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Home My WebLink AboutPermit Building 1992-3-11 RESIDENTIAL PERMIT APPLICATION Inspections: 726,3769 Ollice: 726,3759 . SPRINGFIELD BLOCK: h?//~ V. '~ .Y"\ ASSESSORS MAP: LOCATION OF PROPOSED WORK' 4;''94/~ /7-oZ-'3c,;-~'2 LOT' OWNER: ADDRESS' CITY' f~/.. ~~~-o<?? ~fi7&: --SP~~ . JOB NUMBER 9';2~/VR 225 Fifth Street Springfield, Oregon 97477 TAX LOT' SUBDIVISION' ~/~o PHONF' ? S/.::= -c:::::> 9/'/ STATF' ~;5.:;> . \ d\~61i)rrrl~) DESCRIBE WORK\_~_O_J\\ rt91lbn \) NEW REMODEL ADDITION Iy{) , DEMOLISH OTHER ZIP' "J1.?~~ _<;",..7~ . CONST, CONTRACTOR' PHONE &~ -~-.-< CONTRACTOR'S NAME ADDRESS / A ~ ldi:~ ~,.-yz;,.~ GENERAL:~A1'~ _ h~~ _ - ...:; - _ r PLUMBING' !bvz::."'" ,p'(i!": . MECHANICAl' ELECTRICA' 'UA""?'5 ~ QUAD AREA:4\<. \\ !Y..J :~:yB~:::~: ~?-\ . OF STORIES' \ WATER HEATER: - OFFICE USE - ,LA~D USE: \\ \ \ . OF UNITS' CONSTR. TYPE: ~J HEAT SOURCE: RANGF' r EXPIRES Z-/~-"97. / FLOOD PLAIN' ZONING CODE: wr ) . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: _95 To request an inspection, you must call 726-3769. This is a 24 tlOur recording. AI/Inspections requested before 7;00 a.m. will be made the sal}1e working day. Inspections requested after 7:00 a,m. will be made the following work day. o Temporary ElectrIc D Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical I Mechanical - Prior to cover. "FV"I" Footing - After trenches are ~excavated. o Masonry - Steel location, bond beams, grouting. ~Foundation - After forms are ~ erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench, ~ Underfloo~eChanical ~- Prior to InsulatIon or decking. '"'r21' Post and Beam - Prior to floor ~nsulation or decking. ~ Floor Insulation - Prior to ~ecking, D Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to tilling trench. o Water Line - Prior to filling trench. ;;;::::::;;r'Rough Plumbing - Prior to ~cover. REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to ~ cover. ~ Rou~h Electrical - Prior to ~over. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. &Framing - Prior to cover. ~Wall/Celling Insulation - Prior to ~over. ~DryWall - Prior to taping, o Wood Stove - After Installation. D Insert - After fireplace approval and Installation of unit. o Curbcul & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. O Fence - When completed. .'t ,}~ o Street Trees - When all required trees are planted, ~ Final Plumbing - When all ~ plumbing work is complete. IQf Final Electrical - When all ~ electrical work is complete. ~Final Mechanical - When all ~mechanical work is complete. ~ Final Building - When all ~requlred inspectIons have been approved and building is completed. o Other 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. o Electrical Connection - When blocking, set.up, and plumbing 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 Type. Setbacks . THE PROPOSED WORK IN THE l Loi sq, Itg. I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON - Interior IN I THE HISTORICAL REGISTER? Lot coverage Corner Is I If yes, this application must be signed I and approved by the Historical Topography ~I Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de-sac IE I APPROVED: BUILDING PERMIT ITEM SQ. FT. X $/SQ, FT. VALUE Main Garage Carport /165 .t7' all ':'7-'''''''--" - ~.90 .3.~ Total Val ue Building Permit Fee State Surcharge 7/,1.1 SYSTEMS DEVELOPMENT CHARGE (SDC) ~ .H q( (B) ." 2.n"l - Total Fee (A) PLUMBING PERMIT ITEM FEE -.;z.. t9 .~ Fixtures :2 Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge /. tJ-C ..2.1.40 (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' J Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit /UIV. IS-OD jO,dO .7.s- '2.s.7S Issuance 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, D, and E Combined) c -;sZZ. ~ 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 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. Plan Check Fee' LI Y $""') -;:;,~/3"~ Receipt Number' "J>7'3b Received --'!"""~ ..- -' ~ t'f'f'K- _ ~, (fY'K- Plan nevlewed By Date Paid: '7,~h2.. 7' 5a16 Systems Development Charge is due on all undeveloped properties within the City !~mits ~hich are be,ing improved. ADDITIONAL COMMENTS _~.4?~ # 7 , . 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 all tim~s ..dur~n!~truc:n. ~gnaturea:J/tLp *'1J--- Datp 3 -11- O/r VALIDATION: RECEIPT NUMBER 3'( roE DATE PAIP 3 ~i ( -1 z..-. AMOUNT RECEIVt=n 3zJ? 51 CCuv----Jl- RECEIVED BY JOB NO. "17- 0 1'-1 B CITY OF eRINGFIELD SYSTEMS DEVELOP.Y CHARGE WORKSHEET ' - (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: IN. C,RAHlttvl LOCATION: .5"'1'-1'1- MA/IJ<;'. If01-'?7<f.?J... - 00100 DEVELOPMENT TYPE: LDf'? - APDITION BUILDING SIZE: 1. STORM DRAINAGE LOT SIZE SQ. Ft. ~. -.!.!:.. IMPERVIOUS SQ. FT. 1?R..C,. X $0.186 PER SQ. FT. f (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER-CITY NO. OF PFU'S ') X $38.55 PER PFU (See Reverse To Determine Total PFU'S) $ Iq27~ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x X $388.61 $ '-6"'0" .r x X $388.61 $ '.' .,-. X-~ ,-=. X $388.61 .' ,- ." - . ' :(Se~ Attachment C To Determine Trip Rates) > .,' , SUBTOTAL (ADO ITEMS 1,2, & 3) S . . ",... . ..----... S 1"'I"t"!.!-. . 4. ADMINISTRATIVE FEES 'BASE CHARGE' (SUBTOTAl ABOVE) X ,05 $ /O~ TOTAL-CITY SDC s'J...O"l'U 5. SANITARY SEWER-MWMC NO. OF PFU'S x 513.25 PER PFU + S10,MWMC ADMIN. FEE S (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ - ~~LL - U Kip Burdick SOC Coordinator 'l/I'+ /'l-z.. TOTAL-MWMC SDC S ~ TOTAL SDC $ 'l-Dq't!. . FIXTURE UNIT CALCULAl!.ON TABLE: Number of New Fix1ures X Unit Equivalent = Fix1ure Units (NOTE: For remodels, calculate only the ~dilional fix1ures) . NUMBEfl OF UNIT FIXTURE .FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathlub.......................:.............................................. Drinking Fountain.......;.............................................. Roor Drain....:......:........:..................:....................:... Interceptors For Grease/Oil/Sollds/Etc................. Interceptors For' Sand/Auto Wash/Etc..........:....... Laundry Tub/Clotheswasher................................... Clotheswasher . 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator JWater Station/Etc........ Receptor For Commerclal Sink/Dishwasher/Etc.: Shower, Single Stall................................................. Shower, Gang...................:....................................... Sink, Bar, COmmercial............................._............. Urinal, StaIIJWall......................................-............ Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous:. 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 1 Lf TOTAL FIXTURE UNITS = 5 r' CREDIT CAlCULATION TABLE: calcu1a1e credits separates. I Based on assessed value. 'fbnprovements ~rred after annexation date In.table. Year' Annexed 1985 1986 1987 1988 1989 1990 ,- Rate per $1,000. Assessed Value 1979 or before 1980 19B1 1982 1983 1984 Rate per $1.000 Assessed Value S2.66 2.64 2.53 2.41 2.19 2.04 $1.69 1.35 1.15 0.92 0.59 0.23 J Year - AnneiecJ Credit for Parcel or Land Only If Applicable x S (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL = S Improvement (If after annexation date) RUNOFF COEFFICIENTS FOR STORM DRAINAGE ResidentiaL...:.................................................. 0.4 COmmerciaL.................................................... 0.9 I ndustriaL...... ........ ........................................... 0.45rGovemmental:.................................................. 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT ,