HomeMy WebLinkAboutPermit Building 1993-10-8
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LOCATION OF PROPOSEtp.~O~' l2q \ 1 :::::t \n r; o).()
ASSESSORS MAP' t 'r)U QD~ ~~~ -
r; BLOCK' - ( 0
OWNER:, 9:\Cl Mo ~ ~ ./, 't:\l&~
ADDRES~: I, ~J.-"3 '- ~ ~y J( ~01_ _
CITY' ~ ' STATE: lU-{()
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DESCRIB,E /JORK -5 r\~<L;' ~ .~ll)'_~\d. c.J\..c..a....-
NEW / REMODEL ADDITION DE&buSH OTHER
.. .-
'tI ...
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOT'
'.
'5P Z.10
..
q3l4~~
JOB NUMBER
225 Fifth Streot
Springfield, Oregon 97477
TAX LOT ()S4[')(' ~
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SUBDIVISION: r!!llJ/fi'l.7i.JJ " /8+
J
PHONE: f)4 0- ,2f){..l S
ZIP:
q 'l1-CJ ~
CONST,
CONTRACTOR'
6)~cqq
J3'l94n 5
,~ S'1CfO
CONTRACTO~S NAME _ t"L _^. ~,ADDRESS
GENERAL:l ~ N.lf') '\..:w, l.Q)JJ
PLUMBING: .(\ ~D l<Y n[) JJ\-..;/
MECHANICAL{ j y;y\1'l. J\ ~n..QQJ:Y
ELECTRICAL' C\ \ t"f\5
QUAD AREA: -4 ~S5
. OF BLDGS: \ I
OCCY GRoup:Rh ~\
. OF STORIES:
WATER HEATER:
\ '?../
--
- OFFICE USE -
LAND USE:
\\ \ \
\
EXPIRES PHONE
5 -4.94
10,! .q-3
ll:-l'd:)'~~
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FLOOD PLAIN:
ZONING CODE: ,UJf.t.---'"
. OF SDRMS: '3
SECONDARY HEAT: ()) E?
SQUARE FOOTAGE:~g()
,
To request an Inspection, you must call 726-3769. This is a 24 hour recording. Atllnspectlons 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.
qE..Te~:~nffL~ec i \ . rIl
l...ffJl.\J --~a.:"\l - QU\,I.'.U(
[Xl Site Inspe;~o '::';0 be made
after excavation. but prior to
selting forms.
o
Underslab Plumbingl Electricall
Mechanical - Prior to cover.
t2l
Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, groutlng.
[Ll Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
rn
Underlloor Plumbing/Mechanical
_ Prior 10 insulation or decking.
IT]
Post and Beam - Prior to floor
Insulation or decking.
~ Floor Insulation - Prior to
LL1.J decking.
rJfl Sanitary Sewer - Prior to filting
IL.f-J trenctl.
[Z] Storm Sewer - Prior to flIUng
trench.
IV1 Water Line --Prior to lili~ng
~ trench.
fJ71 Rough Plurnbln'g ~- ~Pri?r to
W cover.
. OF UNITS'
, )
CONSTR, TYPE: ~ tv
HEAT SOURCF' Fr ~
f/
RANG!."
REQUIRED INSPECTIO~.S
rAt Rough Mechanical :- Prior to
L,LfJ cover.
171 Rough Electrical - Prior to .
~ cover.
[II Electrical Service - Must t)e
approved to obtain p6rnianenl
electrical power.
121
Fireplace - Prior to facing
materials and framln9 Insp.
C1J
Framing - Prior to cover.
~ Wall/Ceiling Insulatio~ -~Prior to
l,4J cover. .
IKl Drywall - Prior to .taping..
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
[2']
Curbcut & Approach - Arter
forms are clected but prior to
placement of concrete.
,,:
rn
Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
o 'Fence - When completed,
":,)..... .
rn Street Trees - When all required
trees are plantee!.' ".~ '":..,.....
~., . - . "'..
CZl
Final Plumbing - When alt
plumbing work Is complete,
[1] Final Electrical - When all
electrical worK Is complete.
f-;(1 Final Mechanical - When all
~ mechanical work Is complete.
I7l Final Building - When all
LA-J required inspections have been
approved and building is
completed,
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel-Up - When all
blocking Is complete.
!'
o Plumbing Connections - When
Ilome has been connected to
water and Sewer.
o Electrical Connection - When
blocking, sel-up, and plumbing
Inspec.tions have been approved
and the home Is connected to
the service panel.
.
o Final - After' all required
inspections are approved and
porches, skIrting, decks, and
venting have been installed.
. . -,
Lot face~ ~ Lot Type Setbacks IS THE PROPOSED WORK IN THE ..
I PL. .. HISTORICAL DISTRICT, OR ON
Lot sq, ltg, Interior HSE GAR ACC
K IN Ie' THE HISTORICAL REGISTER?
Lot coverage Corner If yes. this application must be signed
1320 Is 1// and approved by the Historical
Topography Panhandle Iw Coordinator prior to permit issuance.
Total height :Z>~ Cul,de,sac 1/'
IE 11.7' APPROVED:
BUILDING PERMIT
SQ, FT.
cD()c()
..!Son
x 1;',QO ~ II ~4Cc)
, 10 ffiI:L
ITEM
Main
Garage
Carport
/J:1j-7L0
ij~. <'>
? '/.0/
(A) '~7/ <Go
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
(B) ,*,"2.z.~~
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residontlal Bath(s) N' -:2
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
/hC)
Plumbing Permit
/~ <0;0
Ai:~-
/68>~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
h,- <:>0
'/- sP
9.'=
Furnace
Exhaust Hood
Vent Fan
N' '5
Wood Stoveflnsert/Flreplace Unit
Dryer Vent
~.-
Mechanical Permit
;Z;;>. 5' e:>
/~-
/.[3
"?~. 63
Issuance
State Surcharge
Total Permit
(D)
I.'
I'
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
/~
56-
'::? C/. ~ t:?
/~- y&/
It
Curbcut
It
I..
I
Demolition
State Surcharge
1A//'-~A1~A'~/.?:?P C
- ,
y~
/?? 3'0
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~~? ~:J
(A, B, C, D, and E Combined)
, ~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on Ihe express condition that the said
construction shall, in all respects, conform 10 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 Clleck Fee: ,,~{,Q, \ l [) ,-
Dale Paid: q , \!j ,C\~
Recelpl Number:~('r~-T-_
~::_ ?j\(N\ ~~
,rP;/l€j;i ReViewef-~.>>
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Date
Systems Development Charge is due' on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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(lillrn11ie ) ~p~./
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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 fUrl her 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 thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further corti fy that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I furtller 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 proper~y, and the approved set of plans will remain
on lhe site a al~2:~ Cj;tZ;
Datn ~O
VALIDATION:
RECEIPT NUMBER, \\) S\S
/n.~.q~
DATE PAIr>
~
AMOUNT RE~E 'Er,~ . ~W-s: ~
RECEIVED B flY::),
~ ...- ,- -
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;
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. JOB NO. 9?;>\~?~"
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CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: i-h.lG.-I-\ HAS~E:.\d._
LOCATION: Go"'l II G l.-Ac...\ E: 1a.
12:.0'2..o'Z.."2..-=- - 00::>'-\-00
DEVELOPMENT TYPE: LD IZ- - NE:.\'V Sf-'Ii1.-
BUILDING SIZE:
LOT StZE
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
,,?".:>q,
X $0.203 PER SQ, FT,
~
~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
Ie
X $42.08 PER PFU
~ '5>" -+?)
~' , .--/
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1.01 X $424.31
X X $424.31
(;Z5?:)
$
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S 1'6 x $15.125 PER PFU + $10 MWMC ADM FEE $ Ze,"'2.-z.~
(Use PFU Total From Item 2 Above)
X $424.31
~
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ IO'-t!..
TOTAL-MWMC SOC ~
'-- .../
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ "2.. \ 7.. '1"'j:,
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~:13-.-.- ~L 9/ultl\,~
U Kip Burdick I f
SDC Coordinator
~o(o~?)
~
TOTAL SOC $ -z..Z?+~.::!:-
FIXTURE UNIT ;CALCULA T~ TABLE: Numb~r of New Fixtures X. Equivalent = Fixture Uni~s (NmE:
For remodels. calculate only the NET a.onal fooures) "-
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNiTS
.1
., .
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
~
Batht ub,....,.."..,..,.., ,..""..".."""""""".,"""',..,",..,'"
Drinking Fountain,.,.., ,..."""""""""""..",,"',..,"",..,
Roor Drain.......,..,.....,....",..,..,....,......""....".."""",..
Interceptors For Grease/Oil/Solids/Etc,..,..,..........
Interceptors For Sand/Auto Wash/Etc.............,....
Laundry Tub /Ootheswasher.........,.......,.. ...,..,....,...
Ootheswa~her - 3 Or More.....................,...............
Mobile Hdme Park Trap (1 Per Tra'i1er).............,..... ' '
Receptor F9r RefrigeratorjWater Station/Etc,.......
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single'Stall,....."..................,..,.....".,..,..,..,'
Shower. Gang..............,............".,..",......."..,........,.,
Sink. Bar, CommerciaL.....,................,..."............".,
Urinal. StallfWall...............................,...",.....,..,......,.
Wash Basinflav;J,tory. Single..........,.......................
Water Ooset. Public Installation.,...........................
Water Ooset. Private..................",.....,....,.......,....,..
Miscellaneous:
t...
l
'2..
7...
-z.
-z
'Z..
8
TOTAL FIXTURE UNITS
\f'J
CREDIT CALCULATION TABLE:
calculate credits separates.
I
I
Based on assessed value, If improvements occurred after annexation date in table.
Year
Annexed
Rate per S 1.000
Assessed Value
Year
Annexed
Rate per S 1.000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
'1985
$3,21
3.13
3,08
2,96
2,82
2,68
2,51
1986
1987
1968
1989
1990
1991
1992
S 2,24
1.93
1.57
1.18
0,79
0,44
0,28
"
Improvement [If after annexation date)
?'Z.\ X $ -z.l .9(" to-+~
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ toy..::
Credit for Parcel or Land Only If Applicable
RUNOFF COEFFICIENTS FOR,STORM DRAINAGE
Residential........................".....;..,.......',...,.,....... 0.4
COmmerciaL.........................,~.........:....:........, 0,9
IndustriaL........................................................ 0,45
GovernmentaL..,...,...,...,................................, 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
/
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o y!i!I.!!!!!!~!!!
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Job No. q3 Ji<?J3
SYSTEMS DEVELOPMENT CHARGE
NAM'" ~\~, ~OS:EEJ PHONE, f)!\ l,-3l\Q5
ADDRESS:~ !3~f:l~ Q12..)2d.;-4J STATE:t12.. ZIP g'741()
<,
LOCATION OF PROPOSED B}JILDI SITE/, ' 0
Street Address if Known: lJJq 11 ('"1 In r 1 .Q f ) !JLu.>e.J
Plan Name: ~Q)orn rl 0 . No Irm-k.-ax Lot Number: / M~()~ {L?I Ocn1W
1~.d\cicL.,~ .
1. DEVELOPMENT TYPE (Check appropriate dwell i ng(s). SDC Calculations and dwelling type
definitions are on the back,) ,
A. Sinl!le Familv - Detached
1
Single Family home
NO OF UNITS
_ Manufactured home not in a,park
,1~" cd
X $400 PER UNIT = $ \lU,
B. Sinl!le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ 4N).cD
$!2f
$ 4C'f).C()
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)
~~~l~
City of Springfield
\() I
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Date