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Home My WebLink AboutPermit Building 1991-12-9 ~i a.i,' \ A 1.p.A.b^/V"V <..r) ::::l U- Yy\ /A ; "^--' fir';, ~0,Q p j"1 I .' < ~ .' RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: / 1':JZ)? ASSESSORS MAP' 1'1 LOT: OWNER: ADORESS' CITY' DESCRIBE WORK: Yv\i)\f:U iD NEW REMODEL CONTRACTOR'S NAME GENERAL: __-{ilia;! > lA) I?2.-h~rorJ I, PLUMBING: -' I MECHANICAL: ELECTRICAl' (';'\ ..v,., f.r-. h fc!c,YlJvJYl . . q J J Y ()() SPRINGFIELD -s 7-03 tJ4 / 4- K:.ALh'7/A JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: ~3~D SUBDIVISION: --..L:1oJ d"..I,,^, J.&d.<:V'" ('0 PHONE: -;:ll.o.~n J BLOCK: Yv'I ^ Ja.,. ~ ~ S?L ~Ull ZIP: Q,)4,)'f3 STATE: <JQ. ~A~Sl W\&.c I",~ (\ f) CU' Q.. iIv\ ANv+ ADDRESS \"ntH <...()~tJ CONST. CONTRACTOR' WlQ-L-v. Sf. tr^inc.,\ PHONE "J);;J.)q, REQUIRED INSPECT-IONS o Rough Mechanical":"" Prior to cover. . D Rough Ele,ctrlcal'- Prior to cover. [Xl Electrical Service'- Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ADOITION DEMOLISH OTHER EXPIRES 41A7:>' QUAD AREA: ~(R. S '7 ' LAND USF' IISo FLOOD PLAIN' . OF BLDGS: I . OF UNITS: I ZONING CODE: v~ OCCY GROUP, P--."? CONSTR. TYPE: . OF BDRMS: :2, . OF STORIES: I HEAT SOURCE: 1=''7. SECONDARY HEAT: WATER HEATER: 'E. RANG'" '7 SQUARE FOOTAGE:_ i2.orJ - OFFICE USE - 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. L'-l Temporary Electric _I D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical! . Mechanical - Prior to cover. LiJ Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting. . . D' Foundation - After forms are erected but prior to concrete placement. [i] Underground Plumbing - Prior to filling trench. D Underfloor Plumbing I Mechanical - Prior to insulation or decking. D Post and Beam - Prior to floor insulation or decking. D Floor Insulation - Prior to decking. rn Sanitary Sewer - Prior to filling trench. [EJ Storm Sewer - Prior to filling trench. rn Water Line - Prior to filling trench. ... . , , o Rough Plumbing,"",:" Prior to cover. . '. D Framing - Prior to cover. D Wall/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stove - After installation. D Insert - After fireplace approval and Installation of unit. ~urbcut & Approach - After ~ torms are erected but prior to placement of concrete. M Sidewalk & Driveway - After ~ excavation Is complete, forms and sub-base material In place. D Fence - When compl~ted. D Street Trees - When all (equired trees are planted. _ . Q'] Final Plumbing - When all plumbing work Is complete. [Z] Final Electrical ~ When all electrical work is complete: D Final Mechanical - When all mechanical work is complete. [Z] Final Building - When all required Inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS ~ocking and Set-Up - When all blocking is complete. ~umbing Connections - When home has been connected to water and sewer. ~ectrical Connection - When blocking, set-up, and plumbing. inspections have been approved and the home is connected to the service panel. . ,.- ~al - After all required inspections are approved and . porches, skirting, decks, and venting have been installed. Lot faces Lot sq. ftg. Lot coverage Topography Total height \: Lot Type. Setbacks Interior I P.L. HSEIGAR ACC I IN I Corner Panhandle S I Cul.de.sac W IE BUILDING PERMIT ITEM SQ, FT. X $/SQ, FT. Main Garage /1cP Carport Total Value Building Permit Fee State Surcharge Total Fee (VI 11-1 , -L4. /0 /\~'? ')/\ \ (A) VALUE "::l c:.:,IX1.U 2'7&:;''-'' -:2'7103.'" ~.$"o Jq3 '-'- 404:5 SYSTEMS DEVELOPMENT CHARGE (SDC) ~\1\ \ 'tL PLUMBING PERMIT ITEM (B) Fixtures Residential Bath(s) N' Sanitary Sewer FT. L'5D Water FT. ..('50 Storm Sewer FT. <."50 Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan (C) Dryer Vent Wood Stove/Insert/Fireplace Unit N' Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk c;,-:; ft Curbcut / &> ft Demolition State Surcharge PL..+"J ,pGr./IEu) ~ Total Miscellaneous Permits (E) FEE 2~O.t:) . . 2.-:;- DO 2.'5 0-0 /~OO --. - 9'O.DO .~ q.{~O .1J)~.oO :20.00 S":2S;- J~.2-S' /270 $ 5.03 -I-&.. z3 {2.0'!> 3,tK' TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) 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. , I. 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 Fee:. 2. 5.0~ Date Paid: Receipt Number: ReceivA~ Plarf::t~~~ j;),i:~k Daj(, Systems Development Charge is due on all undeveloped properties within the City limits whic~ are being improved. ADDITIONAL COMMENTS .k.r:. Y A-t.. . _,,{},lV~~ ~ = 1~C;2o / ,; - &A:1U 7'! 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 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 co~tractors 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 ajlynes during construction~ Signaturp ~ ~ 7 ~ - / t7 Date I '). - 9 - 1// VALIDATION: RECEIPT NUMBER .ob~:Z7<6 DATE PAID /:2. -,,?q/ AMOUNT RECEIVE,' '2.o~~ RECEIVED BY .~a-A-~ ~~.---, I i JOB NO. q\\~OO CITY OF4pPRINGFIELD SYSTEMS DEVELOJ!lNT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) " NAME OR COMPANY: GIZ-€A"\ WE.'?"\E.~ Moe\l....E. .wOTv\!::S> LOCATION: '5IB~ ICA.L..M\A \"60'J-oL.\.\Y -o~6oo DEVELOPMENT TYPE:,-<h-6l2-- - tAot?;,tL.-t W-D"^",, ~u"t:. ~lZ- l:>vol BUILDING SIZE: 1-Y>....-l'r.. \~"H. 1"2-"'<u.. LOT SIZE . . SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. I 'B'?7- X $0.186 PER SQ. FT. ~ '?o.fo.f 't2.. (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. ~ANITARY SEWER-CITY NO. OF PFU'S \~ X $38.55 PER PFU (See Reverse To Determine Tot~fU'S) ........ 3. TRANSPORTATION $ Co"'!? ~ NO OF UNITS X TRIP RATE X COST PER TRIP X l.ooS X $388.61 $ ~"\o?~ x X $388.61 $ X X $388.61 $ (See Attachment C To Determine Trip Rates) SUBTOTAL (ADD ITEMS 1,2, & 3) $ \'-\-"2-B~ 4. ADMINISTRATIVE FEES BASE CHARtE (SUBTOTAL ABOVE) X .05 $ 114':> TOTAL-CITY SDC $ l'Soo?1 5. ~ANITARY SEWER-MWMC NO. OF PFU'S Ie, x S13.25 PER PFU + $10 MWMC ADIHN. FEE .S?....'-k!. ~ (Use PFU Total From Item 2 Above) ~~L..k.... U Kip Burdick SDC Coordinator /2- /+/'1/ , , (S ~I ~ ') TOTAL-MWMC SDC $ ~I\~ TOTAL SDC $ n \ \ ~.i. MWMC CREDIT IF APPLICABLE (SEE REVERSE) \ " FIXTURE UNIT CALCULaION TABLE: Number of New Fixture.nit Equivalent = Fi>.1ure Units (NOTE .. For remodels. calculate only the ~dditional fixtures) NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub........,................................ ............................. Drinking 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 RefrigeratorfWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink. Bar, CommerciaL.......................................... Urinal, StallfWall....................................................... Wash Basin/Lavatory. Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: 1_ 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 ' 2 t 6 4 '2. 2- TOTAL FIXTURE UNITS = ...,. 2. ? '2.- s:B \~ Based on assessed value. If Improvements occurred after annexation date in table. CREDIT CALCULATION TABLE: calculate credits separates. II I Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value $2.66 2.64 2.53 2.41 2.19 2.04 1985 1986 1987 1988 1989 1990 1979 or before 1980 1981 1982 1983 1984 Credit for Parcel or Land Only If Applicable "2...(",(", X $ 1~."'\'2- "":J"702- (Rate X Assessed Value) ,X $ = (Rate X' Assessed Value) CREDIT TOTAL = s -:" ~ Improvement (II after annexation date) 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 $1.69 1.35 1.15 0.92 0.59 0.23