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HomeMy WebLinkAboutPermit Building 1994-7-18 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Of lice: 726.3759 . 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\ \ ,\- 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 ~ \. f\C\~ \ . ri2fl L\';=) Q~~\1~ to~'~\\ lo ~~~.~' - ,~.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. h~L .. I' , , N' Is Iw IE Setbacks ' HSE GAR Acc'l I I I I : 1jJJt 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- ~~ \ 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 ------- = = CREDIT TOTAL = $ 3-:1.60