HomeMy WebLinkAboutPermit Building 1995-3-13
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
9'5fJ2/7
JOB NUMBER
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSEO WORK: 7/J.... r
ASSESSORS MAP' 11)014 Q P> 1
LOT: -.l.Y {;.vD._.tf? rC" <- ~OCK.
225 Fifth Street
Sprlnglleld, Oregon 97477
tJtrK7)~/ 6
TAX LOT: -.1f]j06
SUBDIVISION: (='~ rln]E,
OWNER:+/1-.'T
ADDRESS' R-r7 :>:L.R"
~ Ahcf.
)
JJ..u/dt..", ~
flp_
? ;.2..f'-/ ~:2..?
PHONE:
/2#
~
~~~./
Of
ZIP: _'l2..'t'? (7
CITY'
STAT~.
P..n(~/
.4'//7",- ,
f)Uld/"'~
DEMOLISH
DESCRIBE WORK'
NEW)I.... REMODEL
ADDITION
OTHER
CON ST.
CONTRACTOR' MPIRES
SF?,>! {. q 'L<f(p
,~ChlLt) 6L9,g q ( I?
CONTRACTOR'S NAME
GENERAl' P.....!:.7
,
PLUMBING: 0-1_"'.''-
,
ADDRESS
PHONE
?21:'___r;q
G~P- '5? pr-
L?" .'?/!"~~
?I../_L..,,_
/
MECHANICAl'
ELECTRICAL: -Da,,/P Fe
''1 r\' l U ./3.t:..t0 s:r9~ - ~ P Y2.
"'v_.... 7;..; ,..
\ R t\J( f ') - OFFICE USE -
QUAD AREA: LAND USE: I( ~J) FLOOD PLAIN:
I . . 1.. ~~
. OF BLDGS. . OF UNITS: ZONING CODE:
OCCY G~OUP: ~t)tM CONSTR. TYPE: -VAl . OF BDRMS: I - ~0
~ LUI-I
. OF STORIES: HEAT SOURCE: SECONDARY HEAT: ..
WATER HEATER: ~ ./ RANG~. E:: SQUARE FOOTAGE: s::!J.f.pll..t2
To requesl an Inspection. you musl 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 ofter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
~ough Mechanical - Prior to
cover.
L1d ,...1081 Plumbing - When 011
plumbing worl< Is complete.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
~Ough Electrical - Prior to
cover.
~ t-Inal Electrical - When all
electrical work is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
r1....Flnal Mechanical - When all
l.....b-K mechanical work Is complete.
rl"Electrlcal Service - Must be
u.r approved to obtain permanent
electrical power.
rI .;oollng - After trenches are
L.(,..j'excavated.
~Inal Building - When all
required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
... materials and framIng Insp.
c:JLrFramtng - Prior to cover.
D Masonry - Steel location. bond
.beams, grouting.
[Q-:oundatlon - After forms are
erected but prior to concrete
placement.
~dergrOUnd Plumbing - Prior
to filling trench.
,..,....,..(.nderlloor Plumbing/Mechanical
L.!:::::J ::. Prior to Insulation or decking.
DOther
~all/Celllng Insulation - Prior to
cover.
~ryWall - Prior to taping.
MOBILE HOME INSPECTIONS
'.
D Wood Slovo - After Installallon:
D Blocking and Set.Up - When all
blocking Is complete.
[J;};.ost and Beam - Prior to 1I00r
Insulation or decking.
D Insert - After fireplace approvel
and Installation of unit.
~loor Insulation - Prior to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer.
~urbcut & Approach - After
forms are erected b~lt prior to
placement of concrete.
c:;z(Sldewalk & Driveway - Aller
excavation Is complelo, forms
and sub-base material In place.
~an1tary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
r:--y'Storm Sewer - Prior to filling
~ trench.
~ater Line - Prior to filling
LJ1 ~ench.
tz( Rough Plumbing - Prior to
cover.
D Fence - When completed.
D Final - Aller all required
InspectIons are approved and
porches, skirting, decks, and
ventIng have been Installed.
D Street Trees - When all required
trees Bre planted.
BUILDING PERMIT
dfifk- :Sj';{A - (t~
't1-D- 14 ' "
Lot (aces
LotTY.
~nterlor
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle
&
Cul.de.sac
ITEM
Main
Garage
Carport
Totar Value
Building Permi I Fee
Slate Surcharge -\ '2;F~o
Total Fcc
(A)
Setbacks
I P.L I HSE GAR ACC
I N I
I S I
Iw I I I
~.J
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
,~~
A~
.'X(o
C21S. \\
SYSTEMS DEVELOPMENT CHARGE (SDC)
P:<'411. ~5
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'~X :l
Sanitary Sew~er .
FT.
FT.
FT.
Water
"
Storm Sewer
Mobile Home
Plumbing Permit
Slate Surcharge i 3Cfl()
Total Charge (C)
MECHANICAL pERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
TOlal Permit
-t (3,Q'O
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk 55 II
Curbcul ...3.LG- ft
Demol i tl on
Slate Surcharge
pljp,J lflv"V1)
FEE
3VJ)!D
, ~Pl) CO
~'5,1d)
31-5,kO
, q .00
1.9. PO
(O.cV
!/fJ,CD
(O.O()
~. ILP
~
l~.7;:,
Le; ,4il
-$fJ .0-0
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcal>4;4-i \. \1
(A. B. C, 0, and. E. Combined) .
\\~ . ;: .~::
. '!~~ .~.
_IS THE PROPOSED WORK IN THE.
..HISTORICAL DISTRICT, OR O~
THE HISTORICAL REGISTER?
" yes. this application must be signed
and approved by the Historical
Coordinator prior to permIt Issuance.
APPROVED: .
This permit Is granted on the express condition that the said
construction shall, In all respects. conform to the Ordinance
adopted by the Clty.of Sprlnglleld. 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:
Date Paid: _.__~
Recelpl Number:. ()~I"
Received By: ~
~ ~Iromv-e_ LttL
Plans Reviewed By ~
~.'~'qs
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
A!;lDITIONAL COrvl,JIQENTS 1", () r )
(11.1 A ffi~ g ) ~..a(} 11 flJL.L/
'- ') 1 f r hfY':li .(10 f\--.ts
l ~TJ \\ IID{)
~nr\Q tl)J-to ,; lq/ A
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 any and all work performed shall be done In accordance
with the Ordinances oflhe City of Sprlnglleld. and the Laws
of the State of Oregon pertaining to the work described
herein, and thai 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
projecl.
I further agree to ensuro that all re~ulred 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 property. and the approved set of plans will remain
on th site at all times during construction.
tK..fi ~--&
- .7
:3-/ :1-'7 ~
VALIDATION: I ( _ C(]C
RECEIPT NUMBER \ \(J "::>-1 ;;
DATE PAID_ .Q., .\~ .<-{l'-A
AMOUNT REC'tI'1D. .=:f\;tr\r I
RECEIVED BY 'fT.\\~b...-/ '.
~~--.:........ .
"" ,.
ATIACHMENT B1
, '. ..DB NO. 9$'0:1.1 7
CI~ OF SPIUNGFIELD SYS~E~S DEVELOPMEWC~GE . ..'
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
NAME OR COMPANY:
LOCATION' "11.7. ,;
,
PA;,U ~
,
I'/~ O~
DEVELOPMENT TYPF' ~
BUILDING SIZE: .
1. STORM nRAINAGF
....
. '
, , I . ~.
I.OT SIZt
SQ. Ft:,.
.Il',
:1;
IMPERVIOUS SQ. FT.
25'0 ~:.
X $0.209 PER SQ. FT. cs.7.<f./0
2. ~ARY SFWFR-CITY
...,0
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATTO~
NO OF UNITS X TRIP RATE X COST PER TRIP
/
:;z.. X ;,0/ X $436.19
3:2
X $43.26 PER PFU
.: (/'38!,ry
X X $436.19
elf /1'1,/')
$
X
X $436.19
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $.2 7'119,"0
4. SANITARY SFWFR-MWM~
NO. OF PFU'S ?2 x $17.19 PER PFU + $10 MWMC ADMIN.FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
..\ .. .IDIAI -MWMr. snr.
$ S~O."f
'SUBTOTAl (ADD ITEMS 1:2.3& 4)
$ -!().'O
J.(<'".1 9.l,'!'
$ ?3"9,/~,.
" .
., .
5. AnMTNTSTATTVF FFFS
BASEfOlARG'E (s;J:UBTO OVE) X .05
~A
~ 0 t 3-/-?5~
/M~rnig. I>.U a e:
SDC~rdinator
(7".s-.1'0
IQIAI snr
$ '$ ~ ?!~. c:-.,,-
-
82 . sac '
...
J fiXTURE UNIT CALCUL.N TABLE: Numbcr of Ncw Fixtu. Unit Equivalcnt c Fixturc Units
(NOTE: For rcmodcls, calculate only thc ME.! additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub,.......,.....,..,.......................................,...."..,., ,
Drinking Fountain.......,.....,..........,.,........,.......,.,.......
Floor Drain.. .....................................,.........,.,....".,...'
Interceptors For Grease/OiIlSolids/Etc.................
Interceptors For Sand/Auto Wash/Etc..,...............
Laundry Tub/Clotheswasher............. ,.....................
Clotheswasl)er - 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, Co'mmercial.; Residential Kitchen........................
Urinal, Stall/Wall..:........ ....... .... ......' ..,.. ...... ......... .... ...
Wash Basin/Lavatory, Single..........,.................,.....
Toilet, Public Installation........................................
Toilet, Private.::..............,.....................................
Miscellaneous:.,:-;" .,,}A.'l/TOP"$ ~N1:'
2. 2
1
2
3
'6 "
2- ", .
2
\ . ~ 6
6
1
3
2
lIHead
2.. 2
2
L 1
6
.'1. 4
~
<1
If
If
4-
Iff>
"
TOTAL FIXTURE UNITS
~2
c
Based on assessed value. If improvements occurred after annexation date in table,
.~ ..,,, X $ //. rQ7J
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT CALCULATION TABLE:
calculate credits separates.
'i
Year
Annexed
Rate per $1.000
Assessed Value
1979 or before
,";.19.80.
. 1981
1982
1983
. 1984 .-
1985
$3.46
3.38
3.32
3.21
3.06
2.92.
2.73
..
Credit for. Parcel,or Land Only If Applicable
Improvement (if after annexation date)
. .' ':-"~". "I
<. .':. ';; .~\ '.'." ~..
'.., . .
Year
Annexed
Rate per $1,000
Assessed Value
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0,61
0.44
0.15
-'I
=
4~, -? r
-
=
CREDIT TOTAL .= $ 4~.1'F
.
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o Y.':{ill~<"!!~!iJJ!~
Job No. ct:f:A \~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:\~ Jli*J '- ~_O.~
ADDRESS: ~9PJf rm'l ) ~QO ~
PHONE:~n IS Z3
STATE: ~IP !1Jf1lS
LqCATION OF PROPOSED BUILDI~G SITE: (A
. Street Address if Known: Il rJ... -\-- \ :\
.~
Platt Name: r., rl'< f\() ob 1T/
~ /'
Tax Lot Number: J0 (l~~ ~ \
. - ~
10400
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. Single Familv - Detached
Single Family home
Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT _=
$.
B. Single Familv - Attached
NOOFUNITS ~
.
X $370 PER UNIT =
. $ 14().cO
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
$ f)4D~
$J?J
$ 'f4[) c()
WPRD SDC
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 CreditJ
~l.~;~!~;;f.;--
,.... ~ r ,... ~ _o_-L". _I.J
:=) , \3 ,35-
Date