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