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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