HomeMy WebLinkAboutPermit Building 1994-10-12
LOCATION OF PROPOSED WO~ _6::5 9< r/v ~
ASSESSORSMAP:-1~O ()22_~ '
"7<9
OWNER: ~ 76-c?'~~~~ ~Z)~.;4{; ...........HONF. _~l/3':~_S-;;;/
ADORE'''''' ~-:;::::::r ~~~/.-c.-... C
CITY' C-/....p-_~ STATE:~-
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LOT'
.
SPRINGFIELD
~.;(' ,; 16
.
JOB NUMBER qV /J ~
, .
:..
225 Fifth Street
Springfield. Oregon 97477
TAX LOT: OCl9C)()
SUBDIVISION:~'7"/ #/!=-_~~~
"
ZIP'
9?s/cy
5~
BLOCK'
DESCRIBE WORK' ~~~~- ?r/5~'). -I ~r-c>:?:::> r~ '
NEW REMODEL ADDITION DEMOLISH OTHER
CONST.
CONTRACTOR #
CONTRACTOR'S NAME ADDRESS
GENERAl' P!-f'~Z?:~~--:-:;, ~/-~-
PLUMBING: N~~ ~7~-
MECHANICAl', #~~.A.._.".,
ELECTRIC" ,. 'i1S'/~~
. . ,.,.-,."-~/.,,
., . ", '., ".. ", ," ..
To request an Inspection, you must call 726.3769. This Is 8 24 hour reciQrdlng.'AIi'inspecllons requeste'd before 7:00 a:ri,.'wlll.b~'"
mada the aame working dny, Inspactlons requested afler 7:00 a.m. wlll"ba made the following work day'-,
REQUIRED INSPECTIONS
~U9h Mechnnlcal ....: Prior to
Cover. INc.L 4;\-:\ {""d.
~UghEleC'rlc8t - Prior to
cover.
QUAD AREA: 4Qs~.J
# OF BLDGS' ,
OCCY GROUP: ~ ~-t 'tV\
# OF STORIES: ~
<&)
WATER HEATER:
~mpornry Electric
~lte Inspection - To be made
after excavation, but prior to
setting forms.
o Undarslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
~otlng - After trenches are
excavated. ~ .
~nry - St~ellOCatlOn, bond
beams, grouting.
~datlOn - After forms are
erected but prior toconcrele
placement.
\
o Undarground Plumbing - Prior
to filling trench.
~derlloor Plumblng/Machanlcnl
- Prior to Insulation or decking.
~t and Beem - Prior to floor
Insulation or decking.
~r Insulation - Prior to
decking.
~tary Sewer - Prior 10 filling
trench.
~rm Sower - Prior to filling
trench.
~er LIne - Prior to filling
~rech.
, '~-(J. ?-.) -,,/
ough Plumbing - Prlor'to
cover.
~$<'2 '7
/
- OFFICE USE -
l\,q
\
VA/
LAND USE:
# OF UNITS:
CONSTR. TYpO"
HEAT SOURCE:, ~ ,.7j;f'.
RANGE" r _
~ectrlcal Service - Must be
approved to obtain permannnt
electrical power.
~?PlaCe - Prior to facing
materials ~nd framing Insp.
~Ing - Prior to cover. .'~
..._ J_
I
~/C"'lIIng InsJletl,?n ~ Prior to
covet ~ .
~II - Prior 10 taplne. ~.
I -
'-. __,___J
r ~ .
[IJ-"""'Stovo - A.fter Installallon.
o Insart - After fireplace approval
and Inslallatlon of unit.
~rbcut & Appronch - After
rorms are erected but prior to
placement of concrete.
~ewnlk & Drlvewey - After
excavation Is completo, forms
and sub.base material In place.
o Fence - When com pie led.
.:. ~eet Trees - Wh'~~.~le~ul;ed
trees are planted. .
EXPIRES
PHONE
.4::'-Y2 ~~ ? y?, 3'.o:>q
, .
FLOOD PLAIN'
ZONING CODE:Lf)VL--1
# OF BDRMS: ~,
SECONDARY HEAT: '
SQUARE FOOTAGE:Cl1 II
g~lnal Plumbing - When ell
plumbing w\>rk Is complel,e.
~ln81 Eloctrlcal - VVohen all
electrical work Is complete. Co
~Inal Mochanlcal - When all
mechanical work Is complete.
~al Building - When all
required Inspections have been
approved and building Is <<
compleled.
DOthor
'j -~
MOBILE HOME INSPECTIONS
,
o Blocking and Set.Up ~. When all
blocking Is complele.
o Plumbln'g Connoctlon"S - When
home has been connected to .
water and sower.
o Electrical Connoctlon - When
blocking, sel.up, and plu"lblng
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After ell required
Inspecllons ere approved and;
, porches, sklrllng, dacks', a~d
venting have been Installed.
U~ll~
4~b. '
3. 7. lS...
5ol.\.tQ
SYSTlMS DEVELOPMENT CHARGE (SDC)
~"-\.^\(').Cr "-
Lot faces
Lot Typel
_ Inter r
.'
Lot sq. Itg.
Lot coverago
~
Corner
Topography
Total height ~
, ' (J4rr\
BUILDING PERMIT
ITEM sa. FT.
I \qD~
!;.(')(,.,
Panhandle
Cul.de.sac
X $/sa. FT. ~
Sb.~O
ll..\, \0 '.
tI1aln
Ga(age
Carport
,
,
.'
I
Total Value
Building Permit Fee
~?.3'\~ '?~
,
Slate Surcharge
Total Feo
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
, ~
Residential Bath(s) N'
Sanitary Sewer FT.
,Water FT.
Storm Sewer FT.
Mobile Home
,
.
l'
"I P.L.
IN
Is
Iw
IE
VALUE
\.(:)10101
,ll'3,c.I~O
FEE
\.<1a,~
,.."";.,.,
'. ", ,Ii. ~
Setbacks, " '
HSE GAR ACC'
".
THE PROPOSED WORK tN THE. '
HISTOI;lICAL DISTRICT, OR ON
....THE HISTORICAL REGISTER?
If 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 10 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 01 any provisions of said ordlnancea.
Plan Check Fee: ~~.6'
'1-I-'1.~1
::~;d~~ber:2:P4~r~)
~ ' . <t~lol'i.'l
Plans Mviewed By , Daie '
Date Paid:
Systems Development Charge Is due on all undeveloped
properties within tho City limits wliich are being Improved.
.
ADDITIONAL COMMENTS
( ~..
~l"
1., \.AlL~ ~
~ iT ~\ \"0
~ '\.\.u ~ ~ c>t,p ~ \ <i 1't1.
i\-ll~,~ .~_~.,.~ ~
Plumbing Permit \. <1.~.GQ
, .~H..3% IS,-Joj \. . .
State Surcharge
.. ~01, 'iL
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO ~
Wood Stove/Insert/Fireplace Unit
Drye; ~~n; If:.&d\ ~~
b\, \~u~ ~ w/~ \.)~v..."\"
Mechanical Permit
lssuahce
State'Surcharge
).7~ -t6of'
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk l~ D
~(:)
It
It
Curbcut
Demolition
State Surcharge
.'
Total Miscellaneous, Permits
(E)
c,.<.Q....
J{.~
lll...~
490
, '
. UQ
~,-
'5.00
- - ()O'"
1~5_ ---
UiL
\(1 .- .
'1-~D.
41.w....J
70 ~
~c-,
\'-l~
S3.S0!2....
By signature. I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all wQrk performed shall be done In accordance
with the Ordlnancus of the City of Springfield, and the Laws
of the State 01 Oregon perlalnlng to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Salety Division.
I lurther certify that only contractors and employees who
are In compllaneo with ORS 701.055 will be used on thla
project.
I further agree to ensure that all required Inspections are
reque.~;eJ~ ~t the proper time, that each address Is readable
from the street, that the permit card 15 located at the front
01 the property, and the approved set 01 plans will remain
on the site a~es during construction.
~naturp \..~~ \LvJ
Date /6 /1 ~/ 71-
VALIDATION:
RECEIPT NUMBER l ~~ ~
DATE PAIO---1\) .12-.4"t
AMOUNT RECEIV~' _~# 5.)i777
RECEIVED BY _ (!I \ l V'----"
. .' .. --. .
TOTAL AMOUNT DUE(e~qludlng electrlcali'--'==l?c;7,Z7'
(A, B, C. 0, 'and E Combln'ed)' '. I
ATTACHMENT Bl '.
. " . JOB NO. _q-?/3~7
CITY OF SPRINGFIELD SYSTEMSDEVELOPM~ CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
, ,
NAME OR COMPANY:
LOCATION: (;,'6'(2
DEVELOPMENT TYPE:
BUILDING SIZE:
1. STnRM ORATNAr,F
I~ /I~
l'~ c;.1.
~
$F/).
tOT SIZF
SQ. Ft.
IMPERVIOUS SQ. FT, 2~'1'8,.>O
X $0.209 PER SQ. FT. 0S9.~
\.)"'. ./
- -
2, SANTTARY SFWFR-r.TTY
NO. OF PFU'S .
(See Reverse)
3, TRA~spnRTATTnN
23
X $43.26 PER PFU
~9~!J)
...
NO OF UNITS X TRIP RATE X COST PER TRIP
/
X j,OL X $436.19
X X 5436.19
~O:!S)
5
X
X $436.19
5
SUBTOTAL (ADD ITEMS 1.2. & 3) ~ / <J~S". ~+
4. SANTTARY SFWFR-~~C
NO. OF PFU'S ~ ~'~ x $17.19 PER PFU + 510 Mh'MC ADMIN.FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
. , ,IQIAI -MWMC: S.Q.C
, SUBTOTAL (ADD ITErS 1.2.3 & 4)
5 4os.J'1
~ ""'6",~'if'
t? 29.JI')
$ .2 32 ". "75-
5. 60MTNTSTATTVF FFFS
BASE C~GE (SUBTO
~'
~aA.
./1oIary Ho nlg: P E.
/' SDC rdinator
OVE) X .05
~~.;z.~)
-
---- ---
,
Date:
~ -".2 ?- 9'~
IQIAI SOC:
s :J.. +'10.1("
B2.SDC .
. .
FIXTURE UNIT CALCUIAfION TABLE: Number of New Fees x Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate on~e tlfI additional fixturesl '
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
4'
.z
2
1
2
3
6
2
6
6
1
3
2
llHead
2
2
1
6
4
~
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 Trailerl.................,
Receptor For RefrigeratorNVater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall....................:............................
Shower, Gang..........,...............................................
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, StaIlNvaIL.:......,..... ...,.,... .... ....... .,... .....,..... ....
Wash BasinlLavatory, Single..................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous:' ' .T~NI T()J!'.s S/NIC
2
I
z.
)
'3
~
/2
?
. ,
23
TOTAL FIXTURE UNITS
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
nate per $1,000
Assessed Value
Year
Annexed
Rate per $ 1 ,000
Assessed Value
Year
Annexed
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
1985
1986
1987
1988
1989
1990
1991
1993
$3.46
3,38
3.32
3.21
3.06
2.92
2.73
J 979 or before
:' . 1980
1981
1982
1983
. 1984
1985
7-5.'? f
5,.fc; X $ ..2.1. 'lvo
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Crediffoi Parcel or Land Only If Applicable
=
~
Imp'rovement (if after annexation date)
=
CREDIT TOTAL = $ 15-. r g-
.
.
fi y!i!l!mE!!t\~t;
Job No. ili.J317
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME\ ~O, ~O~)
ADDRESS: ~~ ~Q~Q ~1,)e1
)
LOCATION OF PROPOSED BUILRI~~ SITE: <:\ _ ,(".+-
, Street Address if Know~: l 0 ~ 'L. ~) \ ~ M
Plan Name:.&. \\&iD ~axLotNumber: \~fJlI)LL'2, CAlC{)
PHONE: ~~ ~ .3StQ(
STATE: ~IP itI..101
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back'>
.\
f.r
..
A. Sinl!le Family - Detached
\
Single Family home
NO OF UNITS I
Manufactured home not in a park ~f'(\ cf]
X $400 PER UNIT ?, $ .:::n..V - ,
.
B, Sinl!le Family - Anacheq
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Family Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$~
$ g,.
$ 4(X) p~
2. SDC CREDIT (If applicable) SDC-payef must furnish proof of WPRD Credit
approyal. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
\.~~~f
_:~.. _f C'_~;:~"..(:,",IA
./
lO I (~Cf1
Date