HomeMy WebLinkAboutPermit Building 1994-7-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Of lice: 726.3759
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SPRINGFIELD
.
JOB NUMB~R.ff:1ICX"Jf_
225 Flllh Street
Springfield, Oregon 97477
TAX LOT:\J(n fJ:"f..J..CX')'
SUBDIVISIONl _ fu" ~ ~f"\~,
OWI:lE'R:C)\~\ i(\ oj\ r f\t~ '(\'\ l:\Q Jl ~~(\~HONE: t \~ . \d-{ ~
ADDREp~: 'R>~rw;~ J...,f'J ~~~..rd \ '-
CITY< 1(\ 1\ 11\ ) ,- {) (\I , , STATE: X) (C)f\
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DESCRIBE WORK: ~ DD.'\ <L ~() N\1 0 L, \ ~ 0 t\\ c1 Qf\C'JL.-
NEW::t.- REMODEL ,- ~ADDITION ' OEM ~ISH OTHER
BLOCK'
ZIP: Ol~ -, C(J)
CONTRACT~'~ NAM~ f J ADDRESS'
GENERAl .l..)'\.'L( J.U Qi\ f\,\\., '
PLUMBIN; ~()Jlli \. "pj. \lo ~ .A
MECHANIC~,:,~__udo!":\ tJ\:t-). \
ELECTRICA;\' ~\ \ Q ~ ~ O_~ lUJ' )
CON ST.
CONTRACTOR #
p., lllq c:=\
5 \'\ ?ll
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Q~~\1~
to~'~\\ lo
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- ,~.Ai2R
QUAD AREA: ~ ~Q ,
# OF BLDGS: \
OCCY GROUP:. ~ '3 -\ /IJ\
\
. OF STORIES:
WATER HEATER: _9 J
- OFFICE ~SE -
LAND USE: \ \ \. \
:::S~::T;PE: 0 J
HEAT SOURCE: \0\-\
f-
RANGE:
EXPIRES
fj.\'A'
q. \.l\.
84~'
FLOOD PLAIN'
ZONING CODE:-lli\c"'"
. OF BDRMS: ~
SECONDARY HEAT:
SQUARE FOOTAGE: ..:,-\ loQ3
To requesl 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
~ R~ugh M'echanlcal ...:. Prior to
~ cover.
o TemporarY Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
r<vI Footing - Aller trenches are
~ excavated.
D Masonry - Steel location, bond
.beams, grouting.
~FoundatJon - After forms are
erected.but- prior to'concrete
placement.
o Underground Plumbing - Prior
to filling trench.
ro'I Underlloor Plumbing/ Mechanical
Lbl_,Prlor to Insulation or deckIng.
rD Post and Beam - Prior to floor
~ Insulation or decking.
~ Floor Insulation - Prior to
decking.
IV1 Sanitary Sewer - Prior to filling
l.."..O( trench.
~ Storm Sewer - Prior to filling
trench. .
~ Water Line - Prior to filling
LL:S.. trench.
r'V'I Rough Plumbing - Prior to
~ cover.
f';J\ Rough Electrical - Prlor'to
~ coYer.
,
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - prIor to facing
materials and framing Insp.
~ Framing - p~lor to cover.
~ Wall/C'elllng Insulation - Prior to
cover.
~Drywell - Prior to taping.
o Wood Stove - Aft.r I~stallatlon.
D Insert - After fireplace approval
and Installation of unit.
~ Curbcut & 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.
D Street Trees - When all required
trees are planted.
~Flnal PlumbIng - When all
- plumbing work Is complete,
, ,
~ Final Electrical - When all
~ electrical work Is complete.
@Flnal Mechanical - When all
mechanical work Is complete.
r::tl Final 8ulldlng - When all
L..Z:l"i'equlred Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
o 810cklng and Set.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.
D Final - After all required
Inspectlons are approved and
porches, skirtIng, decks, and
venting have been Installed.
Lot faces
Lot sq. Itg.
Lot coverage
Topography _
Total helgh~~ \
BUILDING PERMIT
::1: \~T:
J~ltD
Garage
Carport
Total Value
8ulldlng Permit Fee
State Surcharge
Total Fee
,
L~t ~pe.
K Interior
_ Corner
Panhandle
Cul.de.sac
X S/SQi)
0l0.
14./0
';..".:,-
'~:l:, \"'j:' '~l'l.:"':~.~;~.IJ4't1.;i!~f,'
. :',:1\:." ';;.:',:. .... '-::'_ ;;",'.l;:t'<X;".
..S THEPROPOSED WORK, IN THE. '
....HISTOJ;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
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Setbacks '
HSE GAR Acc'l
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APPROVED: '
"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT .
This permit Is granted on the express conditIon that Ihe said
construction shall, In all respects, conform to Ihe 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: ~'f-\ J ./
Date Paid: \} ~
Receipt Numberu y
Received BY:~-
~s:>a~!ili
?l5'JO
34Lf ~
10:41+ ~
(A> (,..~'J[{i!f?-'
SYSTEMS DEVELOPMENT CHAR<A~p,~
(B) ~J
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' c!J-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FEE
J/.tJo .CD
I (aUro
+80 + a.ex;
(C) 172..~c)
N' ~
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Perm I t
Issuance
State Surcharge
Total Permit
.50\
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State sur]r~
Sidewalk U It
Curbcut ' W It
Demolition
S'fl{' Surch'fl\~ C)_
\ }<~ k\ V\~ t\. u.u
4.ffi
<:..t.ea
,':1,.00
l(n .SU
10.00
.f3~
~
,...t() .rsJ
I aHa'
4;l)qJ.
Total MIscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elect"Cal)0 I U.l.f2-
(A, B, c. 0, and E Combined) ,
I). ~.ctt
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~~trn t'X _~OOllJQ\lLtv
-
lA-\' \'. \C). U:D (.li51 )
'--- ~N\Q)( \ q (nn-
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certlly that all
Information hereon Is true and correct, end I further certify
that any and all work performed shall be done In accordance
with the Ordlna~ces of the City of SprIngfield, and the Laws
of 'the Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permIssion of the 8ulldlng 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 Ihe proper time, that each address Is reada~le
from the street, that the permit card Is located at the front
of the property, and the approved set of plan ill remain
on the slle at all times during conslruetlo
Slgnature~ /f:.. ~
Date' ?:7l-;.i/
/
VALIDATION: "?flA r)
RECEIPT NUM~R _ l,-,....,-,-.x
DATE PAID " . \8..'14--
AMOUNT RECt']E~;aB3C;S. I ~_
RECEIVED 8Y ~ \.l_)
ATTACHMENT Bl /111 '\1"'\1\4-
, . .OB NO. V\'t- 1 I! \
CITY OF SPRINGFIELD SYSTEMS DEVELOPME~CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ;!;L4,4 ~ ,~,
\c:.., / /'
LOCATION: 0,~cx-~ 1),/70
3. IBANSPORT IDilli
NO OF UNITS X TRIP RATE X COST PER TRIP
X /, of X $436.19
$ ~4-0..>~-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $
4. SAtilIARY SFWFR-MWMr.
NO. OF PFU'S _/7: x $17.19 PER PFU + $10 HWHC ADMIN.FEE $ 3/'1,~2
(Use PFU Total From Item 2 Above)
HWHC CREDIT IF APPLICABLE (SEE REVERSE) $ !d, c. C)
" IQIAI -MWMC SDC $ ;z..lr~. ~2.
SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ / '1(.0,92.
,5. ADMINISTATIVF FFFS
BASE ~GE (SU~JfABOVE) X .05
~~: ~~o Date: ~-/1l--99
~ary r i9, P.EV
SDC Coo i nator
$ '1 Y:os
IQIAI Sor.
$ ,U)~'iJ,? r
B2.SDC .
.., .
'. ..
t-IX TURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only t~ additional 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 Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall. .... ....... ... ......... ... ..... ........... ......
Shower, Gang......................................................:...
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..:.. ..................... ........ ... ..................
Wash Basin/Lavatory, Single....... ..... .....,...... ..... .....
Toilet, Public Installation.................. ...... ...... ..........
Toilet, Private... ... ..... ................ ................ ............
Miscellaneous:
:2.
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
4
z..
'2.
2..
l1'
/'1'
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
)
I
:z.
2.
TOTAL FIXTURE UNITS
=
I -
Year Rate per $1,000 Year
Annexed Assessed Value Annexed
II 1979 or before $3.46 1985
19BO 3.3B 1986
1981 3.32 19B7
19B2 3.21 1988
1983 3.06 1989
L 1984 2.92 1990
1985 2.73 1991
1993
Credit for Parcel or land Only If Applicable
Improvement (if after annexation date)
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
"J,~r:. X $ /O.t77J-o
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
3?':.c; CJ
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=
=
CREDIT TOTAL = $ 3-:1.60