HomeMy WebLinkAboutPermit Building 1994-3-4
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"RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
7<7<'
SPRINGFIELD
BLOCK'
OWNER'
~A\.v\~S 6. L.A-I2u. ,E
!(7f: Oe612fcle 12{)
CONTRACTOR'S NAME
:\A~ 8.LAf>\AlL
r:.., fI""tCL A--rf A..0 ~J';"""I1, ~" C]
MECHANICA" C, flA((A-rfA-AJ Il\J"'-~''-1.,~
ELECTRICAL: /14':''-, ~ .J.-)-f4---~c.d... d:VJr_
ADDRESS'
n,IO
.t:-- I
e.,..." ..P
CITY'
DESCRIBE WORt<'.
NEW X
A.J ~0
REMODEL
GENERAl'
PLUMBING:
QUAD AREA \ Q '\ l[0
. OF BLDGS:
OCCY GROUP: ~ ~-1- JJ\..
. OF STORIES: ~
V
WATER HEATER'
STAT':'
612...
.-
SF' ~"Io
JOB NUMBER q40~Q3
225 Fifth Street
Springfield, Oregon 97477
{).j {J I <<:. -.,.c
ADDITION
DEMOLISH
QTHER
t.,P :sjJ.eIl'/Cj~tle'~ de..
TAX LOL~-=<J..-r:J
SUBDIVISION: (:, R,A".) IO.~ fi;!4;~ 11. .
PHON':'
':?'IJ -sr;9~
ADDRESS
CONST.
CONTRACTOR'
-(ss~\{
6b4m
~qL\~~
'=--
ZIP: C(7-101
PHONE
] ,/1- {, (?:.-~
n~,
3SCf4 '~
EXPIRES
/-/('1':>
\ n ,SCl4-.
FLOOD PLAIN'
ZONING CODE: M ()lC..J
\ tJ
SECONDARY HEAT: -'r;;:f
SQUARE FOOTAGE: 6H~
. OF BDRMS:
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. Inspectlons 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/Electrical/
Mechanical - Prior to cover.
Wooting - After trenches are
~excavated.
D Masonry - Steel location, bond
beams, grouting.
f Foundation - After forms are
. erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
m Underlleor Plumbing/Mechanical
r - Prior to Insulation or decking.
'i.;6i Post and Beam - Prior to floor
( Insulation or decking.
~ Floor Insulation - PrIor to
t /' deckIng. I .
r:;tY Sanitary Sewer - Prlor'to filling
\ trench.
J"""'A'Storm Se~er - Prior to ~lIl1ng
{trenCh, . .
;zywater Line - Prior to filling
trench. .
'["/ij Rough Plumbing - Prior to
(' cov~~.
- OFFIC~ u~ -
LAND USE: \ \ ~. ( )
. OF UNITS: II ,
CONSTR, T.YPE: ---.1lAJ
HEAT SOURCE: \ I.JH.
~~
RANG':'
REQUIRED INSPECTIONS
\r"'t1 Rough Mechanical - Prior to
~ cove~ .
.g Rough Electrical - PrIor to'
cover.
? Electrical Service - Must be
approved to obtain permanent
electrical power. .
C-' Fireplace - Prior to facing
,..;-.J materials and framing Insp.
~ Framing - Prior to cover.
'~wall/Celling Insulation - Prior to
~ cover.
P Drywall - Prior to taping.
o Wood Stove - After l~stallat'lon.
o Insert - After fireplace approval
'. and Installation of unit.
~ Curbcut & Approach - After
P forms are erected but prior to
. placement of concrete.
~ Sidewalk & Driveway - After
( excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
en Street Trees - When all required
~ trees are planted.
r::i? Final Plumbing - When all
( plumbing work Is complete,
~ Final Electrical - When all
r electrical work Is complete.
~ Final Mechanical - When all
( mechanical work Is complete.
p
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 Plu~bing 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 l.....,I.E PROPOSED WORK IN THE .....
Lot sq. ftg. X Interior I PL. HSE GAR Accl HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER,'?
Lot coverage Corner N If yes, this application must be signed
S I and approved by the HistorIcal
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height ~ Cul-<;je-sac.
IE \I I
fi-'6 ' APPROVED'
BUILDING PERMIT
::1: SQ. FT. X $/S~:!h ~ 0
.~~,IO~
Garage
Carport
Total Value
t~''4
,. '... c:
.,CU
~,~,ILo
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHAR~E (SDC) th
, 91 R'?
(B) 3'Z-~z..-
PLUMBING PERMIT
ITEM
FEE
FIxtures
N,IJ'i. Q
PrJO,W
Residential Bath(s)
Sanitary Sewer
FT,
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
(~()%
((0. r_\
33lD,c()
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
q.CD
I A .00
Exhaust Hood
cO
N' ~
Vent Fan
Wood Stovellnsert/Flreplace Unit
I 0 .CO
U6
(Jf) ,
/C).O{j
1.,-~5
3 b.oS
Dryer Vent
c9-,
MechanIcal Permit
I
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State surchf1~
Sidewalk It
Curbcut ~ It
Demolition
{J\ ,0.~
-' c~,l cO
~~S~h0r_~
Total Mlscellaneous~ts (E)
TOTAL AMOUNT DUE (excluding electrical) ~~~
(A, B, C, D, and E Combined) I
4f) ,cD
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 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:
Da;e Paid: - ~C7J.' ~)
Receipt Number:_t~ ~\B\)J
i1i\~~ ~
Plans Reviewed ~y..' ..
/
A J~3 qf
Date
,Systems Development.Charge.l~ due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
'"....
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By signature, I state and agree, that I have carefully exallned
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 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 site at all times during construction.
SlgnaturY ~ _ . ,/$ _/ J-,
Date K \-{ Q. 4
o
VALIDATION: . \ l ~ '
RECEIPT NUMBEf . ..~~ __.. ':_
DATE PAID _ 0_'.. c::1. _;.. " _
AMOUNTR~l~_ ="1 ~~ , ~
RECEIVED BY ~ ./ ,~}~
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.OB NO. qL/-o1-Z~
CITY OF SPRINGFIELO SYSTEMS OEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: TAMes -B. LA1CuE-
- -
LOCATION: 057i ",6'1 AI. (!LIVf:Uf3.A:J;:. Lt>oP
DEVELOPMENT TYPE: LPje. - New [)tJPLf.X
0'3300
/7o'?'1-7.-? j - fIn 2[')
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SIZE
.SQ. Ft.
t-,?q?..-
X $0.203 PER SQ. FT. CLf55~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
3'2..
, X $42.08 PER PFU
~?<f0 ~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
4. SANITARY SEWER-MWM~'
NO. OF PFU'S ~z.. x $15.125 PER PFU + $10 MWMC ADM FEE $ LfC(~'~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 55 G~
TOTAL-MWM~ SDC ~
~.J,-,,- /1
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ '~I--z..&:>.~
X $424.31
~%i}..)
~,--B .-/
$
$
'2_
X 1.01 X $424.31
X X $424.31
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~b1 2/1-~.h1
SDC Coordinator
~ / '5 (.;~J:)
'- ../
8CJ
TOTAL SDC $ 31-13'2 -
FIXTU RE UNIT ,CALCU LA T.... TABLE: Numb~r of New Fixtures X ~EQuivalent = Fixture Units (NOTE:
For remodels, calculate only the NET a-':onal fixtures) . ...
. NUMBER OF UNIT FIXTURE .
FIXTURE TYpE NEW FIXTURES EOUIVALENT UNITS
Bathtub.........,... .....,...............,..,....."...,.......,...,..,.."..
Drinking Fountain..,.......,......."......,...,...,.......'...'......
Roor Drain...,..,. .....,....,.......,.......,...,........,.. ...."..,.....
Interceptors For Grease/Oil/Sollds/Etc..,.....,..,.....
Interceptors For Sand/Auto Wash/Etc,.........,..,....
laundry Tub /Clotheswasher.....,..., ,....,.., ....,...,... ,..,
Clotheswa~her - 3 Or More...,.."...,...,..."......,.........
Mob"e Home Park Trap (1 Per Trailer)..,.......,.......
Receptor F9r RefrigeratorjWater Station/Etc"..,...
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single .Stall.......,....., ,. .,..... ...................".....
Shower, Gang...............,.."...,..............,....................
Sink, Bar, CommerciaL,...,.......,.........,.........,.........
Urinal, StalljWall.....",..................,."..".......,......,.....,
Wash Basin/lavatory, Single..,......,......."...,...........
Water Closet, Public Installation......"....,...............,
Water Closet, Private...............,..,.......,...........,......,.
Miscellaneous:
L.
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
"7-
"Z.
J..
<-I-
TOTAL FIXTURE UNITS
.f
4-
<l--
'-f
(0
3'2.-
Based on assessed value. If improvements occurred after annexation date in table,
Rate per $1,000
Assessed Value
$ 2.24
1.93
1.57
1.1B
0,79
0.44
0.28
Credtt for Parcel or Land Only 11 Applicable '3......., X $ , I , 3 S 55 (.,<1
(Rate X Assessed Value)
Improvement (If after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = $ S6 &3...
CREDIT CALCULATION TABLE:
calculate credtts separates.
I
I
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
1985
Year
Annexed
Rate per $1,000
Assessed Value
$3.21
3,13
3.08
2.96
2.82
2,68
2,51
1986
1987
1988
1989
1990
1991
1992
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL,......,..........."..,........,........,........... 0.4
CommerciaL..........,..,.............,....................... 0.9
IndustriaL..,........",......,..,...,..,...,.............,...".. 0,45
Governmental....,...,.......,.,...................,.........,.. 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
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.
Job No. C\4 ~Q~
NAME:
SYSTEMS DEVELOPMENT CHARGE
~ J . WORKSHEET
~ ruOJ\ ~ ~ 1LQ j PHONE: ~~ ,~\ta
\\0<:J ~j'~~ I Yl)~ STATE:~ZIP q74D(
ADDRESS:
LOCATION OF PROPOSED/3UILDING SI~E: rV n (\ \ \
Street Address if Known: \ o~f) -t \()~\ .J\ . \.:....\ l\l ') <Lr'l 0 [)
Platt Name: G(Of\n rill .J- Tax Lot Number: \t\ f\'\ 'd.. Q4Q
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back'>
A. SinQle Familv - Detached
Single Family home
_ Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT =
$
6, SinQle Familv - Attached
NO OF UNITS
c9.
X $370 PER UNIT =
$ '740 ~
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ Jt4D ,CO
$0'
$~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~"!,~~~
City of Springfield
. :~4 ~1~
Date