HomeMy WebLinkAboutPermit Building 1994-7-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
OHlce: 726.3759
-.
LOCATION OF PROP~E'?... WORK' ~
ASSESSO'lS MAP' \'d..)~D\r{"f:)
LOT: ~\ 0 BLOCK:
.
qq.\D~'d-.
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
_ TAX LOT;'U!o ~rr)
SUBDIVISION' ~ur. Qf\ 6.o.AdoJ;)
OWNEP' (J\\\...u[\ Q)\ 'r f\'to '(\\)\~ 1:\0 J) ~~(\~HONE: t \'-\L\ . \d--{ Lolo
ADDRE~~: ~~ t j~J ~~::J fY1 \ \. ~D\ 0 0 t' .
CITy:~\'1\ i (\1 ~'(j(V - STATE:!)JJJ X"zP1'\ ZIP: 01"\, <'f)
DESCRIBEWORK:~f\'l\^Q, ~QN\l\Jf{ \ ~Qt\\nQf\C'.sL-
NEW ~ REMODEL ~ADDITION.. DEM~ISH OTHER
CONTRACT~'~ NAM~ E J ADDRESS.
GENERALl)'\.i..t J.( 1 Qf\ 1\\1.. ..
PLUMBING: ~~t1.. \. ):l~\joQ \
MECHANIC),. . fu..u(t 00 T.N-).
ELECTRICAl\. cA \ \ ~ A f J....o.M'iLl. [' J
CON ST.
CONTRACTOR'
R\ l\C\~
5\~?n
B\'\<\S
t ()<?n~
qa~~~
~o~.~tHo
q? '?,{drW ~
L\15.AI~
QUAD AREA: ~ S,Q .J
. OF BLDGS: \
OCCY GROUP' ~ 3 -\ lv\
. OF STORIES" \
9 -'
WATER HEATER'
- OFFICE USE -
LAND US". \ \ \ \
· OF UNITS: . \ . ,
CONSTR. TYPE: 'IV IV
HEAT SOURCE: \0 \1-
f-
RANGF'
EXPIRES
1'").\,;\ .
q. \.4.
,,\.\ Q..
Q4
FLOOD PLAIN'
ZONING CODE; ~\C...,
. OF BDRMS' 5
SECONDARY HEAT:.0 .
SQUARE FOOTAGE: ~ ~L
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. will be made the following work day.
o Temporary Eleclrlc
D Site Inspecllon - To be made
after excavation. but prior to
setting forms.
D Underslab Plumblng/Eleclrlcal/
Mechanical - Prior 10 cover.
~ Fooling - Attar Irenches are
~ excavated. .
D Masonry - Sleal location, bond
.beams, grouting.
~ Foundation - Aftor forms are
erected but- prior to concrete
placement.
O Underground Plumbing - Prior
to filling trench.
~ Underlloor Plumbing/Mechanical
LZ>l _ Prior to Insulation or dacklng.
~ Posl and Beam - Prior to floor
L.2!.J Insulallon or decking.
~ Floor Insulation - Prior 10
decking.
fVl Sanitary Sewer - Prior to filling
L.Al. Iranch.
~ Storm Sewar - Prior 10 filling
trench. .
f'V1 Waler Line - Prior to filling
~ trench.
f"lVI Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
r'iI1 R~ugh Mechanical"':' Prior 10
l....Cr.l cover.
[Q Rough Eleclrlcal - Prior 10
~ cover.
~ Eleclrlcal Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
malerlals and framing Insp.
~ Framing - Prior to cover.
~ Wafl/Celllng Insulation - Prior to
cover.
IZlDrywall - Prior to laplng.
D Wood Stove - After Installation.
D Insort - After fireplace approval
and Inslallanon of unit.
I:2S Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
excavation Is completo, forms
and .sub-base. material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
[2g.Flnal Plumbing - When all
- plumbing work Is complete_
. .
I"Tl Final Electrical - When all
~electrlcal work Is complete.
~Flnal Mechanical - When all
mechanical work Is complete.
r::t1 Final Building - When all
~equlred Inspections have been
approved and bUilding Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blocking Is complete_
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting. decks. and...
venting have been Installed.
Lot faces
~;rype .
-?- Interior
Corner
Lot sq. ftg.
Lot coverage
Topography _
Total helghl ~J
(?,:J:
BUILDING PERMIT
SQ. FT.
\\~~.
5loD
Panhandla
Cul.de.sac
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' &..-
Sanllary Sawer FT.
Water FT.
Storm Sewer FT.
Moblla Home
Plumbing Permit
State Surcharge
4.~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
"3
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State SUrChtjl")
Sidewalk -:1i:t;; It
Curbcut Co ft
Demolition
S~ Surchar~ '" __ n
I A~ . Y\UJ\. t"O I ).
'.:,'".,...._, .'. 1:; ii'I1:-:1: ,,. 'j ; ~ r;'i'!:;i';~.~,. .
: :",: ,. ': ,.,..... ;;:..IJ.l:..,....
Setbacks .
I' P.L HSE GAR ACC.
.'1 N'.
Is
Iw
IE
FEE
I&;O.W
lloO.aJ
gO'
na .?O
<\.~O
C\.m .
~~.CO
~o.S")
I :~ Yo
4f,) OJ
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)OJ'JIU':fJJ-
(A, B, C. 0, and E Combined) .
X S/SQ. FT. - VAWE
5\0 .?Q ~o?' \~
\~ .\D', -'\~IJ>
l \':llQ
~ r::o
ID4'1+ n:'\S: ~ ~
?'1(-,~ .d M
SYSTEMS DEVELOPMENT CHARG~ ~.QG)n
(B) &()"K~' I
1J o. r:!:J)
10.00
.5Ot.%3 i.33
~').'63
.. THE PROPOSED WORK tN THE. .
".HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
and approved by Ihe Historical
Coordlnalor prior 10 permit Issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
conslructlon shall, In all respecls, conform 10 the Ordinance
adopted by the Clty.of Springfield, Including the
Developmant 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 Fea:
-~
Date Paid;
. ~"
Receipt Number, .
Received By:.\. .
Jlm t\\~ .lui
Plans Reviewed By I
'7, /8.q(
Date .
Syslems Developmenl Charge Is due on all undeveloped
properties wllhln Ihe City IImlls which are being Improved.
ADDITIONAL COMMENTS
~-xh\~r . ~U~\Ji::f)
.\., ~-\- T'. \DOCD(-QJst)
\ el\\\ t\~ ){,' \'t\ \ n()
~~\
By signature, I slate and agree, thai I have carefully examined
Iha complatad 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
wllh Iha Ordinances of the City of Springfield, and the Laws
of Ihe State of Oregon pertaining 10 the work described
herein, and Ihat NO OCCUPANCY will ba made of any
structure wllhout 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 Ihls
project.
I further agree to ensure that all required Inspections are
requested at the proper time; Ihat each address Is raadable
from Ihe streat, Ihat the permit card Is located at the front
~f he property, and the approved set of pia s will remain
o the site at al)jimes dur~onst etl n.
I ature -..4/~~ t/ '<-.' 'A. fP
,!~/-;r~ f;~
Date
(\~, \'V
/
ATTACHMENT Bl nAiQ5" _
. ~BNO. ~ ,~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN~CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY:
LOCATION:
DEVELOPMENT TYPE:
#~h ~ .~,
/ i"
?~ fJ,.
.,p~
BUILDING SIZE: ;J.;---
1. STORM ORAINAGE
tOT SI7F ~
SQ. Ft.
IMPERVIOUS SQ. FT.
~/?c;,
X $0.209 PER SQ. FT. $ '7'S~, i?
2. SAtllIARY SFWFR -C ITY
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
/V
X $43.26 PER PFU
$ 71 6'. (" F
NO OF UNITS X TRIP RATE X COST PER TRIP
I X 1,c)1 X $436.19
$ ~~o..>~-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SAtllIARY SFWFR-MWMC
NO. OF PFU'S IV: x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ 3/'1.?2
(Use PFU TDtal From Item 2 Above)
HWHC CREDIT IF APPLICABLE (SEE REVERSE) $ 3'?,' CJ
. . IQIAl .MWMC SQC $ .3-K"~. 6'"z.
SUBTOTAl (ADD ITEMS 1.2,3 & 4) $ 1'1(.0,92.
5. ADMINISTATTVF FEES
BASE C~GE (S;aBTOJPOVE) X .05
:;?'/; -;;7' .J I _ .
%~ /r~ Date:
~ary rig. P.EV
SDC Coo inator .
$ 7Y:os
7-/.;z.- 9'9
TOTAl SOC
$ ;L05''8.? l'
B2.SDC .
- FIXTURE UNIT CALCULA TION TABLE: Number of New Fixlures X Unil Equivalent = Fixture Units
(NOTE: For remodels, calculate only lialiEI addilional fixtures) .
,., NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Balhtub..................................................................... .
Drinking Founlain................................... ......... .........
Floor Drain............................ ............... .......... ...........
Inlerceplors For Grease/Oil/Solids/EIC........:........
Interceptors For Sand/Auto Wash/Elc..................
Laundry Tub/Clolheswasher...................................
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigeralor/Water Stalion/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang.... ..................................................:...
Sink: Bar, Commercial, Residential Kilchen........................
Urinal, Stall/Wall..:....................................................
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous:
z
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4
2...
2.
2..
5f
J?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexa lion date in table,
calculate credits separates.
J
I
z.
2.
TOTAL FIXTURE UNITS
=
Year Rate per $1,000 Year Rate per $1,000
Annexed Assessed Value Annexed Assessed Value
1979 or before $3.46 1985 $2.46
1980 3.38 1986 2.14
1981 3.32 1987 1.77
1982 3.21 1988 1.37
1983 3.06 1989 0.97
1984 2.92 1990 0.61
1985 .. 2.73 1991 0.44 ,I
1993 0.15
-
Credit for Parcel or Land Only If Applicable "'$,.f(;. X $ /0. o-rro = J7!~ 6
(Rate X Assessed Value) -----
Improvement (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ ~60
r.