The URL can be used to link to this page

Home My WebLink AboutPermit Building 1995-6-21 RESIDENTIAL PERMIT APPLICATION :. SPRINGFIELD Inspections: 726.3769 Oftlce: 726,3759 8=- JOB NUMBER Cjl50"3 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: ASSESSORS MAP:-!3 o~ ~ ~9.JS" tC;/"AC ;~;e 09~/ 1/ e 19-00 0.:.2 ~ '90 ....,yI1" cnrJ-. TAX LOT: BLOCK: _I: SUBDIVISION: CA,J.CAd e LOT' M1vpe.. PI , ADDRJ:"'" ~ T)<;,O'/ M CITY:~"it t:::t::: IJ DESCRIBE WORK: _~<!!:.l.v' NEW -X-- REMODEL r .ECA1o/ A. . ~c;Uee't;. t~V//"AAdc-..c,;;../ 1 OWNER: 'STATF" ate f(c,(,.'~ '(;.,'...,./ ~e ADDITION DEMOLISH OTHER H.:,'04'f<:S '-.s.'t t/ t<4i /lu':" PHONE:l5'03 - 7dC-d'l.l/ ZIP: _'1"7t 7 Y CONTRACTOR'S NAME ADDRESS CON ST. ,CONTRACTOR' PHONE GENERAl' PLUMBINC" MECHANICAl' ELECTRICAL' LJWJtJCL QUAD AREA' L\Q..:::f:, :~:B~:::~: ~~M ~ ~...... - OFFICE USE - \\\. \ . OF STORIES: LAND USE: I OF UNITS' \ CONSTR. TYPE: ~ \="~ WATER HEATER: RANGE: EXPIRES FLOOD PLAIN: ZONING CODE:.' f';!- . OF BDRMS: .,. , SECONDARY HEAT: _...f=..tJ SQUARE FOOTAGE: ~'2.[)\1_ Tv lequt:::>l ein in::;pecilon, you nluSt Cc..,j 7'26-:jfbSl. "ftllS ls'a ~4 hour recording. AlIlnspecllons requested before 7:00 a.m. will f)c made the same working day, Inspectlons requested after 7:00 a.m. will be made the following work day. ~e~porery Electric REQUIRED INSPECTIONS ~ Roug'h Mechanical -'Prlor to ~ cover. . dSlte Inspection - To be made ~after excavation, but prior to setting forms. ~ f ~/t. ~ Rough EI~ctrlcal - Prior to ~ cover. D Underslab PlumblnglElectrlcel/ Mechanical - Prior to cover. ~ Electrical Service - Must be )A.l approved to obtain permanent electrical power. lV1' Footing - After trenches are ~xcavated. D Fireplace - Prior to facing materials and framing Insp. ~ Fra~lng - Prior to cover. D Masonry - Steel location, bond ,beams, grouting. t9r Foundation - A'fter forms are ~ erected but prior to concrete placement. T521 Wail/Ceiling Insulation - Prior to ~cover. D Underground PlumbIng - Prior to filling trench. ~ Drywall - Prior to tap.lng. ~Underlloo(Plumbln~echenlcal ::> ' ~_ Prior to )tl::Juldm)n or oecKlng. D Wood Stovo - After Installation. "'F::7f Post and Beam - Prior to floor ~Insulatlon or decking. D Insert - After fireplace approvZlI . . "'" , ( , and Installation of unit. ~ . ..'''' , \~\. ~\""-:" Floor InsulaUon,'-.Prlor to"'. '-~". decking. ',', ,'~ Curbcut & Approach - After c'o. \ \ .~ for..ms are erected but prior to 'K/( Sanitary Sewer _ Prior to filling \. placement of concrete: ")6..J trench. ~ Sldewelk & Driveway - Afler ..;..xcavatlon IS complete, forms and sub-base material In place. ~ Storm Sewer - Prior to filling ~ trench. ' IVr"Water Line - Prior to filling ~ trench. ~Rough Plu.ml?lng - .Prlor to ~cover. ~. 't' . D Fen~e - When cO~Plete..d. ., @), \ ' treet Troes - When all requ~red rees are planted. I '" ' ~ Final Plumbing - When all ~ plumbIng w9rl< Is complet.c. F;71'" Final Eleclrlcal - When all ~electrlcal work 15 complete. "f';7I Final Mechanical - When all ~mechanlcal work Is complete. ~ Final Building - When all ~requlred InspectIons have been approved and building Is completed. DOthor MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D PJumbing Connections - When home has been connected to water and sewer. D Electrical Connection - When blockIng, set.up, and plumbing Inspections have been approved and the home Is connected to the servlce,panel. D Final - After all requIred Inspections are approved and porches, skirting, decks, and venting have been Installed. I~ ~'1s &;::?'2.. $" 'L.... . +'5./0 5gj,es , SYSTEMS DEVELOPMENT CHARGE (SDC) +f3 (B) \:h+UlJ~~ ~ Lot sq. Itg. i!:J.t[O Lot coverage ~!> Topography I~ Total height ~,q, (~5-) ( BUILDING PERMIT. so. FT. Lot Type. V I~terlor Lot facos Corner Panhandle Cul'de.sac ITEM X $/ SO. FT. .~~:-<> 1<1. ~O Main 2>L 1f( Garage Carport qA,$~r "ZIt;; '""do. I tJ .0- c:> , Total Value Building Permit Fee State Surcharge 2.t:;.~ +-IC,/f. Total Fcc (A) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' ~ Sanitary Sewer FT. Water FT. Storm Sewer FT, Mobile Home Plumbing Permit State Surcharge 9.t; '3 -f 578. Total Charge (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' 4- Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Perml t Issuance State Surcharge /,29.+,77 Tolal Permit (D) MISCELL,~NEOUS PERMITS Mobile ,Home State Issuance Slate Surcharge Sidewalk 'j?C::: It Curbcul 2~ It Demolition Slate Surcharge 71/.9I1..ey :VI~~ /~ Tolal Miscellaneous Permits (E) , TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) ";'ll I., 'I: :'::':1,:'"t~r , .,; ~t ~ Setbacks ' HSE GAR ACc'I fi ':" I PL. IN Is Iw IE lo-J VALUE /3-1371 " 02-.19:> 6tJ42- FEE /92 >0 /5,-11 -::>/'/7, 'II 0~ ~:.~ /2.~ :~,()<O ';2.tt:;;,'f'o /CJ .0"0 '2.~r (755 J 5 :~.s- L4,:lO _~o.tX) ~'/O"7.1'5 . - , 3'1~$:2.9 ' s -~ THE PROPOSED WORK.tN THE. ' "HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this appllcallon must be signed and approved by the Historical Coordinator prior to permit Issuance. 1$ APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condlllon thaI 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 a,ny time upon violation of any provisions of said ordinances. Plan Check Fee: . "5 5('), I r ~//7/f.s- Receipt Number' /74/'7 Recelv~ ~~ .d~~.ll-. PIll{is Reviewed By Date Paid: ~~r Systems Development Charge Is due on all undeveloped properties within the City limits which are,belng Improved. ADDITIONAL COMMENTS t-_At \,\C\lCXJ ,~ \'_~~i ffit-~: "~~.f lU I , , ~\ klll.h.<:?S, r\ Q.; ~ 0. 0 IOn QJ.C - . ~A?N 1 I .~ d.ee;: 4-/T/~. " By slgnature,lstate 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 perlormed shall be done In accordance with the Ordinances of the City of Springfield, and the Laws of the Stale of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission 01 the Building Salety Division, I lurther cerll.~y 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 remal~ on the site at all ~s dUrlng.zcllon. ~ature ,~..e/ ar'r~--~ Date. c-!t6I/"Zi) VALIDATION: RECEIPT NUMBER / 7'7;Z 5 DATE PAID t:./~//7.r ' AMOUNT RE6EIVED~.313t!i)!~" ,I RECEIVED BY - _~ . . "'!'., ., fi !l..'!il~,!!,f;!!l!"!~ " Job No. Q50lo,(Q0 SYSTEMS DEVELOPMENT CHARGE WORKSHEET ~~~~, ADDRESS: ~a.t'f\ G. ~~ \ ~ . PHONE: '12.lo, tqlol STATE:.rR_ ZIP ql'\- ~ . '. . . lOCATION OF PROPOSED BUilDING SITE: -Street Address if Known: \()q~~ G.\~;O{? " . . Platt ~ame: ~ ~ ~ t\~ Tax lot Number: \ IDm 1 ~ () rA'LcD.. 1. DEVELOPMENT TYPE (Check appropriate dwellirig(sl. SDC calculations and dwelling type definitions are on the back.l ' " ',', ' '. A. Sin2ie Familv - Detached \ Single Family home , NO OF UNITS I , B. Sinl!le Familv - Attached \ NO OF UNITS C. Multi-Familv Aoartment ' . Manufactured home not in a park $ A.en ~O X $400 PER UNIT -P, .' X $370 PER UNIT = "$ NO OF UNITS D. ManufactUred Home Park X $777 PER UNIT = $ NO OF UNITS X $280 PER UNIT = $ 4tf)cO . $ . $f1 $ 40Q Co WPRD SDC 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. , . 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced (or Credit) \l-('(\ A ~~V . -. . . . . r...........,......n.....' <::('Ion..r~'" l\'I~,('\n ~ I 2-/ I 7F n~IP .' '.JO~'NO. 'i?o(ptr>~ ,CITY OF SPRINGFIELD,SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: vJ"'YN f:. ~ c.~o L Sy L- L-I A A Sf:. N LOCATION: &:,~'?~ GL"'c..I~ 'Pe.. . DEVELOPMENT TYPE:_ L..Qe. ~ t-J.~W S~R.. BUILDING SIZE: I,_OT SIZF SQ, Ft. I. STORM DRAINAGE IMPERVIOUS SQ, FT, '71/7'6:0 X $0.209 PER SQ, FT, (':>G.0'0 2, SANITARY SEWER-CITY NO, OF PFU'S (See Reverse) -z."" X $43.26 PER PFU cGq4- V 3, TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X \ ,0 \ X $436,19 X X $436.19 X $436, 19 G 44-0~ '- --- $ $ X 4. SANITARY SEWER-MWMC NO. OF PFU'S _ '2-? x $17.19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) $ 40,?3,2. TOTAL-MWMC SDC $ 'i3~~ ~~ ~' $ -z..~\'Z-~! MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) ~~~ (j Ki P Burdi ck SDC Coordinator X .05 Date: '5/1'1 1"1<5 I / C 11c)"~ '- ,../ TOTAL SDC $ '242-b ";'> FIXTURE. ~.~I! ,c.t:\lCUlA TICJiL, . T A.BlE.: Number of New Fixtures ~,,*t Equivalent = Fixture Units (NOTE: For remodels; calculate only the .dd.tlOnal flxtures) , .. , NUMBER OF UNIT FIXTURE " FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS \ 2 1 2 3 6 2 6 6 1 3 2 I/Head 2 2 1 6 4 4 Bathtub........"""..",.,....",..." -. -",.,.",."...",." ,.', ,.' ,."" Drinking Fountain....................."...................,........., Floor Drain, ................,.....................,...............,.,..,... Interceptors For Greasc/Oil/Solids/Etc..,.............. Interceptors 'For Sand/Auto Wash/Etc,..............,.. Laundry Tub/Clotheswashcr...,......,;.: ...:......: ..,',::,.... ' Clotheswasher - 3 Or Marc..,.................................. Mobile Home Park Trap (1 Per Trailerl..,......,....,... Receptor For Refrigcrator/Water Station/Etc,..,.... Roceptor For Commercial Sink/Dishwasher/Etc.. Shower, Single StalL.......................,.....,............,...., Shower, Gang....,........,',.. '.'""" ",.',.,. ""'" .,......:~..". Sink: Bar, Commercial, Residential Kitchen,..,.........."........ Urinal, Stall/Wall.......... ..............,...,.......,...,........:..." Wash Basin/Lavatory, Single.........,......,..,........,...., Toilet, Public Installa'tion........,.....................,.,....." Toilet, Private....,....,............................................, Miscellaneous: z.. 2.- z. ? ? ":> 1'Z. TOTAL FIXTUf1E UNITS '2-~ CREDIT CALCULATION TABLE: calculate credits separates. II I Based on assessed value. If improvements occurred after annexation date in table, Year. Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or belore 1980 1981 1982 1983 ;984 t985 $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 0.6t 0.44 0,15 -- --- _._.,..".~~- Improvement (if. after annexation date) ~ .4-1:, X $ '2-'5,4:-1 (Rate X Assessed Value) X $ = (Rate X Assessed Value) '!S"'b I~ Credit for. Parcel or Land Only If Applicable CREDIT TOTAL =$ '8'2S'I~