:
. .,
?, 2.7? t-n.t'... f-c",.........
- OFFICE USE -
/JJJ
J
CONSTR. TYPE: ~
HEAT SOURCE: _Ac,
E
LAND USE:
# OF UNITS:
RANGE: _
EXPIRES
PHONE
4 '0/;''1'707..
Cf,
FLOOD PLAIN'
ZONING CODE:
L)).</
-::2..
# OF BDRMS:
SECONDARY HEAT'
SQUARE FOOTAGE:
}S',2...t:D
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.
o Temporary Electric
o Site Inspection - To be made
after excavation. but prior to
setting forms.
o Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms arc
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Undcrfloor Plumbing/Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Waler Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
o Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fire pi ace approval
---J and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concJete.
o
SidlJwalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
o Fence - When completed.
o Street Trce$ - When allrequired
trees are plant(~d.
o
Final Plumbing - When all
plumbing work Is complel,e,
o Final Electrical - When all
electrical work is complete.
o
Final Mechanical - When all
mechanical work is complete.
o
Final Building - 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.
o Plumbing Connections - When
home has been connected to
water and sewer.
D~ Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After ail required
inspections are approved and
porches, skirting, decks, and
ventIng have been installed.
-'
Lot faces ~ Lot Type tit Setbacks I::'. PROPOSED WORK IN THE
I P.L. , HSE'GAR'ACCI HISTORICAL DISTRICT, OR ON
Lot sQ. fig. ~9.rl Interior
I THE HISTORICAL REGISTER?
L220 ~ N '5 !;
Lot coverage Corner I If yes, this applIcation must be signed
Topography ~ PanhaQ.dle S /9- /"} and approved by the Historical
Iw /0 /01 I Coordinator prior to permit issuance.
Total height :22- Cul-de-sac
IE I I APPROVEf"
BUILDING PERMIT
ITEM sa. FT,
X $/SO. FT.
50f.-o
1.4/0
Main
9,~~
.;::Jq('L
Garage
Carport
IVttv
,4. F6 /. ,dAJ~
Building Permit Fee '?'!>{ - 2. $Cp
/fpff" - I;)."~
Total Value
State Surcharge
Total Fee
(A)
VALUE
':::;?/.,.n~
J251$
05/52-
~5co
":?'7~
"1~7S
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
72.57
PLUMBING PERMIT
ITEM
"
.
Fixtures ..
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
dO
I"
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
FEE
(/~~
Dryer Vent
~o t~b'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge ND ~.lti7
Sidewalk fI ~ ...
Curbcut fI ~U '" ~-,- If
Demolition
State Surcharge
lrIJil ~1Au A'mCtU
,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
4pJ-f
..='"
2/JO,~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grantEd on the express condition that the said
construction shall, in ~II 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.
, ,$ ~,r r,/ / ~I - "'-d/I. 7-1
Plan Check Fee: 2./~, - "U>U>,'" - -rc;,
Date Paid:
Receipt Number'
3-~-"~
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
P/r'TfI 1.
w/ ,,<1-/9A \.A.M.} I s
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 Ordinanc~s 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 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
ot the property, and the approved set of plans will remain
,In the site at all times during construction. ,
^gnature~, /f) .&r ~
Oat'"
VALIDATION:
RECEIPT NUMBER
7?'~5
S - 4' -93
2/)/'J ,()~
~t#1-
DATE PAin
AMOUNT RECEIVED
RECEIVED BY
#. .,
. . JOB NO. '1'2.,'-1-'10
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: S,F":\IE-N t-!OPKIIJ. 50
LOCATION: .J:f;(;~U~ <=j.--tf-S,.
DEVELOPMENT TYPE: LDIZ., ~E:.W SFP-.
170"?7??"21 - '-1'2-00
--
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT S IZF
SQ. Ft.
1"01.--
~
-p I P/"fi(INcC
/". .><. ?~
,X $0.192 PER SQ. FT. \S~ )~7-
/2. ........ ---
&11.
2. SANITARY SEWER-CITY
NO. OF PFU'S \,
(See Reverse)
X $39.78 PER PFU
~
--- ---
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1.00S X $401.05
~O">;,O~)
--- ----
X
X
X $401.05
$
X $401.05 $
-\-.,-- . I '22-
SU8TOTAL (ADD ITEMS 1,2, & 3) $ lG-I"\ - 1/'-t'8-
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
3:'15' c( ~) 57 '!:i-
........ ...-
TOTAL-CITY SDC $ ~ (~~"~
5. SANITARY SEWER-MWMC
NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ \~~%~
(Use PFU Total From Item 2 Above) ,
\~~L~
\j Kip Burdick
SDC Coordinator
1\ k /11.-
( (
$ Z. 4 "t2- i;I:
- '7" ~ 13
TOTAL-MWMC SDC~o?~ f:
TOTAL SDC $ ~4"~;p::)/oOz.
/t7TKL ])iff ~2. .5"7
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
FIXTURE U~nT CALCULA . TABLE: Number of New Fi~ure: X .qUivalent = Fixture Units (N~~~': '.
For remodels, calculate only the NET additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub........... ........... .................... ..... ....,..................
Drinking Fountain..... .............................,..........,...,...
Floor Drain..,.............................................................
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laund ry Tub /Clotheswasher.................,..... ............
Clotheswasher . 3 Or More..................;,...............,..
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator /Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang........................,....,..... ,......................
Sink, Bar, Commercial.......,..............,......,...............
Urinal, Stall /Wall...................."... .....,.. ....." ...,...,....'..
Wash Basin/Lavatory, Single...........................,......
Water Closet, Public Installation.............................
Water Closet, Private...,....,....,........,........,...............
I''!'iscellaneous:
1979 or before
1980
1981
1982
1983
1984
,
\
TOTAL FIXTURE UNITS
2
1
2
3
6
2
6
6
1
3
2
1 /Head
2
2
1
6
4
'2.
7
l
'-+
, \
If improvements occurred after annexation date in table,
- - --
- - --"
Rate per $1,000
Assessed Value
$2.16
1.90
1.60
0.25
0,87
0.50
0.16
"'l-q-f~
~
Rate per $1,000
Assessed Value
Year
Annexed
CREDIT CALCULATION TABLE: Based on assessed value.
\calCUlate cred~ts..:'.e~.-a.~~~___
Year
Annexed
I
.1
$2.83
2.76
2.71
2.60
2.46
2.33
1985
1986
1987
1988
1989
1990
1991
7..'b?:> X $ 10,<1-
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
=
= $ 2-q<l-3>
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