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Home My WebLink AboutPermit Miscellaneous 1999-9-17 ~Jljf"'J0+ -PkLtl/cr:..J 4,;./.4AE".4HONE:-Z.Z%. , A ;_":l! I) 2-19 ~A!//~; ,'-t;>- 5=;"'P'A STATE:',1jf ,;. , - RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' /7t:!7? ASSESSORS MAP' LOT' OWNER: ~.C< ..J,.. y ADDRESS' CITY: ,~' / / 2reJ 2-7 F7f-/"e 1// /f:u 7 . 3 / BLOCK' DESCRIBE WORK: //-!....d. ,rC----=- /rj-# NEW ~ REMODEL ADDITION JOB NUMBER 99//0 '7 225 Firth Street .Sprlnglleld, Oregon 97477 #- set TAX LOT' C)Qc:::., t!!'7-r> SUBDIVISION' -;F<;:9'.,o:f ZIP: To d{~~ ~~ ..-f~. ~~4 CONST. CONTRACTOR # JQ#c7",f." C':/Oc.( < /.2/773 /;;P'I 09 C'-?_ = J 'd,J~ _ 1J ed.J-c' (:(/11 r, ~ --o,>h5 ~ DEMOLISH OTHER CONTRACTOR'S NAME ADDRESS GENERAt.(U" lc.t //'''1'~ to/.J?, lo11e;(" I)' J PLUMBING: ~O~ ;t.~~_/~ (( {T MECHANICAl' ELECTRICAL: I, I I I' EXPIRES .,., PHONE - OFFICE USE - QUAD AREA' LAND USE: FLOOD PLAIN' # OF BLDG'" , # OF UNITS: ZONING CODE: OCCY GROUP: CONSTR. TYPE: # OF BDRMS: # OF STORIES' HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RAN"GE: SQUARE FOOTAGE: 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 s,ama working day. Inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS D Temporary Electric D Site Inspection - To be mado after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. D Footing - After trenches are excavated. D Masonry - Steel location'. bond beams, grouting. D Foundation - After forms are erected but prIor to concrete placement. D Underground Plumbing - Prior to filling trench. D Underlloor PlumbIng/Mechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to deckl ng. D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to HllIng trench. D Water Line - Prior to filling trench. D Rough Plumbing - Prior to cover. D Rough Mechanical - Prior to cover. D Rough ElectrIcal - Prior to cover. ~lectrlcal Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D WalllCelllng Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stovo - After Installation. D Insert - Alter fireplace approv~1 and Installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Drlvewav - Alter excavation Is complete, forms and.sub-base material In place. D Fence - When corilpleted. " D Street Trees - When all required trees are planted. . D Ftnal Plumbing - When all plumbing worl< Is complet,e. D Final Electrical - When all . electrical work Is complete. D Final Mechanical - When all mechanical work Is complete. D Final Bulldtng - When all required Inspections have been approved end building Is completed. D Other MOBILE HOME INSPECTIONS lVf BlockIng and Set.Up - When all ~Iocklng Is complete. , ~p~umblng Connections - When ~ome has been connected to water and sewer; ~Iectrlcal Connection - When ~Ocklng. set.up. end plumbing .. Inspections have been approved and the home Is connected to the service panel. ~Flnal - Alter all required Inspections are approved and arches, skirting, decks, and venting have been Installed. ( Lot faces Lot Type Lot sq. Itg. Interior Lot coverage Corner Topography Total height " Panhandle Cul.de-sac BUILDING PERMIT' "~ ITEM X $/SO. FT. = sa. FT. Main Garage Carport Total Value Building Permi t Fee State Surcharge Total Fcc (A) . 0'.' . .: :,;:,: t~~ \H:.~:' . IS THE PROPOSED WORK IN THE. ""HISTORICAL DISTRICT. OR ON 'THE HISTORICAl. REGISTER? , . Setbacks . IHSE'GARlACdl I PL. IN Is Iw IE VALUE " J' SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary S~wer Water FT. FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsertlFlreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge 7. Z J 1- ~ / S- Sidewalk It Curbcut It Demolition State Surcharge J?-fp + , $4- r"'./7l( .J~~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) lA, B, C, 0, and E yomblned)Sti:f auJO . FEE /I"'J c;- 30 /0,>0 ..J. fh p~ I. $> () /57, .2(i> ~.~~ 3 )~.S'~ '11:.. H) ~ In Z,SOb If yes, this applldatlon must be signed and approved, by the Historical , Coordinator prlot to permit Issuance. APPROVED' BUILDING V'ALtJE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express cc;>ndltlon 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 C'~,eck Fee" Date Paid: Receipt Number: Rec:c~ W/~ PlaM'ReVleW~1 9/r/?? IDate Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS V(5r(/~ )M?ofj,77tJJ<.J f Sf, /....'1 ",j..6t.,) CUU-;#~ I,e; ,4A)V pdt. ~ s-m; <;'~ 8/ n,{Up~ ~~~~ . , , ~~~ ~fPJd /JJiJ(1//HT ).~ Re,ptl/A'a)~ .~,l}'f:I: By signature, I state and agree, that I have carefully examined the completed ~ppllcatlon 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 perlalnlng to Ihe work described herein. and thai 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 property, and the approved set of plans will remain on the s~lte at all tlmZ2ctlon. Slgnatur .:;.,...00-...... f. _ . , >' Dat..--f".....- ./ r:: ~ 9'"9 VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED ~ ~ <:;"''9 r q//; /5'<} ~ ld 2... ?"b -~- T RECEIVEO BY 1 . JOURNeoRJOBNO. c:;q11~9 . ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME OR COMPANY: ;j"M'ES AME'/l.'CA LOCATION: 1120 FA /~ vd;...<../ DEVELOPMENT TYPE: REP<ACe f;"I<"- {',,_,,'w"',..,. 81...D ",,/1-1.14. BUILDING SIZE: 1. STORM DRAINAGE LOT SIZE rJ~w A,oIt.cr.q OLO A~ M~ 2G..lt'-'f.':' 1,'+4- ~o 211)"31: I,/~I 1>/1...> r2...,rz.'r ~ SlED Ioy~ , CO"'" 1,1-++ ~"J.z. 3 , wE......'U...,= '.t"S'f. SQ.Ft. IMPERVIOUS SQ. FT. 2/'1: X $0.232 PER SQ. FT. $ 4<1.42.> 2. SANITARY SEWER-CITY NO. OF PFU'S 2- (See Reverse Side) X $48.27 PER PFU $ qc. . ?4- 3. TRANSPORTATION NO OF UNITS X TRIP RA IE X COST PER PM PEAK. HOUR TRIP X X $486.73 PER TRIP $ e- X X $486.7,3 PER TRIP S 4. SANITARY SEWER-MWMC A. REIMBURSEMENT COST: NO. OF FEU'S X PER FEU $ e- , B. IMPROVEMENT COST: NO. OF FEU'S X PER FEU $ r1" --- MWMC CREDIT IF APPLICABLE (SEE REVERSE) <$ > MWMC ADMINISTRATIVE FEE $ 10.00 TOT AL-MWMC SDC $ 0 SUBTOTAL (ADD ITEMS 1,2,3 &4) $ /4<;;. "Ie,. 5. ADMINISTRATIVE FEES: BASE C~ (SUBTOTAL ABOVE) X .05 $ 7.~o L . ...-". Date: 8 - ;x,..qq SDC Coordinator :rOTALSDC $ I ~3. z.1P ATTACH'A.WPD r; FIXTURE UNIT CALCULATION TABLE: NurnberofNewFixture~UnitEquivalent=FixtureUnits (NOTE: For remodels. calculate only the NETeional fixtures) . NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS tI"..... I OLD Ilff.; ~ Bathtub...................................................................... Z = , 2 ~ Drinking Fountain..................................................... I 1 Floor Drain................................................................ I 2 Interceptors For Grease/OiIlSolidslEtc..................... I 3 Interceptors For Sand/Auto WashlEtc...................... I 6 Laundry Tub/ClotheswasherlMop Sink...........:........ I I ~ <> 2 Clotheswasher - 3 Or More...................................... I 6 Mobile Home Park Trap (1 Per Trailer)................... 6 Receptor For Refrigeralor/Water Station/Etc........... 1 Receptor For Commercial SinklDishwasherlEtc...... 3 Shower, Single Stall...........,..................................... 2 Shower, Gang....... .......... ....... ............. ............. ......... IlHead Sink: Bar, Commercial, Residential Kitchen............ =0 2 Urinal, StalllWall...................................................... 2 Wash Basin/Lavatory, Single................................... '2. z ~o 1 Toilet, Public Installation......................................... 6 Toilet, Private.......................................................... 'Z. "2. ~ v 4 Miscellaneous: TOTAL FIXTURE UNITS Z- CREDIT CALCULATION TABLE: Based on assessed value. credits separately. r- If improvements occurred after annexation date in table, calculate Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1 ,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 $4.47 4.38 4.32 4.20 4.03 3.88 3.68 3.38 3.03 2.62 1989 1990 . 1991 1992 1993 1994 1995 1996 1997 1998 2.18 ' 1.75 1.35 1.17 1.03 0.86 0.71 0.57 0.39 0.18 Credit for Parcel or Land Only If Applicable X $ (Rate X Assessed Value) Improvement (if after annexation date) X $ (Rate X Assessed Value) CREDIT TOTAL = $ RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) Residential........................... 0.4 Commerical......................... 0.9 Industria!.............................. 0.5 Governmental...................... 0.5 FIXUNIT. WPD IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT