HomeMy WebLinkAboutPermit Building 1994-6-2
-'
RESIDENTIAL
PERMIT APPLICATION
Inspections: '126.3769
Office: 726.3759
()
SPRINGFIELD
LOT'
BLOCK'
OWNER' t3reJa.;.. rYlfi yS h.
ADDRESS" Qt,5 Lewis ;#:'.5'
CITY: ~,r, L"'-'" tJ
J
STATE' D Ii
.,
ql.jn(,., 7~
JOB NUMBER
225 Fifth Streel
Springfield, Oregon 97477
".
TAX LOT: ~J
~
SUBDIVISION:
PHONF'
ZIP: 9'7 'If/I'
DESCRIBE WORK: .:::,::", '5~;''l /Yltil:1.lA fe.. L+UY' ~...( JIoVVt-e w{fL GC;;-,()uvf
NEW I)(. REMODEL ADDITION DEMOLISH OTHER
CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR . EXPIRES . PHONE
GENERAL: JI~ I- VVlouVltia,:'" ./-j<JVV1.P<;; c:.., ?-;,C/o '& .' {n<f9 /5~f
PLUMBING: i/fJS P /IJ vv.lh;"0. L.// g05 /j(P '{/~5'~05SJ
/-IIO,^ fYbl.lV>. -k. ~A o~. ~ I (,~ \. '
MECHANICAl'
R.o'v ..,
ELECTRICAL: C _('J I"'fU tJ...'I..,~...... &'lr"-Oq~
~~:DB::::\~ ~l)
OCCY GROUP: .'\J.: ~
. OF STORIES: \
- OFFICE USE -
LAND USE: \\ t:\O
· OF UNITS: .1 . 1
CONSTR.' TYP"" \J lV
HEAT SOURC~ ,~U
RANG'" V
WATER HEATER:
u
.FLOOD PLAIN'
ZONING CODE: ~
~ OF BDRMS: ,~
SECONDARY HEAT:~. i
SQUARE FOOTAGE: J~\.. -')
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
o Temporary Electric
o Rough Mechanical - Prior to
cover.
I'f1 RDU9~I~C~J\ "\ fY;~
~ cover W '-'\.JV,. I
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Site Inspection - To be made
after excavation, but prior to
~settlng forms. . . "'
Underslab Plumbl I Electrlcall
Mechanical - Prior
~ Footing - After trenches are .
~cavated. .
o Fireplace - Prior to facing
materials and framing Insp.
pra;';lng - Prior to cover.
o Wall/C'eUlng Insulation - Prior to
cover.
D Masonry - Steel location, bond
beams, grouting.
~J1ndatlon - After forms are
r ~~~ed but- prior to'concrete
placement.
o Underground Plumbing - Prior
10 filling trench.
o Drywall - prl.or to taping.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Siove'- After Installation.
o Post and Beam - Prior to floor
Insulation or decking.
" .' \
o Floor Insulation - Prior to
decking.
,
..cJ(Sanltary Sewer - Prior to filling
~ench.
"f':/(Storm Sewer - Prior to filling
~rench. '
d Water Line - Prior 10 filling
~ench.
o Rough Plumbing - Prior 10
cover.
o Insert - After fireplace approvel
and Installation of unit.
Lfi Curbcut & Approach - After
forms are erected but prior to
.' placement of concrete.
o Sidewalk & Driveway - After
. excavation Is complete: forms
and'sub.base materlalln place.
o Fence. - When completed.
o Street Trees - When all required
trees are planted. ,
o Final Plumbing - When all
.plumblng W9rk Is complet.e.
f1lnal Building - When all
qulred Inspections have been
approved and building Is.
completed.
o OJher
MOBILE HOME INSPECTIONS
~IOCklng and Set.Up - W~en all
locking Is complete.. .
/
~Iurnblng Connections - When.
orne has been connected to
water and sewer. ',1
~Electrlcal Connection - When
. blocking. set.up, and plumbing
spectlons have been approved'
and the home Is connected to I
the service panel.' .
~Inal - After ell required
spectlons are approved and
porches, sklrtlng, decks, and
venting have been Installed.
~
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, :. '.~, i . '. ":i::~'~'(~~~.,i~fr~J:,:'~~,~;:
~
I' P.L. HSE GAR ACC
IN
Is
Iw
IE
Lot faces
Lot Type.
Interior
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de~sac
I
\
BUILDING PERMIT
ITEM ~O. FT.
~aln (~,)
X $/SO. FT.
35;fW
"
Garage'
Carport \C\ ~
\~1f6'
H).\O \({.:f=\
CA1g;o
3Y 4. '.lO
&() 5h'S)
<tl$d) .&53
(A)' 53.'0-:2..,
Total Value
I'
Building Permit Fee
State Surcharge
Total Fee
SYSTEMS DEVELOPMEN~CHARGE (SDC)
\ ~ 1t:O, ( 'fB) 1~9
PLUMBING PERMIT
Setblcks
.n
'.. THE PROPOSED WORK IN THE.
. ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this appllcallon 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, Inall 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: ~ Lf -~ .
Date PaId:
Receipt Number'
Rec Ived By:
Plans Re ~~
\,).2.~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
ITEM FEE
Fixtures
Residential Bath(s) N' '7tT'. ~ .'l~( )
Sanitary Sewer FT. JjS.OO '. {\f\OvJ))J~-; \qt'} '?{?)
Water FT. ~S.~
Storm Sewer FT. 8.S .OU ~ ') I rur Garl ('0 U\i, ~
Mobile Home
Plumbing Permit
I')5.c0
,0.'lS
r /'r"). '1""
State Surcharge
<ia.a~)
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
-e:J
tCF,~
+3:5 c4()CXJ
5. (:f)
(D)
MISCELLANEOUS PERMITS
Mobile Home
r
State Issuance
State surc~~
Sidewalk It
Curbcut as It
Demolition
I ~.')S
By'slgnature, 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 eny
structure without permission of the Building Safely 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 ring construction.
Slgnature~ 7
DatLfn ~., - 9 i.../
.--,
VALIDATION:
l3\S4
JIDsurCharpt{ r t -". I. r-l
f\ ~, q...QQ, <:::'J b...L RECEIPT NU~BER
" {T ( ~
Total Miscellaneous P.!j:.ylts (E) _"' DATE PAID n'
~ lo'l../ AMOUNT RE~I ED
TOTAL AMOUNT DUE (excluding electrical) <J~ /\0\ . . . (
(A. B, C, 0, and E Combined) RECEIVED B _
.,
'~.
SPR,.I:ELD
DEVELOPMENT SERVICES DEPARTMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
FAX (503) 726.3689
MANUFACTURED HOME SET-UP AGREEMENT
As required by the Ci ty of Springfield Development Code, I understand and agree
that vi th the approval of the attached~o;r:~' 'f~ pre of4,qe folloving
manufac tured homes vill be placed at' I'll l':Q.U.LV 'c'Al)('l
Springfield, Oregon, City Job Number U ()\n4~lj .
~
Ty~e I Manufactured Home. A multi-sectional (double wide or wider)
unIt vith an enclosed floor area of not less than 1,000 square feet,
that has a nominal roof pitch of 3 feet in height for each 12 feet in
vidth, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have an exterior thermal envelope
meeting performance standards vhich reduce heat loss to levels
equivalent to the performance standards required of single family
dwellings constructed under the State Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width
vith an enclosed floor area of not less than 500 square feet, that has
a nominal roof pitch of 2 feet in height for each 12 feet in vidth and
that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided with the
following information:
_ Manufactured Home blocking
- Yater line connection
- Street tree standards
- Sanitary sewer connection
- Electrical connection
- Minimum requirements for permanent steps
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the perimeter vith stone, brick or other. masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade.
T-->~ ~(V~Of
Signature ~
?, - ;:).. - c; Cf
Date
.
JOB NO. ?-?O(;, r 3
. .
CITY OF SPRI NGFI ELD SYSTEMS DEVELOPMENT C!lARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 15~__ 4~
LOCATION: 1-4-0)(.eLt A-'L/
DEVELOPMENT TYPE: ~~/ ~;?Hj_Id/~
'BUILDING SIZE: LOT S{ZE
SQ. Ft.
NO OF UNITS X TRIP RATE X COST PER TRIP
J X 1,0/ X $424.31
X X $424.31
C!2?,?j)
s
X
X $424.31
s
4. SANITARY SEWER-MWMC
NO. OF PFU'S /(1 x S15.125 PER PFU + S10 MWMC ADM FEE S .7-'62,25
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
S $;,30
TOTAL-MWMC SDC ~
<.......... .-/
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S If:J~'?~
,,'.
5. ADMINISTRATIVE FEES
. BASE ~;tE (~)J~ ABOVE) X .;5
~-- -~
./ r.i Ew....'i:el:T
,/ '5bc Coordiklor
r '1/.~~
'-- .-/
TOTAL SDC ~E
4I;~w .(<g'
fiXTURE UNIT,CALCU LATION TABLE: Numt'N (11 NrwFi\lI"eS X Unit Equivalent = Fixturc Units (NOTE:
for rcmodels. ('.1Icul~IC O. nly IhC. addilion,,1 li\1\"l"')
NL'I.~GEf\ OF. L':~iT f1XTUf\E
FIXTURE TYPE NEW f1XTUn~ EOUI.\'i,Lf:IJT UNiTS
Balhtub........................................... ..........................
Drinking Fountain.......................... ..........................
Floor Drain.................... ........... ,................ ........ ........
Intcrceptors For Grcasc/Oil/Solids/Etc.................
Inlerceptors For Sandl/,uto Wash/Elc..................
La undry Tub jClotheswasher............... ....................
Clotheswa~er - 3 Or Morc.....................................
MoMe Home Park Trap (1 Per Trailer)..................
Recep!or Filr Refrigerator fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher IElc..
Shower, Single' Stall................... ........ ......................
Shower, Gang............ .:................. ................... ..,'.....
Sink, Bar, Commercia!.............................................
. Urinal, StalljWall.......................................................
Wash Ba~injLavatory, Single..................................
Water Closet. Public Installation.............................
Water Closet, Private...............................................
Miscellaneous:
I
2
2
2
/
3
6
2
6
6
1
3
2
I/Head
2
2
1
6
4
<:
J
I
'2.
'Z
:1.
~
),
f?
TOT;'.L FIXTURE UNITS
=
./K
CREDIT CALCULATION TABLE:
calculate credhs separates.
I
Based on assessed value. If improvements occurred after annexation date in table.
.,
I
I
Year
Annexed
Rate per $ 1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
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
..
Credit for Parcel or Land Only If Applicable
S-2. / X $ "/, '1-S-0
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL
=
31..1 0
---
.Improvement (If after annexation date)
=
= $ 5/Jt?
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential........................................................ 0.4
CommerciaL.................................................... 0.9
I ndustrial....................................... ....... ............. 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
.
o !!)!ill!!.!!~!ll!t;
.
Job No. Q40lo'1-3
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:~cJ.o n N\~-
ADDRESS: 'C\\OS ~l~t))~ ~ STATE:~-ZIP c{14D2-.
LOCATION OF ~ROPOSED BUILDING SITE: 4<... ~I _..n
Street Address if Known: r,4 D \ ~ \ t ~ t:;LLXJL
Tax Lot Number: \ f') ()3~~\4 role{) J
Platt Name:
PHONE:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back'>
A. Simlle Familv - Detached
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartmenl
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
L Manufactured home not in a park
$ 4{'{)~.
X $400 PER UNIT .F.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4tf)pO
$~
$ 4ft).0{)
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
~ln~~'~~~
City of Springfield
~ ~ ,Cft
Date