HomeMy WebLinkAboutPermit Building 1995-1-10
OWNER' r9N9\1 {)P-re..Y-~h
ADDR~';'" 00 Jtloi 74;;;1
CITY: 1.L-{~~
DESCRIBE WORK' ~,ar~OJVCt 61::
NEW){ REMODEL ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
CONTRACTOR'S NAME
W1 Cl \r\
( J
I
...
..
SPRINGFIELD
-
BLOCK'
STATE:
Oll_
\Y\~,~.
DEMOLISH
OTHER
.
JOB NUMBER
'?1/~~F)
225 Fifth Street
Springfield, Oregon 97477
PHONE:_4')l'~ - 7scrCf
ZIP:
q ~'F-IO?--..
Y1ctAll.ClL
\J
CONST,
CONTRACTOR' EXPIRES P"'''"'E
171./0 OO}~ /?A ('"Yt41IJ~eJj)gq-/9Icr)
, / 1
GENERAL:
ADDRESS
ffi+ 'nOM e.~
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA' ~~
. OF BLDGS: ~
OCCY GROUP: R ~~ M
. OF STORIES: \
WATER HEATER: c:r.--'
- OFFICE USE -
\ \ C;;()
# OF UNIT'" t
CONSTR. TYPE: -1L.^)
~<;
c:;:.
LAND USE:
HEAT SOURCE:
RANGF'
~
FLOOD PLAIN:
ZONING CODE: ~,
.~
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
\ P,O~
r/
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.
o Temporary Electric
REQUIRED INSPECTIONS
o Rough Mechanical -:. Prior to
cover. .
o Site Inspection - To be made ~ Rough Electrical _ Prior to
after excavation, but prior to ~ cover. (i(t-".n..n fl--
setting f~S. _\\....~ ___~
~nderslab Plumbln Elect;~D Electrical Service _ Must be
~ ~eChanlcal - PrIor t"" ...........,. approved to obtain permanent
electrical power,
~
I Y1 ....ootlng - Atter trenches Bre
~ excavated.
o Ma.,onry - Steel location, bond
,beams, grouting.
/' , ,
1'\t1 t"oundatlon - After forms are
'T""'\. 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.
O Floor Insulation - Prior to
decking,
~anltary Sewer - Prior to filling
~rench.
~ Storm Sewer - Prior to filling
~ trench.
,.-,.( Waler Line - Prior io ,filling
l2:SI trench.
o Rough Plumbing - Prior to
cover. .'
o Fireplace - Prior 10 facing
materials and framing Insp.
~Fra~lng - P~~
o Wall/C'elllng In~latlOn - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - A,fler Installation.
o Insert - After fireplace approval
and Installation qf unit,
~urbcut & Approach - After
~ h;rms are erectec;1 but prior to
placement of concrete.
o'l Sidewalk & Driveway - After
?-<. excavation Is complete, forms
and sub-base material In place.
I
o Fence - When ~omPleted:
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w~:Hk Is complet.c.
rc;IFlnal Electrical - \Nhen all
ip~lectrlcal~k Is complete,'
o Final Mech.~~
mechanical work Is complete.
M Final Building _ When all
~ required Inspections have been
approved and building Is
completed, ~
!XI Olher /-lOLl) (JOccupS}",c>,
PL!2M/T W/Yn4 P.eo.7& r
(3-9>$) IS Ac.c.e,Prep.
MOBILE HOME INSPECTIONS
~Iocklng end Set,Up - Whep all
~ blocking Is complete, '
fYt"Plumblng Connections - When
~ home has been connected to .
water and sewer.
1"'><:1 I:.leclrical Connection - When
~ blocking, sel-up, and plurob1ng
Inspecllons have been approved
and the home Is connected to
the servIce panel.
~ ~al - After all required
'---...X"~~pectlons are approved and
porches, skirting, decks, and
ventlng have been Installed.
Lot facos
Lot ~yp"
.x Interior
Lot sq, ftg,
Lot coverage
Corner
Topography
Total ~elght
Panhandle
Cul,de'sac
\~, .\1 'Jll.
BUILDING ,PERMIT
ITEM SQ, FT,
X $/SQ, FT, ~
'%.
~;.\
, ,
",':','
. .,' '.1 ::: ,~~ ::'. \~::~ i'
_;; THE,PROPOSED WORK IN THE,
'. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks,
HSE GAR ACC'
I PL,
IN
Is
,W
\-_\~ -:-
- E'
~ain
VALUE
q5/~5'50
)<4, /0 "/2./9> 2.....
Ga(age
gc;,q
Carport
;=11" )
Total Value
S.ul/ding Permit Fee
State Surcharge -+ 3%
Total Fee
(A)
/e~
/ 3 ?i!.2 ~o
101.50
B2{)
11~'p',)
SYSTEMS DEVELOPMENT CHARGE (SDChr-,
, (B) O?~:~3 ~
PLUMBING PERMIT
tTEM
Fixtures
,
Residential Bath(s) N'
Sanitary Sewer FT
Water FT,
Storm Sewer FT,
~, Mobile Home
'"
Plumbing Permit
State Surcharge
"
Total Charge (e)
MECHANICAL PERMIT
FurnacQ
Exhaust Hood
Vent Fan
N'
, Wood Stovellnsert/Flreplace Unit
Dryer Vent
'Me'chani'cal Permit ..
l~su~hce . . ',;
State :Surcharge'
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surch';j'ge
Sidewalk ~11L ft
r'lJ ') It
~~,:.:",,~O
Curbcut
State Surcharge
FEE
c!J.5.00
~'S~
A.s.OO
']0 .00
, ((J.OO
RI.CO
I2f
/0'5.00
&(J.CO
0.dS
\~.'~
\1, L C::)
-,
If yes, this appllcallon must be signed
and approved by the Hlslorlcal
. ,Coordinator prior to permit Issuance.
(. "~, \
-,-\'~ .''''
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condlllon 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 lime
upon violation of any provisions of said ordinances,
?,.7.73
/1'/3/~
, , ,
Receipt Number' /c:; 31 if
Received By: -<~~
~\.'? c.c,\AU\4.'~ -
P:~ Rev~ed B~
Plan Check Fee:
Dale Paid:
*h~~
Systems Development Charge Is due on all undeveloped
properlles within the City IImlls which are being Improved,
ADDITIONAL COMMENTS
\~+ T: fPJ:t)-f4)~C';()
, \ cAt\f\oJ(;. t\ \1'\....
~
By signature, I state and agree, Ihatl 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 Ordinanc~s 01 the City of Springfield, and the Laws
of the Stale 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 further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on Ihls
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 permll card Is localed at the front
of the property, and the approved set of plans will remain
on Ihe slle at all times during constru~y" ,
Argnature,~l~) d, 'f-/~
,
Date
llln}q~
I I
VALIDATION:
RECEIPT NUMBER /5" ItPO
DATE PAIr> I/I"O~
AMOUNT RECEIVED act 01 rl. .I 0 {(J
RECEIVED BY ~~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclriCal)c9;)G\~ldt '
(A, B, C, 0, and E Combined)
.
ATTACHMENT.Sl
. JOB NO. '1 ~/C; Po
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
\~ORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY:
LOCATION: 4,4-0
;;j /~
Lvy ~-,.J.
~ r1. nu-_n/ A'..o-''''') ~~
, , u-I' 'I""
LOT SI7~' SQ. Ft,
DEVELOPMENT TYPE:
BUILDING SIZE:
1. SIQRt1 ORA T NAG[
IMPERVIOUS SQ. FT. 2 '6/'1
2. ~ANTTARY SFWFR-rTTY
NO. OF PFU'S /7
(See Reverse)
3, TRANSPORT.ATTON
X $0,209 PER SQ. FT. ~3~.~
X $43,26 PER PFU ' ~ a. , ~
'- ---
NO OF UNITS X TRIP RATE X COST PER TRIP
I
X /.0/ X $436,19
X X $436.19
~()'0
$
X
X $436.19
$
SUBTOTAL (ADD ITEMS 1. 2, & 3) $ / "g" () ~.1 7
4. SANTTARY S~W~R-MWMC
, NO. OF PFU'S I 'if x $17.19 PER PFU + $10 HWMC ADMIN,FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
IQIA! -MWMr. snr
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ Jlr.~2
$ d
f5/~f~
$ :2-1 z. r. "I
5. bnMTNTsTATTV~ FFFS
~~GE /}TOT~OVEl X .05
~ ~ - Date: /-9-9s
./ Mar\vlfo nig. P.IE. )
/' SDC'be'ordinator~
c006,:s!)
TOTAl SOC
$;?~.33_9.,
B2 , SDC .
FIXTURE UNIT CALCU~ TION TABLE: Number of New F*es X Unil Equivalent = Fixlure Unil5
(NOTE: For remodels, calculate o.e Nfl addilional fix lures) ..
. NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Balhlub""".""""."."""".""""""""""""""",..",..", ,
Drinking Founlain.,....", .......",...."......, ..'..'",..,.. '...",
Floor Drain,.,.."......."".""",.",.,.,.""",.".""".".""""
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/AulO Wash/Etc..................
Laundry Tub/Clotheswasher ,..'", '.. ".,.,., ,."."", ,......
Clotheswasher - 3 Or More...........,.........................
Mobile Home Park Trap (1 Per Trailer)....,.............
Receptor For Refrigerator/Water Station/Elc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall..."...,...,.,....,......,."......"....,......
Shower, Gang...,..,., ....., ,.",.,..... ,. ,.,.'."....,..,......'."...
Sink: Bar, Commercial, Residential Kitchen,.......................
Urinal, Stall/Wall.,:...,."..."..,....,.,."..,..".... ,...."...".,..
Wash BasinlLavatorv, Single..........,.......................
Toilet, Public Installation....,...,..,...,..,....,.."............
Toilet, Private.........,..,..",.."".,.,.....,."...... ,....', '..,.
Miscellaneous:, ,TJ.NI TOPS $.I"',,"
:2.
/
I
-:2.
;J...
TOTAL FIXTURE UNITS
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
.l.
=
4
z..
:z.
2.
~
J)?'
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separales.
Year
Annexed
Rate per $1.000
Assessed Value
Year
Annexed
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
c--- ./
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Credit for Parc,el or Land Only If Applicable
Improvement (if after annexation date)
=
=
CREDIT TOTAL
Rate per $1,000
Assessed Value
$2.46
2.14
1,77
1.37
0.97
0,61
0.44
0.15
--"
= $
6
/