HomeMy WebLinkAboutPermit Building 1994-8-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
.
ASSESSORS MAP'
LOT: '~,'
LOCATION OF PROPOSED WORK'
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OWNER,-')Q~\Il\ ',v. l1.~Uv
ADDRESS: ' : r")" So ~)f.I,rJ.
CITY: CGH I w;: t.~-V
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DESCRIBE WORK: li'})Ia1. \Al~cU i~~: \
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL: Mr)\~t..
PLUMBING: L1\Lr-.\- ~tllw'a.i,'4
MECHANICAl: /1 It
ELECTRICA" f...fJv.) \) (j nil ~
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BLOCK'
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CL./'Z.1
JOB NUMB~R!J1lL1J 0
225 Fifth Street
Springfield, Oregon 97477
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STATF'
DEMOLISH
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OTHER
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TAX LOT: IOO;)O!!/ /(')0):20
~ \...,+ 0+ ~~.". 0" n
SWDIVISION: '3q)('I~ . c.lll
PHONE: 7Uj ~ <12//
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ZIP: (j)C/) ')
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ADDRESS' .
'f-o CmAhrJ ~,
CONST, '
, CONTRACTOR'
frl-l/J-D
PHONE
7t-f74JIL
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EXPIRES
1,- 9C,-
,
- OFFICE USE -
QUAD AREA: ~~ , LAND, USE: 1/'2... C) FLOOD PLAIN'
0 . OF BLDGS: / . OF UNITS' :2. ZONING CODE: ~
OCCY GROUP: ' /f:'7},':~#1 CONSTR. TYPE: VN . OF BDRMS'
· OF STORIES: " I HE~T SOURCE: .E. U( SECONDARY HEAT:
W~~ER '~EATER:-----F RAt'lG;=' E SQUARE FOOTAGE:
"
To request an Inspection, you mu'st'cafl726.3769, This Is a 24 hour recording, All Inspections requested before 7:00 a,m, will be
made the same working day. inspections requ~sted ~fter 7:00 a.m. will be made the followIng work day: '
- . '"""." REQUIRED INSPECTIONS,
~e"-'~o,ra,y E;';c;rIC
O Site Inspection - To be made
after excavation, but prior t
settln9r{orY'T~~A ~ .
~nderS~Electrlcal/
Mechanical - Prior .n\l~r:
~Footlng - After trenches are
~ ~xcavated. .
o Masonry - Steel location, bond
beams, grouting,
O Foundation - After forms are
erected. but prior to'concrete
placement.
o Undarground Plumbing - Prior
to flfllng trench,
o Underlloor Plumbing/Mechanical
-,Prior to Insulation or decking,
o Post and Beam - Prior to floor
Insulation or decking.
O Floor Insulation - Prior to
decking,
[Lt] Sanitary Sewer - Prior to filling
trench.
[Xl Storm Sewer - Prior to filling
trench. .
rl/l Water Line - Prior to filling
~ trench.
o Rough Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
_ cover.
o Rough'Electrlcal - Prior-to
cover.
o Electrlca' Service - Must be
approved to obtain permanent
electrical. power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Cefllng Insulation - Prior to
cover. '
o Drywall - Prior to taping,
o Final Plumbing - When all
plumbIng w9rk is complet.e.
D 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.
I.KI Othar 47E' ~~/~
(~?" ~RfP lb~# ~
MOBILE HOME INSPECTIONS
o Wood Stove - After I~stallallon.
[Xf~IOCkln9 and Set.Up - When all
o Insert - After fireplace approv41 . ,/ blocking Is complete.
and Installation of unit. (-- '. _ .
. " "~umblng Connections - When
o Curbcut & Approach - After 'home has been connected to
forms Bre erected but prior to water and sewer. .
placement of concrete. _ / ~ .
~~~~trlcal Connection - When
o Sidewalk & Driveway - After blocking, set.up, and plumbing
excavation Is complete, forms InspectIons have been approved
and "sub-base" ma"terlalin place. and the home is connected to
the service panel.
~nal - After all required
~ i~~pectlons are approved and
porches, skirting, decks, and
venting have been Installed.
o Fen~e - When ~ompleted.
o Street Trees - When all required
trees are planted.
". ~;.{?~ \' }::;f '; ~ ;"'~':~::I:.~f:..~ ~:\~ ~1';~~.'~,~('\ ~IS THE PROPOSED WORK IN THE_
Lot faces ~ L~t '~ype . Setbacks
, GAR Acc'1 HISTOJ;lICAL DISTRICT, OR ON
' P,L. HSE
Lol sq, ltg, Interior I THE HISTORICAL REGISTER?
Lot coverage -X- Corner N' /.::> ;- 7/;0/ . If yes, this appllcallon must be signed
S ~~.::>;'"IY : I and approved by the Historical
Topography Panhandle ~'t, I Coordinator prior to permit Issuance.
Cul~de~sac W
Total height /5" I
E I"'~,~ APPROVED'
BUILDING PERMIT
ITEM . SQ, FT: X $/SQ, FT, =
~aln Y/J(vE~/" M1W.....~V'~~
VALUE
~'/9/-r;
Garage
'.
Carport .
fdL' AK .4/d(lukr h.#
/.
Total Value F~ 1'~/.7'
J c;rrf)
,/5'e:Jrt:>.-
--::<:5'->
/ .:?~
_??-
~7. ."p
Building Permit Fee
r5~
"-;J~p
Stale Surcharge'
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
1.79"2,45
(B)
PLUMBING PERMIT
ITEM
FEE'
FIxtures
Residential Bath(s) N'
Sanitary Sewer
FT, s;:,~/5o
</.0, .....
~...
Water
FT,:2< ~O
FT. /70
Storm Sewer
~~,.~
~.~~
#:>,~
17~ -=-
,...~~ 8.?O
r? -!!~ <"' 'Ie
,
(C) . JR=3. ~
Mobile Home -::z X' 15'
/ &r:#r/~ ~C.::F'
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
,
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITs...
Mobile Home -:;::Y /05""
'::?,)( ~&'
. -..::t ~ '!>7;:j ~
State Surcharge ">' 4.<' 7,/:;>
Sidewalk lih7 fl
-:? It:, ft
-:::;> ........,. .....
<f~''''
/0 -::;N:!>
-(-.~ ,
'34)O-s'""
/~.9D
State Issuance
Curbcut
Demolition
Slate Surcharge
Tolal Miscellaneous Permits (E)
3/5:7'5"'
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code, regulallng the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
//_,.2-r
Plan Check Fee: Lea
~/0~
1#5~
Received By: A-'~
'/'Z~~ ~/
'-PIW'!1evlewed ByO', ~
Date Paid:
Receipt Number'
I!!I ~ -5'- 99'
Date .
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
.1'J)J15yI. t ,1'11711
AfT ~ ;Jj b2-$-t7
I
I ~7" L./&/&=~///5TA"'~23:""'/' ......l
1J.,~,"'Pc./C#n&-~.~"'_~_f _
'~/..9)C;' .0 'O.......-~o,~, S5t-~H l
/%,t:f>'Y .4A;. '-, " ?~/";--"'-- -,-"1'
.~~, ~'(~""'''::;'~ .?n ~~-- '
u........-,,/rce.-........ e:r~. ~//,~~~c
p~/7' ;?lc~~~~~' ,:
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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 Ordlnanc~s of the City of Springfield, and the Laws
of the State 01 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 lurther certHy thaI only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
VALIDATION: ' ^.A (j 0
RECEIPT NUM"~" '-\~ \J
DATE PAID_}.1.JI. -4
RECEIVED B
ATTACHMENT B1
. . NO. 9f//70
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~ J~
LOCATION: ,t:;19.2 J s -tt ;:~.d.... s/.
I
DEVELOPMENT TYPE: d~ (~~)
lOT S171=
BUILDING SIZE:
1. ~ ORAIN~
IMPERVIOUS SQ, FT.
2. SANITARY SI=WFR-CITY
NO. OF PFU'S 22..
(See Reverse)
3. TRANSPf1RTATTf1N
SQ. Ft.
..2. f(,C..;t s- X $0,209 PER SQ, FT,
$ 5"9 "1.51
X $43,26 PER PFU
$ 9 5"/. 'Ii!
NO OF UNITS X TRIP' RATE X COST PER TRIP
1 X /.01 X $436,19
X
X
X $436,19
X $436.19 '
s: 3"8' I. /0
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $ 2."1- 3::z ,$'j'
4, SANITARY SI=WI=R-MWMC
NO. OF PFU'S 22.. x $17.19 PER PFU + $10 HWMC ADMIN,FEE $ ]3"4>/i'
(Use PFU Total From Item 2 Above)
HWMC CREDIT IF APPLICABLE (SEE REVERSE> ; $ 5~. ~ ~
_. IQIAI - MWMC 'iOC $ ~ ~ /, l! s-
SUBTOTAL (ADD ITEMS 1.2,3 & 4) 1;z.-;,~2..p
5. AOMINTSTATTVI= FFFS
BAS~ CHARGE (SUB~ ABOVE> X .05
~ /-4. Date:
/ Mary) Hornig. R.E).
SDC"CoordinatoY
$ 1}(l,Z/
g -2- 5' -99'
IOIAI SOc.
$ 2702.jf~
B2.SDC .
t"1^ I vnc Villi I \.,HL\.,ULH IIVIII IHOLt:: Number of New Fixtures]l Unit t:quivalent = Fixture Units
(NOTE: For remodels, calculate only tt*l.EI 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..................
Laundry 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, Res'idential Kitchen.................;..;...
Urinal, Stall/Wall.,:......,......,. ........ "..,.".......,..........,....
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation".,.".,.,..,.... .., ,......"""......
Toilet, Private.....................,..,... .........,.,.....".,."...
Miscellaneous: ,TANI nu'.s $.'-'lk
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
..l
2.
2
2
2
.z
TOTAL FIXTURE UNITS
=
4.
4
-I
z..
~
22.
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table,
calculate credits separates.
I ...,
Year Rate per $1,000 Year Rate per $1,000
Annexed Assessed Value Annexed Assessed Value
II 1979 or before $3.46 1985 $2.46
1980 3.38 1986 2.14
1981 3,32 1987 1,77
1982 3.21 1988 1.37
1983 3.06 1989 0.97
1984 2,92 1990 0,61
1985 2.73 1991 0.44
L 1993 0.15
Credit for Parcel ?r Land Onl,)' If Applicable S .-1- c.. X $ It;, ..2id = Sc;.33
(Rate X Assessed Valuel -----
Improve~ent, (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ S"~.3 .3
,.
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.
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o !!y'ill.i!,I!!,i!!~~~
Job NO.~
NAME:
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
~~
!l ullAli, <;
, I
LOCATION OF (il~OPOSED BUI\.9I~<riIl"t .....1. ~ na A ( J fTlrr J At, , -. \ "
, Street Address If Known: ~. ) L1 Dl -,.- "0' ]V'/, flur ~llt'J W.l-)
, , , ( ,
".ttN.m'~1,ChtJy~ln'N"-1Wro4tl 001 Q()
PHONE:
f\4Jl.Q3f1
STATE: ~ZIP i1J1J.1
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the bacld
A. Sim,le Familv - Detached
-
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached,
NO OF UNITS ~
,
C. Multi-Familv Aoartment
Manufactured home not in a park
X $400 PER UNIT _=
$
.
X $370 PER UNIT =
$ ?4/)r'J
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
$110 ,cD
$IY
$ 110 ,CO
WPRD SDC
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)
c~~~~,~QV
R I&(o/~
Date