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Home My WebLink AboutPermit Sewer Connection Record 1994-12-19 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' / 7/J' ASSESSORS MAP' LOT' . . JOB NUMBER 91/'/1 225 Fifth Street Springfield, Oregon 97477 I<~f) b TAX LOT: SUBDIVISION: '""\'.'" /C)/ ~-3 fj ,SS j~ ~.,.,..., BLOCK' OWNER' ADDRESS' CITY' NON II- .AI 0 R R IS '2f.R tfo Clift!? 1-1 EL--r?JN euCtE-Nc STATE:-Uc.G!Jf..( DESCRIBE WORK' ..:I H $ IVf 'PIC ll/ /-J -n~= NEW REMODEL CONTRACTOR'S NAME GENERAl' "H- +e....- ADDITION DEMOLISH OTHER ADDRESS R, '7<.'c /lId~)"'f ft tfJ, Zi9,x A;:r s?!'d', CONST, CONTRACTOR . s.-~ ~~t) PHONE 1- Z(j;r-Sf 1 ( PLUMBING' MECHANICAL' ELECTRICA' . QUAD AREA: . OF BLDGS' OCCY GROUP' . OF STORIES' WATER HEATER' , . - . PHONE: (p~ r: - <1 Z ft-( - OFFICE USE - '. LAND USE: · OF UNITS' CONSTR. TYPE: HEAT SOURCE: RANG~' ZIP: _t:J =r(..i()~ S; E {IV E,E. Sc'J<: 1/ Ie E- EXPIRES If-I(l-qs- A ~ , FLOOD PLAIN' ZONING CODE:_ . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspectlon, you must call 726.3769. This Is a 24 hour recordIng. All Inspections requested before 7:00 a.m. will be made the same working day, Inspections requested after 7:00 a.m. will be made the (ollowlng work day. REQUIRED INSPECTIONS o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumblng/Electrlcal/ Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond ,beams, grouting. o Foundation - After forms are erected-but prior to concrete placement. o Underground Plumbing - Prior to IIl1lng trench. o Underlloor Plumbing/Mechanical -.Prlor to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. ]:yo( Sanitary Sewer - Prior to filling ~trench. o Storm Sewer - PrIor to filling trench. O Waler Line - Prior to filling trench. ' o Rough Plumbing - Prior to cover. o Rough Mechanical - Prior to cover. .', o Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtai n permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. o Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After I~stallatlon. o Insert - After fireplace approvlIl and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub-base ma,terlal In place. , o Fence - When completed. I o Street Trees - When:aWrequlred trees are planted. ,c.:-\.-.;" o Final Plumbing - When all plumbing w9rk Is complet.e. o Final Electrical - \l'V.hen all electrical work Is complete. c: o Final Mechanical - When all mechanical work Is complete. o Final BUilding - When all required Inspections have been approved and building is completed. I ~ Other~AJ I /!:~ ~ Cf ,>a?!"/e. /MJK._. MOBilE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. . o Plumbing Connections - When home has been connected to . water and sewer. D Electrical Connection - When blocking, set-up, and plurQblng Inspections have been approved and the home Is connected to the service panel. o Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. Lot faces Lot ~yp. Interior Lot sq. Itg. Lot coverage Corner Topography Panhandle Total Ijelght _ Cul.de-sac .~. ": 1.i,' 'r';',' "!"l:;-:.l:-'~,:fl.&.:~). Setbacks . I P.L. HSE GAR ACC' IN Is ~S THE PROPOSED W~RK IN THE. ""'HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? II yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. W E BUILDING PERMIT ITEM sa. FT. x $/SO. FT. ~ VALUE l\1aln Ga(age Carport Total Value Building Permit Fee State Surcharge Total Fec (A) " (B) SYSTEMS DEVELOPMENT CHARGE (SDC) 1 'Jet? .,,, PLUMBING PERMIT ITEM Fixtures , Residential Bath(s) N' Sanitary Sewer FT. J~I') / Water FT. FT. Storm Sewer Mobile Home Plumbing Permit State Surcharge 2~ + ;,20 (e) Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stovellnsert/Flrcplace Unit Dryer Vent Mechanical Permit Issuahce State :Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE ~"o ~ 20 ~.2D '7,25/."11)\ APPROVED: . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the City of Sprlnglleld, Including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provIsions of said ordinances. Plan Check Fee' Date Paid: Receipt Number' Received By: Plans Reviewed By Date Systems Development Charge Is due on all undeveloped properties within tho City limits which are beIng Improved. ADDITIONAL COMMENTS ~r(T- phr7.~ ,,/M//-:r,iC" /'~HJ4/"JJ "17 ,>14- /.JrA-."(,~ :'~77t" .~/h/""\ ~. /77!;rJ/' HAf/:v, l/frl-/L /CJP r~~;'~'<;") c;( p//.L5J t.<J/ ,An)) elk 6"~[ , By sIgnature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information hereon Is true and correct, and I further 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 pertaining 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 In 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 Is located at the front of the property, and the approved set of plans will remain on the site at ~ ~~CllO~ ~natur ~ ~-L4/ /q Dec' Datf' C1Y I VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVEP RECEIVED BY 1~7'J'J /? I/~/tf 775?': 1'0 A'P~ ; . ATTACHMENT B1 .B NO. CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: 1m.< r~ LOCATION: > ?3s- ...t~ A:.~ DEVELOPMENT TYPE:..d.,~! ;. ~.u, ft ~. ~ ~-~. BUILDING SIZE: lOT SI7F' SQ. Ft. '1-1-/9/4 1. . .STORM nRATN~ IMPERVIOUS SQ. FT. --- X $0.209 PER SQ. FT. $ ~ / 2. ~ANTTARY SFWFR-r.TTY NO. OF PFU'S II X $43.26 PER PFU .~~:!0 (See Reverse) 3. TRANSPORTATTOM NO OF UNITS X TRIP RATE X COST PER TRIP X ~ $436.19 ~ X $436.19 /X $r $ X $436.19 $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 4rS;~" 4. SANTTARY SFWFR-MWMr. NO. OF PFU'S )/ x $17.19 PER PFU + $10 HWMC ADMIN.FEE (/9_9.()0. (Use PFU Total From item 2 Above) ~ ~ .. MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ uf..B IQIAI -MWMr.-S.QC. $ / f9d~" SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ t. -:;1'.?~ 5. ~nM.TNTSTATTVF FFFS QJAlIO:;z:r: MJOVEl X .05 _ A Date: H ry Hornig, P.U SO oordinator C33.1V 12 -/.s--'1~ TOTAl SDC $ 1oF.70 B2.SDC . FIXTURE UNIT CALCUL.ON TABLE: Number of New Fixt. X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate only the N.EI additional fixtures) NUMBER OF NEW FIXTURES FIXTURE TYPE Bathtub........ .............................................................. Drinking Fountain..................................................... Floor Drain. ... ..... ....................................................... Interceptors For Grease/OiI/Solids/Etc................. Interceptors For SandlAuto Wash/Etc.................. laundry Tub/Clotheswasher................................... Clotheswasher - 3 Or More..................................... Mobile Home Park Trap 11 Per Trailer).................. Receptor For Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink: Bar, Commercial, Residential Kitchen........................ Urinal, Stall/Wall. .:..:... ............................................... Wash Basin/lavatory, Single.................................. Toilet, Public Installation........................................ Toilet, Private................. ..... .............. ... .... ............ Miscellaneous: ,TANI TlU'.s .$.INk / J / / / TOTAL FIXTURE UNITS UNIT EQUIVALENT 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 .< = FIXTURE UNITS 2 2. J I 4- )/ CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. If Year Annexed Rate per $1,000 Assessed Value 1 979 or before 1980 1981 1982 1983 1984 1985. $3.46 3.38 3.32 3.21 3.06 2.92 2.73 Credit for Parcel or land Only If Applicable Improvement (if after annexation date) Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 Rate per $1,000 Assessed Value 'I $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 X $ (Rate X Assessed Value) X $ (Rate X Assessed Value) = = /""/ / CREDIT TOTAL = $ VI G$ .~ I