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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.