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Home My WebLink AboutPermit Building 1992-01-30BLOCK:SUBDIVISION TAX LOT:fr/'a/ LOT: JOB NUMBER LOCATION OF PROPOSED WOFIK: ASSESSORS MAP: RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office; 726-3759 225 Fifth Street Spri ngfield, Oregon 97 477 \gqz M, r*tolw.ff OWNER: ADDRESS: CITY: PHON E ()uSTATE:ztP NEW - REMODEL ADDITION DEMOLISH OTHER Z-o( \LDESCRIBE WORK: PLUMBING: MECHANICAL: - ELECTRICAL: - ADDRESS EXPIRES PHONE GENERAL:To At )Ezr"r,."orO CONTRACTOB'S NAME CONST. CONTRACTOR # USE -c RANGE g OF BDRMS: WATER HEATER -o LAND USE: ZONING CODE: FLOOD PLAIN * OF UNITS: QUAD AREA: * OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hour 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. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When allplumbing work is complete. Site lnspeclion - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundalion - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underf loor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Slorm Sewer - Prior to filling trench. Waler Line - Prior to filling trench. Rough Plumbing - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prior to facing materials and framing lnsp. '$ finat Building - When ail)=TBquired inspections have been approved and building ls completed. Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Final Mechanical - When all mechanical work is complete. Final - After all required inspections are approved andporches, skirting, decks, and venting have been installed. r;*,: Erecrricar - Prior to E,::1,,:ff;J:?,;#Iitill K ,K.,ffit"-'ng - Prior to cover' (otr*"ll - Prior to taPing. Wall/Ceiling lnsulation - Prior to cover. Other MOBILE HOME INSPE TIONS Blocking and Set.Up - When alt blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Wood Stove - After installation lnsert - After fireplace approval and installation of unit. Curbcut & Approach - After forms are erected but prior toplacement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. [-l Fence - When compteted. Street Trees - When all required trees are planted. /70'< <4 ? 7 4t k- '? tl r r E r I Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type. - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P-L.HSE GAR ACC N S E . -iS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition 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 time upon violation of any provisions of said ordinances. t /z z,/z z- iewed By -7 n;tr Z PI 6S Fleceipt Number: Received Date Paid L- z/-') 2: Plan Check Fee VALUE a5,6: a76b (A) 5-o X $/SQ. FT. i/-,to Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport ?/3ot Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT C (B) HARGE (SDC) fi r orle & ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge N0 t Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood 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 f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, 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 70'1.055 will be used on this project. I f urther 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 ignatuy'" on the site all times ructi MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - tl Demolition State Surcharge Total Miscellaneous Permits (E) <62/ r'3/-3e ZDATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, q D, and E Combined) /73/3 4eo /73 . JoB No . 1t o %'z-t- CITY OF sTRINGFIELD SYSTEMS DEVELOPMLNT CHARGE WORKSHEET, (C0HMERCTAL & RESTDENTTAL) NAME OR COMPANY: BCTCT 3TC??CN #N{ LOCATI0N: (b1z r.l . WRr-ltrr t1a'b z4zb - oobol DEVELOPMENT TYPE: LDK G,AP-AGE- BUILDING SIZE:Z-bt ?* (, to . ov E E++Ar{c)LOT SIZ a. Ft. I. STORM DRAINAGE IMPERVIOUS SQ. FT.b-z 0.186 PER SQ. FT.ozLL (See Reverse For Runoff Coef en ts ctual Imperv. Area Is Unknown)c x$IfA 2 3 SANITARY SEl^lER-CITY NO. OF PFU'S X $38.55 PER PFU s (See Reverse To Determine Total PFU'S) TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x _ x $388.51 x _ x $388.61 x x $388.61 (See Attac nt C To Determine Trip Rates) SUBTOTAL ADHINISTP.ITIVE FEES BASE CHARGE (SUBToTAL AB0Y[) X .0s SANITARY SEWER-Mt,lMC NO. OF PFU'S (Use PFU Total From Item 2 Above) MI^JMC CREDIT IF APPLICABLE (SEE REVERSE) ).^-L Ki p Burdick SDC Coordinator (ADD ITEMS 1,2, & 3) S lO'z-ba t> s s $- 4 5 TOTAL-CITY SDC Y S13.25 PER PFU + $10 l.lwt'tc ADt'iIN. FEE S S TOTAL-Mt,lMC SDC -e | - 2+ -12- TOTAL SDC $ s tor 89 s t ol93- JOB N0. a to ?-C CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET ' (col.lttERcIAL & RESIDENTIAL) DEVELOPMENT TYPE: NAME OR COMPANY:F e-r+-{ 4le*tt-l\So LOCATION:lb4z- wJn u* u-r \-? o:>+Llz2>- Goa -6ol EUILDING SiZE:LOT SIZ E-SQ. Ft . I. STORM DRAINAGE TMPERVIoUS SQ. FT.x $0.186 PER SQ. FT. (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER-CITY NO. OF PFU'S -1 X $38.55 PER PFU $zGqL7 (See Reverse To Determine Total PFU'S) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP $- x _ x s388.51 x _ x $388.61 x x s388.61 (See Attachment C To Determine Trip Rates) $ SUBT0TAL (ADD ITEl,lS 1,2, & 3)s zbn L L Z9 4 ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL ABoVE) X .0s SANITARY SEt,,ER-Ht,lMC NO. OF PFU'S s\b TOTAL-C!TY SDC 2g% S13.25 PER PFU + SI0 I'tW!.tC AD!.:IN. FEE s TOTAL-HWI'IC SDC s +- .1c 5 (Use PFU Total From Item 2 Above) Mr.rMC CREDIT IF AppLICABLE (SEE REVERSE) zr+ "a*Kip Burdick \ ,'r? SDC Coordinator 1- TOTAL SDC S 7A7?!. : s $- FIXTURE UNIT CALCUL* ION TABLE: rlumuer of New Fixtureu*Jnit Equivalent = Fixlure Units (NOTE For remodels, calculate only the NEf additional fixtures) NUMBECOF UNIT FIXTURE FITTURE TYPE NEW Hr|-URES EQUIVALENT UNITS Bathtub....... Drinking Fountain..... Floor Drain. ....-...-...-.-..... lnterceptors For Grease/Oil/Solids/Etc..--...---..-..-- I nterceptors For Sand/Auto Wash/Etc.-..-. ---. --. --.. - Laundry Clotheswasher - 3 Or More..--....---- Mobile Home Park Trap (1 Per Trailer).----.-- Receptor For Ref rigeratorflVater Station/Etc-- -- -. " Receptor For Commercial Sink/Dishwasher/Etc" Head 2 't 2 3 6 2 6 6 1 3 2 1/ 2 2 'l 6 4 Shower, Single Stall Sink, Bar. Commercial. Urinal, StallflVall-.-. Wash Basin/l-avatory, Single.---.-.-.. Water Closet, Public lnstallation-- Water Closet. Private......... Miscellaneous: TOTAL FIKI-URE UNITS cREDtr CALCULAION TABLE: Based On aSseSsed vatue- tf lmprovements occurred after annexation date in table' calculate credits \d Credit for Parcel or tand Only lf Applicable lmprovement (if after annexation date) lndustrial. xs (Rate X Assessed Value)xs (Rate X Assessed Value) CREDITTOTAL = S_- RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residentiat-. """"""" 0'4 Commercial-...--.0.9 0.45 0.5 Year Annexed Rate per S1,000 Assessed ValueYear Annexed Rate per 51.000 Assessed Value 1985 1986 1987 1988 1989 1990 sl.69 1.35 1.15 0.92 niQ o.23 1979 or before 1980 1981 1982 1983 1984 s2.65 2.U 2.33 2.11 2.i9 2.01 IMPERVIoUSAREA=ToTALLoTSIZExRUNoFFCoEFFICIENT -,1/ofi32. La) -aa/ IELD w TAX LOT; SUBDIVISION JOB NUMBER LOCATION OF PROPOSED WORK: ASSESSOFIS MAP: RESID ENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 225 Fifth Street Springfield, Oregon 97 477 d ,,r. 74&7,STATE: PHoNE: =/4 -? Sr'SOWNER: ADDRESS: CITY: NEW - REMODEL ADDITION DEMOLISH OTHER DESCRIBE WOFIK: ADDRESS EXPIRES PHONE 74 CONTRACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # G EN ERAL: PLUMBING * OF BDRMS: _ OFFICE USE - RANGE: QUAD AREA: * OF BLDGS: FLOOD PLAIN: ZONING CODE SECONDARY HEAT SQUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GROUP: * OF STORIES: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will bemade the same working day, inspections requested after 7:oo a.m. will be made the following work day. REQUIRED INSPECTIONS l-_-l remporary Electric X':,'"t: Mechanical - Prior to B Final Plumbing - When allplumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover, Underslab Plumbing/ Electrical / Mechanical - Prior to cover.Electrical Service - Must be approved to obtain permanent electrical power. E Final Mechanicat - When ail mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing Insp. E Final Building - When atl required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Foundation - After forms are erected but prior to concrete placement. Other Wall/Ceiling Insulation - prior to cover, Underground Plumbing - prior to filling trench.Drywall - Prior to taping Underf loor Plumbing / Mechanicat - Prior to insulation or decking. MOBILE HOME INSPECTIONS Wood Stove - After installation Posl and Beam - Prior to floorinsulation or decking.lnsert - After fireplace approval and installation of unit. [-l Blocking and Set.Up - When ail - blocking is complete. Floor lnsulation - prior to decking.Curbcut &Approach - Afterforms are erected but prior toplacement of concrete. Plumbing Connections - Whenhome has been connected towater and sewer.Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Electrical Connection - Whenblocking, set-up, and plumbing rnspections have been approvedand the home is connected tothe service panel. l--] Water Line - prior to fiiling - trench. Fence - When completed Street Trees - When all required trees are planted. Final - After all requiredinspections are approved andporches, skirting, decks, andventing have been installed.F Rough Plumbing - prior to cover. LOT - BLOCK: I WATER HEATER:- tl E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type.. - lnterior - Corner - Panhandle - Cul-de-sac Set ks -rS THE PROPOSED WORK lN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the H istorical Coordinator prior to permit issuance. APPROVED P.L.HSE GAR ACC N S E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Spri ngfield, 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. Receipt Number:- Plans Reviewed By Date Plan Check Fee; Date Paid Received By: VALUE (A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport Systems Development Charge is due on all undeveloped properties within the City limits which are being improved.SYSTEMS DEVELOPMENT C (B) HARGE (SDC) 20<,3f ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 4so <o (c) N0 FT. FT. FT. ?o PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT /C ao ,T 2SJT(D) ,C/r//E N0 Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan 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 f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, 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 f urther 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 Date 1O tion.n the site at all times during 6o Signature l- MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk --- ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) 39a7 <.43-7/ 3{ AMOUNT RECEIVED RECEIVED BY DATE PAID VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) /-r 'f stDrtrN(;FtriLf,, 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder -l- g Bs. oo % 225 TIFTE SlREBf, SPRINGFIELD, ORBGON 97 477 INSPECTION REQT'BST.. 726-3769 OFFICE: 726-3759 EIJCf,RICAL PERilIT APPLICATION City Job Number 7 /0x 3. COHPI.ETB FBE SCEEDUI,E BBLOS Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost t'rg'55lo* oPr( t4d t HffiB%o TJOB 'doo A Sum PTION Permits are transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACf,OR INSTALI,ATION ONLY $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocat ion: 200 amps or less 201 amps to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only C. Temporary Services or FeedersInstallation, Alteration or Relocation B rl!(e.fn cElectrical Contractor Address 3 70 Ci ty €t vL Phone !'tZ - (353 "s{{*tu{\ $ s0.00 $ 60.00 $100. 00 $130.00 s300.00 $ 40.00 Supervisor License Number ?@'s Expiration Date /1- 7? Constr Contr. Number ^ctr/-<Expiration Date q"7l S ufe sing Electrician 0vners Name Address 200 amps or less S 40.00 Over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see rrBrr above Ci ty OIINER The installation is being made onproperty I ovn vhich is not intendedfor sa1e, lease or rent. 0vners Signature: DATE: D. Branch Circuits Nev, Alteration or Extension Per Pane1 One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E Miscellaneous ( Service/feeder -Each installation Pump or irrigation $sign/outline Lighting- $Limited Energy/Res - $Limited Energy/Comm $ STIBTOTAL OP ABOVB 5Z State Surcharge TOTAL not included) 40.00 40. 0o 20. o0 36.00 5 OREGO'V RECETVED BY: cx) I b), t:tu l-lnED WOR SPRINGFIELD BLOCK:LOT: TAX LOT: SUBDIVISION LOCATION OF PFIO ASSESSORS MAP: lnspections: 726-3769 Office: 726-3759\3ban RESIDENTIAL PERM!T APPLICATION PHONE: STATE:ztP < ,r//4l1lr t' ---T---)CITY: ADDRESS: OWNEB: NEW - REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK:wei f&,Ld.*">< EXPIRES PHONECONTRACTOR'S NAME ADDRESS 2/O;6 MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING \\\ - OFFICE USE _ WATER HEATER: HEAT SOURCE: RANGE: LAND USE: ZONING CODE: FLOOD PLAIN CONSTR. TYPE * OF UNITS: OCCY GROUP: * OF STORIES: QUAD AREA: * OF BLDGS: To request an inspection, you must call 726-3769. This is a24hour recording. AII 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. REOU!RED INSPECTIONS f_l Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to B Final Electrical - When all electrical work is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover. p(Electrical Service - Must bea -approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. ffil-Footing - After trenches are - excavated.Fireplace - Prior to facing materials and framlng lnsp. p:f Final Building - When all-N required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. p(Foundation - After forms are|j erected but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover, Underground Plumbing - Prior to filling trench.l--l Drywal! - Prior to taping. MOBILE HOME INSPECTIONS Underlloor Plumbing / Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer. ftfanitary Sewer - Prior to fillingutrench. pf€torm Sewer - Prior to fillingH trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Waler Line - Prior to filling trench.I--l Fence - When completed. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. El' Rough Plumbing - Prior to cover. JoB NUMBE- q\ot2_t/ 225 Fifth Street Springfield, Oregon 97 477 I fuo -a/) I / Oe \Rtttr 'r SECONDARY HEAT: SOUARE FOOTAGE: # OF BDRMS: - r r r E E tl E E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Tvoe v - lnterior - Corner Panhandle - Cul-de-sac acks PL.HSE GAR ACC N S E THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition 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 time upon violation of any provisions of said ordinances. Plans Reviewed By Date Receipt Numbe Received By: Date Paid 3-2a -7/ Plan Check Fee:d3 VALUE (A) BU!LDING PERMIT lValue SQ. FT. X $/SO. FTITEM Main Garage Carport Building Permit Fee State Surcharge Total Fee Systems Development Charge is due on all undeveloped properties within the City Iimits which are being improved. ; SYSTEMS DEVELo PM ENr CHARG =f$U (B) ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 5d,,a 6-5 (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS o Wood Stove/ lnsert/ Fireplace Unit Dryer Vent 6(D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERM!T Fu rnace Exhaust Hood 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 Ordinances of the City of Springf ield, 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 f urther 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 ngon the site at all times duri construction Signature MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) 20%,/ AMOUNT RECEIVED RECEIVED BY DATE PAID VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 24,,79 5mr ,Sre:EISc8 ?5 fuletroDolitan Wastewatet' Manaeenrent-Lommrsslon r_4,,ir,1 Si.-,,.,,,: .,:::S E,! =c--r,._r, -j., t-_ ,-.--....- C., . i1 ..r,_r' -.-c t -- =t -...!-..-.- 1\iLr,trr!-!!!,(--., r,^r.,.-_(.,, -. L - | I ?s-.111-.-.,,' i:,,,_. La:S::.- Si,.r;,ir,: C: -. :, : r.:: -r f : s',i;::.-1-i-:': l::".'-:, i;: :lt'';.: .i .':'J q;s:-:'a-t C::-:, f : -- :: :-:r !.,ia:i. (,jrsi:,:; - : !; r - e !.ii i: :.e:.: -,: ::,. e Fi;TH Ai\D A S.iFEETS S;F|:'.GF:I-D CiTY FiTLL SFRrI(GF.ELD, OiEGCII 97477 TEI-!:::CII.=.].3)IjI.:::i I'i'*I'iC COI{IiECTION CHARGE Euilding Address: Referen I'lum 6r.Tax Lot Number: 0vn Add cit ress: J.State: Phone Number: Zipz cr-)Residential Fee ($222.00) Commercial Fee (nev non-residential development/ - remodel) Total fixture unit charge (see reverse of this form) SUBTOTAL Credit Due (see reverse of this form) TOTAL I'II'I'IC CHARGE s s s <s &7 S Received By: Building Job I'lumber: Date Receivedz --y2a e;r/ Receipt Number z 2A% / Fi:<trrre Unit Calculatic:r Table:;,ber':f r,e;,fi:,:tiires nuLtiplied by unitcalculate onlrr the liET aiditional fiiltirres.equivalents. i{0TE:For re;r,o,:ie1_., Fii:ture T;'pe 3athtub Drinking fountain * of Unit Fiiltures Equivalents Tota1 Units: >t 513.25 each = TotaL Charge: g Fi:rture Lrtrits Floor drain 2 1 2 J 6 2 6 6 1 J 2 1 2 ? 1 6 4 fnterceptors for grease/oil_/solits/etc. fnterceptors for sand/auto ...a_ch/eic.... Laundry tub/elothes -,'a-sher. . . Clothes r.'asher (3 or more) ]{obile home park trap (1 per I.i.i.)?eceptor for refrig/.*ater static:/etc..ieceptor for Cor.r.er sink/dishr.sni,,eic. .Sho'*er, si.ngLe stal1 Shoverr ganB (per head). . . .Sink, bar, connercial. Sink, commercial/industrial/ete. UrniaI, sta1l/va11..'fash basin/lavatory, singJ_eI'ater closet, public install,aticUater cIo-<et, private l{iscellaneous: TotaI fixture units Credi t CalcuLation Table:3ased or total i'alue of property at tine of pern,itapPlication. \ta:- -|--^.,-J . esa /...1r.E/.=i.lto the Citv 10?o 100n 1981 1982 1983 19A4 1985 19e6 1987 19I I Credit per gl,oOO assessed I'aIue $2.65 s2.64' $2.53 $2.41 S2.Ie s2.04 $1.69 s1.35 S1.1s $0.92 so. se 90.23 ,43Cred i t Rate tQ lqcecco \:a ota t 1989-@