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HomeMy WebLinkAboutPermit Building 1994-7-18 RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATIO~ OF PROP~E'?... WORt<. ~ ASSESSOR~ ~P: \'d..)'d-D\r{"f:") LOT'.~ BLOCK' -- iIIt: . JOB NUMBER C\4 \r0<6 4t~ 225 Fifth Street ~JI Springfield, Oregon 97477 AC\ \\ rt2I\ \Jn0.LJ . TAX LOT:\!(n ("y"')qCX'). SUBDIVISION!_~ 1.10_0~ OWNEP' c)\~(\ Q,f\ ?- f\'to '(\\~~ 1:\0 J) ~~(\('.pHONE: t \'-\L\ . \d-Holo ADD~E~:t~~ r;:'J 3Q fYi \" ~tMJ) . CITY:~1\ \ rh W;Y ~ sTAT~J~)110 X"zp1'\ ZIP: 01'\, <'f) DESCRIBE WORK: ~.f\'l\^ <L. ~O "f\fu{ \ ~Q t\\c1 Qf\(\9-.- NEW ~ REMODEL . ~ITION. DEMb),ISH OTHER CONTRACT~'~ NAM~E J ADDRESS. GENERAI.'l'Ci.U(lQf\ 1\\1.. .. PLUMBIN; ~)f<\Qrt \ ):l\~)OQ \ MECHANIC~ . fu.-l..\ ct 0 f\ T f\1-). ELECTRICAD. ~ \ \ Q A fJ oJ,t \'\J' ~ ) CONST. CONTRACTOR . ~ \ lIq l?') 5 \~?{) ~ V\C\S t n~'l~ q:i~1d~ ~oro .'5t '.lo C\ '(\"?>-ldrW J L\15.Ai~ QUAD AREA: ~ ~\' J . OF BLDGS' \ OCCY GROUP: ~ '3 -\ Iv\ . \ . OF STORIES: WATER HEATER: _9 -' - OFFICE VSE - LAND USE: \ \ \, \ · OF UNITS' . \ J CONSTR. TYPE: 'IV_ HEAT SOURCE: W-\4,. L- RANGE: EXPIRES 1'").\,;\ . q.\t\. tj:\Q.. Q4 FLOOD PLAIN' ZONING CODE: Ll)\C..., ~ . OF BDRMS' SECONDARY HEAT:_ SQUARE FOOTAGE: _ \\6\3 To request an Inspection, you must call 726.3769. This Is a24 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 Ihe following work day. . , . REQUIRED INSPECTIONS r'iI1 R~ugh M.echanlcal ...:. Prior to L.Ot cover. o Temporary Eleclrlc O Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. r'VI Footing - After Irenches are ~ excavated. . D Masonry - Steel 'location, bond ,beams, grouting. f'JI Foundation - Atter forms are ~erected'but prior to'concrete placeme~t. o Underground Plumbing - Prior to filling trench. rc7I Underfloor Plumbing/Mechanical L.bI. -.Prlor 10 Insulation or decking. rD Posl and Beam - Prior to floor L...2SJ Insulation or dacklng. iXI Floor Insulation - Prior 10 decking. fV1 Sanitary Sewer - Prior to filling L...O.ltrench. ~ Storm Sewer - Prior to fllJlng trench. . ~ Waler Line - Prior 10 filling l..L::S.trench. . .~ " -' ~ ~ough .PI~mblng 2.-~Prlor~'to ~_ ~ cover. I'JI Roug.hEleClrlcal - Prior 10 l...,.O.,l cover. ~ Eleclrlcal Servlca - Must be a"pproved to obtaIn permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior to cover. r-;JI Wail/Ceiling Insulation - Prior to ~ cover. &DryWall - Prior to laplng. D Wood Slove - After I~stallatlon. D Insert - After fireplace approv~1 and Installallon of unit. ~ Curbcul & Approach - After forms are erected but prior to placement 0.' concrete. ~ Sidewalk & Driveway - After excavation Is complete. forms and .sub.base material In place. o Fence - When completed. D Street Trees - When.'aU.reQulred trees are planted. --t'~, r'o 0- ,0 o~ \:...)'. 0 ~ Final Plumbing - When all - plumbing w9rk Is complet.e. Rl Final Electrical - When all ~eJectrlcal work Is complete. @Flnal Mechanical - When all mechanical work Is complete. r=1l Final Building - When all LZ:I'i"equlred Inspections have been approved and building Is completed. DOther 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. o Electrical Connection - When blocking, sel.up, and plumbing Inspections have been approved and the home Is connected to the servIce panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. - Lot faces L~I~P. K Int~rlor Lot sq. ftg. Lot coverage Corner Topography _ Total height ~ ~, BUILDING PERMIT ~:I~ J~l ~\ Garage ,,) IV Carport Panhandle Cul.de.sac X $/SQ~ &.tlJ 14.f0 Total Value Building Permit Fee Stale Surcharge Total Fee . :.'r1t:. \.'~/!.: , oj\r/r ~,";J ~.~..~~~,~,\'''''' ;,' . Selb-cks . h~L. HSE GAR ACe' I IN. I I S I Iw IE :~ SYSTEMS DEVELOPMENT CHAR~O~~)cn (B) CI I '115'/0 ,~t{~ IO~l+ ~~ (A) 0'J[ii!f'J- ' PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N~ ~ Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home FEE U oQ.crJ Plumbing Permit State Surcharga Total Charge IloUro +80 +- B.O? (C) 172.~U MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' ~ Wood Stove I Insert/ Fireplace Unit Dryer Venl Mechanical Permit Issuance State Surcharge .5Of Total Permit (D) MISCELLANEOUS PERMITS Mobile Home Slale issuance State surCh~~ Sidewalk lJ II Curbcut I (IJ ft Demolition S~ Surch'R~ \) . " l<9.k\ Y\~ t\.UD Total Miscellaneous Permlls (E) 4.m q.CO <~.oo f(n.SU 10.00 .f3~ &1S3 .!)[) 3:) Bqo 4;-Uq:J ."'""!4t::".--:-~ TOTAL AMOUNT DUE (eXCIU~1 e{f)t~.!tl) ~. .. (A, B, C, 0, and E Combined ~' . ,- ~ ':~.... - ..- ""A'. ".S THEPROPOSED WORK.tN THE. . .-HISTOI;UCAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yas. this application must be signed and approved by Ihe Hlslorlcal Coordinator prior to permlllssuance. APPROVED: . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on Ihe ax press condition Ihalthe said conslructlon shall, In all respects, conform to the Ordinance adopted by the City. of Springfield, Including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked al any time I upon violation of any provisions of said ordinances. Plan Check Fea: '\._\t-\ J / Dote Paid: .J ~ Receipt Numbo~ y Received By: ~ ~S1\~lLti "). \'2:> ~ - ~ Dale Syslems Development Charge Is dua on all undeveloped properlles within Ihe City limits which are being Improved. ADDITIONAL COMMENTS ~~tm~ _~dOLt.'Y1~Ltv .~~--\,' \OW) (~) "-- cA N\OK..: \ v{lo 0 ~~ \ ~(\~~...~'0~ N1lJ ~0 ~ )~U\C1 POO~ By signature, I state and agree, that I have carefully examined Ihe completed appllcallon and do hereby certify thet all Information hereon Is true and correct, and I further certify that any and all work performed shall be done In accordance with Iha Ordlnanc~s of the City of Springfield, and the Laws oftha Slate of Oregon perlalnlng 10 the work described herein, and Ihal NO OCCUPANCY will be made of any structure 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 Ihls project. I further agree to ensure that all required Inspections are requesled at the proper time; Ihat each address Is readable . . from the streat, that the permit card Is located at the fronl , . of tha property, and the approvad sel of plans wIll aln \. , tha slle at ~1I I~es during ~ruc ~gnalUre b~t'/:_( Date 7- / #,...qo// - , /j VALIDATION; .\~ RECEIPT NUMBER .-. ,- -rA .\. . t'J ~ ~rt: . :::~A;DRECI(I~Dc:.-; . .... .y. ~-;"... . - ___ RECEIVED By<l\\ to ") o'~-.7fIO.q:z-. I JUts NU. CITY OF ~INGFIELD SYSTEMS DEVELOPMIIT CHARGE C\~()CE5 WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ;/-,L ~ :/~, LOCATION: l1,~<tfL:;:.~ /)/7. DEVELOPMENT TYPE: ") ,c /? BUILDING SIZE: ~.- 1. STORM ORAINAGF I nT SIZE - SQ. Ft. IMPERVIOUS SQ. FT. .2-16""c;, X $0.209 PER SQ. FT. $ -?TSc:',I'"'7 2. ~ITARY SFWFR-rITY NO. OF PFU'S (See Reverse) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP } X U)! X $436.19 /7 X $43.26 PER PFU $ 71 6. " F X X X $436.19 X $436.19 $ ~40..>:s- $ $ SUBTOTAL (ADD ITEMS 1.2, & 3) $ 4. SANITARY SFWFR-MwtlC NO. OF PFU'S /"6 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 3/ 'I, ~ 2 (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ !>?, c. CJ . . IQIAI -MWMr. SDC $ :Llr~.~,z SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ / '7(..0,9.2. 5. AOMINlSIATIVF FFFS B~ ::leOVE) X .05 ~~~c~t~at~rE~ $ "lY'.O$ Date: ;z: - / ~- 99 IQIAI "I'll: $ ;2..0 5"'8. ? iT B2.SDC . ~ FIXTURE UNIT CALCULATION TABLE: Number of New Fixlurcs X Unit Equivalcnl = Fixturc Units (NOTE: For remodels, calculale only t~ addilional fixlures) . NUMBER OF FIXTURE TYPE NEW FIXTURES Balhlub..................................................................... . Drinking Founlain..................................................... Floor Drain.............................. .................................. Inlerceplors For Grease/Oil/Solids/EIC................. Interceptors For Sand/Auto Wash/Elc.................. Laundry Tub/Clolheswasher...... ..................... ........ Clolheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigeralor/Waler Stalion/Elc........ Receplor For Commercial Sink/Dishwasher/Elc.. Shower, Single Slall................................................. Shower, Gang......................................................:... Sink: Bar, Commercial, Residential Kitchen........................ Urinal, Stall/Wall..:.................................................... Wash Basin/Lavatory, Single.................................. Toilet, Public Installation........................................ Toilet, Privale.. ....... .......... ..... ....... ............... ......... Miscellaneous: UNIT EOUIVALENT z 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 FIXTURE UNITS 4 2.. 2. z. li" /'i' CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexalion date in table, calculate credits separates. I 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 19B5 $2.46 1980 3.3B 1986 2.14 1981 3.32 1987 1.77 1982 3.21 1988 1.37 L 1983 3.06 1989 0.97 1984 2.92 1990 0.61 1985 2.73 1991 0.44 J 1993 0.15 Credit for Parcel or Land Only If Applicable 7,~r- X $ /0. tnJ-o = 5-?.~6 (Rate X Assessed Value) ------ Improvement (if after annexalion dale) X $ = (Rate X Assessed Value) CREDIT TOTAL = $ ~6 0