HomeMy WebLinkAboutPermit Building 1993-11-19
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
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LOCATION, OF PROPOSAq....,~~:;',? 9 J
ASSESSORS MAP' \' \~ )j'ck~~\
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LOT:
.
SPRINGFIELD
I
JOB NUMBER <17"3'//&> '3'
225 Fifth Street
Springfield, Oregon 97477
N, ((.oJe.Jt. (~Af' LiJ
BLOCK'
OWNER: l).,e.,.~<::. L..z:..iR...I.>....'L
ADDRESS:' (J7), D'C (J Il. ie...f..,.... Q 0
CITY' I? "'1 ~
DESCRIBE WORK:
NEW X
D,J P I~_~
REMODEL
ADDITION
v
STAT~'
oR
DEMOLISH
OTHER
TAX LOT:
\ \ \Nj
c.e..t:J~A-O~ P/kt...1l ~
SUBDIVISION:
PHONE:
7<-/7"': ~bqL
,"
ZIP:
Q7<-(OI
CON ST.
CONTRACTOR'
De/J.R.~c... '( fO i.,x, '---
~\cA~
CONTRACTOR'S NAME ADDRESS
GENERA" ..~.o.vv.r '" LAI2v...iL /(7 S
PLUMBING' ('\~Jll"" HA-((A,ri..tJ
MECHANICAL: (:,po,e 1 "- flA-Uj"~
ELECTRICAL:-...l;fAd'ok. ~A(,("-
C2,q4'L~
~
EXPIRES
S'$"3.c...(
\n.s.aA
PHONE
/-/J-", "( "p..S("ti
~.s.q5
\\\\\)0 - OFFICE USE -
QUAD AREA- LAND USE: \ \ ~() FLOOD PLAIN'
. OF BLDGS: L . OF UNITS' ~ ZONING CODE: _\J\.\)~
OCCY GROUP: R~\- \S\. CONSTR. TYPE:~) . OF BDRMS: \ ()
. OF STORIES: ~ HEAT SOURCE: \o\:\. SECONDARY HEAT:
.. SQUARE FOOTAGE:(~ \~
WATER HEATER: ? J RANG~' y.;
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 maele the following work day.
~ Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting (arms.
D
Under-slab Plumbingl Electricall
Mechanical - Prior to cover.
r-:::1l Footing - After trenches are
~ excavated.
D Masonry - ~teel location, bond
beams, groutIng.
rd, Foundation _ After forms are
l,Z:}erectcd but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
f":1f' Underlloor Plumbing I Mechanical
~_ Prior to Insulation or decking.
~ Post and Beam - Prior to floor
~ insulation or deckIng,
k-A Floor Insulation - Prior to
l.bJ. decking.
IQ\ Sanitary Sewer - Prior to filling
~renctl.
~ Storm Sewer - Prior to filling
Ll} trench. .
i'v"1 Wator L1no - Prior to filling
~ trench.
I'll Rough Plumbing - PrIor to
""""f".. cover.
REQUIRED INSPECTIONS
Ul Rough Mechanical - Prior to
~ cover. '
~ Rough Electrical - Prior to
L.,A< cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to facing
materials and framIng Insp.
)Q
Framing - Prior to cover.
.K7"l Wall/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taping.
D Wood Stove - After InstallatIon.
D Insert - After fireplace approval
,and installation of unit.
~ Curbcut & Approach - Aller
~ ferms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
I/.::t" excavation Is complete. forms
and sub.base material in place.
D Fence - When completed.
o Street Trees - When all required
trees arc planted.
V1 Final Plumbing - When all
~ plumbing work is complete.
~ Final Electrical - When all
~electrical work is complete.
WI Final Mechanical - When all
~mechanical work Is complete.
9Q Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Eleclrical Connection - When
blocking, set-up, and plumbing
inspectIons have been approved
and the home is connected to
the service panel.
D
Final - After all requi'red
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
)
Lot faces,
Lol Type
,
Selbacks
I :L, IHSE 'GAR'AC~
I S I
aE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Tolal height
Panhandle
ffiJ
Cul.de.sac
W
--
E
BUILDING P,ERMIT
SQ, FT.
~nlD
<\~~
X50Sh~
\<\..\0
VALUE
\~~~
_ \.o\\o~
ITEM
Main
Garage
Carport.
Total Value
I.Q,~_~\Q
,rxa..n,';lS
~S\
5~, \ \D
Building Permit Fee
.
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
.tJ q?<
(B) ~"21..'i5'7;, -
PLUMBING PERMIT
ITEM
FEE
Fixtures
N&'lQ.
~~t\cf) ,
Residential Bath(s)
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
0&0 ,cP
11o,oO
--5~\o t;O
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood ~ C\'.CO
, \~p.J
Vent Fan N'
Wood Stove/Insert/Fireplace Unit \O~
Dryer Vent &-..
Mechanical Permit c!J (I,OU
Issuance I () .CX)
State Surcharge _ \ .()S
-37-1,0:::5
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
, State Issuance
./"
State Surcharge'
Sidewalk \:...0<::)
Curbcul 3\.; It
\q,(~
\~~
It
Demolition
~\;~Z\'( ~ ~\)~D
Total Miscellaneous p\~~ (E)
,TOTAL AM~.UNT DUE (excluding electrical)4rlSt9,5~
(A, B, C, D, and E Combined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction stlall,in all respects, conform to the Ordinance
adoplcd by the Cily of Springfield, including the
Development Code, regulating the construction and use of
buildings. and mOlY be suspended or revoked at any time
upon violation of (In rovisi s of said ordinances.
Plan Check Fee: \.
"
Date Paid:
"
Receipt Number:
Received By:
//h7-. ~
Plan~ed By .
l~f~J
Systems Development Charge is due 'on all undeveloped
properties wittlin the City limits which are being improved.
ADDITIONAL COMMENTS
(" sA-\- \', \\ I ~~)
"~~\J2&~~' \L\\ ocr,
,
,
0\\'\ \:\~\rtQ..)~Oq o'Tq OD-
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b\ +52- ~ \JL
By signature, I stalc and agree, that I have carefu Iy 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 k
herein, and that NO OCCUPANCY will be made of any 0
structure wilhoul 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.
-0
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 f~ont
of the property, and the approved set of plans will remain
on the sile at all times during construction,
Signalu're / ____ - If ((I '.
Dale ~,_L:--'Cf - 13
VALIDATION: \ fY1!l (\
RECEIPT NUlf1ER" , 1..M1\.J
DATE PAID I . I Cf ,y" ~
AMOUNT REC~ ...~ U~ ' S\
RECEIVED BY Cl)l Dr'A... \ "
:.
I' '.. <cZii::I;'?;I.,I',
tl, ....>,.'.'
~fI !!..'!.i! I.!'.!!,l!!!!,!!~
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Job No. q~~
1.1.'
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: ~\\\\~ ~~~LUL.. PHONE: ,-aA3.5\oC\~
ADORES> W\'S ~'\\n:(\r ') Y\'('~QX\\). sTATe(;flLzlP ql)4t\(
LOCATION OF PROPOSED BUILDING SITE:
Street Address if Known: {oq 3 CO>\ loQ5 ill - (\1 C\\ '"\0 flQW
-, \1 ~
Tax Lot Number: \"Dj ~~~\ '\ \ \\'C)
Plat! Name: .G~\"f'Co j 1Y
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.>
A. Sinl!le Familv - Detached
Single Family home
_ Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT =
$
B, Sinl!le Familv - Attached
NO OF UNITS
c!),
X $370 PER UNIT =
$ Il\~ r;:D
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D, Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ 'II4\) ~
$ e5
$V14\) ~
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 Credit)
\ffi,J\~~h
Community Services ~i~ion
City of Springfield
\ \ / \ ~ I q~
Date
..
_B NO. 't?l7lJ?
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: jA,,,\E.S lA RuE:..
LOCATION: Co"l '? zl. "''TS fJ, (iL-o",E.e L-E:At=- LP.
DEVELOPMENT TYPE: \..0\2.. - t--ie:W \:)uPL-E:..)(
\IO?'?'2..."?\ -11\00
NO OF UNITS X TRIP RATE X COST PER TRIP
-z.
X \.0 'I X $424.31
~?'110:)
'- --
$
X X $424.31
X
X $424.31
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S ''3'2. x $15.125 PER PFU + $10 MWMC ADM FEE $ y.'1L-l-~~
(Use PFU Total From Item 2 Above)
$ c.-: "'~
MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~~
TOTAL-MWMC SDC ~ .
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ '~\'?1 ~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~ ,L~ \1/n/'1'?:J
<J Kip Burdick "
SDC Coordinator
~
"1~
TOTAL SDC $ .?'Z-~? -
FIXTURE .UNIT ,CALCU LA"'T ABLE: Number of New Fixtures ~uivalent = 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/Oll/Sollds/Etc.,....,...,..,..,
Interceptors For Sand/Auto Wash/Etc..."....,...,...,
Laundry Tub /Ootheswasher, ....,.. ...,.., ".......,.....,....
Ootheswa~her . 3 Or More.."....."...,......,...........,..,
Mobile 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 Ooset, Public Installation..,..,....,..."....,.....,..
Water Ooset, Private..,.....,..."...........,........,...."......
Miscellaneous:
'1.
2
1
2
3
6
2
6
6
1
3
2
I/Head
2
2
1
6
4
7.
'Z.
I.\-
4-
TOTAL FIXTURE UNITS
4
4
'-\-
4-
\lD
?'z..
Based on assessed value. If improvements occurred after annexation date in table,
CREDIT CALCUUl.TION TABLE:
calculate credits separates.
II
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
'I
Rate per $1,000
Assessed Value
S 2.24
1.93
1.57
1.18
0.79
0.44
0,28
Credit for Parcel or Land Only If Applicable '3 .'2..\ X $ \I ,"2;.'7 S 'S ~.8
(Rate X Assessed Value)
Improvement (rt after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ <?'? ~
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