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Home My WebLink AboutPermit Building 1994-11-1 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 ASSESSORS MAP' \~ LOT: OWNER' LE5SR RD) ADDRESS:' 4- 7 Lf L/ - W $' 5p" -I--rl ~ CITY: . BLOCK' Lesile d- Sh,Q.rrY Rile. 5.uJ.; {fp"r-.~'t03 STAT'" . u/A DESCRIBE WORK' S' REMODEL s", T, R,;<)/i)31TL!.r- ADDITION DEMOLISH OTHER . SPLf'~ ',. . C)-;I.;~/.~ JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 c:;T; TAX LOT: .D ~ 'lfX) SUBDIVISION: tJJ l' 01) y\ PHON'" tzo{;) c;'5::Z -494-:? ZIP' 98 I ( 6 CONTRACTOR'S NAME GENERAL: -rAnur? (:(jN,T co PLUMBING: In NIU ~ Y In /"",_, MECHANICAl' //A QVEY ;/lt1A/ ELECTRICAL: /0/, d d !I Co /z L (let CONST. CONTRACTOR . /q;),q,tJ .~~~ ~ ~LttSI . If- S, 9S . ('It .(jllt 16)-/3Cft ')4'). A. 'fJk. ~.!}fo-9S 11b.?Io'J? ~~.?,r,.q~ QUAD AREA" o+<f..C'...J . OF BLDGS' \ OCCY GROUP: )p(~\ ,. t\A . OF STORIES' WATER HEATER: -f "' ADDRESS !lQ.<I Sf'W.4RD - OFFICE USE - \ \ \ l \/N f"S LAND USE: . OF UNITS' CONSTR. TYPE: HEAT SOURCE: RANGE: _E-- EXPIRES PHONE FLOOD PLAIN' ZONING CODE:~ '.OF BDRMS' ..s SECONDARY HEAT: \J SQUAREFOOTAGE:~ To request 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. ~ T~mporary ElectrIc D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumblng/Electrlcal/ Mechanical - Prior to cover. '(/'( Footing - After trenches are ~ excavated. D Masonry - Steel location, bond ,beams. grout! ng. ~Foundatlon - After forms are ~ erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. REQUIRED INSPECTIONS f':7f Rough Mechanical - Prior to ~ cover. ' 'l""21 Rough Electrical - Prior to ~ove~ , ~ Electrical Service - Must be ~ approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~Framlng - Prior to ~over. f"'Y(Wall/Celllng Insulation - Prior to ~ cover. JZl Drywall - Prior to taping. .. 'C71' Underlloor:Plumblr<tf1liiechanlc!ll/ 0 ~ - Prior to 1nSulatioh-:or aecKlng. . Wood Stove - After Installation. . ~ Post and Beam - Prior to floor )6J Insulation or decking. ~ Floor Insulallon - Prior to ~ decking. ~ Sanitary Sewer - Prior to filling ~ trench. r\::rStorm Sewer - Prior to filling r trench. or Water Line - Prior to filling ~ trench. rvrRough Plumbing - Prior to ~ cover. D Insert - After fireplace Bpprovlll and Installation of unit. . K7t" Curbcut & Approach - After ~ forms are erected but prior to placement of concrete. ~ Sidewalk & Driveway - After ~ excavation Is complete, forms and sub-base ma,terlal In place. D Fence - When completed~. ~Street Trees - Wh~n all required (y trees Bre plantedr . ~ Final Plumbing - When all plumbing w9rk Is complet.e. rv1 Final Electrical - \NtIen all ~electrlcal .;"Jerk Is complete. ~ r57f Final Mechanical - When all ~mechanlcal work Is complete. d Final Building - When all ~ required Inspections have been approved and building Is \ completed. I DOther MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been con nected to . water and sewer. D Electrical Connection - When blocking, set.up, and plull,lblng Inspecttons 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 ~ Lot sq. Itg. ~ Lot coverage ~ Topography L2-?e Total ~elght ~) Lot ~yp" Interior X Corner Panhandle Cul-de-sac BUILDING PERMIT SQ. FT. 17"SD /2.tf:>7 ~ ..i ';'n.' . .~~ .: : ~: .l~' ~'. ~\~.' :~:} ~S THE PROPOSED WORK IN THE _ ....HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. I P.L. IN Is Iw IE Setbacks. HSE GAR ACC' /i.~ /~Q II~ X $/SQ. FT. ~ VALUE ,Go ~<> '772-2(,.. I~,/O" /7fl,~ ITEM t-.1ain " Ga~age Carport Total Val ue Building Permit Fee z~.fr--+-14.D7 State Surcharge Total Fee (A) /jC:;OU ..f'6'?:t:1C 375"2- 5~.S"2. SYSTEMS DEVELOPMENT CHARGE (SDC) ~ (B) 'It Z'-lG:.\ 'iL PLUMBING PERMIT ITEM Fixtures , Residential Bath(s) N' 2.. Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home PlumbIng Permit State Surcharge fb~ -f-l,SO Total Charge (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' ~J Wood Stove/Insert/Fireplace Unit Dryer. Vent Mechanical Permit Issuahce State :Surcharge /./!. T..~e Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk /~ It Curbcut :l/P It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT OUE (excluding electrical) (A, B, C, 0, and E Combined) FEE .#"~ 6Ip J2.~ 172 :~o . c.,~ 4!o 9_~ :.? o-c. _?? ~o / b) ,0 0 ?, 4.:H 370- /:,;-10 ~2- ,-Fa 3;&'21,91 70 APPROVED: . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition thallhe said construction shall, in alf respects, conform io 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. Plan Check Fee: ~ ",4 ~.s- 9(/ S:/5'.,t Iq/G ~x..., Date Paid: Receipt Number: ReCe~Y: pfa~ ~~ '-- /.Ph~/9.,t / Dat~ . Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS , I ~f)tbOY'r J ~)j\OIl "() g r ^ _ " o.\~ T: 13 f'}ffi . : lqf}~ PA77-J 1.. ~~~ P~~~A;~dr I') ~/.//.~e2J, By signature, I state and agree, that I have carefully examined the completed application and do hereby certify 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 Ordinanc~s 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 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 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 approved set of plans will remain on the Slt~. during construction. 4,atur,. Oat~ VALIDATION: \ "l RECEfPT NUMBER ~:,. ") \S DATE PAIr> I {. I 'Cf4- AMOUNT REC91YEh "3 d:' 2. 7 ,'If RECEIVED BY 'Fl\ (D():----' , ,/ Al I Al.nl'lc.l~ I 01 . . ~B NO. ~'-\l"'\?,. CITY OF SPRINGFIELD SYSTEMS DEVELOPME~CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: \_1'0:7\..\1'0: i; c"HE:~f<.---( L€o7?A~t> LOCATION: '-1(,,08 Ho\-,--'" ,,::>,. \ '2:> O-z.o'?1"Z. -011~() DEVELOPMENT TYPE: \..p~- t-.lE:JA\ '::>f-lZ BUILDING SIZE: LOT SIZE SQ. F t. 1. STORM nRAINAGE IMPERVIOUS SQ. FT. ?l"\'? 2. SANTTARY SFWFR-rTTY NO. OF PFU'S \9 (See Reverse) 3. TRANSPORTATTON X $0.209 PER SQ. FT. $ 19"';> I'::' X $43.26 PER PFU ' $ '62-\ "I '-\- NO OF UNITS X TRIP RATE X COST PER TRIP X \. 0 \ X $436.19 $ '-j<-lo~ X X $436.19 X X $436.19 $ $ SUBTOTAL (ADD ITEMS 1.2, & 3) $ 2-0??!."::' 4. SAMlIARY SFWFR-MWM( NO. OF PFU'S \9 x $17.19 PER PFU + $10 MWMC ADMIN. FEE $ ?"?(.,"'l (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 41 ?~ IQIAI -MWMr snr $ 2&902- SUBTOTAL (ADD ITEMS 1.2.3 & 4) $1.'?'-\ '-t (,.~ 5. AOMINISTATTVF FFF~ BASE CHARGE (SUBTOTAL ABOVE) X .05 $ \\I"Z.~ ~~~ ~~~~Mary Hornig, P:E. SDC Coordinator Date: 10/4 /q<-J , I IQIAI snr $ "2-L/(.,\ ~ B2.SDC . 1 FIXTURE UNIT 'CALCULATION TABLE: Number of New FiX. X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate onl. M.EI additional fixtures) . NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. I Bathtub..................................................................... . Drinking Fountain..................................................... Floor Drain................................................................ Interceptors For Grease/OiIlSolids/Etc...............:. Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher...... ...... ...... ....... ....... ... Clothes washer - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For RefrigeratorlWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink: Bar, Commercial. Residential Kitchen.;...................... Urinal, StalllWall..:................................................;... Wash Basin/Lavatory, Single.................................. Toilet, Public Installation........................................ Toilet, Private......................,................................ Miscellaneous: ,TAN/rcP'$ $//-Ik 7_ 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 ..1. y z. 2- ? ? z. 1:> TOTAL FIXTURE UNITS \9 = 7,'4<.. X $ 1',,;>.7'> (Rate X Assessed Value) X $ (Rate X Assessed Value) Year Annexed Rate per $1,000 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 Credit for Parcel or Land Only If Applicable Improvement (if after annexation date) Year Annexed Rate per $1,000 Assessed Value 1985 1986 1987 1988 1989 1990 1991 1993 $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 = 4, "'8 = CREDIT TOTAL = $ 4\ ">..!. .' r/ . . fi yy}!t'!~!!~!!,~ JObNO.~ Nt.. PHONE: 1.D1o!J PeL 4<=f42- . I )=#:-103STATE:W8zIP ~RH lo ~. . LOCATION OF flROPOSED BUILDING SITE: '),.,\_\ ~ . Str~Addressif~nOWR: 4\oO?> \. .Y2\'H q. &rOOY-o LJ ~ . Platt Name:..c:~ f\ Tax Lot Number:j ?fJ W S-\1 r\-nW NAM~'" ADDRESS: 4-141 4\ ~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the backJ A. Sinl!le Family - Detached NO OF UNITS Manufactured home not in a park l X $400 PER UNIT .= cd $ 4-{fL_ . -L- Single Family home B. Sinl!le Family - Attached NO OF UNITS X $370 PER UNIT = '$ C. Multi-Family Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park, NO OF UNITS X $280 PER UNIT = $ WPRD SDC $4GD~ $ff $40V cJO 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) ~ ..~ I ISlon \ \ / \ ,Si Date