HomeMy WebLinkAboutPermit Building 1991-11-27LOCATION OF PROPOSED WORK: Z V fO /A4 5_,
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BLOCK:LOT:
TAX LOT:
SUBDIVISION
ASSESSORS MAP:
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
PHONE:
STATE:ZIP:9*l +-)')Y- -l
CITY:
,4.\)
ADDRESS:
OWNER:
S.r;, r.r.^ .Ae-t"(
DESCRIBE WORK:
PLUMBING:
MECHANICAL:
ADD EXPIRES PHONECONTRACTOR'S NAME
G EN ERAL:
CONST.
-CONTRACTOR
#
SQUARE FooTAGE: 3?O
A
RANGE:
SECONDARY HEAT
* OF BDRMS:
WATER HEATER:
* OF UNITS:ZONING CODE:
FLOOD PLAIN
_ OFFICE USE _
LAND USE:QUAD AREA:
# OF BLDGS
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. wlll be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
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.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underlloor 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
tren c h.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
Rough Electrical - Prior to
cover.Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Final Building - When atl
required inspections have been
approved and building is
completed.
Other
MOBILE HOME !NSPE TIONS
Blocking and Set.Up - When all
blocking is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Electrical Setvice - Must be
approved t/obtain permanent
electrtcaffower.w Fireplace - Prior to facing
materials and framing lnsp.
Framing - Prior to cover,
Wall/Ceiling lnsulation - Prior to
cover.
f-l Drywall - Prior to taping.
Wood Stove - After installation
lnsert - After fireplace approval
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
l--l Fence - When completed
Street Trees - When all required
trees are planted.
JoB NUMBE R ?/rn 1
225 Fifth Street
Spri ngfield, Oregon 97 477
oA.
ELECTRICALi
Ittt
LDP
r
E
Er
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type.
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
-._.j THE PROPOSED WORK tN 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.
aafu77
Date's Reviewed B
2z€-/
//-t ?€/Date Paid
Receipt Number:
Received By
Plan Check Fee:"a 7=
VALUE
?4.a
(A)
X $/SQ. FT.
/a.ro v*3t*
Total Value
Building Permit Fee
State Surcharge
Total Fee
//-P
--2,,22/2.27
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 CHARGE (SDC)
<"/f4 /4.7?
ADDITIONAL COMMENTS
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
((-)
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
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 Springfield, 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 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 f ront
of the property, and the approved set of plans will remain
Signatu q,/Date
on the site at a times duri n.ru
//- z
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -'- ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
4>
DATE PAID //*ZZ>+ f
EIVED
VALIDATION:
RECEIPT NUMBER
AMOUNT REC
RECEIVED BY
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
/fr./2
JOB NO.a//?y /
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(cot'tl'tERcIAL & RESIDENTIAL)
NAME OR COMPANY:
LOCATION:z
DEVELOPMENT TYPE:
BUILDING SIZE: //x/a LOT SIZE sQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.5Za x $0.186 PER sQ. FT. $ /aq./6f Actual Imperv. Area Is Unknown)(See Reverse For Runoff Coefficjents I
SANITARY SEWER-CITY
NO. OF PFU'S X $38.55 PER PFU
(See Reverse To Determjne Total PFU'S)
TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x x $388.61 $ /Yr/ '
x _ x $388.61 $
x x $388.61 $
(See Attachment C To Determine Trip Rates)
sllsrornr'(ADD rTEMS r,2, & 3) $ /2!./4
4. A0IINISTSaTiVE FEE!
BASE CHA;-i (SUBT0TAL ABOVE) X .05 s ;,21
TOTAL-CITY SDC $ /O?,27
2
3
5 SANITARY SEt^lER-MWMC
NO. OF PFU'S $13.25 PER PFU + $10 MI^JMC ADMIN FiE S
$
TOTAL-MI^JMC SDC
(Use PFU Total From Item 2 Above)
Mt^lMC CREDIT IF APPLiCABLE (SEE REVERSE)
Ki p Burdick
SDC Coordinator
$
$
t/r4-
TOTAL SDC
FIXTURE UNIT CALCU1 ION TABLE: Number of New Fixtur . _ Unit Equivalent = Fixture Units (NOTE
For remodels, calculate only the NE'[ additional fixtures)
NUMBER OF
NEW FIXTURES
TOTAL FIXTURE UNITS
UNIT
EQUIVALENT
FIXTURE
UNITSFIXTURE TYPE
Bathtub...
Drinking Fountain......
Froor Drain..................:..::.::............:.............::... .
I nterceptors For Grease/Oil/Solids/Etc.................
I nterceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.
Clotheswasher - 3 Or More...
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorAVater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall
Sink, Bar, Commercial
Urinal, StallflVall.
Wash Basin/Lavatory, Sin91e..........
Water Closet, Public lnstallation..
Water Closet, Private.
Miscellaneous:
eadH
2
1
2
3
6
2
6
6
1
3
2
1/
2
2
1
o
4
CREDIT CALCUT-ATION TABLE: Based on assessed value.
calculate cred its separates.
lf 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 before
1 980
1 981
1 982
1 983
1 984
$2.66
2.64
2.53
2.41
2.19
2.04
1 985
1 986
1 987
i 988
1 989
1 990
$1.69
1.35
1 15
l?2
0.59
0.23
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x$
(Rate X Assessed Value)X$
(Fate X Assessed Value)
CREDIT TOTAL - s
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Flesidential..
Commercial
lndustrial.....
Governmental................
................. 0.4
..............,.. 0.9
0.45
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT