HomeMy WebLinkAboutPermit Building 1994-9-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726,3769
Office: 726,3759
~ ~ qq 1./ Lji)
JOB NUMB~R "3_"":'~ 71 /
225 Fifth Street m
Springfield, Oregon t;477
, '---
<1<.. /"'6~~g-A'~' ,. --'~ .
- TAX LOT: \D\()()
SUBDIVISION: ~A7~~ ,;::1.. .'- f/2:.
'.
, I
LOCATION OF PROPOSED '1)RK: ,:;:,~"'9~
ASSESSORS MAP' \ D 3M4~
LO;' If)
.hJ
BLOC\<'
OWNER: ~~-r ??~7.)~-1': ""
ADDRE~:"~~<p, >- r1fV\~ )\~
CITY: ...."f\l\ 1. N'\\-~oQ1i)
DESCRIBE :ORK' Lt.'\{ 1 N Q }.J I
NEW '-IJ REMODEL A\DITIO: "
/
- PHONE:
:.~:~ J\lIn
, DEMOLISH
OTHER
2j\?1 . \ o'lIYL
ZIP:
C{I~
CONTRACTOR'S NAME
GENERAL: (A--r~ ~~-,.; ~
PLUMBING: ~~.c::; , ,-
MECHANICAl' Pv~'-:>T
...,.,. ~
ELECTRICAL: _ tf4r~ i"-/'Ac7';
CONST,
ADDRESS ..... ~~ AisONTRACTOR # EXPIRES PHONE
~~~~S:- ~8?/t:~-~S ~~::~~
... ',~~()\lo d.~,q,~ Lo~',~K<::,
n~l-:J \ _ \ ,ex ,Lt.~ < ~<)?,. fQ?02/
. -,'~--,~. \ \.. \?r9f ~,:yA.? ~
FLOOD PLAIN:
ZONING CODE: ~
# OF BDRMS: ,')+ ~
SECONDARY HEAT: C3
SQUAjlE.EQ,OIf,GE:f'-Q/olto
( I.....nc;;.z.,."~
To request an Inspection, you must call 726,3769, This Is a 24 hour recording, All Inspections requested before 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 8.m. '-."'111 be made the followIng work day.
QUAD AREA: \\U\)~l..)
\
OCCY GROUP: ~~ N\
8.
# OF BLDGS'
# OF STORIES:
WATER HEATER:_L
o Te":lporary Electric
.... .
;..l, Site Inspection - To be made
P after excavation, but prior to
V~~~\\rm~
o Undersla~IUmblng/ Electrlcall
Mechanical - Prior to cover.
~otlng - After trenches are
9'\ ;~cavated.
o Meaonry - Steel location, bond
.beams, grouting.
N-, Foundation - After forms are
~ erected but prior to concrete
placement.
o Undarground Plumbing - Prior
to filling trench,
~nderlloor Plumbing/Mechanical
~,prlor to Insulation or decking.
~08t and 8eam - Prior to floor
ILi ;nsuletlon or decking,
~ Floor Insulation - Prior to
~deCklng,
aSi Sanitary Sawer - Prior to filling
~ trench.
!i:J Storm Sewer - Prior to filling
G trench.
~,~ter Line - Prior to filling
nch.
Ro~gh Plumbing - Prior to
cover.
- OFFICE USJ,,-
LAND USE: \ \ ~U
# OF UNITS: '~. I
CONSTR. TYPE: ,i I\..J
HEAT SOURCE: \0~
y"...
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical"":' Prior to
cover. .
~ Rough'Electrlcal - Prior. to
T cover.
fElectrlca, Service - Must be
approved to obtain permanent
electrical power, ,
o Fireplace - Prior to facing
materials and framing Insp.
Framing - Prlor'to cover.
Wall/Cefllng Insulation - Prior to
cover.
"R- Drywall - Prior to taping,
b Wood Stove - After I~stallatlon.
o Inaert - After fireplace epproval
and Installation of unit.
;zicurbcut & Approach - After
forms are erected but prior to
placement of concrete.
~Idewalk & Driveway - After
xcavatlon IS complete, forms
and sub.base material In place.
o Fen~e - When com~leted.
o ..Street Trees - When all required
trees are planted.
'5(j Final Plumbing - When all
I .- plumbing w9rk Is complete.
Final Electrical - When all
electrical work Is complete.
Flnat Mechanical - When all
mechanical work Is complete.
~Flnal Building - When all
required Inspections have been
approved and building Is
completed.
o Othar
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 approvod
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.
Setbacks,
HSE GAR ACC'
'IS THEPROPOSED WOR'K tN THE, '
""HISTORICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
'1
Lot faces
L~t:~yP.
,'. '"...' '. ..... , .; .... ~~.-' -'," ....,. .'
"~.' >' -'-'1"" ';'I'-"::.l".j 1 ~~ ".J"l.t!}J: ~f,-.'-,
:':T~~:! '~:', :: ., '.'''" - >~:" ;;"~::~~.i\,..;' :.
3fiGW (lll.11J"6no J o'.rjiLinJLO
\ <l+T. \\I'\rxJ
~~ {\~ :< ITili.:>" \q \ ()~
- - --..............
_ Interior . PP.L.
V "IN
~ Corner
P h 'I Is
Topography _ an ana e
J\f1/ . I W
Total height C)I....L' _ Cul,de,sac I
\4'" ~r\ 1\0" JtilM:f'l E
, Lot sq, f1g,~ ~
_-'" ~,-~"., '.f 1 ~
Ie .L~t cov~ra~e 01_
BUILDING PERMIT
::i: ,~fjk
Garage I }
'&JD" d;~~
\~.\O" "
Carport
Total Value I~
Building Permit Fee~~ ,A....~
Slale Surcharge \,,\q '5T~ ~ \: . .IJ,;q.1<:.lJ;
(A)' 5oK\ \
Tolal Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
, (B) ~ .3 'IS9. ?!
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Balh(s)
~'i~
Sanitary Sewer'
FT,
FT,
Water
Storm"Sewer
FT,
Mobile Home
Plumbing Permit
~O,CV'
llQ.CClrq.toO c4 S (..of)
3'\ n; .l.{)
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
'1.00
I {l,OO
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
'J.tJ .CD
Mechanical Permit
c91,Q)
( (}(X)
d;. II f)
09,llQ
Issuance
,~IT 1.3.5
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge "'\
Sidewalk -' {j?(./ It
Curbcut -.3( Q It
1]/\ 00
,,-1'1.
15 .'1'0
Demolition
~X\ui\:~~:")'o u "')
..?A?J .<6(P
Tolal Miscellaneous Permits (E)
TOTA~ AMOUNT DUE (excluding electrical) ",\\f.:)~ ~I()
(A, B, C, D, and E Combined)
I
I
I APPROVED:'
BUILDING VALUE, PLAN CHECK
AND' BUILDING PERMIT
This permllls granted,on the express condition that the said
construction shall, In all "respects. conform to the Ordinance
adopted by the Clly of Springfield, Including the
Development Code, regulating the construction and use 01
buildings, and may' be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
~~i.:"d By:
, \.,.)\)\ \ \'t.~' . \ \J
Plans Revlllwed By
,
Systems Development Charge 15 due on all undeveloped
properties within the City limits which are being Improved,
,6'3L~
ADDITIONAL COMMENTS
~€ ~ .k~Y//9o
Y'
\, (J) 9 MJ\1 tl'1 ~ '- \. Wvt
\: ~~_\\J\Of'-\ \ ' ,
By signature, I state and agree, that I have carelully 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 ollhe City of Springfield. and the Laws
01 the State of Oregon perlainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Salely Division,
( 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 15 readable
from the street, that the permit card 15 located at the front
~f he property, and the approved set of plans will remain
o the site at all times during construction. ,
S nature P_ 4 d~
. . _-w--- -- ./'
Date '7- ;L~.7
RECEIVED BY
r/ ;;-=':'::;:C,o,.". ',',
~/ .... ....
.
ATTACHMENT B1 .' . NO. .22//4/
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIOENTIAL)
twlE OR COMPANY: ~Lf J31./rv:-
UX:ATION: 2. :jq/ ~ ;;'/"1-93 /~ .;2~
?' '
DEVELOPMENT TYPE' I)./,/~-<:, '
BUILDING SIZE: LOT SIZF'
1. ,STORM nR~INAGE
,IMPERVIOUS SQ. FT.
J,-4-.fo
X SO.209 PER SQ, FT.
2. SAtilIARY SFWFR-c:ITY
NO,. OF PFU' S ,2. x / C:>
(See Reverse)
3. IMNSPORTlliOO.
NO OF UNITS X TRIP RATE X COST PER TRIP
:L X /,0/ X S436.19
X S43.26 PER PFU
X
X
X S436.19
X S436.19
s
SUSTOT AL (ADD ITEMS 1. 2, & 3) s 2 11S",;J ~
~
o
SQ. Ft.
S S09'. '76
S /3K'4,J:z.
S 0(3"/./0
$
4. SAtllIARY SFWFR-MWMr,
NO. OF PFU'S ~Ic. x $17,19 PER PFU + $10 HWMC ADMIN.FEE S S"c,o,o'i1
(Use PFU Total From Item 2 Pbove)
HWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 40, i/?
IQIAI -MWMf. Sl)C ~ ,n 'l.t:."
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ ;S2.9~ 9 r
5~ 'hOMTNISTATTVF FFF~
BASE ,GHARGE ~SUBT ABOVE) X .05
~~ h ' '
/0~ /-fe '. ,Date: tr-/~-.,.~
~ Har~ Hornig, P.~
SDc"Ctlordinator
IQIAI snr.
B2,SDC .
1> /,,~, 7:'-
S 3f,-r. 73
FIXTURE UNIT CALCUL.aON TABLE: Number. of New F,ixt. X 'Unit Equivalent c Fixture Units
(NOTE: For. r.emodels, calculate only i'IIr !'LEI additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub..................,..,.,..,............................,............. .
Drinking Fountain..........,...,.,.....,....,.,.,........,............
Floor. Dr.ain...,..................................,...,.,......,......,.....
Inter.ceptor.s For. Gr.ease/Oil/Solids/Etc.................
Inter.ceptors For. Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher..,.,.......................,.......
Clotheswasher.. 3 Or. More.....................................
Mobile Home Park Trap 11 Per. Tr.ailer).....,............
Receptor. For Refr.iger.ator.lWater. Station/Etc........
Receptor For Commercial, Sink/Dishwasher/Etc..
Shower., Single StalL.................:..............................
Shower., Gang..............,.............,.........,...................
Sink: Bar., Commercial, Residential Kitchen........................
Urinal, StaIlIWall..:................,.....".,.......,.,............,...
Wash BasinlLavatory, Single..................................
Toilet, Public Installation.,.,..,.... .,.,..........,.... ......'...
Toilet, Private..........,........,........,.,...........,............
Miscellaneous:
I
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
/
/
z
2.
TOTAL FIXTURE UNITS
=
2..
z.
'Z.
-:z.
~
,2-"/0
Based on assessed value. 1/ improvements occur.r.ed after annexation date in table,
I
Rate per $1 ,000 -,
Assessed Value
$2.46
'2.14
1.77
1.37
0.97
0.61
0.44
0.15
= #J,4F
= ---
CREDIT CALCULATION TABLE:
calculate credits separates,
I
Rate per. $1,000
Assessed Value
Year.
Annexed
Year
Annexed
1979 or. before
1980
1981
1982
1983
1~84
1985
$3.46
3.38
3.32
3.21
3.06
,2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
Cr.edit for Par.cel or Land Only 1/ Applicable
3, -It;, X $ I/. ro-e>
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
lmpr.o,vement (if alter annexation date)
CREDIT TOTAL = $ 40, fl'F
.
.
~m
o Y.'!inl!m:!!~!!!:;
JObNO.~
NAME~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
it\_~~~
f)~~L~~
PHONE: ~~~.\o'20lc
STATE:~IP ~
ADDRESS:
LOCATION OF ~~OPOSED ~I~~~ SITE:f\f)t1...3 JD I ,- '
, , Street Address If Known: I ~ rl-/. ~op
Platt Name: ~Jl Tax Lot Number: 12n?>AI113 Cf)1{)O
1. DEVELOPMENT TYPE (Check appropriate dwellingls). SDC Calculations and dwelling type
definitions are on the back,)
A. Simile Familv - Detached
Single Family home
_ Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT ?,
$
B, Single Familv - Attached
NO OF UNITS
&
X $370 PER UNIT =
, $!J40 r;x:;
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ fJ40.DO
$a!
$ fJ4{) rn
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)
~"i~~~i9
City of Springfield
-fL "
Date -l ,!11-