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Home My WebLink AboutPermit Building 1994-8-26 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 . LOCATION OF PROPOSED WORK' 5 'S ') \ ll(~ ~A'd.rY) ASSESSORS MAP: I \ LOT' OWNER' (r\e"", ADDRE!J.S' '1. hq CITY- 1-\-\ '.0"""'5 DESCRIBE WORK: GVlostrUc--t NEW X \t(t) -b,r '" F\rc..rt:st REMODEL CONTRACTOR'S NAME GENERAl' G-lc:..n VI l<,-br", PLUMBING' \0.... Rlj/'k MECHANICAL: ~ SOY'l'", ELECTRICAl' IV\ '1- fA) BLOCK' (--VI'\.", r J.r STATE: .12~ tJow :'S 1-, D/ - C{4\~ ~ ADDITION DEMOLISH OTHER JOB NUMBER 225 Fifth Street Sprlnglleld, Oregon 97477 TAX LOT: -.rn..tnD'J (.pIC> SUBDIVISION: Oe;k-"l" l,. \)1", ~ PHON'" 47q'b'22 ZIP' "'I 7 ~ 2./ ADDRESS CON ST. CONTRACTOR' A ~'1.~~ P!;I.,o'1E qh'l fd2Z.. . ,( p'f)3/P~ EXPIRES 1.:Jq.Ql &;./c({j5 7/Yf .fo(1/ \ ~J\)L0 - OFFICE USE - QUAD AREA: LAND USE: Il~D FLOOD PLAIN: · OF BLDGS: \ . OF UNITS: I ZONING CODE: u.l)JL OCCY GROUP: R ~-t .M. CONSTR. TYPE: -.JL..f\.J . OF BDRMS: "J.., . OF STORIES: \ HEAT SOURCE:_~f- SECONDARY HEAT: WATER HEATER' U RANGF' S SQUARE FOOTAGE: -l1.i/q7 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 8.m. will be made the following work day. D Temporary Electric ~ Site Inspection - To be made after excavation, but prior to V~t':~~ D U~ders~lumblng/EI.ctrlcell Mechanical - Prior to cover. g~ootlng - After trenches are excavated. D Mesonry - Steal location, bond beams, grouting. ~ Foundation - After forms are l...l::t erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. m Underfloor Plumbing/Mechanical ~ - Prior to Insulation or decking. ~ Post and Beam - Prior to floor l,lJ Insulation or decking. ~ Floor Insulation - Prior to {deCking. -V1 Sanitary Sewer - Prior to filling I trench. ~ Storm Sewer - Prior to filling P trench. ~ Water Line - Prior to filling If-1 trench. ~Rough Plumbing - Prior to L.)9- cover. REQUIRED INSPECTIONS [1S Rough Mechanical - Prior to cover. rKl Rough Electrical - Prior to ( cover. ~ Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior to cover. IX'I Wall/C'elllng InsulaUon - Prior to ~ cover. ~ DryweU - Prior to taping, D Wood Stove - After Installation. D Insert - After fireplace approvlSl and Installation of unll. ~ Curbcut & Approsch - After forms Bre erected but prior to placement of concrete. ~ Sidewalk & Driveway - After . excavation Is complete, forms and sub.base materIal In place. D Fence - When completed. D Street Trees - When aU required trees Bre planted: ~ Final Plumbing - When all ~ plumbing w~Hk Is complet.s. ~ Final Electrical - \N.hen all P electrical work Is complete.' IX.:l Final Mechanical - When all r mechanIcal work Is complete. ~ Flnsl Building - When all required Inspections have been approved and building Is completed. DOther MOBILE HOME INSPECTIONS D Blocking snd Set.Up - Whep al/ blocking Is complete. D Plumbing Connoctlons - When home has been connected to . water and sewer. D Electrical Connection - When blocking, set.up, and pluroblng Inspecllons have been approved and the home is connected to the service panel. D Final - After all required inspections are approved and porches, sklrllng, decks, and venting have been Installed. , Lot Type" "~' , ,., , . Lot faces Lot sq. Itg. -Ylnterlor I' p.L. Lot coverage Corner N Topography Panhandle S Total h,elght ~ Cul.de.sac \W IE BUILDING PERMIT ITEM sa. FT. 1~'11- 4 2... ~ X $/SO. FT. ~ VALUE ~lo.~ 115Cl<;{ 1-4.10 ,,~qlPt Main Garage Carport Total Value ']!1!5103 -3lo1.CO ,~ .~.:;:. " . l"H 3Y 1o.3(P Bul/ding Parmi t Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) '1,20 '81.0" (B) PLUMBING PERMIT ITEM FEE Flxy..res c-O Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home / (d). CO Plumbing Permit l.l.a{). w ~.~ 11tJ..8Q l(J.CO 4.5Q {".u..-; Stat~. Surcharge Total Charge (e) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent ~.ou Mechanical Permit (q.5U ID.c!) .'1'lS . 51:? 01,07' Issua'nce State'Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk 4(J ft ~~) Curbcut l<6 ft Demolition j)\1\c~Jli); qJi2 4flW Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) ,',' '. j ; ~ . 'h .. ,;. 'iL~ i' ..r. I",,, :..\t'\ Setbacks. HSE GAR ACe' I I I I I t& THE PROPOSED WORK IN THE. "..HISTOI;lICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical . Coordinator prior to permit Issuance. , APPROVEP' 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: Ii ~,/ Date Paid: ~tJ) ~ Receipt Numbt/'~ R~elved By!." \.J)'(\ tt\J '~.l LA.. I Plans Reviewed By I~ ?3'a4~ Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS ~~+ I: ~\ l.old1 c.....G..f\l\VL! l en )< ~-\huL 1~ ... ,;- l ilitv\ 1 , 0 Yo .riJUi.aJJ \ D Or1l'fu"L ~ - 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 Ordlnanc~s 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, thaI 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 ~he slte~s du~nstructlon. Slgnatu~ .//1 - /~ " /". . Date VALIDATION: l .A A (J RECEIPT NUMBER { r \11 f'I DATE PAID ~Jlh,q4 _ AMOUNT RECE~ ~(a(JJ RECEIVED BY II \tL<'Y1 ) - ATTACHMENT Bl ~ .lA NO. o/~/z '? ~ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: G..t- J( ~ ~, LOCATION: 5"33 ~~ DEVELOPMENT TYPE' e;F () BUILDING SIZE: 1. . STORM DRAINAGE' IMPERVIOUS SQ. FT. I.OT SIZF SQ. Ft. '2..'29z X $0.209 PER SQ, FT, $ ~., 7'.0 :3 2. SANTTARY SFWFR-CTTY NO. OF PFU'S (See Reverse) 3. JEANSPORTATTON NO OF UNITS X TRIP RATE X COST PER TRIP J X 1.0 I X $436.19 /'f X $43.26 PER PFU .... $ 118.c,'8 '$ f-fo.S">" X X X $436.19 X $436.19 $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ /c,.<?K.2c.. 4. SANlIARY SFWFR-MWMC NO. OF PFU'S /7' x $17,19 PER PFU + $10 MWMC ADMIN.FEE $ 3Ir.~z (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE> $ 2'7. r r . ~. . IQIAI -MWMC snc. $ 2..'ff'i'.1'3 SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 19<;"'.'-9 5. AnMTNTSTATTVF FFFS B~ ~GE (SUB O~ABOVE) X .05 ~ri- )... Date: If - ;z.:>~- Y'~ /Hary 0 nig, P.E: SDC Co dinator. $ 11.~'ii" IOlAI snr: j Z () If 1. (J 1 B2,SDC . . .... .. _____._1 FIXTURE UNIT CALCULJ.,.TION TABLE: Number of New Fixtu~es X Unil Equivalent = Fixture Units (NOTE: For remodels, calculale only the M.EI additional fixturesl NUMBER OF NEW FIXTURES FIXTURE TYPE Balhtub,.........,.....,..............,.,.,..................,.,.....,...". . 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 Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall................,.,..,.......,.........,......... Shower, Gang,."....,........,.................,,,....:.:...........:. Sink: Bar, Commercial, Residential Kitchen...................:.... Urinal, StalltWall...:..,.:....,.,.,.,......,.,..,.............,.......... Wash BasinlLavatory, Single.................................. Toilet, Public Installation..........,.,..,., ".....,.........,.... Toilet , Private..............................,.,...,...........,.,.... Miscellaneous: ,T.4Nl7l>P:S ,$,INk' UNIT EOUIVALENT I I / 2. :z.. TOTAL FIXTURE UNITS FIXTURE UNITS 2 1 2 3 6 2 6 6 1 3 2 lIHead 2 2 1 6 4 .). 2.. z -:z.. -c:.. z. s;: = IP CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after ~nnexation date in table, calculate credits separates. Ir Year Annexed Rate per $1 ,000 Assessed Value II 1979 or before 1980 1981 . 1982 1983 1984. 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 ---, Rate per $1,000 Assessed Value $2.46 2.14 . 1.77 1.37 0,97 0.61 0.44 0.15 Credit for Parcel or Land O~y If Applicable = 29.rf ------ Improvement (if after annexation date) ? ~c. X $ lr. '"'-" (Rate X Assessed Value) X $ (Rate X Assessed Value) = CREDIT TOTAL = $ ;2..9. '11 lit fi !!!ill,<!.!!!.l!!t\!!~ . JObNO.~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: 1;,\ 0 f\" ~~m. fV)_) ADDRESS: 'l\{)q 'A\)\t'~Qt)\:JGrJ '_~ PHONE:~ .STATE~IP~ LOCATION OF Ii'ROPOSED BUILDING SIlJ\. Street Address if Known: ,C)::\?- rU\ Y.c\.~ lD , Platt Name: fWr. \ 0 . Tax Lot Number: v\\)~~ OQkCO .- 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on lhe backJ A. Sinl!le Familv - Detached Single Family home NO OF UNITS B. Sim!le Familv - Attached NO OF UNITS ! C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS WPRD SDC Manufactured home not in a park X $400 PER UNIT _= $ X $370 PER UNIT = . $ :3!1D,cn X $277 PER UNIT = $ X $280 PER UNIT = $ $ {2Jn.cO $& $:;31{).OcJ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. 3. TOTAL WPRD N,\" SDC ASSESSED (If SDC reduced for Credit) L.M, _ Community Services City of Springfield i) ~ 1~C{1 Date