HomeMy WebLinkAboutPermit Building 1994-06-24SPH ,o q4aRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PRO
ASSESSORS MAP:
qr\
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:
SUBDIVISION:
OWNER:
ADDR
CITY:STATE:
/26-Vt) c-PHONE:
ZIP:
NEW
-
REMODEL ADDITION
DESCRIBE WOFIK:
DEMOLISH OTHER
CONST.
CONTRACTOR ,'NAME AD EXPIRES PHONEcoN
GENERAL:
PLUMBING
MECHANICAL;
ELECTRICAL:
WATEH HEATEB:
- OFFICE USE -
ZONING CODE:
FLOOD PLAIN:
SECONDARY HEAT
SQUARE FOOTAG
* OF UNITS:
LAND USE:
FIANGE:
OUAD AREA:
# OF BLDGS
CONSTR, TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726'3769. Thls ls a24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m, wlll be made the followlng work day.
REOUIRED INSPECTIONS
@'"^oorarv Etectrtc rx
m
[-_l Underslab Ptumbing/Electricat/.J Mechanical - prior to cover. L+J
ffi Footlng - After trenches are* excavated.
Masonry - Steel locailon, bondbeams, groutlng.
r&
Site lnspectlon - To be made
after excavation, but prior to
setting forms.
Foundatlon - After forms areerected but prlor to concreteplacement,
Post and Beam - prior to floorlnsulatlon or decking.
Floor lnsulatlon - prior to
decking.
Rough Mechanlcal - prlor to
cover,
Rough Electrlcal - Prlor to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
M flnat ptumbing - When altL.N plumblng work ls complete.
ffi flnat Electricat - When altL.p electrlcal work ls complete.
ry Flnal Mechanlcal - When allmechanlcal work ls complete.
[-l UnOerground plumbing - prior.+ to fllllng trench.
Underlloor Plumbing/ Mechanlcat
- Prlor to lnsulatlon or clecklng. | | Wood Slove - After lnstallation.
MOBILE HOME INSPECTIONS
[l Flreptace - prtor to factnglJ materlals and lramlng lnsfr
f,J tt'-'ng - Prlor to cover.
ffi Watt/Celting lnsutatlon - prlor to? cover.
[F Drywafl - prlor to taplng.
Sidewalk & Drlveway - Afterexcavation ls complete, formsand sub-base materlal ln place.
Fence - When completed.
Slreet Trees - When all requlredtrees are planted.
Il Flnal Buildtng - When ailfl requlred lnspectlons have beenapproved and bullding is
completed.
m
m
m
Sanitary Sewer - prlor to filling
trench.
Curbcut & Approach - Afterforms are erected but prior toplacement of concrete,
lnserl - After flreplace approvaland lnstallatlon of unlt.
I-_l Slocking and Ser.Up - When ail
-
blocklng is compleie.
Plumbing Connections - Whenhome has been connected towater and sewer.
Storm Sewer - Prlor to fllllng
trench.
l-_l Water Llne - prior to fiiling|J trench.
E Rough Plumbing - prior to
cover.
Eleclrical Connection - Whenblocking, set.up, and plumblnginspections have been approvedand the home ls connected tothe servlce panel.
Final - After all requiredInspectlons are approved andporches, sklrilng, decks, andventlng have been installed.
LOT
-
BLOCK:
3R\trt-
t 'r OF BDRMS:
-
OCCY GBOUP:
E OF STORIES:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total hel ht
-s pe_
nterlor
t.'ii:?,p,i i
Setbacks
PL.HSE GAR ACC
N
S
W
E
r S THE PROPOSED WORK rN THE -
-HrsToRtcAL DtsTRtcT, oR oN
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Hlstorlcal
Coordinator prior to permit issuance.
APPROVED:
5'
-
Corner
-
Panhandle
-
Cul-de-sac
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls 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
bulldings, and may be suspended or revoked at any tlme
G
DatePRevBy
Plan Check Fee
Date Pald
Recei pt Number:
upon vlolation of a f said ordinances.
5.53€h.I^*
(A).l.l-lr.ff-
)rnc
++e#s&
\\o.*Total Value
Bullding Permit Fee
State Surcharge
Total Fee
Garage
Carport
BUIL
ITEM
Main
}ERMIT
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /fu}/
ADDITIONAL COMMENTS
ITEM
Flxtures
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
t?oAuU^
3
!rr--ao.
,so
3IAh-(c)
No
PLUMBING PERMIT
FEE
30jq
Plumblng Permlt
State Surcharge
Total Charge
. FT,
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No\*)r(-
By slgnature, I state and agree, that I have caref ully examlned
the completed appllcation and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Divislon'
I further certily that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
prolect.
Wood Stove/ lnsert/Flreplace Unlt
Dryer Vent
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
15 q)
Lb.q)
3t $d^U\
(D)
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address is readable
lrom the street, that the permlt card ls located at the f ront
of the property, and the approved set of plans will remalnMISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
times durlng c tion.on the site at
Slgnatu
Date -L
VALTDATION:
RECEIPT NUMBER
q Oo4
Total Mlscellaneous Permlts (E)b DATE PAID
AMOUNT RECEIVED
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, D, and E Gomblned)
583.\6
RECEIVED BY
5 2 b
By:
aq{ .8ff6:Wq\1
tY14,s.=.\:" E-\Bc-+Fi
FT.
FT-
q q./
cITY 0F !. TtINGFIELD sysTtHs DEVtLOPHrr{T cilAttGE
,ror*oH?l[t^t55I,n,
NAI.IE OR COI.IPAI'IY:
-r/LOCAT IOI{://,<o 3/
DEVELOPI{ENT TYPE:92,
BUILDING SIZE:' xZG'
I. STORI.I DRAINAGE.
rHPERVtous sQ. FT.
2. SANITARY SEWER.CTTY
NO. OF PFU'S
(See Reverse)
?
BASE BT
211/+2 siz Ft
/ |
7rlrA t*'t/
/5o x s0.203 PER SQ. FT.
TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
x x s424.31
x _ x s424.31
x _ x s424.31
4. SANITARY SEII'TR-t,il{t.tc
NO. OF PFU'S
(Use PFU Tota
7 X 542.08 PER PFU
Sl5.l25 PER PFU + Sl0 Mh'HC ADI'i FEE
Above)
TOTAL.MWHC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
) x .os
s
s
I From Item 2
l'lh'l'lc CREDIT IF APPLICABLE (SEE REVTRSE)
s 4d,f.z
//. s s-
i nat
TOTAL SDC
FIXIUHE UNII UIfUt-\JlJlll\JlY lA\E'LE:hrt'nrlrc'oln*crvlr\it't('s.rLtrrirt.t'u^'r'rr" - "^'.r'r
For telrrcrJe!s. c;rlcuilie orrly ttrc I--Et ;ttl'';:;t''rt:rt liilrrrl';')
v lJLr''lF[',t L)l: L':tll' rl]:IUnE
FIXIU^E n'lrE v l.'E\T l:t.\iulics- l'OLti\'/'tf:tJT U:"ltS
Blltrlub.......
Drirrking Fourrl.rilt.....
Floor Drain. ....'.....:...'."'
I ?
lnle, c epl ors For G rea s e/O il/ S ol id s/E t c........... -.....
tnl ercepl ons For Sand//.ul o Vr'a sh/E1c...............'..
Laundry Tub/Ooihesrva slrcr.'....
:l
I
3
3
t)
2
6
6
I
3
2
1
2
2
I
6
1
Clothesrasher - 3 Or llore.....
llobile Hdriie Park Trap (l Per Trailer).......
Becep.tor F9r Retrigeral orfi'ater Stat ion/Et c........
Beceptor For Commerclal S inkr/Dishv,'a sher/Et c..
Shorver, Single'Stall.
I
4
/HedShower. Gang..................
SinK Bar. Commercial.......-..........
\{ash Basin/kvatory. Sing!e.-.-....
\l,ater Close[ Public lnstallation.
Water Closet. Prh'ate........
l,{iscellaneous:
I
TOTi.L FIXTUAE UI.IITS z
CREDIT CALCUI-ATION TABLE: 6aseJ on assessed value. tf improvemenis occurred afier annexation date in ta5e.
calculate crei!:s ies.
Cred?t for Parcd or tard Onty lf Applicable
tmprovement (rf after annexation date)
(Rate X
xs
Assessed Value)
(Bate X Assessed Value)
CREDIT TOTAL $
Yezr
Annexed
nale per St.OOO
AssesseJ Value
Ye.r
AnnexeC
Fate per 51,O00
Assessal Value
1979 or before
193C
r931
1932
1993
1994
rges
s3.21
rr. lJ
3.09
2.X'
2.e?
2.69
2.51
19'35
1937
1998
19e9
roo.l
1991
r oo2
s2 24
1.93
1.57
1.18
0.79
o.44
0.28
HUNOFF COEFFICIENTS FOR STOBM DBAINAGE
lndustrial...0.45
Governmental............... .............-... 0'5
Ih4PERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT