HomeMy WebLinkAboutPermit Building 1994-5-31
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCA~ION OF PROPOSED WORK' \'i-~~
ASSESSORS MAP' \ '7 ().~~ 'l44
LOT'
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Cf4D13!
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BLOCK:
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
OsC\nO,
SUBDIVISION:
I
i
OviNE~' \ \\ \. '( Q ) \.A-< \l h L' \ _ ,.{, ,'PHONE:
,,:,\~f)\~(rl.' '" ~\IX'U---' f.\
CIT . )}. .l ~ C) ~ _ . '.' STATE:\} J ~ ~_ fl11't .J
DESCRIBEWO~k..A\\t\s\l \ ~ \..~() ~~(~)\,,~~~ ~
NEW X REMODEL ADD~N ..; DEMOLISI:i 'OTHER \ *
~ CONST. _
CONTRA ~ S Nt-ME ,\ ADDRESS' CONTRACTOR # EXPIRES -ONE
GENER~' '\~n.Q ~ 'lld')~ q ..Qq.Q4 tj4t).lo1/,5
PLUMBIW" IT 0.."""')\\0 ~
MECHANICAL' .
ELECTRICA; .l~ \,\\\t) O~
. . '.\ .-
QUAD AREA: \ Q ~l ']
# OF BLDGS:_A
OCCY GROUP: KCS-\-M
\
9 /
# OF STORIES:
WATER HEATER:
f'A \ ff 'fS'A..~f}
ZIP: (]? ff)01
'1 {.'I,.
r') iAqS
- OFFICE ~~
LAND USE: . \ \ ':::'LJ
# OF UNITS' I
. ,
CONSTR. TYPE: --V::.^ 7
HEAT SOURCE: 1=' f)
RANGe. f'J'
044n7f1S
FLOOD PLAIN: JJ" ()
ZONING CODE: . )K--
. OF BDRMS:- ~
SECONDARY HEAT: P'
SQUARE FOOTAGE:~I~a
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
D Temporary Electric
D Site Inspection - To be made
after excavation, but prIor to
setting forms.
M Underslab Plumbing/ lectrlcal/
~ Mechanical - Prior t over. .
'K/(Footlng - After trenches are
~ excavated.
D Masonry - Steel location, bond
. .beams, grouting.
ft 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
decking.
~ Sanitary Sewer - Prior to filling
(trenCh.
~ Storm Sewer - Prior to filling
Gtrench. '
~ Water Line - Prior to filling
(' trench.
D Rough 'Plumblng - Prior to
cover.
D Rough Mechanical"':' Prior to
cover.
rR='~
D Electrical Service ~ Must be
approved to obtai n permanent
efectrlcaf power.
D Fireplace - Prior to facIng
materials and framing Insp.
txiFra~I~~
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
. Wi' Curbcut & Approach - After
F forms are erected but prior to
placement of concret,e.
D Sidewalk & Driveway - After
excavation Is complete. forms
. and 'sub-base material In place.
D Fence. - When completed.
D iStreet Trees - When all required
trees are, planted. '
D Final Plumbing - When all
plumbing W9rk Is complete.
~ Final Electrical - When all '
,electrlcaf work t;{~
D Final Mechanical ~ When all
mechanical work Is complete.
VJ Final Building -.When all
required Inspections have been
approved and b11.1.J\" fJ.f )
completed. qL-~ "-^^"'~'-"
DO.ther
MOBILE HOME INSPECTIONS
locking and Set.Up - When all
locking Is complete.
umblng Connections - When
home has been connected to
water and sewer. ..1
~ctrlcal Connection - When
locking, set.up. and plumbing'
Inspections have been approved
~nd the home Is connected to ~
the service panef., .
, . ..', .
Inal - Aiter all requl red
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM sa. FT.
...... .
Main
Garage
~~
Total Value
Building 'Permit Fee
State Surcharge
Total Fee
! .
,
,,~':":." ,
.. -'. ,
Lot 'TYpe
Interior
Corner
Panhandle
Cul.de.sac
x $/SO. FT.
. .",' ~ t.... :l .~"
':, l";.~ ';. (I,,~ ~ ~"n.t;'li:~"~' ~t"'~~~ ..~t:.::
.',:':'~f..:'.1J. \t,/,l.:.~ : ',:", ~~~ .;'';;:t;1}:. ',J"
. \:~'
,PP.L.
,;.i I
.: N
Is
Iw
IE
= VALUE
~()~
..b tJ.-;<'L
J .
~)mr.v
J" -'
r.. (\3,000.) .
~~.~@ \03.
SYSTEMS DEVELOPMENT CHARGE (SDC)
1/9'1:;', fC,
o PLUMBING PERMIT
ITEM
Fixtures
Resld?ntlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home'
Plumbing Permit
State Surcharge
Total Charge
(B)
N'
FT.
FT.
FT.
FEE
d..~
<SS
AS
C " fl~~
.f-d,.{j5J -(,,~,'lS
(C) 'If),1).C) .
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Dryer Vent
Wood Stovellnsert/Flreplace Unit
N'
Mechanical Perml t
Issuance
State Surcharge
Total Permit .
(D)
Mobile Home
MISCELLANEOUS PERMITS
..
.+3.\5
State Issuance
State. .s.u.'c~ar~
Sidewalk V) II
Curbcul 31.o II
Demolition
.\"
RJ
lQ~~
rQOOO
,,1:o).,Q:=)
~
jS~)
~ ~~~~~.: h:- '0 IM.03
- .. '\ IJJ)V Hl
TOTAL AMOUNT DUE (excluding electrIca~
. (A, B, C, 0, and E Combined) .
Setbacks.
HSE GAR Accl
I
;1
I
I
". THE.PROPOSED WORK.IN:H'E~.
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,constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of anl ~1~Jlll.. o!z'ald. ordinances.
Plan Check Fee: --1 .u..=>
Date 'Pald:
Receipt Number:
Received By: .
, ,)
.{ tJi'f\
prans .Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
( ci~T', ltJ ~\O
I
uAlLf\.tK., Cnt<b :,,_Pl Q \31o()
~ui).er6~ GJ\l'\
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By signature, I stale 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
lstru~ture 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.
.~gnature~~"l Jl~~
Date .5,. ~ I - CL4 '
\
VALIDATION: ~
RECEIPT NUM5R A..
DATE PAIf"l I.... ''''h../.lI,
AMOUNT REC~ ~ r; rJ 8". / R"
RECEIVED By( '7'\;'; )
- , -
.". . ."
.
.
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
FAX (503) 726.3689
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of'Springfield Development Code, I understand aDd agree
that yith the approval of the attached ~ermits,.?ne of the fo~oying
maDufactured homes will be placed at _ \l\-s5 '1"\, \\u. P-\J-tl...
Springfield, Oregon, City Job Number _ qb,:D'\?;- \ l\.
Type I MaDufactured Home. A multi-sectional (double wide or Yider)
uDit with an enclosed tloor area of not less than 1,000 square feet,
that has a Dominal roof pitch of 3 feet in height for each 12 feet in
width, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have aD exterior thermal eDvelope
meeting performaDce standards yhich reduce heat loss to levels
equivaleDt to the performaDce standards required of single family
dwellings constructed under the State Specialty Codes.
Ty~e II Manufactured Home. A unit of Dot less than 12 feet in width
with aD eDclosed tloor area of Dot less thaD 500 square feet, that has
a nominal roof pitch of 2 feet iD height for each 12 feet in width and
that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided yith the
following information:
- MaDufactured Home blocking
- Yater line connection
- Street tree standards
- SaDitary seyer connection
- Electrical conDection
- Minimum requiremeDts for permaDent steps
I also uDderstaDd that if I am installiDg a Type I Manufactured Home, the home
shall be eDclosed at the perimeter with stone, brick or other. masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade.
J~~ -C- ~
SIgna ture )
~,..lI\A
.I
5'"~I-fJ
Date
.
.
.
o y!i!I!!.!!!!~!!~
Job No.
Q4DrySI
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: \ f'\\ ~ ~Q, "M PHONE: f\4 \D.:-~~W
ADDRESS: ~t'\ \f\~~ _ J\ 4ILr& I ~ STATE:QLIP!Ilf1B
LOCATION OF Ii'ROPOSED BUILDING SITE: ~. \L 1 Q\ (\
Street Address if Known: \4S S \ ~ C\ i.Y\I
. Tax Lot NU~ber: \ f\ ()~~ [)?}tCY)
Platt Name:
1. DEVELOPMENT TYPE (Check appropriate dwell ing(sl. SDC Calculations and dwelling type
definitions are on the back,)
A. Sinl!le Familv - Detached
\
NO OF UNITS
Manufactured home not in a park
$~~
Single Family home
\
X $400 PER UNIT _=
B. Sinl!le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv ADartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ 4.00~
$ff
$ 4DDlP
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 Credit!
.hill_,. \_~J\OV
Community Servi~es' Di~
City of Springfield ,
_~t) 181 131
Date
JOB NO, '1-fO~3/
.
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT C/lARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAHE OR COHPANY: g,d, /J
LOCATION: /4.~.> -f"d ~
DEVELOPMENT TYPE: ~~
- /
"'~~
LOT SiZE
SQ. Ft.
. BUILDING SIZE:
1, STORM DRAINAGE
IMPERV 10US SQ. FT. ;Z ;VfO
X $0.203 PER SQ. FT.
~-f5?"'~
-- ~
2. SANITARY SEWER-CITY
NO. OF PFU'S
. (See R.everse)
I?
X $42.0B PER PFU
((" 'J S7. ;;,
~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I
x /,~/ X $424.31
X X $424.31
0.2 f. s-;)
.......... ,/
S
X
X $424.31
s
4. SAN ITARY SEWER-MW/1C
NO. OF PFU'S /11' x $15.125 PER PFU + $10 MWMC ADM FEE $:Z ~2.~5
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL
s 39',~
TOTAL-MWMC SDC ~
~
(ADD ITEMS 1,2,3 & 4) S 1??'3.77
5. ADMINISTRATIVE FEES
( (S,jAI/QE) X .05 .
/( ~ ~. 5""-;2-S--'J7Z-
coor~;natoU .
~ q~/7)
'- /'
TOTAL SDC $ I'1Tf.?C,
FIXTURE UNIT,CALCU~lON TABLE: r~urnt>N 01 New Fixtures X Unit Equi\,;\lent = Fix1lJfC Units (N01E:
For remodels. ('"lcuI3Ie only the ~ddi;ion:tlli\l11Il"') .
. Nur.~G(fl OF l':~IT FIXTURE
FIXTURE TyPE NEW F1XlUI1ES ECUI\'i.I.EIH UI.JIfS
Bathtub.............................................. .
Drinking Fount3in........................ ............................
Floor Dldin................ ............... ,... ................ .............
Interceptors For Grease/Oil/Sollds/E1C.................
Inl~rceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clot heswa sher...................................
aotheswa~her - 3 Or More.....................................
MobUe Home Park Trap (1 Per Trailer)..................
Recep!or f9r Refrigerator fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single' Stall. ............. ...... ........ ..... ................
Shower, Gang...........................................................
S!Dk, Bar, Commercia!.............................................
, Urinal, Stall/Vyall.......................................................
Wash Basin/Lavatory, SiDgle..................................
Water Closet, Public Installation.............................
Water Closet, Private...............................................
Miscellaneous:
2..
.,
4
~
.c
2.
3
G
2
6
6
1
3
2
l/Head
2
2
1
6
4
2..
2
7,
2
l?
TOTAL FIXTURE UNITS
~
/?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
- -- 1
~- --
Year Rate per $1,000 Year Rate per $ 1,000
Annexed Assessed Value Annexed Assessed Value I
1979 or before $3.21 1936 $ 2.24 \
1980 3.13 1987 1.93
1981 3.08 1936 1.57 I
1982 2.96 1989 1.18 11
1983: 2.82 1900 0.79
1984 2.68 1991 0.44
'1985 2.51 1992 0.28
.1
.. ?.2 ) $ /2 ...2/ t) :5 ?-/'7
Credit for Parcel or Land Only If Applicable X ~
(Rate X Assessed Value) =~
Improvement (If alter annexation date) X S
(Rate X Assessed Value) 39,/9
CREDIT TOTAL = $
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