HomeMy WebLinkAboutPermit Building 1994-10-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
OHlce: 726-3759
.
.
C)cfLi/7'
JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: ~'1. iJ ?,
{f;-6Z-03-z..,
BLOCK: 'f-
;\"'2.5 "i/Cf.t L-1-1V' <--
TAX LOT' ( <f cD
SUBDIVISION: ~{' (~ "ferrA-c.,.,.
-
-
I/'r>_d" r5'hr)l)
K/;J'C;S 4') Oz,/)
~c;r51,.)c:
ASSESSORS MAP'
LOT:
fi'
OWNER:
Tit'{ / /..LJ
" (
ADDRC~C.
CITY:
~ --
(5 J : ~ <isf> ~ G-It-~~ ":)."
OTHER \. ~ '/
--.- ---
STATE:
DESCRIBE WORK' )M."'","~ ~f'...C.\"'\'-= rl
NEW t/'7 REMODEL ADDITION-
hl~
f
MECHANICAl'
DEMOLISH.
PHON'"
CONST. 1"(8!:> ?-2.Z-7r-:'l<(-767u,'J
CONTRACTOR # EXPIRES ~ PHONE
'~lr/Z~~~~~I.:rri)
~.
. 0'
QUAD AREA: AR'f-f', - OFFICE USE -
LAND USE: \ \ ~t) FLOOD PLAIN'
# OF BLDGS: , # OF UNITS: \ ZONING CODE: \ re .~
OCCY GROUP: ~~,.~ CONSTR. TYPE: ~t\J, # OF BDRMS: .~
# OF STORIES' HEAT SOURCE: ~F ---' SECONDARY HEAT:
y/ ~, , wrf't
WATER HEATER: RANGE: SQUARE FOOTAGE:
<;;>
CONTRACTOR'S NAME , ADDRESS
GENERAL: t A I:.,. :'), rl e 0 ,"',.~ {, V-u c..t. r ~
PLUMBING: 'G~":2_\"( r frrt iJ\u.,'lM.~(J~~I\~
~ .. I
ELECTRICAl' (1f>.MAP ~ ;? ~
~
To request an Inspection, you musl 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. wlll,be maqe the following work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
settl~.g r\~~\ _ _L_ 0
'tv'l Unde~rlcall
P Mechanical - Prior 10 cover.
r7I'" Footing - After trenches are
~ excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - PrIor
to filling trench,
D Underfloor Plumbing/MechanIcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl ng,
.r7f Sanitary Sewer - Prior to filling
N trench.
f"::Ir Storm Sewer - Prior to filling
~rench.
f';;fl Water Line - Prior to filling
~ trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D R~ugh MechanIcal ~ 'Prior to
cover. "
D Rough ElectrIcal - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing insp.
D Framing - Prior to cover.
D Wail/Ceiling InsuleUon - Prior to
cover.
D Drywall - Prior to taping, ,
,
D Wood Stove - After I~stallat,on.
D Insert - After fireplace approvlll
and Installation of unit.
IV1 Curbcut & Approach - After
,. ~ forms are erected but prior to
placement of concrete.
M Sidewalk & Driveway - After
~ excavation Is complete, forms
and' sub-base material In place.
D Fen~e - When completed.
D Street Trees - When all required
trees are planted.
'0 Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - \^./.hen all
electrical work Is complete. ~
D Final MechanIcal - When al/
mechanical work Is complete.
D Final BuildIng - When all
required Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
IJVl Blocking and Set,Up - Whep all
~ blockIng Is complete.
VT Plumbing Connections - When
~ home has been connected to .
water and sewer,
I"\?T Electrical Connection - When
7P'I 'blocking, sel'uP, and plur1jblng
inspections have been approved
and the home Is connected to
the service panel.
'~ Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
;,;. .,...... .; ;:..~;\.~..\f\!; ~S THE PROPOSED WORK tN THE "
Lot faces Lot ~yp. Setbacks.
Lot sq, ltg, Interior I PL HSE GAR ACc'I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total t;eight Cul.de.sac IE I
APPROVED:
BUILDING PERMIT
SMF~
S/SQ. FT 3(''/lor)
ITEM
Ivlaln
Ga(age
"
Carport
j?JiJ . ~ /?10 ff.
22aO
Total Value
Building Permit Fee ~?,. ~
State Surcharge I.q;j+-I.//p .Q.c.J...\
Tot~1 ~ee ; (A) 4:'\ .~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) !.LOOf, 7- /
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
Residentlat Bath(s)
, .
N'
Sanitary Sewer.
FT
~~~
cQCSP~
c5)SCD
Water
FT,
Sto~m 'Sewe.r
Mobile Home
FT.
,
Plumbing Permit
'l5p:J
3.'75 fo.6l.a::> La,co
f'[.CV
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
lssuahce
State'Surcharge
~
Lf)5 pO
.s:--')n~
..... Q::) '\~
BA~
1~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ff)
Curbcut A3- It
It
c,..:....., .,gDJo D\'\.~. W
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding ~lectriCal)~~l)l. ~
(A, B, C, D, 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, confo'rm.to the Ordinance
adopted by the City.ol 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:
Date Paid:
Recei pt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
./ ,
I . .
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 certlfx
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
Date
!
VALIDATION:
RECEIPT NUMBER I C::;I q ~
DATE PAin, I 0 - 'Z.-J-( _'1,L)
AMOUNT RECEIVED _....') .10 \ . \ ~
(~
RECEIVED BY
. ATTACHMENT Bl -.
JOB NO. cr -1-/"1-/7
CITY OF ~PRINGFIELD SYSTEMS'DEVELOPM~ CHARGE
WORKSHEET
(COHHERCIAL & RESIDENTIAL)
NJ\liE OR COMPANY: ~~ T~
LOCATION: 5"'14-3 ~
. ,
DEVELOPMENT TYPE: /It':'''"jt.v~ /~
BUILDING SIZE:' f5;2. x.2-F)f (2.0"'/~ tOT SIZF
1. STORM ORATN~
SQ. Ft.
IMPERVIOUS SQ, FT. /f.9~
2. SANTTARY SFWFR-rTTY
NO, OF PFU'S /7
(See Reverse)
3. TRl.NSPORTATiOlj
X SO.209 PER SQ. FT.
s015". 3~
~ ~-
X 543,26 PER PFU
g-11?, G))
'", ~
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X S436.19
>(!~.s-~-")
S
I
Xl, t) / X 5436, 19
X 5436.19
s
SUBTOTAL (ADD ITEMS 1.2. & 3) s /~q4. 5"'1
4. SANTTARY SFWFR-MWMr
NO. OF PFU'S /~ x $17.19 PER PFU + $10 MWMC ADMIN,FEE S 3/t'. "/Z
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) S --- ~
TOTAl -H'WHr <::.oc S (~/ 7'.~ Z )
SUBTOTAl (ADD ITEMS 1.2.3 & 4) S /~/ 1-,0/
5. hOMTNTSTATTVF FFFS
BASE ~E (SUBT
~~.
, AA-7
../"Hary\Hornig. P.
,../ SDC C06rdinator
ABOVE) X ,05
~.,.7D)
Date: 9~;27- 99
TOTAl SDC
S Zoo'1,!.J.
B2.SDC .
FIXTURE UNIT CALCU.ION TABLE: Number of New Fi.e: 'X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the W additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
Bathtub...,..,.,..,.",.,."."."""."""."",."""""""",.""" ,
:Jrinking 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)..................
Receptor For Refrigerator/Water Station/Etc......,.
Receptor For'Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.,......,....:....:......~.........,.,......,....
Shower, Gang.,...,.,...,....,.."....."...,....,..,...,.,..,.,....".
Sink: Bar, Commercial, Residential Kitchen,...,.............,.....
Urinal, StaIlNvall..:........,..,..,..".."........ ,.,.,.... ....,.., ,."
Wash BasinlLavatory, Single..................................
Toilet, Public Installation....."...."...."....,..,...."..,....
Toilet, Private...........,...."....",....,..,........,............,
Miscellaneous:' ,;"'N' rr:R'5 So'Nk
:2
J
I
:<.
'2
TOTAL FIXTURE UNITS
UNIT
EOUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
.2.
=
FIXTURE
UNITS
<f
<.
<..
:z.
?
/?
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980.
1981
1982
.1983
1984
1985
$3.46
3,38
3,32
3.21
3,06
2.92
2.73
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
Rate per $1,000
Assessed Value
$2.46
2.14
1,77
1,37
0,97
0,61
0.44
0.15
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value]
=
=
CREDIT TOTAL = $
.
D Y)'We!!!~!~!!!;
.
n-A /A Ie
JobNo.~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
PHONE: fl4laJ.cf'l1e)
STATE:~IP q~
NAME: ~ \1.. \[')\ )..""f'\~........
ADDRESS:Qb \ttC\~_ f\4~
-
LOCATION OF ~ROPOSED BUI~~ ~ITE: (\ ~ _'. )
Street Address if Known: V^f\ ~_ ~ (\)7)
- \J -
PlattName: ~ \l.:\'0ffiJ(til'$LotNumber: \CUfLi~6D'ft{j)
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Familv - Detacheq
Single Family home
NO OF UNITS
B. Sinl!\e Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
0, Manufadured Home Park
NO OF UNITS
WPRD SDC
1
Manufactured home not in a park (j)
$~bl _
X $400 PER UNIT -=
.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$~to
$ 0cO
$:IDO ·
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit>
\~~i~~~~
r:...... ~lc_~:,.~:....I..J
I
1
Date