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Home My WebLink AboutPermit Building 1994-2-7 " R[SIDENTIAL PERMIT APPLICATION Inspections: 726,3769 Office: 726,3759 LOCATION OF PROPOSED WORK: ASSESS~RS ~A~:-'..:.tff-... 1 LOT: . ,." " 1 v ' . SPRINGFIELD ~- ~737r. "ir ()f- -,.,~ _.-a '4 , <~. - ..'............ "' .1/ BLOCK: ~ V\!.-1il! \ \ 7"'f'(1U, ,,, OWNER: --jrJl./LJ1~1 , ~ .' , ~ ADDRESS' .::l Q "$-7 I tl~.,o CITY- st~jjJ) - 1- ~ ,) . STATE: .&i DESCRIBE WORK' NEW 1./ REMODEL c. r:_ flo N nO nl'lD ) CONTRACTOR'S NAME GENERAL: -/l"".aAPD PLUMBING: r:r.AI LJ2..,.u;c MECHANICAL:"~ A .1r<~ ,,go.._ ,ELECTRICAl' 'd; I ~ n<y- ADDITION DEMOLISH OTHER \ ';;,f':.18 . C/3/10b , JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: 1.,IDD l .,UBDIVISION: PHONE: '/'1'7- :J...1'1-i ZIP: q, 4 7)<" . CO'NST, CONTRACTOR' ADDRESS 1~",-{")-LD L1&R'A/ ~~~ S-;;L~ ~OO tI:..-<Z.<e>....f/e.kI (,~ ~~<'>~(.., LJfn~'i 'YvI",,;:'A' 9.P-- <"~"<l':"l QUAD AREA: 4R~ I OCCY GROUP: \o\~:::tJ\J\ '~ . OF BLDGS: ~\ . OF STORIES: WATER HEATER:......d:JO A - OFFICE USE - \ \ I \ I \I AI.. .. OF BDRMS' ~ '~ .~tl<:..sECONDARY HEAT: +'-P SQUARE FOOTAGE:;1 1 C:l L .... ~l '<;'- .., -,0--, LAND USE: # OF UNITS: CONSTR, TYPE: HEAT SOURCE: ~.. RANGE: .l-\r> " EXPIRES ~/q<,:-:- {o/qJ r: I '-;).:1. d 79, PHONE ?!f C, -Of <-J I fftcX/-i"!3/ ~t.lt, .:.7[.,7" FLOOD PLAIN: LO\'L ZONING CODE: 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. REQUIRED INSPECTIONS D Temporary Electric ~ Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. ~ Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. J8J Foundation - After forms are erected but- prior to concrete placeme~t. o Underground Plumbing - Prior to filling trench, ~ Underfloor Plumbing/Mechanical - Prior to Insulation or decking. [2Sf Post and Beam - Prior to floor Insulation or decking. ~ Floor Insulation - Prior to decking, I2J' Sanitary Sewer - Prior to fJIling trench. ~ Storm Sewer - Prior to filling trench. . . ~ Water Line - Prlorto filling . trench. I ~ Rough Plumbing - Prior to cover. ~ROU9h Mechanical - Prior to cove~ . ~ Rough Electrical - Prior to cover. 0Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior to cover. k8T Wail/Ceiling Insulation - Prior to cover. ~ Drywall - Prior to taping, D Wood Stove - After I~stall~tlon. D Insert - After fireplace approval and Installation of unIt. ~ Curbcut & Approach - After forms are erected but prior to placement of concrete. ~ Sidewalk & Driveway - After excavation Is complete, forms and sub.base materlal In place. o Fence - When completed. ~ Street Trees - When "all required trees are planted. ~ Final Plumbing - When all plumbing work Is complet.e. [2(f Final Electrical - When all electrical work Is complete. ~ Final Mechanical - When all mechanical work Is complete. I25r 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 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 Inspections are approved and porches, skirtlng, decks, and venting have been Installed. bl'::: ","' Lot faces\ \ ' ~ lot sq, ftg, . lot Type X InterIor Lot coverage Corner Topography _ _ Panhandle " Total hg[9ht~~ _ Cul,de,sac o'1-0U(5S') , BUILDING PERMIT ITEM SQ, FT, -1:--ID7- (0 ?-'J X $/ SQ, FT. h~-V> IY,ID Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee (A) Setbacks \: C' THE PROPOSED WORK IN ~HE " ---HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. ., .:. , HSE GAR ACC I PL. IN Is Iw IE VALUE If? I,3'ul ;q ,1o'i'?'.0) ) 1.-CflO,9o /.J.96.tJO 1-'I/iJO t:;Z13St? SYSTEMS DEVELOPMENT CHARGE (SDC).ff, (B) 'if Z,/2.-:;'!.!:- PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' ~ Sanitary Sewer FT, Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge, (C) MECHANICAL PERMIT Fu mace Exhaust Hood Vent Fan N' 3 Wood StovellnsertlFlreplace Unit Dryer Vent ~ q-Ar /../~P s' W/If Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk t(, ft Curbcut ';\() ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE /60.00 -L.l.." .Dc) f)oOn J6-g ."0 h'.oo 4,ffi q.(')'-' \.:5,cV 3.fJO t!i.(JO $ C!f) --IJ)..1l {} ~ 55,lt€> -.-. .-;---- I q .90 f'I.5(J ...3.L-/,lfO J1.qO~. f!;fI ,'. APPROVED' ., BUILDING VALUE, PLAN\(:HECK 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 provisions of said ordinances. Plan Check Fee: ~'Z2-, LftJ /7_-7--q -.c;~ /(ZJ:}-J ~ Date Paid: Receipt Number: Received 'By: -dfi>>1 ,JYt~ Plans Reviewed By 1- 'Z-I-?f Date Systems Development Charge is due on all undeveloped !'ropertles within the City limits which are being Improved, ADDITIONAL COMMENTS lli~ ffi\C). <LJ ~ rio,u 'YO OD ccl~~ 1~t:LV , i (Din nON:.1YIT<b! \qrtPJ \,\bm \ I~' By signature, I state and agree, that I have carefully examined the completed application and do hereby certi fy 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 OAS 701.055 will be used on this project, I further agree to ensure that all required Inspections are requested at the proper tlme, 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 "'1.1_ .,. 1J;t-,). , .d -r~-'",/ ( Date VALIDATION: 4- RECEIPT NUMBf,R I II Z"'C \ DATE PAID '->I' ) -0\4- AMOUNT RECEIIft';7 <~3n~ . ~4: RECEIVED BY ..f:7\ (1\~ j-' . . .OB NO. q?/~t>~ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ---risKR. y LE A V I TT , LOCATION: (,,7"?! TvY S-r. / r020?/'f - Z/OO DEVELOPMENT TYPE: LPt:,- Alew $fF:. BUILDING SIZE: LOT sizE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ, FT. ?o'-fS X $0,203 PER SQ. FT, ~~fY,/i) ......... ...-/' 2, SANITARY SEWER,CITY NO, OF PFU'S /<6 X $42,08 PER PFU (7S7~ (See Reverse) 3, TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP I X /. oJ X X X $424.31 X $424.31 X $424.31 az.e 51) -.......... ...-/' $ $ 4. SANITARY SEWER,MWMC NO. OF PFU'S /'6 x $15,125 PER PFU + $10 MWMC ADM FEE $ '2-8'Z. 'Z-~ (Use PFU Total From Item 2 Above) 'MWMC CREDIT IF APPUCABLE (SEE REVERSE) $ 0:1;.~ TOTAL,MWMC SDC ~/i ~~ SUBTOTAL (ADD ITEMS 1,2,3 & 4) $2---0'2-'1- fl; 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 0...--rl ."L:4 J!S/q<j- , --cJ Kip Burdick ' SDC Coordinator ~,10 TOTAL SDC $ '7../7.- ~ ~ FIXTURE UNIT ,CALCU~N TABLE: Number of New Fixtures eit Equivalent = Fixture Units (NOTE: For remodels. calculate only the NET aBditional flXlures) . " NUMBER OF UNIT FIXTURE FIXTURE TYpE NEW FIXTURES EQUIVALENT UNITS I 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 '2- / Bathtub,.. ,."",.."....,.."..""",..""",""""""""',..,....".. Drinking Fountain"....,.."""""""""",,',""',..,""" '.,.. Roor Drain..,....,.."......""'.."'..""".."'.."...."".......'... Interceptors For Grease/Oil/Sollds/Etc...,............. Interceptors For Sand/Aulo Wash/Elc.................. Laundry Tub /Ootheswasher.......... ,.......',..' ...... ,.,.., Ootheswa~her - 3 Or More...................................., , Mobfle Hdme Park Trap (1 Per Trailer)..:,...,.:,....... Receplor Fgr RefrigeratorjWater Slation/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single'StaIL........,..,........"........,................ Shower, Gang..,...,.....,......,....,.....,..,......................". Sink, Bar, CommerciaL........,......,..,..,.........,.......,.... Urinal, StalljWaIL...........,..,..,....".....,...,...........,....... Wash Basin/Lavatory, Single.................................. Water O'oset, Public'lnstallation.......,..................... Waler Ooset, Private,......,......."""....................".... Miscellaneous: I 2- 'Z- I -z. z "2. 1- B TOTAL FIXTURE UNITS J<t> CREDIT CALCUUl.TION TABLE: Based on assessed value, If improvements occurred after annexation date in table, calculate credITs separates, Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value II 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 $ 2,24 1.93 1,57 1.18 0,79 0,44 0,28 Co?, ~ Improvement (If after annexation date) ~.'2.-1 X sJ3...8 (Rate X Assessed Value) X S (Rate X Assessed Value) CREDIT TOTAL = Credit for Parcel or Land Only If Applicable = = $ 0?5~ 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 ..... . . t~ y!i!I.!I,!!!!~!!!l, . Job No. Cf3\9DLo SYSTEMS DEVELOPMENT CHARGE ) VVORKSHEET - '- '..Ll. NAME: '\~./ml-c~n lJ\'.lJ ~ PHONE:~rJ-~~ \ ADDRESS, ~sP> ~f) .c'f)'\I"Iv9L\ ~ STATE!'e- ZIP !Il113 LOCATION OF PROPOSED BUltDING5!,TE' C\ -#. t ' Street Address if Known: '.p fI ,")Fl ,-,)l.\) (61:\. .A ~o 0 ' Platt Name: ~I-\tI ~\ ~Oj) Tax Lot Number: J MN\.~ M \rO ()~-tr\ - 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back.) A. Sinl!le Familv ' Detached -L Single Family home _ Manufactured home not in a park rf) NO OF UNITS k X $400 PER UNIT = $4ff). B, Sinl!le Familv ,Attached, NO OF UNITS X $370 PER UNIT = $ C. Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ VVPRD SDC $ 4rf).CD $J?f $4tf)~ 2. SDC CREDIT Of applicable) SDC'payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. 3. TOTAL VVPRD NET SDC ASSESSED (If SDC reduced for Credit) '\ \ fn -t-' '- Community S~ices City of Springfield ~ I I} ICft Date