HomeMy WebLinkAboutPermit Building 1995-5-12
RESIDENTIAL
PERMIT APPLICATION
~175~
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: ~ffi \.
ASSESSORS MAP' \f)D(l-,~\ ()\~ .
LOT'
BLOCK:
OWNER~ ~'\\~'{ L ~\l\ \\YJ)~~
ADDR~t"C:\\O~. f\ \{lS'-\f\ .
CITY:'- \J~ r1 . STATE:~~
DESCRIBE~RK: ~ . ~ \ \JWir1o f){"(L
NEW V REMODEL ADDITION DEMOLISH OTHER
:::::,~ 'S.~V~ ~~\[ 0 t\~_
PLUMBING:
MECHANICAl' () _ ~
ELECTRICA~:~~r(\ ,n
QUAD AREA:.c!) ~ lLU
. OF BLDGS' \ _
OCCY GROUP: \-\ '?r\-- M
. OF STORIES: ~
WATER HEATER: ( "'1
CON ST.
CONTRACTOR'
~O
IO~ f>
. 'pi) ,
:t:'4 5/3
.~
q 5)4.\01.
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
ZIP:
eXl4: l~
. c;:>
I.cr(r{~ ~. PHOOAt
Old,liglo ~
\0 4. CJ~ G\.~
-'.'.~ 141.
- OFFICE USE -
1\\ I
. OF UNITS: \ ,
CONSTR. TYPE: \/ AJ _
HEAT SOURCE: -Jibl-N P
RANGE:_-E- )
LAND USE:
FLOOD PLAIN'
ZONING CODE: L\')\2..-
. OF BDRMS: .~ ,
SECONDARY HEAT: - ~YU::l!1o
SQUARE FOOTAGE: ~o'1\
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons 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.
~mpora~ Electric ~~~~~:~~h~~c~~E~::?t~S
~ cover.
D Site Inspection - To be mado
after excavation. but prior to
setting forms.
D Underslab Plumblng/Electrlcsl/
Mechanical - Prior to cover.
~otlng - After trenches are
excavated.
o Mason~ - Steel location, bond
beams, grouting.
G-!:oundatlon - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~dernoor Plumbing/Mechanical
U::::l :::.: Prior to Insulation or decking.
r:-J...pQst and Beam - Prior to floor
Ll::::::J in-sulatlon or decking.
~or Insulation';"" Prior to
decking.
~nJtary Sewer - Prior to filling
trench.
~rm Sewer - PrIor to filling
trench.
~aler Llna - Prior to filling
~ ;;ench.
~U9h Pl'Umbln9"'~YfIOr, to.;-,
~ ~~ver. '-. . ".
rVl Rough Electrical - Prior to
L....f"J cover.
rv:I Electrical Service - Must be
L..f::l approved to obtain permanent
electrical power.
o Fireplace - Prior to faCing'
materials and framing Insp.
c:P Framing - Prior to cover.
r::::::l Wall/Ceiling Insulation - Prior to
~ cover.
5{l Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv41
and Installation of unit.
f"'rl Curbeut & Approach - After
L.,CJ forms are erected but prior to
placement of concrete.
rYI Sidewalk & Drlvewav - After'
~ excavation Is compiete,.forms
and sub-base material In place.
o Fence - When completed.
rY1 Street Trees - Wh~n all requlr,ed
~ trees are planted. ' . .
r'il Final Plumbing - When all
~ plumbing w9rk Is complet.e.
r\II Final Electrical - When all
r electrtcal work is complete.
~
Final Mechanical - When all
mechanical work Is complete.
LfJ
Final Building - When all
required Inspections have been
approved and building is
completed.
OOthor
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blockIng Is complcte.
o
PJumbing Connections - When
home has been connected to
waler and sewer.
o Electrical Connection - When
blocking, set-up, and plumbIng
inspections have been approved
and tile home is connected to
the service panel.
o Final - After all requirC!d
inspections are approved and
porches, skirting, decks, and
ventlng havo been Inslalled.
Topography Panhandle
Total hejlht ~ . _ Cul.de.sac
( 45' -lQtt\ OD t)
.....
BUILDING PERMIT
so. FT.
~50
1013
Lot (aces
Lot sq, ltg,
Lot coverage
ITEM
Main
Garage
Carport"
Total Value
Building Permit Foe
Slate Surcharge
Total Fee
Lot TY.
II' I~terlor
Corner
:.:-
IP.L.
IN
Is
Iw I
lLJ
HSE GAR
x 6~~W = l~u~lO
14./0 " -B'lc7t~
1
N'
3,
\4{\1\~
S&f;.~
"-I~.D\
Sb 1.~t1
SYSTEMS DEVELO.PMENT CHARGE(SD~ ~
, (B) #-z..98G.-
&J. A6 + IS. Ie
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
SanJtary Sewer
~~t~1 t
St,grm Sewer
Mobile Home
Plumbing Permit
Slato Surcharge
Tolal Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FT.
FT.
FT.
~'b\ + 5.1fl
(C)
Wood Stove/Insert/Fireplace Unit
N'
4
Dryer Vent
~~~ ~(\~
MechanIcal Permit
Issuance
\.11; +- \,~S
(D)
State Surcharge
Total Permll
MISCELL.!\NEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk l" ft
Curbcul \ 5 It
,-lf1 Ue~ !J4s5ti5~
'-_ _--.....J
r;.:..:.: 3......."Q,~\;;I
~~tu.-.~~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
lq~.~
lC,~.~
lSo'1l.
a-.O 1, <l.L
c,.~
~,'i.Q
\1)..~
--, '~:
~ "4,
Cl>>
3.-
'5.~
'2,s..~
\D.C'.l!2..
~.~
.Ln.~
\ !:l. &.e.
" .1.S
\...-
if 1.1'0; lz:.. i
/J"f;.., .
.,3'-1 \. '-1L_
_3b5":..~'
Q.S:i ,!.,.,..:-
. -J.fl75-~1
",'
.~ -j ~:~ ~'~i~. ~tJi~~; -
., IS THE PROPOSED W~RK.tN THE. '
--HISTO~ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks.
Acc'1
I
I
I
I
APPROVED: .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the expre<;s condition that the said
constructlon sha"~ in all respects, conform to the Ordinance
adopted by' the City 01 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'
Date Paid:
Receipt Number-
Received By:
p~l~lewed By
s/'iko.{
~e
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
. , .'
\.AW\~A~ COMMENTS
o\-\-T:/JI'\\n
\ \ rA\\nQ){', \C\ If! ~
By signature, I state and agree, that I have carelully examined
the completed application and ,10 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 Ordinances of the City of Springfield, and the Laws
of the State 01 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 lurther 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 site t all times during c tructlon.
~ t!j/
Date
'\~/.:z_ 44-
VALIDATION:
RECEIPT NUMBER I 7~
DATE PAID C; -j /_ :.. '1!5
AMOUNT RECEIVE( ~'~ !S._~'!:7__,
RECEIVED BY ~.
.
.
, ~
@ !!.'!ilt~<!!~!!g!!!l;
JObNO.9~~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NNk; ~rO. ~ ~n'\.... PHONE:l4lQ.om
ADDRESS: ili3J\ V:f6m~ l STATE:~ ZIP 011:13.
'.
- .
lqCATION OF PROPOSED BUI~DING SITE: .::\.\... ...I . ('0.. " ~ 1 . rn J'
Street Address if Known: F\~ \ ~ 'l ) t J( 1 Q It t\:illf 11 Q J l X f.J...-.l
~.. N_ . t\ \n. ') T~ lot :"mh<r. ''7('I?.fJ!O//) Q{f)f8
1. DEVELOPMENT TYPE (Check appropriate dwellirig(s). SOC Calculations and dwelling type
definitions are on the back.) , , '. .
A. Sinl!ie Familv - Detached
\ . Single Family home
NO OF UNITS
Manufactured home not in a park
, ..A "'.f\ d)
X $400 PER UNIT .r.. $ ~l1. ), .
B. Sinl!le Familv - Attached
.
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv Aoartment .
NO OF UNITS
X $777 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
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 SOC reduced for Credit!
$ 4{'f) ~
.'g
$
$4D{J(V
~
~ t<\. \\_ . . .
r,..,n"'........n.f-l' <:,..,.~..r('\r '"' fl<"f'\n
I
I
n~,p
.
. .B NO. Q'So4-{,,2..
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR.COMPANY: ~\\q:,. e:,LAr-.l~~?\-l.,\P
LOCATION: Be:,9 WAYOt::.1-l "OIL. t2-.t:> .
DEVELOPMENT TYPE: L-Vl<- - t--t~W St::\Z.
\\O"?'2..fo \'1... - O\O\~
BUILDING SIZE:
1. STORM DRAINAGE
LOT SIZE
SQ. Ft.
IMPERVIOUS SQ. FT.
4-'Z.€>"1
X $0.209 PER SQ. FT. ~'b9?~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
'2..("
X $43.26 PER PFU
cG 24,0
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X t.OI X $436.19
X X $436.19
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S /_", x $17 .19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
X $436.19
cC440~0
$
$
$ 4Sfo 9~
TOTAL-MWMC sDC
$14-~
~
"-- ----
$ Z'?A4-I~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
\i" ~ ~ -A-J.-.-
, U Ki P BurdicK
SDC Coordinator
X .05
Date: 4A? /q,r;
f I
cC'~~0
TOTAL SDC
$ 2-4'3(", "?to
: .' . .....<~':: :...-:?!.~:~~:y~,~ ':~:::~"~':'"' .": '0< . ,_: .
FIXTURE. Ul\llr.(;~~lJlA lAN TABLE: Number of New Fixturc.nit Equivalent = Fixture Units
(NOTE: For remodels; c,lIet/latc'only th~ additional fixturesl .
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
?4b X $ "2--1.41
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Bathtub.................................. ........................... ~ ........
Drinking Fountain.................... ........... ..... .................
Floor Drain............................................. ....... ............
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors 'For Sand/Auto Wash/Etc..................
Laundl)' T ub/Clotheswasher.... ................... ... .........
Clotheswasher ",3 Or More.......,.,...;........:.,.:............
Mobile Home Park Trap (1 Per Trailerl..............:...
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang.................................................. .:.......
Sink: Bar, Commercial, Residential Kitchen.........................
Urinal, Stall/W all.................................................:.....
Wash Basin/Lavatory, S;ngle.....;............................
Toilet, Public Installation........................................
Toilet, Private... ............................................... :....
Miscellaneous:
r
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
19,83
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
..
~--,-
Credit for Parcel or Land Only If Applicable
Impro,Jement (if after annexation datel
"
"2..
4-
2
1
2
3
.6
2
,6.
6
1
'3
2
lIHead
2
2
1
6
4
r
-z..
2-
.
1..-
4-.
4-
1'2..
...,
TOTAL FIXTUflE UNITS
-z.c.,
~
---..,
0- -
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
~
14-oe
~
CREDIT TOTAL ~ $ -74 ~