HomeMy WebLinkAboutPermit Building 1995-4-4
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, SUBDIVISION: (;l"t1 n;;h Pl.", <d~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFIELD
6'1i't!>.
LOCATION OF PROPOSED WORK' /I"C, 2
ASSESSORS MAP: Sh 22. LI 7 <:;
- ,
7.0
.IlL.. '"
LOT'
BLOCI"
OWNER' ,L 111/ V 'I
ADDRESS' 2.2~('\
CITY' ' S'/'ri'-f/1 P
DESCRIBE WO'RK:~' ,J
NEW ! /' REMODEL
lA/" i'f<
cl~l1<' I tLvt )
STATE: nV"
rQY!"'~vu~h,;:.., -
ADDITION
o.~n/~ y
DEMOLISH OTHER
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAL: ,T;,/'_/1 6r> t~ /,,,jnv -lY' .'S''-f....Ii.cIc" lLl:LtO ~f(C;'i7
~ J I ~'
PLUMBING:, r;; (, VI R I' fe.u - :l...5'J1J() l/u'y3t c/'~L<>
I I
MECHANICAl'
ELECTRICAL: 4M ~p F (;,rfv,',. - 2 7'5/',/ ~nycl"'N R.J.
, J:c.../?/". 97<1'1'D
- OFFICE ~Sf -
QUAD AREA'. \,'Kr0u ') LAND USE' ~ \1 u
. OF BLDGS' \ . OF UNIT~: cSl.
OCCY GROUP: r~~ tJ\ CONSTR, TYPE: ,1.2},J
. OF STORIES: ,,'..k HEAT SOURCE: 2rx::r (~L:
WATER HEATER: V RANGF' S
L' '35'
.
JOB NUMBER ~tCJ~ /
225 Fifth Slreet
Springfield, Oregon 97477
PHONF'
'/'%5 - .2t,91
ZIP: 97 7'1) ~-
EXPIRES
/-::ZUc.
PHONE
U7-()//9
'1'1';' -':<['12..
I/l:?-'N~r'
FLOOD PLAIN:
)
fvU Yf./
ZONING CODE:
. OF BDRMS: ,~~
SECONDARY HEAT:
SQUARE FOOTAG~/l { p~~
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.
REQUIRED INSPECTIONS
lIJ Temporary Electric
rvl Rough Mochanlcal - Prior to
~ cover.
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
rVl Rough Electrical - Prior to
L..fJ cover.
o Underslab PlumblnglEleetrleal1
Mechanical - Prior to cover,
IV] Electrical Service - Must be
~ approved to obtain permanent
electrical power.
f\il Footing - After trenches are
L...l.J excavated.
D Fireplace - Prior to facing
materials and 'ramlng Insp.
o Masonry - Steel location, bond
,beams. grouting,
'lSfJ Framing - Prior to cover.
f'\JI Wall/C'elllng Insulation - Prior to
I cover.
(':'\"JI Foundation - Alter 'orms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
~ Drywall - Prior to taping"
r'Vl Underlloor Plumbing/Mechanical
L..f'-J - Prior to Insulation or decking.
D Wood Stovo - After InstallatIon.
rvl Post and Beam - Prior to tloor
L...ft.:J Insulation or decking.
D Insert - After fireplace approval
and Installation of unit.
rvl 'Floor Insulation - Prior to
'-t'-' deckl ng.
f\f1 Curbcut & Approach - After
L....l:-J forms are erected blll prior to
placemont of concrete.
rvl Sanitary Sewer - Prior to filling
~ trench.
I\Il Sidewalk & Driveway - After
L-IaJ excavatIon Is complete, forms
and sub-base material In place.
c:il Storm Sewer - Prior to filling
T trench.
Rl Water Line - Prior to filling
Lp trench.
o Fence - When completed.
rlr1 Rough Plumbing, - Prior to
l....p>J cover.
D Street Troes - When all requIred
trees are planted. -
rYl Final Plumbing - When all
l...p.J plumbing work Is complete,
~ Final Electrical - When all
L.,t!J electrIcal work Is complete.
M Final Mechanleal - When all
LfJ mechanical work Is complete.
rVl Final Building - When all
~ required Inspections have been
approved and building is
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
waler and sewer.
o Electrical Connection '- When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected 10
the service panel.
D Final - Alter all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
.spt!-
Lot TYP.
InterIor
Lot sq, ftg,
Lot coverage
Corner
Topography _
Total height &.fr.
( 5 -Z/)
Panhandle
--L.. Cul-de-sac
" . ~';:~ ~ ,,~., >.
~IS THE PROPOSED WORK IN THE_
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I PL. I HSE GAR I ACC
IN I \~ ~I
Is I 33/
Iw I 5 I I
~-L,I
BUILDING PERMIT
ITEM SQ, FT: X $/SQ, FT. - VALUE
Main ::?/A;;: -!O"rf, s:;'~-;:>~ /71- ?9/.~
Garage 4:1'7 11-/0 " 61f?"_ ~
Carport
~ ~ 1.'7-()
Tolal Value I?/; 3"~~~
Building Permit Fee 'b~!;, qQ,
Slate Surcharge ~t;..gs + 't~ ltO,~
TOlal Fee (A) 5'''\S.~
SYSTEMS DEVELOPMENT CHARGE (SDC) -t>
(B) 11>~ I 4-1
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s)
.l\
N'
Sanitary Sewer
FT.
Water
FT,
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
\b,~ ,,3~
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
~
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~
Mechanical Permit
Issuance
State Surcharge
\.ot;,. -r ~"'b
(D)
Total Permit
MISCELLANEOUS PERMITS
Moblte Home
State Issuance
State Surcharge
Sldewalk~!) It
Curbcut _3.S _ It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, 0, and' E' Combined)
FEE
~M.r.JD....
~&o.~
&5,r.E
~'-I5, lo2
q.~
b. "::2-.
Co. QU.
&.1. @.
1a, ~
\, s&.
~~,I.11
\S,~
\S:.Mi
~.5.9
lJ4-4S.bb
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Clly,of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: ~z..,!!!$ "2~
-r -/~"'7~
" -
Receipt Number: /h'770
/7~_
"P
Date Paid:
Received By:
p~~lewed By
~ !;).!J.jqS
o Ie
Systems Development Charge Is due on ell undeveloped
properties within the City limits which are being Improved,
AD09;IONAL COMMENTS
~#/
Az:"",:;m 11 o..tJ.t.L-
1P~'(j /1520. ,-
~.u I.t T)1) 1'./ ~
cl fie.T ~;#?l?/H ~ r d...
1t1ld
5h1? ~?C
A'2i?~.R'e3)
By signature, I stale 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 eny and ell work performed shall be done In accordance
with the Ordinances ollhe 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 Ihe Building Safety Division,
I further cerUfy that only contractors and employees who
ere In compliance with ORS 701,055 will be used on this
project.
I further agree to ensure that ell required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located et the front
of the property. and the epproved set of plans will remain
on the site a}1-" times durin constr ctlon.
Slgnatu€'1' (/ 1'1 ~
Date.:? , - ~ ry/lt.; _Lj_ q,C;-
VALIDATION:
RECEIPT NUMBER /~2>C:;,?-
DATE PAID +/~/9. <)
AMOUNT RECEIVED f; t 8':) .bS
RECEIVED BY ~
.
ATIACHMENT Bl
.13 NO. ,950'2.& r
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
--
NAME OR COMPANY: LA-1{!<.. y WA-iiS>
LOCATION: t, So ;J c, 5 "L CJA/4)AL--E
nO'?'].-"2-":3/- oc,Sao
DEVELOPMENT TYPF' MryE"_ - ~J ESIAI b()PlA~,.')l,
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
I_OT SIZF
SQ. Ft.
"
-z.be:,\
X $0,209 PER SQ. FT,
c?~~
'-- -------
2, S8NlIARY SFWFR,CITY
NO. OF PFU'S <?'Z.-
(See Reverse)
, X $43,26 PER PFU
~'?~A '??)
"-- -------
,
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
'Z X \. 0 I X $436, 19
X X $436.19
C:SBI ~ )
"--- ------
$
X
X $436.19
$
SUBTOTAL (ADD ITEMS 1. 2. & 3) $ Ze,'Z- '" ~
4. S8NlIARY SFWFR-MWtl[
NO. OF PFU'S <?2- x $17.19 PER PFU + $10 MWMC ADMIN.FEE
(Use pFU Total From Item 2 Above)
$ 5c"D c:!.
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL,MWMC SOC
SUBTOTAL (ADD ITEMS 1.2,3 & 4)
'-2-
d (00 -
$ 4'9"'1 '4-b )
$ ?;>~z.r::. '2.1
5. ADMINISTATTVF 8EES
BASE CHARGE (SUBTOTAL ABOVE) X .05
C;\to~1-~ )
-- --
v' -=>r .L.k.
~^~~,.. - ~-
'l:;tt-".. -,OJ. - . =-.
SDC Coordinator
Date:
? /14/9S
IQIAI SOr.
$ ~49.\41
B2.SDC .
FIXTURE UNIT C~LCULA T~ TABLE: Number of New Fixture*,nit Equivalent =, Fixture Units
(NOTE: For remodels, ,calculate only th~ additional fixtures) .
NUMBER OF UNIT FIXTURE .'
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
4-
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4
Bathtub.......................................,.,........................... .
Drinking Fountain.....................................................
Floor Drain,.,...."",....",.."",..,."."..,."."."..,."...."."..
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sandi Auto Wash/Etc.................,
Laundry Tub/Clotheswasher.",.. ,,',,,.,,.,....,,.......,..,.,
Clothes washer . 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, Stall/Wall......... ,...... ..... ............... ..... .... .... ":. .,.
Wash Basin/Lavatory, Single,...........,.,...................
Toilet, Public Installation........................................
Toilet , Private.........",..".""..,..,.."....,....,.....,....: ...
Miscellaneous:
7..
Z-
4
Z-
4
4
4-
16
TOTAL FIXTURE UNITS
=
"?'l.
CREDIT CALCULATION TABLE:
calculate credit~ separates,
I
Based on assessed value. If improvements occurred alter annexation date in table,
II
Year
Annexed
Rate per $1,000
Assessed Value
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
1985
1986
1987
1988
1989
1990
1991
1993
$ 2.46
2,14
1.77
1.37
0.97
0.61
0.44
0.15
Improvement (if after annexation date)
Z, .4i., X $ \I, '?"2-
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
(po~
Credit for Parcel or Land Only If Applicable
=
CREDIT TOTAL = $L:,O"!:.
.
.
,
~,... Willamalane
'-(;(1' Park & RecreatjO~ District
Job NO..!15/JB. (P.f
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: 1/4KYIA U.k-fiz;
v
PHONE:
L(~6' ~(AI
ADDRESS: '1./1/1;0 ~.tv.tJ(IJ1L
STATE:
. ZIP
" '
LOCATION OF PROPOSED BUILDING SITE:
-Street Address if Known: {(J&:XJ t &S?~ 0/JJ:dJ.v r,-.!
Platt Name:~~ J1-Tax Lot Number: ~1 D~'1/Jfi;f_()~U)O
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Familv - Detached
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached
NO OF UNITS 1,..
C. Multi-Familv Aoartment '
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
Manufactured home not in a park
X $400 PER UNIT j:,
$ "
.
X $370 PER UNIT =
, $ L4tJ. 40
X $277 PER UNIT =
$
X $280 PER UNIT =
$
WPRD SDC
, $ -,tkJ. 10
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. $
3. TOTAL WPRD NET SDC ASSESSED (if SDC reduced for Credit) $ ::J!j/J. I()
1/~4{
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