HomeMy WebLinkAboutPermit Building 1999-03-24RESIDENTIAL
PERMIT APPLICATTON
lnspections: 726-3769
Office: 726.3759
SPRINGFI ELO
LOCATION OF PROPOSED WORK:5 2-t 3r */
.JOB NUMBER f 7o zsz
225 Fifth Street
Sprlngfleld, Oregon 97477
ASSESSOBS MAP:/7 0 23rzq TAX LO]I /o to(
LO.l:
-
BLOCK:SUBDIVISION:
/4qt n PHONE:
Or'e tut-ZIP:
6?
STATE:
5oL oOWNER:
ADDRESS:
CITY:
ADDITION/<
a aDESCRIBE WORK:
NEW- REMODEL
AODRESS
DFtrIOT
DU
EXPIRES ,l PHONECONTBACTOB'S NAME
GENERAL:
ZONING CODE:
FLOOD I)LAIN
S PERMIT I
RE IFTHE
PLUMBING:
MECHANICAL:
ELECTRICAL;
CONST.
CONTFIACTOR #
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be macje the following work day.
REOUIRED INSPECTIONS
Temporary Eleclrlc Mechanical - Prior to al Plumbing
blng worl<- When all
is complete.cover.plum
SIle lnspectlon - To lre made
after excavation, but prior to
setting forms.
Electrical - Prior to al Electrical - When allover.electrical work is complete.
E Underslab Plumblng/ Electrical /Electrical Service - Must be
approved to obtain permanent
electrlcal power.
al Mechanical - When all
- Prlor to cover.hechanical work ls complete.
ng - After trenches are al Buildlng - When attexcavatedFlreplace - Prlor to facing
materlals and framing lnsp.
red lnspectlons have been
Masonry - Steel locatlon, bond
beams, groutlng.
approved and building is
completed.
- After forms are
lng - Prior to cover.
t Other
erected but prlor to concrete
placemont.l/Ceiling lnsulation - Prlor to
D Underground Plumblng - Prior
to fllllng trench.| - Prlor to taplng
MOBILE HOME INSPE TIONS
Plumblng/ Mechanlcal Wood Stove - After lnstallatlon.- Prior to lnsulatlon or decking
and Beam - Prlor to floor Blocking and Set.Up - When alt
blocklng ls complete.lnsulatlon or decklng lnserl - After fireplace approval
and lnstallatlon of unlt.
lnsulation - Prlor to Plumbing Connections - When
home lras been connected to
water and sewer.
ing.Curbcut & Approach - After
forms are erected but prior to
placoment of concrete.lary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Storrn Sewer - Prior to fllling
trench.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base malerial in place.
Water Llne - Prlor to filling
trench.
Fence - When ccir'lpleted
Final - After all required
lnspections are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
ugh Plumbing - Prior to n Street Trees - When all roqulred
'J trees are planted.
?7
/
'r OF BDRMS:
-
tl
E
tl
D
tl
Etltl
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typ
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
rS THE PROPOSED WORK tN THE .
HISTORICAL DISTRICT, OR ON
THE HISTOFIICAL REGISTER?
-
lf yes, this applloatlon must be signed
arrd approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
BUILDING VALUE, iTRITI CHECK
AND BUILDING PERMIT
This perfirit 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
ouildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By
7
Date
Date Paid
Receipt Number:
Received By:
st.2 7Plan Check Fee:
BUTLDING PERMIT
ITEM SO. FT. X $/SQ. FT.VALUE
@l-Qtw--
c?z
13.'.t 2
/0,7/gJo
(A)
Main
Carport
Garage
/0, flc 3o
86sa
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
7a
2o
/.6 o
2Ltr, o
L
(c)
Nc
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
with the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon perlaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with OFIS 701.055 will be used on this
proiect.
I further agree to ensure that all required lnspections are
requested at the proper time, that each address is readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
n.
Slg natu re
Date
on the site at all times during st ru
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge50L 72, ({
Total Mlscellaneous Perrnits (E)
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood
TOTAL AMOUNT DUE (excludlng electrical)
(A, B, C, D, and E Comblned)
.i3-7^Lg
VAt-IDATION
RECEIPT NUMBER
DATE PAIi),1
AMOUNT HECEIVED
032?73
RECEIVED BY
3
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ngTeSO .Jaqtlrru uo r.'+;)B$uri...tj
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Lt t L6 H$,pIsIJ|6ut.-r,J5
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Tr.ansact ion ni;s|1361,r. nlSStSApr.iI 0?1 1S9S i[;58 Fff
Rere:ivpcj fr.onr: HAftIA lli-;l;; 1;0ontract,/0rln ;
Addr*ss I litp B4TH{.'i.ty; SFEINGFIELT| .S1;;0R il:pr 9.t+??
-Br"l:i. ldinr,_
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ilescr.ili.L ron Fe*
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$l;arf * gr"rr.*iiar.oe
IJZ A,Jrrrin Fpe -
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JOURNAL OR JOB NO.qEo utz
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY /l/lqtro 5o/-/"
LOCATION S z'l 3?le
DEVELOPMENT TYPE
BUILDING SIZE:SIZ Ft
1. STORM DRAiNAGE
IMPERVIOUS SQ. FT
q5 X $0.227 PER SQ. FT 2 5
2 . SAN ITARY SEl,'lER-CITY
NO. OF PFU'S
(See Reverse Side)
3. TRANSPORTATiON
NO OF UNITS X TRIP RATE X COST PER TRIP
x x $475.32
x $475.32
X $47.14 PER PFU
$
-*-
$
$
X
4. SANITARY SEWER-MI',IMC
A. REIMBURSEMENT COST
5. ADt.lINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE) X .05
lns u
SDC Coordinator
ATTACH 'A. I^JPD
NO. OF FEU'S X PER FEU
B. IMPROVEMENT COST
NO. OF FEU'S X PER FEU
|-4!\lt.4c CREDIT IF APPLICABLE (SEE REVERSE)
l'4td1.4c ADMINISTRATIVE FEE
$-
$
<$C.....-
$ 10.00
TOTAL-MWMC SDC $
SUBTOTAL (ADD ITEMS 1,2,3 & 4)$ 9t,57
$ / ,Otr
Date
TOTAL SDC
4zee s 2Q,b,f
FIXTURE UNIT CALCULAaON TABLE: Number of New Fixturr Unit Equivatent = Fixture rriits
(NOTE: For remodels, calculate only tl
FIXTURE TYPE
..1 ET additional fixtures)
NUMBER OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTURE
UNITS
Bathtub.....
Drinking Fountain....
Floor Drain.
lnterceptors For Grease/Oil/Solids/Etc.................
lnterceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher......
Clotheswasher - 3 Or More.....
Mobile Home Park Trap (1 Per Trailer)......
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall
Shower, Gan9.........
Sink: Bar, Commercial, Residential Kitchen......
Urinal, Stall/Wall...
Wash Basin/Lavatory, Single........
Toilet, Public lnstallation.
Toilet, Private...........
Miscellaneous:
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits rates
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x$
(Rate X Assessed Value)
X$
(Rate X Assessed Value)
CREDIT TOTAL $
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1 989
1 990
1 991
1 992
1 993
1 994
1 995
1 996
1 997
$1.98
1.55
1.15
o.96
o.83
o.67
o.52
0.38
o.21
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
1 986
1 987
1 988
$4.27
4.14
4.12
3.99
3.83
3.68
3.48
3.18
2.82
2.42
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Onlyl
Residential
Commerica1...............
lndustrial...
Governmental............
o.4
0.9
05
0.5
FIXUNIT.WPD IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT