HomeMy WebLinkAboutPermit Building 1994-8-26
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RESIDENTIAL
PERMIT APPLICATION
~ \95~O
JOB NUMBER
Inspections: 726,3769
Office: 726,3759
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSrD~!lf 5")4 nlJ kJ"" It'"
ASSESSORS MAP: \ f')U;:) ~~ eJY
10
-
, TAX LOT: ()'J,kCO (PID)
SUBDIVISION: MJ.", Ip P (c..-(-
LOT:
BLOCI<'
OWNER' (~""I1V\ L([)-h"rc, Gn",f-,
ADDRF"1",'7h1 {::r"r <:<<61 Jr
CITY: A I h~ J STATE:
DESCRIBE WORK' CoY\.5"h-ucr f\\ ew 5 r D
NEW 'I. REMODEL ADDITION DEMOLISH
PHON~' 47'1 -f,(22.
()~a{)n
'v'
ZIP: -.!jJ '32.,
OTHER
CONST.
CONTRACTOR'
~ 9,03~
CONTRACTOR'S NAME
GENERAL: G- leAV'\ ~Ilr-l
PLUMBING' \1)"'1 RL.dar
'-'
MECHANICAL' ~'" ~rll'l C,
ELECTRICAl' I\A l' W,
ADDRESS
EXPIR~ PHONE
'2;8''1':> Qto?'folZ2-
lo',)&~
(rJ' rt,4'S tJ8:t ,G!; I
- OFF~CE USIt -
LAND USE: V-~'F""~ \ \ l \
. OF UNITS: \
CONSTR. TYPE: J.L.f\J
HEAT SOURCE: t==S
y~
\\: \\)U)
K~~
~
V
QUAD AREA:
FLOOD PLAIN'
ZONING CODE:~"f' -'
""2..,
SECONDARY HEAT:- Q5
SQUARE FOOTAGE: I. {M:J-
· OF SLOGS'
OCCY GROUP:
. OF STORIES:
. OF BDRMS:
WATER HEATER'
RANGF'
To request an Inspection, you must call 726,3769, This Is a 24 hour recordln9, 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.
REQUIRED INSPECTIONS
o Temporary Electric ~ Rough Mechanical - Prior to
~ cover. .
~lIo Inspection - To be made ~OU9h Electrical _ Prior to
L-..fT";tter excavation, but prior to ~ ~-over.
settlngfv~kl SdtocC6
o Unde,slab Plumbln~'~ctrICal/ ?Elactrlca, Servlca - Must be
Mechanical - Prior to cover. approved to obtain permanent
~ electrical power.
ootlng - After trenches are t
excavated. 0 I f
Flrep ace - Prior to acing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting,
'r-7C/oundatlon - After forms are
rr==r ~rected but prior to concrete
placement.
~Inal Plumbing - When all
( - plumbing W9rk Is complete,
~Inal Electrical - \l\C.hen all
( electrical work Is complete, ~
~Inal Mechanical - When all
T mechanical work Is complete.
~Inal Building - Whan all
~equlred Inspections have been
approved and building Is
completed.
~Fra~lng - Prior to cover,
~Wall/Celllng Insulation - Prior to
r cover.
~Drywall - Prior to taping,
o Wood StOVD - After Installation.
DOthor
o Undarground Plumbing - Prior
to filling trench,
~Undarlloor Plumblngl Machanlca'
tp - Prior to Insulation or decking.
dyost and Beam - Prior to floor
T1nSUlatlOn or decking.
c7(.Floor Insulation - PrIor to
( decking,
~ Sanitary Sewer - Prior to filling
}L-J trench.
MOBILE HOME INSPECTIONS
o Blocking and Sot.Up - When all
blocking Is complete.
O Insert - After fireplace approval
and InstallatIon of unit.
f8curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set,up, and plu"lblng
Inspections have been approved
and the home Is connected to
the servIce panel.
pf:ldawalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
'F;Z!..Storm Sawar - Prior to filling
r trench.
m Water Llna - Prior to filling
r trench.
rlRoUgh Plumbing - Prior to
~over.
o Fence - When completed.
o Final - Alter all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
o Street Trees - When all required
trees Bre planted.
LOI Typa '. .'-':: ;.;., .:..,. . r"':~ .y;.:.. ,.j'~}
, " ".;;: -: fl.ij:, - .~S THE PROPOSED WORK tN THE_
, ' ", ~, ,
Lot faces Setbacks .
Lot sq, ftg, K Interior I.P.L, HSE GAR Acc'l HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must ba slgnad
Is I and approved by the Historical
Topography JL Panhandle Iw I Coordinator prior to permit issuance.
Total h,eight Cul,de,sac IE I
APPROVED:
BUILDING PERMIT
SQ, FT,
wn~
493
X $/SQ, FT, = VALUE
~(J.~ 1)/ ~qt
11_ID,,~
ITEM
Main
Garage
Carport
Total Value
1'15(0.3
.s 1I7 .00
1'i5',~""
",or
.3 Q 10,3lp
Building Parmil Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
1.z0ffl.Ol
(B)
PLUMBING PERMIT
ITEM
FEE
Fix~ures ~
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Moblie Home
/ (d),oD
Plumbing Permit
/w,w
~WJ
/rJ8 .~O
l2,W
4,50
it; ,LV
Stat~. Surcharge
Total Charga
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~ ' {;()
Mechanical Permit
/q. 50
( 0 'c:c:
'~J
~(,07
lssuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homa
State Issuance
State Surchar~
Sidewalk ~~j ft
Curbcut -l.....:t- ft
Jlo~
~
Demolilion
I~t~~ar\ku~
L\-U f.-U
Tolal Mlscelianeous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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 Fea: ~
Date Paid: V
Receipt Number~~A
r\a~e~edffit~ /
\-1\'t, \ _ _ u...tl-
Plans Reviewed By I
Rfl1- Cf1
Date
Systems Development Charga Is due on all undevelopad
properties within the City limits which ara being Improved,
ADDITIONAL COMMENTS
\ ~-r I : ~\lolo~
(clN\o~J'Y't~() : '\q[ <;s
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cttbO.l'L ~\ri rLL~
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W~_'\^ .
By signature, I state and agree, that I have carefully examlnad
the completad application and do heraby 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 Ordinanc~s of the City of Springfield, and the Laws
of tha 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
ara 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 t e property, and the approved set of plans will remain
o the sit~e: d~ constr::.tion.
natut / #,/ ~
,.
Data
VALIDATION: I
RECEIPT NUMBER \44--1
DATE PAID ~.~\;'q Lf)
RECEIVED BY \
. ATTACHMENT Bl
.JOB NO. q'f/ZoO
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
N#1E OR COMPANY: G~/(~ ~,
LOCATION: 5'>'1 r0a./ /.4-
DEVELOPMENT TYPE: <;F /)
BUILDING SIZE:
1. . STORM DRAINAGE
'IMPERVIOUS SO, FT.
1.aT SIZE
SO, Ft,
'2.1.92
X $0,209 PER SO, FT, $ -111.0:3
2, SAMlIARY SFWFR-(TTY
NO. OF PFU'S ' /'f
(See Reverse)
3, TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
X $43,26 PER PFU
..' $118,(,,"8
J
X 1.0 I X $436,19
'$ '9-10.:>>",
X
X
X $436,19
X $436,19
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) ,~jt:;,~.f'..z1Q...
4, SAMlIARY SFWFR-MWMC
NO. OF PFU'S 1'7 x $17,19 PER PFU + $10 MWMC ADMIN,FEE $ 3/'1.#2.
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 29. r r
, '-~ . . IQIAI -MWMC sac $ 2.'ir9'.1'3
SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ /9rir."r
5, AnMTNTsTATTVF FFFS
B~ ~GE (SUB O~ABOVE) X .05
~ri ). Date:
~Hary 0 ni9. P,E:
/ SDC Co dinator
$ 91.7'i"
"i ,~}~' Y'~
IQIAf snr.
$ Z 0 ~ 1. 0 1
B2,SDC '
FIXTURE 'UNIT CALCUL40N TABLE: Number of New Fixt. X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the MEI additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
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 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: ~ TANI ",p~ ~"'J.-
I
/
I
2.
:z..
TOTAL FIXTURE UNITS
UNIT
EOUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
~
=
FIXTURE
UNITS
2..
'Z
-z.
~
'2-
5i'
II>
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after ~nnexation date in table,
calculate credits separates,
Year
Annexed
Rate per $1,000
Assessed Value
1979 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 O~y If Applicable
Improvement (if after annexation date)
Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
?~c.. X $ 1.C."'1
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
=
Rate per $1,000
Assessed Value
'1
$2.46
2,14.
1,77
1,37
0,97
0,61
0,44
0.15
J
29.'11
------
CREDIT TOTAL = $ :2- q . f'l
.
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o lL'!i!I.!I!!~!~!!1l;
JObNO.~
ADDRESS:
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: --Glof\ n \{6~ -.
f") toCl ~lJ\il'l\n~tl\ M)
LOCATION OF IiROPOSED BUILDING WE: d1.. /.r rJA A
Street Address if Known: ...r:;~ L{ flJfl)u I 11/ ~ ~
Tax Lot Number: ( f) O~!). (){j) ():ifo clJ
. PHONE: q'fl.!ol/J..'JJ
STATE:~ZIP !l13j/
Platt Name: {()JLtdo Jv
1. DEVElOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.!
A. Sinl1le Familv - Detached
Single Family home
Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT _=
$
B. Sinl1le Familv - Attached
NOOF UNITS
I
X $370 PER UNIT =
$ .J'1(), CO
C. Multi-Familv Aoartment
NOOF UNITS
X $277 PER UNIT =
$
D, Manufactured Home Park
NOOF UNITS
X $280 PER UNIT =
$
3.
$ .Q?L), as
$#
~1o. ~
WPRD SDC
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
~t(\ ) I ~)J)
Community Services at
_~... _~ c_.:_~:,",l...j
~ ,61lo 1C\'\
Date