HomeMy WebLinkAboutPermit Building 1993-4-9
OWNER'" ~OY" ,-^\)~b\\
ADORESS: '.01) '?J30\ \'1\ {I ~f'l\ Hm\'r\,,:\ '5 .~-
CITY\" dr ~0 f\ 1 y- STATE: --CQ,1 0 "h f}'("'..-
OESCRISE WORK"-1'\'\.\1\ul. ~~ ~ :* n(\J\(\ f\9-- ~
NEW REMODEL AD~N DEMOLISH \ OTHIil, :1!
CONST.
CONTRACT<ft:.N~ME, _ U. ADDRESS ,_AAf--., CO~TRACTOR'. EXPIRE PHONE
GENERAL illWJQY \-'\lTIl OF\_~lo.crl\\ ml \ hu.t. ~.15 \ ' c{{()0-~
. ...
R'ESIDENTIAl
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPqS
ASSESSOR,,~: \
LOT' c,; ( )
PLUMBING:
MECHANICAl'
ELECTRICAl'
QUAD AREA' ')..~q1 "I
''-"
. OF BLDGS' A -
OCCY GROUP: R. ~ M.
l
V
. OF STORIES:
WATER HEATER:
BLO~K: ~~l
- OFFICE USE -
\\':0
LAND USE:
. OF UNITS: \ J
CONSTR. TYPE:--1[_
j::E-
r_____
HEAT SOURCE:
RANGF'
e.
C(3M~3
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
)
TAX LOT: ()~ -SL1{ ~ )
SUBDIVISION: fit:) (to tin y.. mf'Q
PHONE: -ff (cf7 -q 1 fJ... ~
ZIP:
qf\ 3J-;1
FLOOD PLAIN' _ 1
ZONING CODE: LOU
. OF BDRMS: ,~
,
SECONDARY HEAT:
SQUARE FOOTAGE: Jt:)!{ ~
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. wilt 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 Electricall
Mechanical - Prior to cover.
ruFooting - After trenches are
I excavated.
o Masonry - Steel location, bond
beams, grouting.
t79Foundation - After forms are
I erected but prior to concr te
placement. C\( I
o Underground PIU~bing - or
to filling trench.
o
Underfloor Plumbingl Mechanical
- Prior to insulation or deckinlJ.
o Post and Beam - Prior !o floor
Insulation or decki:1g.
o Floor Insulation - P~lor tc'
decking.
~anitary Sewer - Prior to fillIng
~ t-rench. -
r=I? Storm Sewer - Prior to flIllna
~ trench.
r'tj)watcr Line - Prior to fi!/ing
\ trench.
o Ri:::U{lh Plumbing - Prior to
COVBr.
REQUIRED INSPECTIONS
o Rough Mcchanical - Prior to
cover.
. n7ROU9h Electricnl - Prior to
I covo, q~
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Framjng - Prior t~
o Wall/Ceili3~ation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After installation.
L I :nSCil - Afa;r !ircp!:1,ce approval
- and instaflal!On of unit.
yq_ 7
1 n.urbclIt & Aprronch - ,\ fter
(OrllIS ;:(0 crectccl bui prior to
r"acen;cnt of COflcr'~~c.
fidCW:Jlk & Drivewa'J - p.fier
cXt:a'lillion is cornplp.tc, forms
and sub-base matcr;;t! :n place.
o Final Plumbing - When all
plumbing work is complet.e.
~, inal Electrical - When all
~~;ectrlcal wO(l(1OAmXc~i (J
D Final Mechan~c~;~ ~~
mechanical work Is complete.
k-A1inal Building - When all
~ ~eqUired inspections have been
approved and bU~' jng is
completed.
,
o Other
MOBILE HOME INSPECTIONS
~IOCkjng and Sel.Up - When all
(.-.....IOCking 1s complete.
rPlumbinc Connections - Vv'hen
home has been connected to
water and sewer.
F":JcctdC'11 Connection - When
. blocking, set-up. and plumblnQ
inspections have been approved
and the home is connected to
the service panel.
o Fer.ce - V";;)Cfl completed.
~.ina' - Aftar all required
inspecti')ns are approved and
i i Str~et lr.1tlS ~- When ;::11 r~~'luire.: porcr,cs, skirtinG. fj~r;ks, Rf'ld
I.rees ar(~ p!::"'!€~. ventlna have been insfalled.
.
Lot faces
Lot Type
Setbacks
,
IHSE GAR
Lot sq. ltg.
Interior
I f'L
IN
Is
Lot coverage
Corner
Topography
Total height
Panhandle
Cui-de-sac
W ,
~T
BUILDING PERMIT
ITEM sa. FT.
X $/SO. FT.
4ALU&i )
~I\~\
4\D:J
Main
f'Sf)LQ
\LX.tO
Garage
~~
53L?\ 1O
CI~p(C\lP) q<A.::O
4A~
\ rA1L-2>
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) $
(8) {J ('I()gl2!
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
~c;:=) P!
A 0.00
J)~ .Cf-J
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
'15 !.JU
,,~.'l5
r") B.'75
State Su.rcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Firepl~ce Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
05
Total Permit
(0)
MISCELLANEOUS PERMITS
\fJS.UO
.Q f),OJ
}:; .~~
L4~
Mobile Home
State Issuance
State SurchAa~
Sidewalk L.1L"\
Curbcul .3~
lt
It
Demolition
OJJ). oJ
~~?\a\\r l. 00 ,
Total Miscellaneous \}rmits (E)
TOTAL AMOUNT DUE (excluding clcctricall&.Q ~ .IA"
(A, 8, C, D, and E C?mbincd) ~l'-
Ace I
I
tHE PROPOSED WORK IN-THE
HISTORICAL 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 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 Fcc: ~.Q r M.J. J'\...../
Dale Paid:
Receipt 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
(\)Vl .h~rio .0In.QJlnQ1)
Lc:Af\~nj \G\\\~
\~Tl \\..or.YO
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify thai 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 thaI only contractors and employees who
arc in compliance with ORS 701.055 will be used on this
JJroject.
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 tile properly, and the approved set of plans will remain
:::::"::4if;F
VALlOATlON:
~D70
'-fJ1,C-(6
(Jt cili1d-' Le Y
p_ UUJv
RECEIPT NUMBER
DATE PAID
'AMOUNT RECEIVED
RECEIVED BY
....-.. .~.
.
.
JOB NO. q2,o<./7..;'
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
'WORKSHEET '
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: I-!"MP-IZ AUS-rll.-L
LOCATION: 518'i KALMIA /<'(01--0'/-1'-{ -03100
DEVELOPMENT TYPE: l {)fZ- - A!E:w MIWUF/t{...rBLeD ~F:.
HoIl1f:. ~. P.w.
BUILDING SIZE: 7.1,l.'f"J.U~u,. 2-D,l~ LOT SIZE
. .
SQ.. Ft.
1. ~TORM DRAINAGE
IMPERVIOUS SQ. FT. 2<;"1 "I X $0.192 PER SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S (r, X $39.78 PER PFU
(See Reverse)
3. TRANSPORTATION
c: '-1'1'1 ~
"- ~
~
(, 7 HOD':!. )
........ ----
NO OF UNITS X TRIP RATE X COST PER TRIP
1 X 1,005 X$401.05
Gtfo3 o!!.-)
........ --
X
X $401. 05
X $401.05
,
~
X
,
SUBTOTAL (AOD ITEMS r; 2, & 3) $ ((, 1 & ~
4. AOMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
c;- <;(O~)
~
TOTAL-CITY SDC $ l(pq'l~
5. ~ANITARY SEWER-MWMC
'I-
NO. OF PFU'S I~ x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ZS5 -
(Use PFU Total From Item 2 Above)
0<,~Lk
: ~ Kip Burdick
SDC Coordinator
tj./~I1;
I (
~dfo '!:-
, ob
TOTAL-MWMC SDC Zoq-
TOTAL SDC uq 0 g ~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
, '. '
FIXTURE UNIT CALCUU\TION TABLE: Number of New Fixtures X u.ttquivalent = Fixture Units (I~bTE:-'
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
Bathtub.... ........ .... .................... ............ ........ ..............
Drinking Fountain.....................................................
Floor Drain................................................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laund ry 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, Commercia!.............,..,.........,.,.....,..,.......
Urinal. Stall/Wall.....................".........."... ,..,..,........,.
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation,............,............,..
Water Closet, Private............. ....'..,.........................
Miscellaneous:
1.
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
'2.
1.
TOTAL FIXTURE UNITS
=
FIXTURE
UNITS
J..
'Z-
'2-
-z..
8
1C6
Based on assessed value. If improvements occurred after annexation date in table,
-~ate per $1,OO~11
Assessed Value j
$2.16
1.90
1.60
0.25
0.87
0,50
0.16
CREDIT CALCULATION TABLE:
ralCUlate cred::~~~:~ates.. _.. ,
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
1985
1986
1987
1988
1989
1990
1991
..., / 'I ," '!.,
Credit for Parcel or Land Only If Applicable '" , 'b ~ X $ _ ", '2- _ ....,. "" ~
(Rate X Assessed Value)
Im~rovement (if after annexation date) X $_
(Rate X Assessed Value) ,l'D
CREDIT TOTAL = $ ...,..b--
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residentia!........................ .................. ....... ....... 0.4
CommerciaL.................................................... 0,9
IndustriaL...... ................. ....... ........................... 0.45
Governmental. .................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT