HomeMy WebLinkAboutPermit Plumbing 1992-08-28SPrl!NC:FtELI)
RESIDEN IAL
PERMTT APPLICATION
lnspections: 726'3769
O{fice: 726'3759
22-lt7o
h,
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97 477
I.OCATION OF PROPOSED WOtlK:
ASSF-ssoRS MAP: -- -/2eV:2/:27 -- -
r_oT:BLocK: --#t44(suBDrvrsroN, ?z& 42a
TAX LOI &
PHONE1*6 rlto
47{>>_ztPSTATE:CITY: ..
OWNER:
ADDRESS
ADDITION DEMOLISH OTHEB
DESCRIBE WORK:
NEW ...,.-...--, REMODEL
EXPIRES PHONEADDNESSCONTRACTOR'S NAME
CENERAL.:.- 1P5'T4A\
CONST.
CONTRACTOR #
t,t t,r\4BlN(l:
MF-CHANICA[-: -
ELECTRICAL: ..
RANGE
FLOOD PLAIN
# OF UNITS ZONING CODE:
WNTER HEATER:
# OF STORIES
I OF BLDGS: -
OUN D AREA
- OFFICE USE -
CONSTR. TYPE: -
# OF BDRMS:
--
SQUARE FOOTAGE: --
SECONDARY HEAT:
OCCY GIIOUP
LAND USE,:
HE^T SOURCE:
--
To request an inspection, you must <;all 726-3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be
macie the same working day, inspections requested afler 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
oover.
Final Plumbing - Wlren all
plumbing worl< ls complete.
Site lnspection - To be made
after excavation, but Prior to
setting lort'ns.
Rough Elcctrical - Prior to Final Electrical - When all
electrical work is complete.cover
Underslab Plumbing / Electrical /
Mechanical - ['rioI to covc'r.
Eleclrical Service - Must be
approved to obtain pernlanent
electrical power.
Final Mechanical - When all
rnechanical worl( is complete.
Footing - After trenches are
excavated.Fireplace - Prior to faclng
r-naterials and framlng lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Stet:l location, bond
beams, grouting.Framing - Prior to cover.
Foundation - After forms arre
erected but prior to concrete
placernen t.
[Zl o,rer
Wall/Ceiling lnsulation - Prior to
COVET
Underground Plumbing -' Prior
to filling trench.Drywall - Prior to tapin0.
MOBILE HOME INSPE TIONS
Underlloor Plumbing/ Mechanical
- Prior to insulatior-r or decking.Wood Stove - After installation.
Post ancl Beam - Prior to floor
insulation or clecliing.lnsert - After fireplace approval
ancl lnstallation of unit.
Blocking and Set-Up - When all
blocking is completc.
Floor lnsulalion - Prior to
decki ng.Curbcut & Approach - Af ter
forms are erected but prior to
l)lacerncnt of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to f illing
trench.Electrical Conneclion - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Slorm Sewer - Prior to filllng
trench.
Sidewalk & Driveway - After
excavation i..; contJ>lete, forms
arr<l sub-base material in place.
Water Line - Prior to lilling
trench.
Fence - When completed.
Street 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.
L]
tl E
E
tl
tl
r Drtfuo-
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tl
wr
tl
tl
tl
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E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ(
-
lnterior
-
Corner
-
Panhandle
-- Cul-de-sac
ACC
IS THE PROPOSED WOFIK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTOFIICAL FIEGISTER?
-
lf yes, this applicalion must be signed
and approved by the Historical
Coordinator prior to permit issuance.
E APPROVED:
GARP.L.HSE
N
S
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Ttris pertnit is grantcd on llle express conditior-r that the said
construction l;hall, in all respccts, conforrn to the Ordinance
adopled by tlre City of Springf ielci, including the
Developrrtent Coclc, regulatin0 thc conslrLlction arld use of
buildinllt;, ;rnd tlay br,' suspcnded or rcvol<eti at any tirllc
upon violalion of any provisions o( said ordinances'
D:rtcPlans Fleviewed BY
PIarr Chct;k Fcc
Date Paid
Reccipt Nutnbcr:
Received By:
VALUE
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
Systems Developtrtent Ch;rrgc is due on all undeveloped
properties within the City limits which are beinq improvcd'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /DA-6
ADDITIONAL COMMENTS
k?zraffis e//@--
ITEM
Fix t u res
Residential Bath(s)
Sanit::rY Sewer
Water
Storm Sewer
Mobile Home
FEE
No
-/2,?
FT.
FT.
oa
oaP
aA
(c)
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Chargc
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully exatnined
the completecl application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all worl< performed shall be done in accordance
witl.r the Or<Jinarlces of the City of Springfield, arrd the Laws
of the Stale of Orcgon pertaining to the worl< describcd
herein, ancl that NO OCCUPANCY will 'be m;rde 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 f urther agree to onsure that all required irrspections are
requeste<J :rt tlle propor tirne, that each address is rcadat"rle
lrorn thc strcet, th:rl tllo l)ernlit carcl is lot;atr-'cl;rt the Iront
of thc property, arrcl tlre approved set of 1rl;tr-rs will rerrtain
on tlre si tc at all titrtos during constructiorl.
oate
-
A.ugrz,',**AS)i32*-
Signaturc -1- lt^\ L
MISCELLANEOUS PERMITS
Mobile Home
St:rte lssuance
State Surcharge
Sidewalk --- ft
Curbcut
--
ft
Demolition
State Surcharge
(E)
elaa. ya
Total Miscellaneous Permits
6o 79
2_
-7
:Z 5 72,7q
DATE PAII)
AMOUN'T Rt:CEIVED
FIECEIVED BY _-
VALIDATION:
RECEIPT NUMIf ET]
4TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
r
I
CITY OF SPRINGFIELD SYSTE!'tS DEYELOPMEiiT CHARGE
WORKSHEET
NAHE OR COMPANY:.L_
LOCATION:g€
DEVELOPI'IENT TYPE:
BUILDING SiZE:LC)T SIZE-SQ. Ft
cTnnM nDA Ttl^r'c'JIt t\l'l un,1 1t\^uL
ir.lpERVIOUS SQ. FT. X S0.192 PER SQ
(See Revepse For iunorr Coeirici;i-,is if ^;t"al imperv. nr'io is,iiniiu,t,iT
1
.t
ET(. I l. J
?. SANiTARY SEI,IER-CITY
NO. OF PFU'S 6 X 539.78 PiR PFU
(See Reverse To Determjne Total PFU'S)
3. TR.ANSPORT
I.IO CF UNITS X TRIP RATE X COST PLR THIP
X x $401 .0s
x x $401.0s
x _ x $401.05
6
Kip Burdick
SDC Coordinator
s 2 76.69
S
S
(See Attac t C To Determjne Trjp Rates)
SUBTOTAL (ADD ITTMS 1,2, & 3)(
J
4 ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .05
TOTAL-CITY SDC S ?,A. 6/
5. CREDITS
IF DEVELOPMENT iS PROFESSIONAL OFFICES OR INDUSTRiAL:
ToTAL-CITY SDC X (50%) = ADJUSTED CiTY SDC s
SAN ITARY S EI,,IER-MI,{MC
N0. 0F PFU'S b x $13.62 PER PFU ffi. FEE S 8/.2?
(Use PFU Total From ltem 2 Above)
MI{MC CREDTT rF APPLTCABLE (SEE REVERSE) s a /.:
T0TAL-l''1\,ll'rC SDC c -4*
s //.43
TorAL sDC s 2fu'6 '
FIXTURE UNIT CALCUUfiON TABLE: Number of New Fixtures'-',Jnit Equivatenr = Fixrure Unirs (NorE
For remodels, calculate only the Nf' -diticnal fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE WPE NEW FIXTURES EQUIVALENT UNITS
Er^^, hFi^I tuut urarrt.
I nterceptors For G rease,/Oil/Solids/Etc.,...........,..
i nterceptors For SandiAuto V,'ash7'Etc..................
r-aunCry Tub/Clcthesv;asher......
Clotheswasher - 3 Or More...........
Ir4oblie Home Park Trap (1 Fer Traiier)..................
ieceptor For Refrigerator/"Warer StationriEtc........
Receptor For Commercial Sinki Dishv;asher/.Etc..
Shower, Singie Stai|.............
Shov,,er, Gan9...........
Sink, Bar, Commercial...................
Urinal, SiailiVfail....
Wash Basin/Lavatory, Single.
Vt'ater Cioset, Public lnstaliation..
\^r^.^,
^l^^^.
D-;.,^.^YYAtEt \rrVSEilr I rrvotO.....
t fi^^^t!^^^^!,^.,',,>iEi'e, r=JiJ.
--4-
TOTAL FIXTURE UNITS 6
2
1
2
3
6
2
b
6
I
Z
1i'
I
2
1
o
?-
2i-O
CREDIT CALCUI-ATION TABLE: Based on assessed vatue.
calculate credits 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
I 60ntJw
1981
19e2
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
1 985
MO
I Oa7
1988
1989
1990
.t ool
co 1A
1.90
1.60
0.25
0.87
0.50
0.16
Credit for Parcel or Land Only lf Applicable
Improvement (if aiter annexation date)
X$
(Rate X Assessed Value)x$
(Rate X Assessed Value)
CREDIT TOTAL = g
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
k6cr^6nt'rl
Commerclal..........
industrial..
Governmental
u.+
0.9
0.45
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
I
EHGI} RING DIVISION DEVELOPHENT PLAH '-VIETI,
4r-,.Lzcrlt arlrif=k- ', e*ln+t4,
CiTY CF SPRIiiGFIELD SYSTEI'IS DEVELOPH[iIT CiiARGE.rY\ WoRKSHEET
NAI'IE OR COMPANY:
I n^ iTTnlr.LUt-n I lrJN.
DEVELOPI'IENT TYPE:
BUILDING SIZE:LOT SIZ F sn Fr
1 CT/\nrr nnAirlaniI. JlrJnl'l rJr\^l.rrnuL
2. SANITARY SII,IER-CITY
NO. OF PFU'S b
ir{PtRVI0us sQ. FT
\Jtrc ntrVEl Js iui nuiroii ;oeiii ci anf s 1
x s0.192 PER SQ. FT
r nL LUO I 1lltptrl y . rrt =o rS viir..iiOnliT
c
s
s
sffi 626-{8X S39.78 PiR FFU. -(See Reverse To Deter;n'ine Total PFU,S)
3.. , TRANSPORTATION
NO OF UNiTS X TRIP KATT X COST PIR TRIP
x x s401 .05
x _ x $401.05
x _ x $401.0s
See Attachment C To Determ'ine Tr.ip Rates)
SUBToTAL (ADD ITEMS 1,2, & 3)s
"- 4. ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
5. CREDITS
IF DEVELOPMINT IS PROFESSiONAL OFFiCES OR INDUSTRIAL:
TOTAL-CITY SDC X (50%) = ADJUSTED CiTY SDC
s 4%- vt.r?
T0TAL-CITY SDC S,?r*+AaA.V
.s
6. SANITARY SEI{ER.I,II.II,IC
NO. OF PFU'S
/4
$13.62 PER PFU + $10 t'tI,JMC ADMIN. FEt_ S ?Uzq,a*
(Use PFU Total From item 2 Above)
I''III|MC CREDIT IF APPLICAtsLE (SEE REVERSE)
T3*- l*J.- q z-t 1-z-
Ki p Burd ck
SDC Coord'inator
J I llllullnu Jr L\, r r rv^ I rvrtJ I
SHALL BE RESTORED TO FULL CURB HEIGHT AS DIRECTED BY THE ENGINEER.
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