HomeMy WebLinkAboutPermit Building 1994-10-28BESTDENTTAL
PERMIT APPLICATION
lnspectlons: 726.3269
Offlce:726.3759
LD
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon gl 4lZzLOCATION OF PROPOSED WORK:
ASSESSORS MAP:TAX LOT
SUBDIVISION
STATEi
PHON
ztl. a nq2>
OWNER:
ADDRESS:
CITY:
ITION DEMOLISH OTHEF
DESCRIBE
NEW REMODEL
ADD EXPIRES PHONE
,I
CONTRACTOR'S NAME
PLUMBING:
GENERAL:
MECHANICAL:
ELEfiRICAL:
CONST,
CONTFIACTOR ,
\
- OFFICE USE -
LAND USE:
ZONING CODE:
r OF BDRMS:
r OF UNITS:
FLOOD PLAIN;
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
QUAD AREA:
r OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATER:
To request an lnspectlon, you must cail 226.3769. Thls ls a 24 hourmade the same worklng day, lnspecilons roquested after 7:00 a.m.
recordlng' Ail rnspectrons requested before 7:00 a.m. wilr bewlll be made lhe followlng work day.
l-Vl Temnorary Eleclrlc
l-l Slte tnspecilon - To be mades after excavatlon, but prlor tosettlnO forms,
[-l Underslab ptumblng/ El-ectrtcat t
-
Mechanlcal - prloi to cover.
ffi Foottng - After tfenches are+ excavated. ,
l-l frlasonry - Steel locailon, bondu beams, groutlng.
ffi Foundatlon - After forms areT- erected but prlor to concreteplacement.
ffi Unaerground ptumblng - prlor
'-{-' to fllllng trench.
Undartloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - prlor to floorlnsulatlon or decklng.
REQUIRED INSPECTIONS
ffi Rough Mechantcal - prlor to
-
cover.
ffi Rough Electrlcal - prlor tot cover.
ffi flnat ptumblng - When ail-f plumbtng work ls complete.
ffi Flnal Electrlcal - \ lhen ail'f electrlcal work ls complete,c
ffi Flnal Mechanlcal - When allf mechanlcal work ls complete.
ffi flnat Bultdlng - When ail*t- requlred lnspecilons have beenapproved and bulldlng lscompleted.
Electrlcal Connectlon - Whenblocklng, set.up, and plurpblnglnspectlons have been approvedand the home ls connected tothe servlce panel.
tr
tl
tr
Eleclrlcal Servlce - Must beapproved to obtaln permanent
electrlcal power.
Flreptace - Prlor to faclng
materlals and framlng lnsp.
Framlng - prlor to cover.
WalllCblllng
cover.
i
lnstltatlon - Frlor to
Other
MOBILE HOME INSPECTTONS
[-l elocklng and Ser.Up - Whep ail* blocklng ls compleie.
Plumblng Connectlons - Whenhome has been connected towater and sewer.
fB oo*"tl - Prlor to taptns.
f] Wooa Stove - After tnstailatton.
[_l lnsert - After flreplace approval
-
and lnstallatlon of unlt.
E
N
ry
tr
tr
ry
Sanltary Sewer - Prlor to fllllng
trench.
Curbcut & Approach - Afterforms are erected but prlor toplacoment of concrete.
Storm Sewer - Prlor to fllllng
trench.
Sldewalk & Drlveway - Afterexcavatlon ls completo, formsand sub.base materlal ln place.
Yjl:.n.L,r" - Prtor to fililns l-l Fence - When completed.
Floor lnsulatlon - prior to
decklng.
Rough Plumblng - prlor to
cover,[-] Street Trees - When alt requtred
-
trees are planted.
Flnal - After all requlredlnspectlons are approved andporches, sklrtlng, decks, andventlng have been lnstaileo.
I
&Afil\l
l'll''9, t'
Lot lacos
Lot sq. ftg.
Lot coverage
Topography
Total tlelght
Lot Typ
v
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sacIIa/
- IS THE PROPOSED WORK TN THE .' HrsToBtcAL DtsTRlcr, oR oN/.'THE HtsroRtcAL REGtsrEFl?
It yes, thls appllcatlon must bs slgned
and approved by the Hlstorlcal
Coordinator prlor to permit lssuance,
APPROVED:
P.L,HSE GAR ACC
N
S
E
VALUE
t sB. gl
2?o*
(A)
&O.cro
lr{i.sa
x $/so. FT.
-?.3?+& -ltF
tv.tlain
Carport
Total Value
Bulldlng Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
au,.rsfr-@-
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express conditlon that the sald
constructlon shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld, lncludlng the
Development Code, regulatlng the constructlon and use ol
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances.
Reviewed By
R
P
Reoelpt Numbe
By:
u/adqqI----6ate-
Date Pald:
Plan Check Fee:2z-a=
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /6^ ^
Systems Development Charge ls due on all undeveloped
properties wlthln the City Ilmlts whlch are belng lmproved.
ITEM
Flxtures,
Resldentiai Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
t\.so
toq.3'2
t
FT.
FT.
(c)
Not
S.oG+ g% 8.u1
PLUMBING PERMIT
FEE
16 %3
\()t.EPlumblng Permlt
State. Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Flre.place Unl t-.j....
Dryer Vent
t5.s2
Lb,
w_j
q^2
&GE(D)
I5+e? \.8
Vent Fan
Mechanical Permit
lssuahce
State:surcharge
Total Permit
MECHANICAL PERMIT
Furnaco
Exhaust Hood
No\
By slgnature, I state and agroe, that I have carefully examlned
the completed appllcatlon and do hereby cerilfy that all
lnformatlon hereon ls true and correct, and I (urther cerilfy
that any and all work performed shall be done in accordanco
wlth the Ordlnances of tho Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permisslon of the Bulldlng Safety Dlvlslon.
I further certlfy that only contractors and employees who
are In compllance with ORS 701.055 wlll be used on thls
proJect.
I further agree to ensuro that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from tho street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all times durlng constructlon.
v
Slgnatu
Date
MISCELLANEOUS PERMITS
Mobllo Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permits (E)6
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, Q and E Comblned)
q 1
/5a
b 1AMOUNT
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
FT. .
t , rr ., rvr.r rLrt I vL
JoB No. az a
CITY OF SPh.,.IGFIELD SYSTEMS DEVELOPME:
WORKSHEET
' (COl'{l',lERCIAL & RESIDEMIIAL)
CI{ARGE
NME OR COHPAI'IY ,l-,---ill;
4LOCATiON:
DEVELOPMENT TYPE:
BUILDING SIZE:4z v2t
STORI4 NRAINAGF
IMPERVIOUS SQ. FT.
2. SANTTARY SFWFR-CTTY
OT Si |.!. rL
X $0.209 PER SQ. FT S 237-o /
X 543.26 PIR PFU s 3/6.d F
,c
1
//3y'
NO. OF PFU'S
(See Reverse)
TR.ANSPORTATTQiJ
NO OF UNITS X TRIP P,ATE X COST PER TRIP
_x x $436.19
x s436.19
x s435. i9Y
Y
SUtsTOTAL (ADD ITEMS ].,2. & 3)5 {73.o7
4. SANTTARY SEl^lER-Mhll'4C
N0. 0F PFU'S f, x $17.19 PER PFU + slO M'vJHC ADMIN.FEE
(Use PFU Total From item 2 Above)
Ml^lMC CREDiT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS 1.2,3 & 4) S 583. o 7
5 W
BASE
(
s z 7.zs'
/
() x .05
Date: '6 a2o - 7f
Har
SDC
ni
82. SDC
v
i nator
TOTAI SDC $ G/ 2,2/
.l\
FlxruRE Urvtrtcar-cuLATloN TABLE: NumUer or New Fixr,' -s X Unir Equivatent = Fixture Units
lr.,!OTE: For remodels, calcutate only - NET additional lixtures)
NUMeen or uNtT FIXTURE
FIXTUBE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.....
)
1
2
3
6zt
6
6
1
3
2
1/Head
2
2
I
6
4
Lrrinking Fountain. " " """'
Floor Drain
lntercePtors For Grease/Oi
tors For Sand/Aut oWr
il/Solids/Etc
sher...
Clotheswa she
ash/Etc......we
Park TraP (1 Per Trailer)"""
Ref rigeratorflVater Station/Etc
Commercial Sink/Dishwasher/Etc"
tuiobile Home
SecePtor For
Receptor For
Shower, Single Statl.""""'I
Shower, Gang........
Sinft A"t, Commerciat, Residential Kitchen'
Urinal, Stall/Wall..l
Wash Basin/LavatorY, Single""'
Toilet, Public lnstallation'
Toilet, Private.....:..."""""'
Misceltaneous: ,TtAt toBb gar
i..]REDIT CALCULATION TABLE: Based on assessed value' lf
I
TOTAL FIXTURE UNITS
2
improvements occurred after annexation date in table'
calcu late credits separates'
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
xs
(Rate X Assessed Value)xs
(Rate X Ass essed Value)
DEL
CREDIT TOTAL = s
Year
Annexed
Fate per $1,OOO
Assessed ValueYear
Annexed
Hate per $1,OO0
Assessed Value
1 985
1 986
1-q87
I YOO
r oQo
1 990
1991
r oo?
s2.46
2.14
1.77
1.37
0.97
0.61
o.44
o.15
1979 or before
1 980
i 981
1 982
1 983
1 984
1 985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
I
l I
?
,I
.4
-f