HomeMy WebLinkAboutPermit Building 1995-2-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' /-:?~15 1/V"~7
ASSESSORS MAP: /7"'ld';J-2::::>- ~/
LOT'
2.
PHONF'
7~'7"-2'2bY
U~~~C?'7-=- r
ADORES'" ~ ~-5.7' #~
~~p , STATE: ' ~ . ZIP' ~/o/'//
~ v .
DESCRIBE WOR~ 1 N'\nt\t'J'\"\ l_~, N\(')Do ro 't-'OF"\\f\o f\l'\2.-
NEW REM~L ADDITION' \)DEMOLlSH OTHER
OWNER'
CITY'
BLOCK'
.
,..
JOB NUMBER
9tz//96 '7
225 Fifth Street
Sprlnglleld, Oregon 97477
..
CONTRACTOR'S NAME
GENERAL: 1?Y1'f".A<P~. ~',
I'
PLUMBING'
w
ADDRESS
~~.
CONST.
CONTRACTOR # EXPIRES ,~N,i"...
S6'"~ /r2""95: ~':-R~9
MECHANICAl'
ELECTRICAL: 2/~? &~ ~
.
,
QUAD AREA:
\ Rt\)0
# OF BLDGS: \
OCCY GROUP; ~~
# OF STORIES: J:4
WATER HEATER: _9 )
- OFFICE USE -
\ \\ \
LAND USE:
# OF UNITS'
CONSTR. TYPE:
\
VN
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS:
\ s>xU
A
HEAT SOURCE:
V
RANG='
SECONDARY HEAT:
, SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording, All Inspections requested belore 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.
. D.Temporary Electric
O Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
~Footlng - After trenches are
/...cavated. . .
o Maaonry - Steel location, bond
,beams, groutl ng,
iVf'Foundatlon - After forms Bre
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to lIIIlng trench.
O Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation - Prior to
decking,
~ Sanitary Sewer - Prior to filling
~ trench,
I'c;:(Storm Sawer - Prior to filling
~ trench,
'K7I" Water Line -Prior to filling
~ trench.
o Rough Plumbing - PrIor to
cover.
REQUIRED INSPECTIONS
o Rough Machanlcal - Prior to
cover.
o Rough Electrical - Prior to
cover.
I'<;7(Electrlcal Service - Must be '
~ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior: to Cover.
o Wail/Ceiling In.Jlatlon - Prior to
cover. . .
o Drywall - Prior to taping:
o Wood SIOVG - Aft~r InSlallatlon.,
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Appro'ach - After ,
forms are erected but prior to
placemont of concrete.
dSldewalk & DrIveway - After
~xcavatlon Is'completo, forms .
and sub-base material In place.'
o Fence - When ~omPleted.
o Street Trees - When all required
trees are planted. ' .
o Final Plumbing - When all
, plumbing w~"k Is complete,
o Final Electrical - When all
electrical work Is complete. C
o Final MechanIcal - When all
mechanical work Is complete.
k:.( FInal Butldlng - When all
~ required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set. Up - Whe/l all
blocking Is complete.
o PlumbIng Connections - When
home has been connected to .
water and. sewElr.
o Electrical Connection - When
blocking, set.up, and plun;lblng
Inspections have been approved
and the home Is connected to
the service panel.
o FInal - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces -e.L--
Lot sq. ltg, ~D
Lot coverage /~!d.,
Topography 411
Total ~elght M, ~
, (rlr~ )
BUILDING PE.RMIT
ITEM SQ. FT,
Lot TYP. '
~erlor
_ Corner
,Panhandle ..
,Cul.de.sac
~'
.- ", ! ....' ~:>.;\1'.'~;
., THE PROPOSED WORK tN 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,
P.L. HSE GAR" ACC' I
N
Is
Iw
IE
7)
20
2D
~
l\1aln
X $/SQ, FT, a VALUE
.'B.9D
, 3.57
, -d.9J.o7
SYSTEMS DEVELOPMENT CHARGE (SDC)
h4r..s. s("
Ga(age
Carport
,~
Total Value
Building Permll Fee
State Surcharge 2?) -r /. J f
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
Residential Balh(s) N'
Sanl tary Sewer FT, <: 50 I
Water FT. < <.,.71) I
<' Sf) I
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge ~.7S +- 2-~)
Total Charge (C)
MECHANICAL PERMIT
Furnace
"
":3~,"
F.EE
;2c; <J"O
"'? C;. C1()
2< trO
7<5 "It!
~,~O
.16/,ao
Exhaust Hood
Vent Fan N' " /'"
Wood Stovellnsert/Flreplace Unit /.
Dryer Vent / ,"" '.
/
MechanIcal Permit
Issuahce
State'Surcharge
Total Permit
(t?>
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk ;? (n ft
Curbcul fl
Demolition
Slate Surcharge
~tA.v #?:///Q...,),
Total Miscellaneous Permits
(E)
/ C; ~O
2~,71
TOTAL AMOUNT DUE (excluding electrical) ":::/.,2,9-, rtp
(A, B, C, 0, and E Combined)
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 City ,01 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:
Date Paid:
Receipt Number:
R~~~
Plans.. Reviewed By -
~:ps
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS I
~9J~ g~~g/T /(~
l .... # ~-.,~ -' .
" .. --I.-V.! ("""'-
f.h,~) /
\~. N ,",or JC.J ~ 0 cLYi ~ t)
" A.R../ /n..c4. (JJL/1 ~u/"3 - ~ ,H )
~)~.-C c5l- ~~) '5 ;--7: .-
. _ {f}Q)ql /h(/~' I/71V77
.L:7ttfh#6-r IT 7b ~~-)W4'/.V,7/"7q)
Z' C'.nrA/r:JA 7D CJt?P'~
By signature, I stale and agree, that I have carefully examined
the compleled 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 Ordinanc~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
struclure 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 ensur that all required Inspections are
requested at the prope'A me, that each address Is readable
from the streett that ttill permit card Is sled at the front
of the property. and t e approved sel' of p ns will remain
on the at all tI durl~s r ctlon
Signature 'j I ,~
/ \... 1- '
data
~
VALIDATION: (-l I
RECEIPT NUMBE7 . V! 1
DATE PAID AI , \ ,~. ~
~ --, :.... /4P (INe!.., e-/e;CI)
AMOUNT RECEIV~ ..c:.r ..I~2- .
RECEIVED BY ctIlCl'i"-/'..)
.6 NO. .:li/?~ r.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
ATIACHMENT B1
NAME OR COMPANY: . ~ /)
LOCATION: a.,,? tV". O.i;~
DEVELOPHENT TYPE' C,;:D (__~ /7~)
NO OF UNITS X TRIP RATE X COST PER TRIP
X 1,0/ X $436.19
X X $436.19
X X $436.19
r:s- .f~o. 5'?:)
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $ Ilqre.c.'i'"
4. SANTTARY SFWFR-MWMC
NO. OF PFU' S II X $17 .19 PER PFU + $10 HWHC ADHIN. FEE $ If 9.0 r
(Use PFU Total From item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ , -'
IQIAI -MWMr. snr. '~~
SUBTOTAl (ADD ITE,..S 1.2,3 & 4) $):3 ?5'. 7Y
5. ~nMTNTSTATTVF FFF~
~~ C GE (SUBTOTAl ABOVE) X .05
, )Jr-'
~ 4~ - Date: /~/3-.7S-
/ Mary ~~i~, P.E. )
SO~oordi nato"-/
Q~"-70
TOTAl snc
$ / f (;.,. }k,
B2.SDC .
FIXTURE UNIT CALCUL.ON TABLE: Number of New Fixt. X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the tiEl additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
/
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
~
2
Bathtub......,...........",................,............................... .
Drinking Fountain,...,.............,......,............,.,......,.,...
Floor Drain......... ................. ......"..............................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.. ..............., .................
Clothes washer . 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorN/ater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang.................................;........................
Sink: Bar, CO,mmercial, Residential Kitchen........................
Urinal, StaliN/ail..:.. ..'...,.....................,.,..................,.
Wash BasinlLavatory, Single..................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneou~: ,TJ.iVl TOPS .$.IRk
2.
2.
/
/
/
.4
/
TOTAL FIXTURE UNITS
If
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Rate per $ 1,000
Assessed Value
Rate per $ 1 ,ODD
Assessed Value
Year
Annexed
Year
Annexed
1979 or before
19BO
1981 '
1982
1983
1984 '
1985
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Credit~for Parcel or Land Only If Applicable
X $ ~
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
Improvement (if after annexation date)
=
CREDIT TOTAL = $
/tOT 'I.!' T
AIVNj;.,{ e-LJ.
.
fi y!i!I~T..~!~!!!;
.
Job No. OA\ql6i
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM" ~(lfJ1\g. j){)'5f l~ . PHONE,~44.qwf-
ADDRESS: ~~O~ Y ....~~~ool}::4:h-q\ Sf STATE: Qf.ZIPW7.
LOCATION OF ~ROPOSED B~ILD~G SITE:
Street Address if Known: \ ~l ) 91 \ ~ ') .
Platt N
(\
Tax Lot Number:
(t')\~
V,n3~3 \ ()~~)
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.!
A. Sim!le Familv - Detached
\ Single Family home
NO OF UNITS I
B. SinQle Familv - Attached
NO OF UNITS
C. Multi-Familv ADartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
$ 4tf) ,ad
X $400 PER UNIT _=
X $370 PER UNIT =
. $
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ 4{'f) pO
$f!
;. M c{)
$~AJ.
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If sac reduced for Crediu
'u~
Community services
,-:...""(("'........:...........+;....1....
~ 1\
fC1S
Date