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HomeMy WebLinkAboutPermit Miscellaneous 1994-11-1 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORI<' . SPRINGFIELD "?o-?-? 47/l'h'/ ~" / 7-CJZ -,5':;>-3,';;' BLOCK: ASSESSORS MAP' LOT: OWNER. //7t?C/e->?- 6'A-Z--~ ADDRESS: /22h/Z.' ~NZ;'R..J ~,i2. CITY' ;S;tCI~~rY-=.J~ STATF' /7,;[? PESCRIBE WORK. NEW ----- REMODEL ,/J;A..t//}~A /'?__'r"'.7?~ ,~Lh"" ?/ ~/7?6?..u2-V-- ADDITION CONTRACTOR'S NAME GENERAI'&;:"-''''::;-- tfb7=P~ I( PLUMBING: I( MECHANICAL: _ r .J ELECTRICAl' ~ ~A '"ZPn-..d.Ut'. DEMOLISH OTHER .OB NUMBER ct4l4fSL 225 Fifth Street Springfield, Oregon 97477 TAX LOT: SUBDIVISION: ..5:..,,--.,<J(') PHONE: 7.yg. ZIP: 4? :?<7'?? ADDRESS .,::;'0,2/ /J;A-h</ CON ST. CONTRACTOR' yZc/? z- PHONE 72? -.2/ // /(' /1 EXPIRES //4/ '/ Q' 4~~ - OFFICE USE - OUAD AREA: LAND USE: \\SCl FLOOD PLAIN: . OF BLDGS: \ . OF UNITS: ZONING CODE: lJ)R.... OCCY GROUP: p,;-:>, CONSTR. TYPE: viJ . OF BDRMS: ~ \~ HEAT SOURCE: ~[) - . OF STORIES: SECONDARY HEAT: WATER HEATER: V/ RANGE: ~.J SQUARE FOOTAG E: :f} ~ ( L To request an inspection, you must call 726-3769. This Is a 24 hour recording. AI/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 following work day. D Temporary Electric D Site Inspection - To be made after excavation, but pri to setti n rrn ~Unders m I Electrlcall ~_ Mechanical - Prj to cove Wooting - After trenches are (' excavated. D Masonry - Steel locatIon, bond beams, grou.ting. ~FOUndatlOn - Atter forms are erected but prior 10 concrete placement. D Underground Plumbing - Prior to filling trench. D Underlloor PlumbingJ Mechanical - Prior to insulation or decking. D Post and Beam - Prior to floor insulation or decking. D Floor Insulation - Prior to decking. [2PSanitary Sewer - Prior to (1lIlng l/"ltrench. ~Storm Sewer - Prior to filling 'P trench. ~Water Line - Prior to filling ~ trench. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. D Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materIals and framing Insp. D Framing - Prior to cover. D Wall/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. o Wood Stove - After installation. D Insert - After fireplace approval and Installation of unIt. D Curbcul & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. D Fence - When completed. D Street Trees - When all required trees are planted. D Final Plumbing - When all plumbing work Is complete. D Final Electrical - When all electrical work is complete. D Final Mechanical - When all mechanical work Is complete. D Final Building - When all required inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS Ii9BloCking and Set.Up - When all ~ blockIng Is complete. ~ Plumbing Connections - When ~ home has been connected to water and sewer. ~ Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. ~Final - Atter all required 'P Inspections are approved and porches, skIrting, decks, and ventlng have been installed. Lot Type ,. 'IS THE PROPOSED WORK IN THE Lot faces Setbccks Lot sq. fig. Inlerior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is and approved by the Historical Topography Panhandle Iw Coordinator prior to permit Issuance. Total height Cui-dc-sac IE APPROVED' BUILDING PERMIT ITEM SO. FT. x $/SO. FT. =~ ,., (Y) Main Garage~ 4-~O \ \1\~ 4f1CO 4'n,?ID (o2COJ ~o,so &<63-1'\.10 <:\. ~ 101.03 Total Value Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) 1.2 fJ:J3'. 9() (B) PLUMBING PERMIT ITEM FEE Fixtures Resldenllal Bath(s) N' Sanitary Sewer FT ~~ 4.CL L\(j Water FT. Storm Sewer FT. Mobile Home Plumbing Permit Jtb~ 5,25 +3.6 P>~O \ \3."\0 State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance Stale Surcharge d Total Permit (D) MISCELLANEOUS PERMITS \~~ dj D.OO '-C),~S Mobile Home Stale Issuance State Surch~ Sidewalk ~ fI Curbcut ~, It Demolition State Surcharge Total Miscellaneous Permfls (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) B-~~.S& I BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on tile express condition that the said construction shall, in all respects, conform to the Ordinance adopled by the City 01 Springfield, 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. ,","y/ Receipt Number' C""- '\\.>" 7' Plan Check Fee: Date Paid: Received By: , Plans Reviewed By Dale Systems Development Charge Is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS \ 9\+ i~CLt~'w ~\\N. '. \ L\ \ en By signature, I stale and agree, that I have carefully examined the completed application and do hereby cerllfy 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 Ordlnanc~s of the City of Springfield, and the Laws of the Slale of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building ~afety Division, I further certify that only contractors and Jmployees who are In compliance with ORS 701.055 will be used on this prolec\. I further agreo to ensure that all r~qulred Inspections are requested at the proper time, that each address Is readable from the street, thai the permit card Is located at the front of the property, and the approved set of plans will remain on the sile at all times. du.::,ng./rn. s,gnatud- ('-8- ( Dato d-~.-P7 VALIDATION: . I RECEIPT NUMBER I c;,';)/ Y DATE PAID II -/ =-q 4 - rJ AMOUNT RECEIVED (; / ~'L Y G\ ~ RECEIVED BY ~ . SpnINGFI~,.~' Thelollowlng proj...'t as oubmlltod has the lollo'N1n zoning, and doe. not roquira opeclllc land UIlO 225 FIm STREET apprO'la\. . (2; ELECTRICAL PERMIT APPUCATION SPRINGP'IELD, OREGON 97477 .. Zon!n!, L...P /LA \A~1 INSPECTION REQUEST: 726c~.,~6_~.. I ~ '-!-. Ci ty Job Number '-f"t r-t.... ') OFFICE: 726-3759 , ;' . Authorized Slgnotur.L~ C/'lJilLl'T" "'!E SCDEDULE BELOV I: LOf1~~~~$_) LEGAL DE~I.2."-:-1 ' \\ (}'L ~ .~O~S[Y) ~~~~]J'\L Permits are non~ransferable and eKpire if york is not started vithin 180 days of issuance or if york is suspended for 180 days. '2." CONTRACTOR INSTALLATION ONLY . . Electrical Contractor I-tF-RrrAGF-_tl..tC/. lOX? J:Jn-... r;, .- . - Address "".--;."'; 'n0r-~ ,,'lr;\ AJF~ Ci ty_l=,Il. h\r.-AI F_ Phone 72.-<1 -l'5DO (]'-\-,l.C' {,';;_/(,oo Supervisor License Number -,~.) Expiration Date \.0 --I -q<=') Constr Contr. Number (O3\?l1 Expl'ration Date I 2. -7... -<13 'i! The installation is behig made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: .' DATE: ----;- 'J I -- J -1';:j~--------------~ RECEIPT, ,: . " ~-?1 y RECEIVED BY: /~ A. Nev Residential-Single or Multi-Family per dvelling Service Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd 1I0me or Modular Dvelling I) Service or Feeder ~ B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only unit. Cost Sum $ 85.00 $ 15.00 $ 40.00 ~O $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D.' Branch Circuits $ 40.00 $ 55.00 S 80.00 see flDtI above Ne~. Alteration or Extension Per Panel One Circuit Each Additional Circuit or ~ith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE Pf) ~ 5% State S~arge "\ .(JCj - ,;:;)70 ' r{l.~n S(O~ . . o Y.'!i!IJ!!,!!~!~.!!~ Job No. CJ414~1 SYSTEMS DEVELOPMENT CHARGE WORKSHEff NAMe ~l\lUt ADDRESS: VL ru: 0 \ 17 - PHONE: f)\\,.q~ . ~~\Jc STATE:~IP q1t17 Platt Name: \\r\.... &not Tax Lot Number. \ ~OL ~~ 33 oSSCXJ LOCATION OF ~ROPOSED BUILDING SITE: \N'"\f\';. ~ Street Address if Known: ,\l).~~~ \ 1. DEVElOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back'> A. Sim!le Familv - Detached NO OF UNITS 1 Manufactured home not in a park $1f;DpD Single Family home { X $400 PER UNIT _= . B. Sim.le 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 = $ WPRD SDC $~()~ $ff $4()D~ 2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAL WPRD Nff SDC ASSESSED (If SDC reduced for Credit) ~ci\, Commu-nity Servic r:.... .....(C"......:.........+:......I...f I I Date '""vu "v. I / I 1---' C. OF SPRINGFIELD SYSTEMS _LOPMENT CHARGE WORKSHEET-' (COMMERCIAL & RESIDENTIAL) N.AJo1E OR COMPANY: 0.u.:- JJI..IAfA LOCATION: 1" 3 3JJ1~ ,/. I DEVELOPMENT TYPE:./k ___, .,~;~ L-.., j, ~~1 jk/ ~~ BUILDING SIZE: (4?.<.17-)/zo;<M)I.!OX20) tOT SIZt' SQ. Ft. 1. STORM DRAINAGF IMPERVIOUS SQ. FT: }./ t- (, 2. SANTTARY SFWFR-rTTY NO. OF PFU'S . /"( (See Reverse) 3. TRANSPORT A TT ON X $0.209 PER SQ, FT. ~ ~ X $43.26 PER PFU . $(i-;r~) NO OF UNITS X TRIP RATE X COST PER TRIP I X /,()/ X $436.19 X X X $436.19 X $436,19 ~ $ $ SUBTOTAL (ADD ITEMS 1.2, & 3) $ Ie. 'f.<t.OI 4. 56NlIARY SFWFR-MWMr. NO. OF PFU'S /'i x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ ?',,;~2 (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ~/.~2 . , IQIAI -MWMr snc s.:-z" '" . ~ SUBTOTAL (ADD ITEMS 1.2,3 & 4)$ /94/.lf/ 5. ~nMTNTsTATTVF FFFS BASy-cHARGE (SUBTOTAL ABOVE) X .05 d /iL Date: ~ MaryJHornig. ~ SDUoordinator c(r;t'.o~ 7- 30 -7'-72 TOTAl SDC $..(038.'/0 B2. SDC . . .". _.-- ---.. _. ~.....___..-... .-.- .. .---. ......'.............. ....... .........,...-.. -.... -..,....._._..~ ~ ............... .......l~ (NOTE: For remodels, calculate only the tiEr additional fixtures), I . NUMBER FIXTURE TYPE NEW FIXT ES Bathtub....,................,.......,......."......,.,....,......,..,...,.. . Drinking Fountain..............,.,........"...,.............,..,..... Floor Drain................,.............,..,.,...........,............,... Interceptors For Grease/Oil/Solids/Etc....,............ Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher..,.,......,.,...,.......,..,...... Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For RefrigeratorlWater Station/Etc......., Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall.,.......................,.,..................... Shower, Gang....,...........,......,.,.:.............................. Sink: Bar, Commercial, Residential Kitchen........................ Urinal, StaIlIWall..:........,.....,.,.....,........,..............,....,.' Wash Basin/Lavatory, Single.................................. Toilet, Public Installation........,............................... Toilet, Private,.......,...........,....,........,........,........... Miscellaneous: ,TANI TCP'.$ $,fNr 2 I I '2 7 TOTAL FIXTURE UNITS UNIT EOUIVALENT 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 .2. = FIXTURE UNITS 4'- z z. 2.. ~ /? CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates, Year Annexed Rate per $1,000 Assessed Value Year Annexed L 1979 or before 1980 1981 1982 1983 1984 1985 1985 1986 1987 1988 1989 1990 , 1991 1993 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 Credit for Parcel or Land Only If Applicable 3/1(; X $ /1, '120 fRate X Assessed Value) X $ (Rate X Assessed Value) Improvement (if after annexation date) = = Rate per $1,000 Assessed Value $2,46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 .5'/,(;, 2 ------- CREDIT TOTAL = $ S /, C, 2.