HomeMy WebLinkAboutPermit Building 1995-05-11t.
SPFlIh.GFIELE)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WOFK:
JOB NUMBER 3
i7 03 3s / /aSR4a
225 Fifth Street
Sprlngfleld, Oregon 97477
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TAX LOT:o.5eoo
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ASSESSOFIS MAP:
LOT;BLOCK:/Av/? { tr SUBDIVISION
'77 rna(/zt t /hr' feh€-rn PHONE:
ZIP:Or<STATE:7z lzz
OWNEB:
ADDRESS:
CITY:
c?
LISH
--
OTHER
zDESCFIIBE WOFIK:a ,LNEW- REMODEL DDITION DE
ADDRESS EXPIRES PHONECONTFIACTOR'S NAME
GENERAL:
PLUMBING
MECHANICAL:
ELECTRICAL:
CONST.
CONTBACTOR #
IAP-3
€--
FLOOD PLAIN
ZONING CODE:
I OF BDRMS:
FIANGE:
OCCY GBOUP:
- OFFICE
HEAT SOURCE:
CONSTR. TYPE:
WATER HEATER:
E OF STORIES:
E OF UNITS:
LAND USE:
SECONDABY HEAT:
SQUARE FOOTAGE:
QUAD ABEA:
# OF BLDGS
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. AII lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
Temporary Electrlc It'nough Mechanlcat - Prtor toG cover.
lfnough Electrlcat - prtor to.Fl cover.
N
E
B
g
,8.x
-K
K
fr founOatlon - After forms are/Serected but prlor to concrete
placement.
,( ttut'"g - Prlor to cover.
fu*:l"elllng lnsulatlon - Prlor to
Xl DrVwall - Prlor to taping,
Othor
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocklng ls complete,
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set.up, and plumbing
lnspections have been approved
and the home is connected to
the service panel.
Final - After all required
lnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled.
Site lnspection - To be made
after excavatlon, but prior to
setting forms.
Underslab Plumbing/ Electrical/
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng,
Underground Plumbing - Prior
to f llllng trench.
Post and Beam - Prlor to floor
lnsulatlon or decking,
Floor lnsulation - Prlor to
decklng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filllng
trench,
x':!;?5j:i 3"li;":;#;1"ff, x'
olectrlcal power.
Final Plumbing - When allplumblng worl( is complete.
Flnal Electrical - When all
,electrlcal work is complete.
Final Mechanical - When all
mechanical work ls complete.
U n d e r | 1 osfFiuG.5iEq-t*l e c h a n ic a I
- Prior i6-inEilAf6i-or ctecking.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Wood Stovo - After lnstallatlon.
lnsert - After fireplace approval
and installatlon of unlt.
Curbcut & Approach - After
forms are erected bUt prior toplacoment of concrete,
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base materlal in place.
[-l Fence - When completed.
Trees - When all requlred
es are planted
ffi flnat Buitding - When ail
,,->requlred lnspectlons have been
approved and building is
completed.
E y;lnllne - Prior to rilring
,X-:;** Prumbrns - Prior to
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
'lEJj-
<"-32&"
5
Lot Typ
-
lnterlor
! arrn",
-- Panhandle
-
Cul-de.sac
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k IS THE PROPOSED WORK TN THE.
HISTORICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER?
--lf yes, thls applicailon must be slgnedand approved by the Historlcal
Coordinator prlor to permit lssuance.
APPROVED:
PL.HSE GAR ACC
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2AE
BUILDING PERMIT
VALUE
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4ztp /oac
7Q(A)
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ITEM
Main
Garage
Carport
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ZS,7O
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.
P!J.ID_|NG VALUE, PLAN CHECKAND BUILDING PERMIT
Thls pehit is granted on the express condiilon that the sardconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprlngfield, includlng theDeve,lopment Code, regulating the Jonstrucilon and use ofourrorngs' and may be suspended or revoked at any timeupon violation of any provisions of sald ordlnances.
Pla Reviewed te
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Becelpt Number:
Received
Date Paid:
Plan Check Fee:zo?,
SYSTEMS DEVELOPMENT C HARGE (SDC)
#sdy:'9,(B)
ITEM
Fix t u res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
A PPO
FT.
FT.
(c)
8o
ao
Noz
90 /zg)?f 4.
Plumbing Permlt
State Surcharge
Total Charge
Systems Development Charge is due on all undevelopedproperties within the City limits which are being improved.
ADDITIONAL COMMENTS
\
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MECHANICAL PERMIT
3oo
,93+.€o /293(D)
N0
Mechanical Permit /b.5'-a,*/,3 3
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlnedthe completed application and do hereby cerilfy that alllnformatlon hereon is true anct correct, and I f urther cerilfy
that any and ail work performed shail be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Lawsof the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of anystructure without permission of the Buildlng Safety Division,I further certify that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thlsproject. t
I f urther agree to ensure that all requlred lnspections arerequested at the proper ilme, that each address ls readable
from the street, that the permlt card ls located at the frontof the property, and the approved set of plans will remaln
Date
on the site at all times ri n.st
nature
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk 7Z n
curbcut 32 ,,
Total Miscellaneous Permits (E)2'?,60
go
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEDw3 ?-
'Oa'TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and'E Combined)z?BECEIVED BY
/D
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SPrlII\lGFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office; 726.3759
LOCATION OF PROPOSED WORK:ia 03 3s / / cSRaO
JOB NUMBER
225 Fllth Slreet
Sprlngfleld, Oregon 97477
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TAX LOT:o5Aoo
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ASSESSORS MAP:
LOT:
-
BLOCK:,/,1 vh { ,tr SUBDIVISION:
PHONE:
y'zzZIP:n<STATE:CITY:
ADDBESS
OWNER:
(1
D LISH
-.
OTHER
.<.
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ADDITII
,C/a-z{
ONEWNEMORELD
DESCRIBE WORK
)5/I L
EXPIRES PHON E
,
ADDHESSCONTRACTOR'S NAME
GENEBAL:
PLUMBING;
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOB / .
.ARTDD t\ \
FIANGE:
L.DP-
\
€_-
HEAT SOURCE:\r)H
sE-
I
r-
- OFFICE U
WATER HEATER:
LAND USE:FLOOD PLAIN:-
CONSTR, TYPE:
E OF UNITS:ZONING CODE:
r OF BDRMS:
OUAD ABEA:
, OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GBOUP:
E OF STOBIES:
To request an I , you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wllt be
made the sa worklng day, lnspectlons requested after 7:00 a.m. wlll bo made the followlng work day.
REQUIRED,INSPECTIONS
Temporary Eloclrlc Rough Mochanlcal - Prlor to
cover.
[-| ftnal Plumblng - Whcn atllJ plumblng worl< ls complete.
Slte lnspectlon - To be madc
after excavatlon, but prlor to
settlng (orms.
Rough Electrlcal - Prlor to Flnal Eleclrlcal - When all
electrlcal work ls complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrlcal e - Must be Mechanlcal - When all
anlcal work ls complete.
olecBFoollng - After trenches are
excavated,Bulldlng - When all
red lnspectlons have been
approved and bulldlng ls[-l Masonry - Steel locatlon, bond' ''beains, groutlng.
ffi founaatlon - After forms are.,Herected but prlor to concret€
placemont.
completed.
to cover.
WaltlColllng
cover.
Underground Plumbing - Prior
to fllllng trench.Drywa ll - Prlor t s
E
,8.
E
-K
K
U n d e rl I ofFiffiElfrETll ech an ic a I\--+_-__---F
- Prlor toTiTtrlETIon or decklng.
MOBILE HOME INSPECTIONS
Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng,lnsert - After flroplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor to
placomont of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prlor to lilllng
trench.Electrlcal Connecllon - When
blocklng, set-up, and plumblng
lnspections have beeh approved
and the home ls connected to
the servlce panel.
Storm Sewer - Prlor to lllllng
trench,
Sidewalk & Drlvewav - After
excavatlon ls complete, forms
and sub-base materlal ln place.
M water Llne - Prlor to lilting
,lA\trench.
Fence - When completed,
Stroel Troes - When all requlred
trees aro planted.
Flnal - After all required
lnspectlons are approved andporchos, sklrtlng, decks, and
ventlng have been lnstalled.
Rough Plumblng - Prlor to
cover.
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CITY OF SPRINGFIELD
COMMUNTTY SERVTCES DTVISIOI.I
BUILDING SAFETY
AUIHORIZATION TO PROCEED AGREEHENT
THIS AGREEHENT is entered in
betveen the City of SPringfi
hereinafter cal-led CitY, and
the Applicant.
to this
e1d, a lil u1l C
day of
a1 o
, hereinafter calle<i
VHEREAS, the aPPlicant has aPP lied to the City Community Services Building
Division for issuance of certa in construction ermits for develoPment
improvements to be located at Springfield,
0rego n or vithin the CitY's Ur rovt ct o rea;Coun tyur
Asses sor's Map and Tax Lot number \1D33s\\ FSz-OC)
1JHEREA
imnredi
subseq
Admini
s, the applicant has asked the city to authorize the Applican_t to
ately "orr.t." development improvements vithout a completed plan reviev or
;;;i'approval ." r"qui.ed by ihe springfield Building Safety Code
strative Code section 303(a).
VHEREAS, the Applicant has submitted to the City a completed permit -application,3 (three) ""t" bf construction draviDgSr_specifications, and other data required
foi the 6ity to complete the necessari plan reviev of the proposed development
improvement.
LTHEREAS, the intended development improvement is of a nature that requires no,
other reviev "ppio""i. froru other Staie or IocaI agencies and is exemPt- from the
criteria established by the Building Safety Division, attached as Exhibit A of
this Agreement
SHEREAST the City has not revieved or approved the submitted materials for the
development impi-ovement, the City is thlrefore. unable to confirm at this tj.me
vhethei the peimit applicatj.c:: submitted vilL be approved, and vhether the
required conitruction permits can be issued'
SHfREAS, the applicant has requested the City to provide expedited authorization
to-p.o"""d vitit'certain phasei of constructitn prior to the completion of the
Citi's reviev of the permit application'
VHEREAST the City,s fee for the administrative services rendered in providing
expedited authorization is $150.00'
NoV, THEREFORE, in consideration of the foregoing recitals and of the mutual
promises .o.,t"ir,.d herein, the City authorizes immediate commencement of the
bevelopment irpior.*"nt specified in the permit application subject to the
fol.loving terms and conditions:
Au thori za t ion
Page 2.
to Proceed Agreement
1. City agrees that the Applicant may immediately commence vith the
development improvements set forth in the permit application. City,sauthorization to proceed is conditioned hovever, upon Applicant's agreementthat the project vill be constructed as set forth in the attached submitteddravings and specifications, except as may be modified by city, and vill
comply vith aII applicable lavs and ordinances. Applicant's innediate
commencenent of construct is at I cant's ovn risk. The City nakes no
assurernce e ts viI1 be roved
or cons truct on tsv ter c
2. City agrees to reviev Applicant's. permit application in the normal revievprocess and to thereafter:
a) issue Applicant the appropriate construction permits; or
b) advise Applicant of deficiencies in the proposed construction vhich
must be renedied before permits can be issued; or
c) advise Applieant of any statutes, ordinances or code provisions vithvhich Applieant must comply vith before-city can issue the permit.
3. Applicant agrees that if City finds Applicant's permit application andsubmitted materials inadequate or deficient in any manner including but notlimited to, the application or the proposed construction do not comply vithall applicable statutes, ordinances or code provisions, Applicant vi1Iexpeditiously_cure the deficiencies so that the City may iisue the requiredpermits. Shou1d Applicant fail to expeditiously correct submitted materials,or should correction prove impossible, City may in it,s discretion, take anyor all of the folloving actions:
a) stoP all further construction of the project in the manner prescribedin the Springfield Building Safety Code Administrative Code (BSCAC),
sEcTroN 201 (d)
b) order disconnection of serving utilities in a manner as prescribed in
BSCAC, SECTIoN 201 (f)
c) issue a NOTICE .{'l 0P.DE3, for removal of aI] such ror!: in a nanner as
PTCSCTibCd in BSCAC, SECTION 204. ABATEHEM OF UNSAFE, SUBSTAT'IDARD oR,
DANGEROUS BUILDINGS, STRUCTTJRES OR BUILDING SERVICE EQUIPHENT. Uponreceipt of such notice, Applicant shalI imnediately remove the vorkspecified in the Notice and Order.
4. Applicant agrees, if the issuance of the permit is denied: ..
a) to remove, at the Applicant's sole cost and expense, arr completedconstruction or improvementsl and
b) to restore the site or structurefree of all hazards
ructt or cons
to it's pre-agreement condition and
Authorization to proceed Agreement
Page 3.
5 Applicant agrees that until A pplicant's permit application is ap proved,construction vi11 not to proceed beyond the point of authorization approvedby the City,s Building 0f fi ci 1.cent's Point of Authorization is
6. Applicant agrees that all voraccessible and exposed for inspeOfficial nor City sha1I be liatLreplacement of any material nece
k performed under this agreement shall bection purposes and that neither the Buildinge for the expense entailed in the removal oissary to a1lov in,"pection.
7' Applieant agrees that_any or aLl'deficiencies icientj.fied during thenecessary inspections vill-be promptly remedied, at Applicant,s sole costand expense before.proceeding yith'any furthei construttion. Applicant a1*<oagrees that these inspectioni do not ieplace the required plan reviev nor dothey imply any approvir of the submitted materiars.
B' Applicant agrees that no vork shall be done on any part of the buildingor structure beyonl !h. point indicated in each .u""Lr.ire inspectionvithout first obtaining the approval of the Building ofrlciai. sueh approvalshaIl-be given only afier "n inspection has been made of each successivestep in the construction as indicated on the ittached Exhibit s.
9' Notvithstanding anY other provisions of this Agreement, this AgreementshaII terninate upon issuance of. a buiiaing lermit or thirty (30) days fromthe date of this Agreement, vhichever firsi 6""u.". Applicant understandsthat all vork on the project sha1I immediaieiy """r" vithout any notice fromt!9 city if this agreLment terminates before . uri:.aing p"i*ii is issued.This agreenent shaI1 terninate on
10' Applicant agrees to defend, indemnify_and lrold city harmless from anyand all costs (ineluding attorney fees),-liability or a";;;;" of any kind ornature vhatsoever, for personal injury-and p.op"riy d"r.g""..ising ir", ii,"-Applicant's early comnencement of ion!truction and the vork undertaken orcomple ted
11' The terms of this Agreement sha11 extend to and be binding upon theparties hereto and t:,eii heirs, successors and assigns
. t2- rf any suit, action or other proceeding, or an appeal therefrom, isinstituted to obtain, establish,- enforce, ii compet any right or obligationresulting from this Agreement, ihe pr"r.iling paity snalr E. "ntitled torecover from the adverse Party, in iaaition io-"osts and disbursements, suchadditionar sums as the courts, both trial anJ appellate, may judge ,reasonable attorney fees.
Authorization to Proceed Agreement
Page 4.
BEFORE SIGNING TEIS AGREEHENT, PLEASE READ AND IJNDERSTAND THE HEANING OF EACH
PARAGRAPH OF THIS AGREEHENT. IT AFFECTS YOTIR INTERESTS IN THE PROPERTY AND, INTHE EVENT OF DEFAULT, IT PLACES YOU PERSONALLY AT RTSK AND THE SUBJECT PROPERTYAT RISK OF FORECLOSURE FOR COSTS AND EXPENSES INCT'RRED BY THE CITY IN ENFORCINGTHE TERMS OF THTS AGREEI,IENT. IN TEE EVENT THAT YOU DO NOT I.'NDERSTAND ANY TERHS
OR CONDTTIONS OF THIS AGREEMENT, PLEASE SEEK ANY LEGAL OR OUTSIDE OPINIONS YOU
HAY .DESTRE.
CTTY APPLICANT
City of S i eld
By:Contrac tor t"fu"ildi 0fficial * Business Name
Address
CC Registration #
I..A!{D./PROPERTY O9NER (s)
I/WE HAVE READ TEE ABOVE AUIEORIZATION TO PROCEED AGREEHENT. I/IJE I'NDERSTANDVHAT TT EXPRESSES A}TD THE RESPONSIBILITIES IT PLACES UPON US AS TIIE
LAND/PROPERTY OIJNERS. I/VE AGREE TO BE BOI.JND BY ALL TERHS AND CONDITIONS OF THEAGREEHEM.
Name 4 -r'A.
7a, 8q . ^at # Z C."?^ ?ZfofAddress
' f[\.iii:\'.'l^l 3, l.ir;i:C,VE]
TC F.1
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L,'.'iE: tf=:r<-Jl*$t1--
C:i:Fii:: (;F CITY A.TTOnl\iEY
Cl'l-\' ,- , !.",::1..'::F!t-:i,D
rT-.,\t\.
t SF. furidrnnq coTl\)&rb' ^t to
Willamalane
,
PHONE:
lob No.
Park & Recreation District
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
\qn\NAA4L
ADDRESS:
LOCATION OF FROPOSED BUILDINC SITE:
Stre€t Address if Known:
srArE:-UL=,, q?fl1
\1^\
1 OfVetOpMEt{T fype (Check appropriate dwellingG). SDC Calculations and dwel l ing type
definitions are on the baclc)
A. Sinsle Familv - Detached
NO OF UNITS X $400 PER UNIT;.
B. Sinple Familv - Attached
a
NO OF UNITS
C. Multi-Family Apartment
Platt Name:tr,l0r--.1 Tax Lot Numbec
fL*r3?n.cP$370 PER UNIT =
NO OF UNITS X $277 PER UNIT =
D. Manufactured Home Park
.
NO OF UNITS X $280 PER UNIT =
3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for Credit)
$
$
$3 @WPRD SDC
2. SDC CREDTT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit worl<shet.c
$
$
-L1 LT
/'^^. ^., .a?0., (nr. ,ia^r lJ rfa
0o
)B NO.lsov-t t
CITYoFSPRINGFIELDSYSTEMSDEVELoPMENTCHARGE
WORKSHEET
(C0MMERCIAL & RESIDENTIAL)
NAME OR COMPANY:rHY ITLH EM
zr! Sr,/1 obbStl -o 2-O OLOCATION:1 u A/. I
3FRDEVELOPMENT TYPE:LPR -
BUTLDING SIZE:
I. STORM DRAINAGE
IMPERVIoUS SQ. FT.
2. SANITARY SEt,lER-CITY
NO. OF PFU'S
(See Reverse)
OT SIZ
ttll x $o.2oe PER SQ. FT.
X $43.26 PER PFU
x $436.19
x $436. 19
l8
. Ft.
$
$
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3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
1 x l.ol_x$436.19
X
X
4 SANITARY SEI,IER-Ml^lMC
N0. OF pFU,S lt x $17.19 PER PFU + $10 M91MC ADM FEE
(Use PFU Total From Item 2 Above)
l4t.lMc CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .05
5
K p Burdick TOTAL SDC
4o52
1-a?lo
SDC Coordinator
Date:orr,
$ \81a '1,2
o!
FTXTURE UNtT CALCULA-I--<)N TABLE: Number of New Fixrurc Unit Equivalent :'Fixturc Unirs
(NOTE: For remoddls, catJulatc onty ttr. ,FT additional fixtures)
NUMAER OF UNIT FIXTURE -.
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNTTS
+Bathtub..---2
1
2
aJ
6
2
6
6
i
J
2
1
2
2
1
6
4
Drinking Fountain-
Floor Drain-
lnterceptors For Grease/Oil/Solids/Etc
lnterceptors'For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher-...-.-.-....
Mobile Home Park Trap (1 Per Trailer) ......
Receptor For Refrigerator/Water Station/Etc...--..-
Receptor For Commercial Sink/Dishwasher/Etc-.
Shower. Single Sta1l..........
Shower, Gan9......... ..................
Sink: Bar, Commerciat. Residential Kitchen....
Wash Basin/Lavatory,'single -
Toilet, Public lnstallation
Toilet , Private...-.
Miscellaneous:
lHead
1-
L
TOTAL FIXTURE UNITS
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CREDIT CALCULATION TABLE: Based on assessed value.
calculate credits separates.
Credit for Parcelor Land Only lf Applicabte
lmprovement (if after annexation date)
lf improvements occurred after annexation date in table,
?,+(- x $>r. +,
(Rate X Assessed Value)
X$
(Rate X Assessed Value)
= $ ll5 1+
CREDIT TOTAL
Year '
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
1 9BO
1 981
1 982
1 983
1 984
1 985
$3-46
3.38
3.32
3.21
3.O6
2.92
2-73
1 985
1 986
1 987
1 9BB
1 989
1 990
1 991
.1993
$2.46
2.14
1.77
1.37
o.97
0.61
o.44
o.15
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