HomeMy WebLinkAboutPermit Building 1995-6-7
ASSESSORS MAP' J7I'JS 27
LOT:~'='if:';
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ADDRESS: ) ?' ~ Z- 1-01W WJof>
CITY' ..:5.PPD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
OWNER:
l f_:'
.
/7<j.? ~A/;=:'
22
,
BLOCK'
STATE: :.f'rf(
DESCRIBE WORK' (1D Y)W('t' I If r OJ:
NEW REMODEL)( ADDITION
e.X(~ti4 1AeA,:.R..
DEMOLISH
OTHER
L----- /
.
JOB NUMBER ~5"d' 5"~-:Y
225 Fifth Slroel
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
~7./-L?
1
PHONE:
74-J-12g0
ZIP'
bv,<I~I<
.JA,
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fA\
.fv ('~~.{'
- OFFICE USE -
III t
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
t\:/('Rough MechanIcal - Prior to
~ cover.
'"ls7f Rough Electrical - Prior to
~cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to faclng,-
materials and framing Insp.
~ Fra~lng - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
~cover.
~ Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavatIon Is complete, forms
and sub-base material In place.
,.',
o Fenc~ - Whe~ completed.
,
o Street Trees - When all required
trees are planted. '
\.
,
CON ST. (<1V1- '1 U, '~r) ~.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES. PHONE
GENERAL: - \(. V\J\ :RA1"vlAf1: =3'10 L.11W{c k- '61:,32 ( :Sft'/'. ~ 1'~~ .ffl-r.;~~b
PLUMBING: --12k,.!f~ ~ 17 11~^"t' b~l c; It-'1 kI 4'f'l- <S \>r9 ......ZOZ2-'fPP, 'H/Ji'~ --n.b--hcr(1o
MECHANICAl' f\J J l}-
i ELECTRICAl' k\,~ 'S-kc. 'Xqq 71.0 '01 Ln. ~"'11~~Z- 'S1.f-'t-31 ~-3/)&JJ- J...'i(lo-()qOS
FLOOD PLAIN:
ZONING CODE:.-bJJ P-
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested beforo 7:00 a.m. will bo
made the sarne working day, Inspections requested after 7:00 a.m. will be made the following work day.
~ Final Plumbing - When all
~Plumblng w9rl< Is complete.
'fC71 Final Electrical - When all
P.J electrical work Is complete.
~ Final Mechanical - When all
~ mechanIcal work Is complete.
-,;:71' Final Building - Whon all
~ required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is comptet~.
o PJumbing Connections - When
home has been connected to
water and sewer.
o 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
Inspectlons are approved and
porches, sklrllng, decks, and
venting have been Installed.
.-
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
I ~N/)J
~-
o Temporary ElectrIc
O Site Inspection - To be made
after excavation, but prior to
setting forms.
K:A"UnderslaIkPlumblnQ) Electrical/
~echanb~-to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
,beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
O Post and Beam - Prior to floor
Insulation or decking.
~ Floor Insulation -. .f!1~~to _
~ decKlng.:5"~ t;P<i'c.. W~
~.
O Sanilary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
O Water Line - Prior to filling
trench.
~OU9h PlumbIng - Prior to
~~over.
, ~
',i. : .~ ;:: "~, .. 'if'r;;.'}.
Lot TYP. \.' r:;1,~ ,.il . .IS THE PROPOSED WORK ;N THE.
.: .~ : ~
Lot (aces Setbacks,
Lot sq. ftg. Interfor I PL. IHSE GAR ACC' HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Lot coverage Corner N II yes, this application must be signed
S I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT. VALUE
Main
Garage
"
~<
/'
//~--
'/
Total Value
Building Permit Fee
1,33 + :2 ~o
(A)
......... -' $".0
- --{ -'.
("",93
q'?, .":3
Slate Surcharge
'. ~
Totiii"'f:"ife' .
t .' ) .... \ I
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
(B) iP ?,,?<;~
PLUMBING PERMIT
ITEM
FEE
3t::>PO
Fixtures
?"
Residential Bath(s)
N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge /.1'0 r , "'='
Total Charge (C)
~O<Sl-iO
-;24.cl
~ 2. _~()
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
I
h1/iJ !..
Wood Stove/lnserl/Flreplace Unit
Dryer Vent
Mechanical PermIt
-l... z;' ,40
--L0 . tJ-o
/,~
Z~ ,2.0
Issuance
.
State Surctlarge
,7S'r.fO
Total Permit
(D)
MISCELL.{-\NEOUS PERMITS
Mobile .Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcul
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
.........~;TAL AMOUNT DUE (excluding electrical)
_ B, C, D, and E Combined)
1"1"'~.~
, -
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction 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 at any time
upon violation of any provisions of said ordinances.
5"'4. 'Z ':7
'!!S' -'2 ~9_'
Plan Check Fee:
Date Paid:
Receipt Number: /? 2/&
RecelvedY: ...--z.~
~~Nl.J? .
PI~Reviewed By
~ l..A..r
f o':te
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~A.J, ~/DAJD.7 /A-m
.
{ .
~~ ~/JM_'7 /S ~L
J:b YVU (J(~i',u JO fA i1 (~ ./ Per yvu J
Jt'\UXV\U10 *" Q6-01-('J1o
By signature, I state and agree, that I have carefully examined
the completed application and do hereby cerllfy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure wlthout,permlsslon 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 this
project.
I further agree to ensure that. all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the ap~ed set of plans will remain
on the~lt t all times dur n finstr tlon.
Signa r ~
. .'
-. .
Date <::-- -q, .
I
VALIDATION:
RECEIPT NUMBER /7'::;"9
h- /-':::;P~?
7/.5:'~ ,
DATE PAID
RECEIVED BY
.
,.
," ",
, .
'j ~. :', ", ~. '. " " . . . . :', ..;. ~
'..' :~o:;Cq~o"';~{"'':;'''';'; ~
-' . . ~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ?':>E:-" Wne-I-\!:::."'"
LOCATION: \"2."6"2.- U>R-'-lE:. Loop
110,?')..'1"2-'2- ~ <Yl (",4~
DEVELOPMENT TYPE: LOIZ. - ~eMoDe.1.-C\-l.-I>r\lL""""'Ul/-..\.\
BUILDING SIZE: I".>,t. It.? '" 14"1 "'.F.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SIZE
SQ. Ft.
X $0.209 PER SQ. FT.
r;-
'---
)
.-/
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'5
X $43.26 PER PFU
0-z..\b~~
----- ...-/"
3. TRANSPORTATION
Cot>e:. '1.\4- - ~AL-TV f.f:.TAI1.. '" 4.q~(-ro;.<.f)
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $436.19
X $436.19
c: ?-w~)
-----. ----
$
$
o. \4-"1
X 4-."i'? X $436.19
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAL-MWMC SDC C - ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ '?'?c.. 1~
5. ADMINISTRATIVE FEE~
BASE CHARGE (SUBTOTAL ABOVE)
~' ~J..:...k-
(j' Ki P Burdick
SDC Coordinator
X .05
Date: ?/'7DJ1~
I (
G U'l4~
'-- .-/
TOTAL SDC
$ S(,,"3;> ~
FIXTURE UN,rr. <(!\!-,CULA T~ T A.BlE: Number at New Rxtures .a.Irl.nit Equivale~t =; ~~t~re.unit; ':;"
(NOTE: For remodels, calculate only the. addItIOnal ftxtures) . ' " . ""
. 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 T ub/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
'1
2
3
6
: 2:
6
'6
1
3.
2
l/Head
2
2
1
6
4
4-
TOTAl. FIXTUflE Ui"TS
=
<;
CREDIT CALCULATION TABLE: Based on assessed value. It improvementsocc'urred ;,ftcra'nnekation,date. in.table,
calculate credits ~cparates.
Year
Annexed
Rate per $1,000
Assessed Value
Vear
Annexed
Rate per,$l,OOO
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
J
Improve'ment'(it atter annexation datel
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
Credit tor Parcel or Land Only If Applicable
CREDIT TOTAL = $ ~/A
, "
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