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Home My WebLink AboutPermit Building 1994-04-08RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: 5? b'siaH)5ol lV rtN JOB NUMBER ctq 3Lp 225 Fifth Street Springfield, Oregon g7 471 )@ ASSESSORS MAP: ) 1ro )Zt4z TAX LO-I: LOT BLOCK:SUBDIVISION c 'CL/\D(.10,, Oiz:Y rrn ZIP:STATE:-) PHONE:oS1*)L/1 -q ( 3-\ q ?LOWNER: ADDRESS: CITY: NEw -/ REMoDEL ADDrloN DEMoLtsH orHER )H,DESCRIBE WORK: ADDRESS EXPIRES f CONTRACTOR'S NAME ELECTRICAL: MECHANICA PHONE -q CONST. CONTRACTOR # G EN ERAL: PLUMBING ?; il\ RANGE: - OFFICE USE - LAND USE: OCCY GROUP: FLOOD PLAIN ZONING CODE: * OF BDRMS: * OF UNITS: \IJATER HEATER: # OF STORIES OUAD AREA: # OF BLDGS SECONDARY HEAI SOUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. Thls ls a24hour recording. All inspections requested before 7:00 a.m. will bemade the same working day, lnspections requested after 7:00 a.m. wlll be made the following work day. REQU!RED INSPECTIONS Temporary Electric R Rough Mechanlcal - Prior to cover.& X X Final Plumbing - When allplumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. [-f,fRough Electrica] - Prior to ){ cover.Final Electrlcal - When all electrical work is complete. Underslab Plumblng/ Electrlca! / Mechanical - Prior to cover.&Electrical Service - Must be approved to obtain permanent electrlcal power. Final Mechanical - When all mechanical work is complete. X Footing - After trenches are excavated.Final Building - When ail required inspections have been approved and building is completed. Fireplace - Prlor to faclng materlals and framlng lnsp. Masonry - Steel location, bond beams, grouting.4 K X Framing - Prior to cover. F\TFoundation - After forms arelAerected but prlor to concrete placement. Other Wall/Ceiling lnsulatlon - Prlor to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping. ffi Unaeftoor Plumbtng/MechanicatIr - Prior to insulation or decking. MOBILE HOME INSPE TIONS Wood Stove - After installation X tr tr fi K N Posl and Beam - Prlor to floor insulation or decking.lnserl - After flreplace approval and lnstallatlon of unit. Blocking and Set.Up - When all blocking is complete. Floor lnsulation - Prior to decki ng.K Curbcul & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - When home has been connected to water 3nd sewer. aSanitary Sewer - Prior to filling trench. w Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & Drlveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench. n Fence - When completed Slreet Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover.m -1J.^ a I E E tl Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type X tnterior - Corner - Panhandle - Cul-de-sac P.L.HSE GAR Acc N S E IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OFI ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and apProved bY the Historlcal Coordinator prior to permit issuance' APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ranted on the express condition that the said \+€- Plans Reviewed BY Date This permit is g conform to the Ordinanceconstruction shall, in all respects,including thethe City of SPringfield'adopted bY tion and use ofCode, regulating the construcDeveloPment at any timemay be suspended or revokedbulldings, and ord i nances.any provisions ofupon violatlon of Plan Check Fee: Date Paid: Becelpt Num Received BY: BUILDING PERMIT .. lt+tD (A) qg X $/SQ. FT. =tob ITEM Main Garage Carport = VALUE L4,14C.. t:1 G9 Total Value Bullding Permit Fee State Surcharge Total Fee SQ. FT. lor I Systems Development Charge is due on all undeveloped properties within the City limits which are being improved'sysr EMS D EV ELo P * r*r,j r o^ffillLf ADDITIONAL COMMENTS tTEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE FT. FT FT. (c) ()Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/Fireplace Unit Dryer Vent MECHANTCAL PERMIT lc cr ry) ) (D) Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan No& By signature, I state and agree, that I have caref ully 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 Springfield, and the Laws of the State of Oregon pertainlng 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 ln 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 ls located at the front of the property, and the approved set of plans will remain -T-- ot \l e /rySignat Date on the site at during const 2 MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharoe Sidewark 'T) ,, curbcut Lf t, Demolltion Total Miscellaneous Permits (E) rc !-ILJ-J(/ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) VALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVED FIECEIVED BY -----7T--N.- )C Willamalane Park & Recreation District fob No. SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME:f^n 1\LA PHONE: ADDRESS: LOCATION OF FROPOSED Street Address if Known: Platt Name: 1 srArE: bP- r,, DEVFTOPMENT TYPE . (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back.) A. Single Family - Detached -]- Single Family home----r-- u NO OF UNITS B. Sinele Familv - Attached NO OF UNITS X $370 PER UNIT = C- Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = Tax Lot Number: Manufactured home not in a park X $400 PER UNIT -=$+Dop $ $ ,CDWPRD SDC $ 2, SDC CREDTT (lf applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC'Credit Worksheet. $ 3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credit) $ d Com s City eld D Date o \_ ) 18 No. l4ovao CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE }IORKSHEET (coMl'IERcIAL & RESIDENTIAL) NAME OR COMPANY:ttM l-lo ,r e b 9. ?lU fr- -/1 >zb r*b - o obtoLOCAT ION: Le R- NE utrkDEVELOPMENT TYPE: BUILDING SIZE:LOT SIZ I. STORM DRAINAGE IMPERVIOUS SQ. FT.z tbb x $0.203 PER SQ. FT. 2 . SAN ITARY SEI-IER-C ITY sQ. Ft. NO. OF PFU'S (See Reverse) (8 X $42.08 PER PFU 3 TRANSPORTAT ION NO OF UNITS X TRiP RATE X COST PER TRIP I x x X rE f,o I x $424.31 x $424.31 x $424.31 $ $ 4 SAN ITARY Etl R-z1 NO. OF PFU'S (Use PFU Tota Ml.lMC CREDIT 5. ADl{INISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) x 'os Kip ck nator tg $15.125 PER PFU + $iO MI,IMC ADM FEE s 282 I From Item 2 Above) IF APPLICABLE (SEE REVERSE) bL TOTAL-MWMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4)$IZ 52- a Burd s1+! L4q 13 SDC Coordi a 70 AL DC b vZ $l1 lnit Equivalent = Fixlure Units (NOTE FIXTUREUNIT.CALCUL-IONTABLE:NumberofNewFixlure For remodels. calculbie oniy ,rlu NE r additional fixtures) NUt\1BER oF NEW FIXTURES UNIT EOUIVALENT FIXTURE UNITS FIKTURE TYPE Bathtub...""" " "-" " Drinking Fountain' Floor Drain"""""" /Solids/Etc.lntercePtors For G rease/Oil lntercePtors For Sand/Auto Wash/Etc. Laundry Tub/Cl otheswash er Clothes,vaqher -3 Or More..- Mobile Hdme P ark TraP (1 P RecePtor F6r Refrigerator flVate r Station/Etc-"' RecePtor For Commerclal Sink/Dishwasher/Etc' Shower, Single 'Stall...-..-.---"" Z 2 1 2 J 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 L L 7 L b Water Closet. Private""' Miscellaneous: CREDIT CALCUI'-A.TION TABLE:Based on assessed value calculate credits es. Shower. Gang"""""""""" Sink. Bar. Commercial""" Credit for Parcel or tand Only lf Applicable lmprovement (rf after annexation date) TOTAL FIXTURE UN S lf improvements occurred after annexation date in table' n.zt XS o,t3 n5LL- (Rate X Assessed Value) XS Assessed Value) REDIT TOTAL 0.4 0.9 0.45 0.5 'L- tb =$4 ^52 RUNOFF COEFFICIENTS FOR STORM DRA INAGE Besidential. lndustrial.... Governmental....---.-.-...-' (Rate X c Rate Per $1'000 Assessed ValueYear AnnexedRate Per $1'000 Assessed ValueYear Annexed 1986 1 987 1988 1989 1990 199'l 1992 s 2.24 1.93 1.57 1.18 0.79 o.44 0.28 1979 or before 19BO 't98'l 1982 1983 1984 1985 s.21 3.13 3.08 2.96 2.82 2.68 2.51 IMPERVIOUSAREA=ToTALLoTSIZEXRUNOFFCOEFFICIENT I I