HomeMy WebLinkAboutPermit Building 1994-8-31
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RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
LOT:
OWNER'
CITY'
DESCRIBE WORt<.
/I.J~'
NEW ';c' REMODEL
.
BLOCt<'
(3Vrk.4.. O€I..K..'L-
STAT~' '
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6/"-'-FL.tE.
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"DEMOLISH
OTHER
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"ADDITION
.
JOB NUMBER
9'1--/0/L
225 Fifth Street
Sprlngflefd, Oregon 97477
)
TAX LOT: CP-..{(J.)
SUBDtVISION' tf3/6/iOP ~S771"-tS
PHONF'
f5~-833'C...
ZIP:
9>7"2. b
, CONST,
,CONTRACTOR .
7'cr 3.5" ~
8(.. yJ>S-
CONTRA~R'S NAME ADDRESS'
/l II ~)!?"p/.....<O.. ,c.r
GEN.ERAI Nt<R..IID~Abn.~5 rL?€~-0$'LL.o-<t.
PLUMBIN'" N/'1tUIlAft./ p?-li(r.Jrf?,. ce€S~
'.' . 7'.;20 > A/ ,7 Tn. ,
MECHANICAL: _/5,Aei~ k..LA"73. a~.
, '4/lC '~'" . 5 '133 .I-Hv'r9r
ELECTRICAl' ./7~' n;.L<<ct!! ~C oaa~':;'. eJAP' ,
,?ij -c; ~
EXPIRES
, /"/7"/.9r'
PHONE
~cl'33~
R75, <7'237
3~o/ - L'r"o:' /
/7'/-a7'9~
QUAD AREA: ,--~R.'S.,(~ ./ - OFFICE USE -
LAND USE: \\ \ '\ FLOOD PLAIN:
. OF BLDGS: \ · OF UNIT!'" \ ZONING CODE: l12I.L"
OCCY GROUP: \>\?J-\- N\ CONSTR. TYPE: VN ~ OF BDRMS' :3
. OF STORIES: \ HEAT SOURCE: -, F7= SECONDARY HEAT: r::;r--
WATER HEATER: E RANGE: E. SQUARE FOOTAGE: {\'11
To request an Inspection, you must call 726,3769, This Is a 24 hour recording, All Inspections requested before 7:00 a,m, will be
made the same working day, Inspections requested after 7:00 a.m, will be made the following work day,
.
REQUIRED INSPECTIONS
[$I Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to coyer.
rvl Footing - After trenches arc
~ excavated. .
D Masonry - Steel location, bond
.beams. grouting.
flZl Foundation - After forms are
L...f-I erected' but prior to 'concrete
placement. '
D Underground Plumbing - Prior
to filling trench.
[K] Underfloor Plumbing/Mechanical
I -Prior to Insulation or decking,
m Post and Beam - Prior to floor
,InsulatiOn or decking,
. . ,........... t
nJl Floor Insulation - Prior, to
L...f=1 decking. . ..._,,, ,
"
\
R1 Sanitary Sewer - Prior 10 filling
I trench.
f"ll Storm Sewer - Prior to filling
I trench.
ClI Waler Line - Prior to filling
T trench,
rR!.RoU9h Plumbing - Prior to
T .cover.
rYl Rough Mechanical -.:. Prior to
~ cover.
rvl Rough ElectrIcal - Prior' to
~ cover. .
f'll Electrlca' Service - Must be
~ approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
!;zi Framing - Prior to cove:, ,
m Wail/Ceiling Insulatlon.- Prior to
~ cover,
SXJ Drywall - prl.or 10 taping. ,
D Wood Stove - After Installation.
D Insert - After fireplace approval
" and Installation of unit.
rvl Curbcut & Approach - After
~ forms afe erected but prlo~ to
placement of concrete.
~ '
Sidewalk & Driveway - Aller'
excC!-vatlon Is complete, forms
and sub-base material In place.
D F~n~e. - When ~O~Pleted.
m Street Trees - When ~1I required
""\ trees are plante~. . .
/
m Final Plumbing - When all
T plumbing wc;>rk Is complet.e.
~
r\fl Final ElectrIcal - When all
~ electrical work Is complete.
m Final Mechanical - When all
~ mechanical work Is complete.
ntJ Final Building - When all
LP required Inspections have been
approved and bUilding Is
completed.
D Other
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~servlce panel.
D Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot sq, ltg,
Lot coverage
Topography
Total height lLLf \.
( ,fl(i, )
BUILDING--PERMIT
ITEM SQ, FT,
Main
Garage
/2~S-
5"1'~
Carport
Total Val ue
Building Permit Fee
State Surcharge
PLUMBING PERMIT
ITEM
L~t'~ype'.,
_ Interior
_ Corner
x
Panhandle
Cul.de'sac
,;,., .:, .'0 .... "., -'.' .'.'.r).... ...'~...,:.,
. ").' , '.r.< '11'.,' i. .~'.i . . ~ )"l':"! P .....,
. :':h: \r:',:; . 0 ':." :~'." ;;";'.:iJ1,"'>,!."
,.(tl THE,PROPOSED WO~KIN THE.
'...HISTOI;lICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
"h~L,
"'1 ..
, N'
Is
Setbacks.
I I I 'I
HSE GAR ACC'
I
',,;n.
<. W.
E
X S/SQ, FT, = VALUE,
(B),
FIxtures
Residential Bath(s) N' !)..
Sanitary Sewer FT. '
Water FT,
Storm Sewer FT.
Mobile Home
77f?:,/j 7
~G7. ~
'l8. ,s~
~~J\c.t.....1.I. 11."""-
Total Fee (A) _~c..,:u.
SYSTEMS DEVELOPMENT CHARGE (SDC)
:i .
~'-=~=-
j 23G.S;~
FEE 7'0'
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
'6"% MWi>.
(C)
N'
~
Wood Stove/Insert/Fireplace Unit
Dryer Vent
l
Mechanical Permit
Issuance
State Surcharge
Total Permit
,,~ 1I\d......
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk' It
Curbcut ;)...~ It
Demolition
.-. . - -
,.:, ..,..... .......,....."..}:fo'";'J .
f 1, <: \;s)., .:r.<>.i), \: ~~.s>Q...
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~.Q.2...
\t:t,~
\().9l2.
.~
.~
::0.
\ '?:..3.s:l.
\ ~-,"\. ~
\31.s.Q
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) -<:,\(j~.~
(A, B, C, D, and E Combined) '11"=1.! 3
APPROVEP' '
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 provisions of said ordinances.
Plan Check Fee: .2. ~&.~r
Date Paid: r'13/5'~
Receipt Number' f ,eo!.. 3:E3 It"
Received By:' ~I\ \ ~(Y)~
~ '"
piaM Reviewed By ~!i4
Systems Development Charge Is due on all undeveloped
properties within the City limits which arc being Improved,
ADDITIONAL COMMENTS
I clr\1\o}[) Cm-Q): IY (d)
," ~+-r " C 4,CYXJ ,_0 1J:t')
,
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 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 dur ng constr Ion.
Signature
Date d5/3{/97
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIV~n,
RECEIVED BY
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Job No. C{4'\N \
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:~~O~("~\~)
ADDRESS: \Q~D l1i'~ 0119 \Ct
PHONE: C\~\ ~130
STATE:~IP Q142Jp
LOCATION OF ~ROPOSED B>l'I;P.!~.PJE: r-! __ J l^ '- '\ "
Street Address i~ Known: ~ ~ 't\ -\-{)\ 'i::---. ~Tlll0--J . , '
P1'ttN'm~~ r..WN,mber. \~D~()9-qcP
1. DEVELOPMENT TYPE (Check appropriate dwellingls). SDC Calculations and dwelling type
definitions are on the back.!
Manufactured home not in a park
$ 'iD),cO
X $400 PER UNIT _=
.
X $370 PER UNIT =
, $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$400 .OJ
$ 0 a)
$ 4(1).
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
/ /
Date
~f,
1"'\1 1f"'\\..11l ILI1 I UJ.
. ' , JOB NO.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMI CHARGE 1'1/0; /
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: f,:-,rO< IS e......I .JI ~
LOCATION' 4178' )b~ 5/
. 1
DEVELOPMENT TYPE: S;'i)
BUILDING SIZE:
1. STORM ORAINAGE
IMPERVIOUS SQ. FT. '3 4'6"3
2. SANlIARY SFWFR-CTTY
NO. OF PFU'S l't
(See Reverse)
3. TRANSPORTATTOtl
LOT SIZE ~ SQ. Ft.
X $0.209 PER SQ. FT. $ 1 2 7. 75
X $43.26 PER PFU $ ;c r 6>'_, d'
NO OF UNITS X TRIP RATE X COST PER TRIP
X I,M X $436.19
$ #0.5j-
X
X
X $436.19
X $436.19
$
.$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SAMllARY SFWFR-MWMG
NO. OF PFU'S /'8 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 3/'1.~<
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ /?- IT'f
, IQIAI -MWMr SOr. $ ." s.s-i
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 22.~.2., r (..
5. ~OMTNTSTATTVF FFFS
i{/JS ,CHARG~ rTOTAL ABOVE) X .05
. ~ Date: 1-;~- '79
/ Ma Ifornig, PJ.E.
SDC Coordinat6r
$ 112." of
TOTAl SDC
$ 23r..s:'1t/)
B2.SDC .
FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit ~qulvalent = t'lx\ure unlt~ ""'IIIIIIl
(NOTE: For remodels; calculate only ~ additional fixtures) .
., ',', NUMBER OF ,~UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
z.
J
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
Bathtub................... ..... ,..,..,.,...........,.,.. ..:.............. ,... '
!?rinking Fountain....,.......,......,.. ....,..,........ ...............
Floor Drain.,....,. ......,..,............,...,..,.......... ................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
laundry Tub/Clotheswasher ........................... ........
'Clotheswasher. 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Acceptor For RefrigeratorN"ater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang................... ;'................,.................;...
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..:.. .:.......................,........................
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation......,.................................
Toilet, Private.......................................................
Miscellaneous:'
~
~
}
:z.
2-
~
?'
;z
...L'Y
TOTAL FIXTURE UNITS
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits' separates.
Rate per $l,OO~
Assessed Value 1
$2.46 '
2.14
1.77.
1.37
0.97
0.61
0.44
0.15
'I
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1979 or before
1980
1981
1982
1983
1984
1985' ,
3,-1~ X $ 4. tn-D
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
/f,,?,,9
------
Credit for Parcel or land Only If Applicable
=
=
Improvement (if after annexation date)
CREDIT TOTAL = $ /3,?f
"