HomeMy WebLinkAboutPermit Building 1992-4-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
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..
OWNER'
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ADDRF"'"
CITY'
sFO?
DESCRIBE WORK'
NEW v/. REMODEL
CONTRACTOR'S NAME
GENERAL: ~..L..... (g I~
PLUMBING~ tPl. I .
MECHANICAl' R..Lt.... iLk:
ELECTRICA" ,J..~, lJ ~
iJ
QUAD AREA:
l QJ\ 'Jl;:)
k~+ }J\
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" OF BLDGS:
OCCY GROUP:
" OF STORIES:
WATER HEATER'
OTHER
CONST.
CONTRACTOR" EXPIRES PHONE
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SPRINGFIELD
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JOB NUMBER
225"Fllth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION' 3~ Acl J, {'OJ -'X.....;J,,--,
li's-I-kr
PHON'" '/J J 31 7 ~
ZIP: .
FLOOD PLAIN'
ZONING CODE:
If)t>J
,--i~
. BLOCK'
STATF'
ADDITION
DEMOLISH
" OF BDRMS'
SECONDARY'HEAT: ~.
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 same workIng day, Inspections 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 Plumbingl Electr1call
Mechanical - Prior to cover.
ill Footing - After trenches are
excavated.
o Masonry -:- Steel locatton, bond
beams, grouting. .
c:;K] Foundation - After forms are
erected but prior to concrete
placement.
!Zl Underground Plumbing - Prior
to filling trench.
[4]
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
(1J Post and Beam - Prior to floor
Insulation or decking. ".
r-v1 Floor Insulation - Prior to
l....k\J decking.
[l] Sanitary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
L...AJ trench.
,
m Water Line - Prto~ to filling
~ trench.
[!] Rough Plumbing' -;- Prior to
cover. .
ADDRESS
cJ~fj. fl11~ <fl- .L '
JC- l= ~ ,- ~
3 ;170 .:~~+ iVrt. / E"",
..;
701..3 .~ir....i.llcl
- OFFICE USE -
\ \\ \
"..OF UNITS: \ ~
CONSTR. TYPE: V
HEAT SOURCE: _ ~ ~
PJ
LAND USE:
RANGF'
REQUIRED INSPECTIONS
ctl Rough Mechanical - Prior to
cover. _
r\It Rough Electrical - Prior. ,to
~ cover.
rjV1 Electrical Service - Must be
lAJ approved to obtai n permanent
electrical power.
rn Fireplace - PrIor to facing
materials and framIng Insp.
~ Framing - Prior to cover.
[KI Wall/Ceiling Insulation - Prior to
cover.
[]t] Drywall - Prior to taping.
o Wood Stove....:.. After installation~
D Insert - After fireplace approval
and installation of unit.
!ZI Curbcut & Approach - After
\forms are erected buCprior to
placement of concrete.
IIIl Sidewalk & Driveway - Alter
~ excavation is complete, forms
and sub-base material in place.
rn Fence - 'When .~omPleted.
r:t.;;:;l Street Trees - When all required
~ trees are planted. - _.
r\7I Final Plumbing - When all
lAJ plumbIng work is complete.
f71 Final Electrical - When all
W electrical work is c,<?';lplete.
[Zl
Final Mechanical - When all
mechanical work is complete.
VEl
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.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When'
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
. inspectlons are approved and
porches, skirting, decks, and
venting have been installed. .
......~~'
Lot faces ~fJ-t Lot Type. . Setbacks
Lot sq, Itg. 4W.{ _ Interior P.L. HSEI GAR ACC
Lot coverage ~"/P V'corner N /81>. '#/.
Topography O~2?t? Panhandle S ~<J'
Total height ,q" Cul-de-sac W ('l6"
IE Ie:>MI'Y.
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VI\LUE
'71. .51/
7153
Main
/lrK7_ X 31. ro
-; n-. -'!:f. /oJ
Garage
Carport
Total Val ue
1~ J ()€J
)
"'37 =3. -
Building Permit Fee
/.&.65"
~/. 6/5""
SYSTEMS DEVELOPMENT CHARGE (SDC) r$>
. (B) f/ ()..o 5 of ~
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' -?
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
/~.D.-
Mobile Home
-PPr~/"C~ Z2,fi)7C.=
V" .
Plumbing Permit
/c;::>.-a-
/~-
8. ;5i:!:)
1/ 7fi? Sc>
~tate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
h. -:;>
4: So
<:Jt'.=l>
.. ;'-.
Furnace
Exhaust Hood
Vent Fan
N' '"3x ~
Wood StovellnsertlFlreplace Unit
Dryer Vent
~.
-
Mechanical PermIt
-:;? zS-t?
//./. --
/f~
-::::?"?C,,;5
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk /,c<1" It
Curbcut~.t7 It
.-g~ ~~
. / .y. 'f.2P
Demolition
State Surcharge
FENCe
\rlO.
~<>t?
fiY...~
27/-:3.}8
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D, and E Combined)
)...'1;'" V.-
,
,
,
I
I . THE PROPOSED WORK IN THE
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
APPROVED:
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 ~/ti1>'\S o.Yf~rdinances.
Plan Check Fee: ~ rJ .-:::t:.....:)
Date Paid ~ ~,.QS . 4Q
Receipt Number' - 4m ~
Re/7BY: c-i\ rn- .)
(~~~_?
'3-:r/'~
Date
.
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~nQ)L:
\,cr\ lo
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 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.
Signature
~ ~_<b!<....
Date
3./}.fJ~ ,~
VALIDATION: A \n (\
RECEIPT NUMBER "'1. ~\' I
DATE PAin 4..Zr.Q:J.....
AMOUNT RECEIV~'fI2&~'7. ihB
RECEIVED BY \ 1\( [)( A )
,..,.., --'-"~ '.,;'
JOB NO. 1;;,0I.ftI-I
CITY OF SttINGFIELD SYSTEMS DEVELOPM-' CHARGE
WORKSHEET I
,:(COHHERCIAL & RESIDENTIAL)
NANEOR COMPANY: PwrufI{!E- 1.:; -HoMes
LOCATION: '601 JAfJA11E-7""re:. Cr.
DEVELOPMENT TYPE: L.P/Z.. - !Jew -:.FR
:'
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LOT SIZE
SQ Ft " \'.1',"
. .
",.
. "...
$. . . , . '.~i:\,
i . "'~;1~}/
.w..."....
.J g I i; &,',.
&3) .s J (,1, - . ..!l~t:).;:
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BUILDING SIZE:
1. STORM DRAINAG~
IMPERVIOUS SQ. FT. 1-6~i X SO.186 PER SQ. FT. I~ .;??~.!:.
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
2. SANITARY SEWER-CITY
NO. 'OF PFU'S ~o X S38.55 PER PFU
(See Reverse To Determine Total PFU'S)
3. TRANSPORTATION
Is 11(~1
NO OF UNITS X TRIP RATE X COST PER TRIP
I X 1.005 X $388.61
Is- "'''0 <;2, f
X'
X $388.61
X X 5388.61
(Se~ Attachmen~ ~ To Determine Trip Rates) .
..'.'. . . SUBTOTAL (ADD ITEKS 1.2.
4. ADMINISTRATIVE FEES
'BASE, CHARGE . (SU~TOTAl ABOVE) X ;05
1$ ~<I-?:f,. I
S/""i"'l~
TOTAL-CITY SDC
5. SANITARY SEWER-MWMC
NO. OF PFU'S . ?--D
"'15~
x S13.25 PER PFU .+ S!O.MWKC ADMIN. FEE S ~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
S
TOTAL-MWMC SDC Is '2-75 ~ I
TOTAL SDC s "'2-oS'-f~
~~.L.~
~ Kip Burdick
SDC Coordinator
~ /2-~ /'1 Z--
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FIXTURE UNIT CALCULA~N TABLE: Number of New Fi'1uresX ~ Equivalent c Fi.1ure Units (I~OTE:
For remodels, calculate only the NET .itionalli.1ures) . ·
NUMBEfl OF UNIT FIXTURE
.FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub......................................................................
. Drinking Fountain.......;.....................................,........
Aoor Drain...........:........:.......................,...................
: Interceptors For Grease/Oil/Solids/Etc.................
.'Interceptors For. SandI Auto Wash/Etc...........:......
. . Laundry Tub/Ootheswasher...................................
.' Ootheswasher . 3 Or More.....................................
., Mobile Home Park Trap (1 Per Trailer)..................
. ',Receptor For Refrigerator /Water Station/Etc........
.. Receptor For Commercial Sink/DishwasherjEtc.;
Shower, Single Stall.......:.........................................
..... Shower, Gang.;.......~.,.-....:........................_...........
... Sink, Bar. COmmerclaL........................-
Urinal, StaUJWall-....-..-..... .
I' Wash Baslnflavatory, Slngle.__.........
. Water Ooset. Public Installation..
. '. Water Ooset, Private......____._.__..
Miscellaneous:. '
;z... 2
t
2
3
6
2
6
6
1
3
{ 2
I/Head
.(' 2
2
?- 1
6
"2- 4
t..f
. ~! . .
.'"
'2-
1-
s..
?-
~
TOTAL FIXTURE UNITS ~
:;2.0
.,
!
.. CREDIT CALCULAll0N TABLE: Based onass~ed value. 1f,lmprovements occurred alter annexation. da. te In .table.
calculate credIts silparates.
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Rate per $1,000
Assessed Value
Year'
Annexed
. Rate per $1.000
Assessed Value
$1.69
.1.35
1.15
0.92
0.59
0.23
J
" Year
'. AnneXed
1979 or before $2.66 1985
1980 2.64 1986
1981 2.53 1987
. ;
, :"... .t982 2.41 1988
1983 2.19 1989
"', 1984' 2.04 1990
NI> IN"'/) A-VIHWl""/PJ"l-f!..
Credit for Parcel or Land Only If Applicable X S ~
(Rate X Assessed Value)
lmpr~ement (If alter annexation date) . X $ ~
(Rate X Assessed Value)
CREDIT TOTAL = s
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
, '''~ 1 r
-.. (.','
ResidentiaL...................................................... 0.4
CommerciaL................................................... 0.9
IndustriaL.............;..................... ..................... 0.45
GovernmentaL................ .....,.. ........ .........,...... 0.5
.:-:"
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IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT