The URL can be used to link to this page

Home My WebLink AboutPermit Building 1991-8-12 RESIDENTIAL PERMIT APPLICATION . Inspections: 726-3769 Office: 726-3759 LOCATION OF PROP~SED W~: - q I p.; ASSESSORS MAP: \ ,r)\::)H l 0 ~ ~ OWNER' \ ~ \ " ' ~\ \ l~ . PHON'" CITY: . ~ . C . - @,.A~: -1. ~ 0 q-t)1\...J ZIP: DESCRIBE WORK: ~ Q D. \6 _~ \;\T-\ G.. \J.. - \.~\dJ-?..\rlJ\ ADDITION V) DEMOLISH /- ~l CONTRACT 'S NAM ADDRESS GENERAL:t;J,O (\ \JO 1\ If) ~~-S'S'~,(Y II\...) LOT' NEW REMODEL PLUMBING' MECHANICAl' ELECTRICAL' QUAD AREAcOR\\ 'k 0 . OF BLDGS: 'R~ f hI OCCY GROUP: . OF STORIES: WATER HEATER: BLOCK' OTHER JOB NUMBER G\ \tf33\ 225 Fifth Street Springfield. Oregon 97477 (\ TAX LOT: ()q rZ, \ ',) ;> SUBDIVISION' CAI4\/ CONST. CONTRACTOR' ~)"\\()o. < - OFFICE USE - LAND USE: '\ \ \ \ . OF UNITS' \ CONSTR. TYPE: ~AJ HEAT SOURCE: RANGF' EXPIRES PHONE \ \11~ 14la ' 'tAl. ~ FLOOD PLAIN: ZONING CODE' UYU # OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspection, 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 following work day. D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. ~ Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting. ~oundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. ~nderfloor 'PlumbinglMechanlcal ~ ~ Prior to 1I1~Uldo.lIV.-1 '5r decking. D Post and Beam - Prior to floor Insulation or decking. ~ ~joor Insulation - Prlor to deckl ng. 'fVr"Sanitary Sewer - Prior to filling ~trench. D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. ~ROU9h Plumbing - Prior to cover. REQUIRED INSPECTIONS ~ I Rough Mechanical - Prior to cover. ~ough Electrical - Prior to I-6J cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~raming - Prior to cover. ~all/Celllng Insulation - Prior to cover. ~rywal1 - Prior to taping. D Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. D Curbcut & 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 - ~hen completed. D Street Trees - When all required trees are planted. . ~nal Plumbing - When all k:SJ piumblng work 15 complete. ~inal Electrical - When all J.2SJ. ~Iectrlcal work Is complete. !' I Final Mechanical - When all mechanical work Is complete. @Inal Building - When all required Inspections have been approved and building Is completed. I DOlher MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. D Electrical Connection - When blocking. set-up, and plumbing Inspections have been approved and the home Is connected to the service panel. D Final - After all required inspections are approved and . porches, skirting, decks, and venting have been Installed. I 16E PROPOSED WORK IN THE Lot faces Lot Type . Setbacks Lot sq. ftg. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT. OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I and approved by the Historical Topography Panhandle Iw <';;oordinator prior to permit issuance. Total he; ght Cul-de.sac IE APPROVED: BUILDING PERMIT ITEM SQ. FT. X $/SQ. FT. Main Garage Carport ~~ JM. 7iJ.. s<1.70 Total Value Building Permit Fee State Surcharge Total Fee (A) VALUE ;AI 11>$.1/-1/ :<.' & t;/? 'fO f >~CJ /.1~ 40.'1."5 (6) SYSTEMS DEVELOPMENT CHARGE (SDC) ?-'i 1 ~ (2q PLUMBING PERMIT ITEM Fixtures ~ Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft DemolItion State Surcharge -M...4?t.ov A't5.I/tiU Pt76 Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C. D. and E Combined) FEE 4aa:; 4lJ. t>O :z..~B 5L-GJ{:) 75~3 _40~(pft, 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: :2 S:.'~~ Date Paid: Receipt Number. ReCe;~y: PI~~/m y{{j-/ Systems Development Charge is due on all u.ndeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS 'I 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 OAS 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 app d set of plans will remain on the site at all times duri g c stru ion. Slgnatur~' '" '" .A'~' .<p '''' ,t ~ . Date Y'-/Z.-7'/ VALIDATION: (") RECEIPT NUMBER . (CJ:J. 'L ~ DATE PAIr> 8- \ ')" _C\v\ . - AMOUNT RECEIVED Q.t)5_:__~ RECEIVED BY , \. ~ - ~ ~ . .. .-#qIOe.,=>,-\- CITY. SPRINGFIElD SYSTEMS DEVEe>HENT CHARGE . WORKSHEET NAME OR COMPANY: Q\...IFF" ~\<;:H- LOCATION: q \ e ..!O~-n-le.ID6E::. DEVELOPMENT TYPE: LDI2. - A.DO I "Tl0/'o! 1103'2k1'Z-- 64-~1'2.. BUILDING SIZE: . , I " -/. 17_ .:. 72-sQ..1"~ LOT SIZE SQ. Ft. I. STORM DRAINAG~ IMPERVIOUS SQ. ET. _ ,1/ X SO.186 PER SQ. FT.. i 1~3.1.' (See Reverse For'.~Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER-CITY . NO. OF PFU'S ., X S38.55 PER PFU (See Reverse To Determine Total PFU'S) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP M /~ X X S388.61 s "Z-b"l ~'S s . X ." X S388.61 s ~ X X $388.61 . (See .Attachment.C .To Determine Tdp Rates) . SUBTOTAL (ADD ITEMS 1,2, S & 3) S 'Z~~~ 4. ADMINISTRATIVE FEES BASE,CHARGE (SUBTOTAL ABOVE) X .05 s \4 ~ TOTAL-CITY SDC ~ 1:.n--k> 5. CREDITS IF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL: . , 1A TOTAL-CITY SDC X (50%) = ~DJUSTEO CITY SDC S ~/M 6. SANITARY SEWER-MWMC NO. OF PFU'S x S13.25 PER PFU + SID MWMC ADMIN. FEE S - (Use PFU Total From Item 2 Above) HWHC CREDIT IF APPLICABLE (SEE REVERSE) ~ '--;13r~L~ 'V Kip Burdick SDC Coordinator S - '7 /-l/l. hi 1 ' TOTAl-MWMC SDC S ~ TOTAL SOC S '2-q..., 'f!!.. . . FIxTuRE UNIT CALCULA TI. TABLE: Number of New Fixtures X uAquivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT FIXTURE EQUIVALENT UNITS Bathtub......:................................:.............................. Drinking Fountain.......... .................. ....... ........ .......... Floor Drain... ............................................................. Interceptors For Grease/Oil/Solids/Etc.............:.:. Interceptors For Sand/Auto Wash/Etc.................. . Laundry T ub/Ootheswasher.............. ..................... Clotheswasher - 3 Or More..........:.......................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator fWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Singl~ Stall................................................. Shower, Gang.......................................................... Sink, Bar, CommerciaL.......................................... Urinal, StallfWall....................................................... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation.:........................... Water Closet, Private............................................... Miscellaneous: , 2 -z.. 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 ll- TOTAL FIXTURE UNITS = -, CRED.lT CALCULATION TABLE: Based on assessed value.., If,improvements occu~red after annexation date in table, . ~. ,f . ,_ ~ . . . calculate credits separates. Year Annexed I; r , S 79 or befors 1980 1981 .1982 .. 1983 1984 - .. ~.' . Rate per $1,000 Year Rate per $1,000 II Assessed Value Annexed Assessed Value ,. S2.E6 . -.-- ,~ ,::'.: ;, ""'.-'- 2.64 1986 1.35 2.53 i98i 1.15 0' .- 2.41 1988 0.92 2.19 1989 0.59 2.04 1990 0.23 Credit 'or Parcel or Land Only If Applicable Improvement 0' after annexation date) ., . X $ "(Rate X Aseoeeo" Value) X $ . (Rate X Assessed Value) CREDIT TOTAL = = = $ RUNOFF COEFFICIENTS FOR STORM DRAINAGE Resid ential...................................:.................... 0, ~ Commercial. ........... .....,.. .................... ....., ........ 0.9 I nd ustrial........................................................... 0.45 Governmental.............................:.......... ,.......... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT