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Home My WebLink AboutPermit Building 1992-1-8 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP' /7 ()~ LOT' <c;q . SPRINGFIELD '7~L/ 5" 754 ? 7. .<1 I . 9 fL4 'lJ-tJ JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 C9~,JA-?~ TAX LOT:"ifgP o9Q (")(") SUBDIVISION: ~ ~L r>tJ'iMp:. Z BLOCK' OWNER:~ ~.-/ --61-4-----1, .." ~lil.~.Lu / ADORES8" ~ 7 "i' _=l.5-~ 1";A.R~.? 1)./LUu. CITy:j)~;;~U STATE: ~~ OESCRIBEWORK: fJ~A~~ I r / NEW'I REMODEL ADDITION DEMOLISH CONTRACTOR'S NAME GENERA' .fi/>>-?1PA /' PLUMBING: MECHANICAl' /J~ ELECTRICAl' QUAD AREI" . OF BLDGS: I I r NIl Z OCCY GROUP: ~3 . OF STORIES: WATER HEATER: ~ , OTHER PHON~' "71'/....,;2 701 "f ZIP: 97?'5'~ ADDRESS CONST. CONTRACTOR' PHONE REQUIRED INSPECTIONS ""K71 Rough Mechanical - Prior to ~ cover. "R/1' Rough Electrical - PrIor to ~cover. '1":71' Electrical Service - Must be ~approved to obtaIn permanent electrical power. D Fireplace - Prior to facing materials and framIng Insp. ~Framing - Prior to cover. ~Wall/Celling Insulation - Prior to ~over. ~ Drywall - Prior to taping. D Wood Stove - After installatIon. D 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 - When completed. ~treet Trees - When all required ~rees are planted. EXPIRES FLOOD PLAIN: ZONING CODE: --M.l2Q . OF BDRMS: ---3 +<. SECONDARY HEAT' SQUARE FOOTAGE: ..zCJ~ + To request an Inspection, you must call 726-3769. This Is a 24 hour recording. AlllnspectJons 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. - OFFICE USE - LAND USE: -1/ Z 0 # OF UNITS' ~ CONSTR. TYPE: TT-1o/ HEAT SOURCE: \IV I:,} RANGE: E. I"V'1' Final Plumbing - When all ~ plumbing work Is complete. IVrFlnal Electrical - When all ~ electrical work Is complete. ~ Final Mechanical - When all ~ mechanical work Is complete. i":71' Final Building - When all ~ required inspections have been approved and building Is completed. DOther MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. . o Plumbing connectio~~~1.1'Vhen home has been conn~to water and sewer. .'. '." . . . D Electrical Connection \- When . blocking, set-uPi~..!!1d pl~mblng Inspections hav~);i.f!en approved and the home~[~if:lfJnnected to the service pa~.. ...~. ..r . D Temporary Electric N1 Site Inspection - To be made J:::,::X after excavation. but prior to setting forms. SEr/S~S D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. 'fV71 Footing - After trenches are ~ excavated. o Masonry - Steel location, bond beams..groutlng. l'VT Foundation - After forms are ~ erected but prior to concrete placement. "r\71 Underground Plumbing - Prior ~ to filling trench. "K71' Underfloo(Plum~J)<lechanlcal' ~ - Prior to Insulation or decking. 1":71' Post and Beam - Prior to floor ~ Insulation or decking. 1::::7'1 Floor Insulation - Prior to ~ decking. ~ Sanitary Sewer - Prior to filling ~trench. ~ Storm Sewer - Prior to filling ~rench. TV'1 Water Line - Prior to filling ~trench. 1C7f Rough Plumbing - Prior to I6J. cover. '.' D Final - After all required InspeG.tlons are approved and porche$;.skirting. decks, and ... venting have been Installed. . ,,,1 -q Lot faces --l!:- Lot Type . Setbacks .THE PROPOSED WORK IN THE Lot sq. ftg. 5'A'V 7. Interior I P.L HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? ~ 5' Lot coverage Corner Is I If yes. this application must be signed <ll'o 5' and approved by the Historical Topography Panhandle Iw I/) , I Coordinator prior to permit issuance, Total height z:J2 ' ~Cul'de'sac IE ,31>', I APPROVED: BUILDING PERMIT ITEM SO. FT. X $/SO. FT. ~q70 /'1:'0 Main ~ -::z.t 44, '- 4(".8 Garage Carport " . . , Total Value Building Permit Fee State Surcharge Total Fee (A) VALUE 9119/k .~ f,#f,"D '''. /.123 5/2- ~o 4.SCZ!!; . 2..1.'1'1 4~1.71 (B) SYSTEMS DEVELOPMENT CHARGE (SDC) ~O"l,'!o~~ PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO '2 + z.. Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood .2 Vent 'Fan NO (" Wood Stove/Insert/Fireplace Unit Dryer Vent "2- Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~5 ~~ It It Curbcut Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D. and E Combined) FEE .-S Zo ?f' ~foD0 55'" f?'O qe-o / f!JI!JO (pea ~~.so /0. a-o /,~<; 44. <D5 -J3,7S -1-4. ';2,0 33,'95 3% 7 73 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This ~errrit Is gr~nt~d on the e?<press ~onditlo~ t,hat the said . construction shall, in all respects, conform to the Ordinance , , adqpted' 9Y' !he Ci!y. of Springfie!d,:'i'i1cl'!ding the Development Code, regulatiQg 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: ~""'7 \ ~'"' .,.,0 /2 ~/?t-9/ Receipt Number' .'< ),(.,19 Receive By' ~~ ~n.l . Reviewed By Dale Paid: P , jd..hZ ~~. Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS /?JkV~ ~r L/flJo/Z> A::'.~ , 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 certi fy 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, that 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 on the site at all&/~uring CO"ctlon. I!. Slgnature.,.~hlh{ (~')()!.R/r,> Date I - g - 7 tL VALIDATION: '2..4"74- - . DATE PAIl' / / !2,/"i' 2..- AMOUNT RECEIVED -;{"'}('O 7.73 ./~ RECEIPT NUMBER RECEIVED BY JOB NO. 9\\'4'00 CITY O~PRINGFIELD SYSTEMS DEVELO~ENT CHARGE WORKSHEET } (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: K\c..I-\:A~O ~ "?14\l2.E:.Y COOML.EK LOCATION: ISO ~ 1<::>'-1- OAK.DP<l.-E:. l1o~'"'2-"2-?1 - 0"1'100 DEVELOPMENT TYPE: Mvg." - NEw 'DLlPLE:..)( '01-0(,. t:>w BUILDING SIZE: ">,-z..,c, u.-f , '2"-+)l.. ~I.o LOT SIZE I. STORM DRAINAGE IMPERV IOUS SQ. FT. '2-"lI'l- X $0.186 PER SQ. FT. ~ <7'-\ II..~ (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) SQ. F t. 2. SANITARY SEWER-CITY NO. OF PFU'S ~~ X $38.55 PER PFU (See Reverse To Determine Total PFU'S) $ \ "2-":7::>(,,2- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP '2-- X \.oo'? X $388.61 $ 12>\\2,. x X $388.61 $ - x X $388.61 $ (See Attachment C To Determine Trip Rates) SUBTOTAL (ADD ITEr'IS 1,2, & 3) $ '2.<7';.1., ~~ 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 $ I"Z-i ~ TOTAL-CiTY SD( S "Z.u.B....I2- ...> 5. SANITARY SEWER-MWMC NO. OF PFU'S '?"2.- x S13.25 PER PH' + SID MW,.,C AOI1JN. FEE S y?",~ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~ ~L..L.. . ~ Kip Burdick SDC Coordinator 1"2-/7-7/9/ , S'2k ~ TOTAL -MW,.,C SDC $ YOI "l-Lf TOTAL SDC $ ?c:P1\~ FIXTURE UNIT CALCUL..1tON TABLE: Number of New Fixture.nit Equivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) NUMBE~ OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub........... ..'....... ....... :.......................................... Drinking Fountain................. ................... ................. Floor Drain......................... ...... .............. ..... .............. Interceptors For Grease/Oil/Solids/Etc................. Interceptors For Sand/AUto Wash/Etc.................. Laund ry Tub /Clotheswasher............................ ....... Clotheswasher - 3 Or More....................................: Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator flNater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink, Bar, Commercia!............................................. Urinal, Stall fINal!.... ..... ............. ................. .......... ...... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: . 7.- 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 ?- 1- ~ ~ TOTAL FIXTURE UNITS -+ '-I ~ Lj. Ib ?'2- Based on assessed value. If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: calculate credits separates. II Year Annexed Rate per $1,000 Assessed Value Rate per $1,000 Assessed Value IYear Ailnexed 1979 or before 1980 1981 1982 1983 1934 $2.66 2.64 2.53 2.41 2.19 2.04 1985 1986 1987 1988 1989 1990 Credit for Parcel or Land Only If Applicable "2-.(,(.,. . X $ 10,oc", (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL 'Zc.. :=. = Improvement (If after annexation date) = - = S "Z..(,p 1.::. RUNOFF COEFFICIENTS FOR STORM DRAINAGE ! Residentia!................... ............... ....... ............... 0.4 Commercial...................................................... 0.9 Ind ustrial........................................................... 0.45 Governmental................................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT $1.69 1.35 1.15 0.92 0.59 0.23