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Home My WebLink AboutPermit Building 4-3-4 t-~~ -- ....1 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 SPRINGFIELD LOCATION OF PROPOSED WORK: ~O l.-.O<t\-\ " ... L\. -..~_~ ASSESSORS MAP: ~ LOT: ~R\\Je cf~ 42Jj6~,~CJ.I d A rY2!IU JOB NUMBER ~ ,LtVi 225 Fifth Street Springfield, Oregon 97477 BLOCK: TAX LOT: SUBDIVISION: ~US\\~ p~~~ ~u.\\\ ADDF. CITY: - OOtf>EO AND i CONSTRUCTION, INC " #711-58 84959 parkway_ ~LEASANT HILL, OR 97455 YE: OWN, DESCRIBE WORK: NEW V REMODEL ~~t) CONTRACTOR'S NAME .GENERAL: ~ PLUMBING: J MECHANICAL: ELECTRICAL: _ I I QUAD AREA:Q # OF BLDGS: J OCCY GROUpJ I # OF STORIES: WATER HEATER: ADDITION DEMOliSH OTHER PHONF,7~ ~ 3S'98 ADDRESS CONST. CONTRACTOR # REAT-SOOHyE:~~~-' r-... RANGI=' HE and i Const.,Inc. 84959 Parkway 71158 Pleasant Hill, Or 97455 Bills Electric 3170 W 11th, 21351 Eugene, Or 97402 Don Lewis Plumbing 500 Greenfield 33076 Eugene, Or 97404 Marshalls Oil 8. Ins. 4131"E "St. 25790 Springfield, Or 97478 Brooks Excavation 27661 Crow Rd 55921 Eugene, Or 97402 ZIP: EXPIRES PHONE 02/95 726-3a9.8 04/94 687-1851 06/94 688-1931 -, 12/94 747-7445 03/94 345-7564 vt:::\Jor"j"L:I'r'\'I:rl:-""I-I.t="""I~ _ _;::: SQUARE FOOTAGE: l6\ Q.... To request an inspection, you must call 72,6-3769, This is a 24 hour recording, All inspections requested before 7:00 a,m, will be maae the same working day, Inspections requested after 7:00 a,m. will be made the following work day, , U ~ Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms, o Underslab Plumbing/ ElectricalJ Mechanical - Prior to cover, ~'Footing - After trenches are excavated, o Masonry - Steel location, bond beams, grouting, ~ Foundation - After forms are , erected but-prior to concrete placement. o Underground Plumbing - Prior to filling trench, ,~ Underfloor Plumbing/Mechanical -..es..J - Prior to insulation or decking. ~" Post and Beam - Prior to floor U insulation or decking. , , ~ Floor Insulation - Prior to G decking, .B' Sanitary Sewer - Prior to filling trench, ~Storm Sewer - Prior to filling . trench, . ..J~aterLine - Prior to filling ~~;enCh' ., Rough Plumbing - Prior to cover, ~QUIRED INSPECTIONS Rough Mechanical - Prior to ove~ " M" Rough Electrical - Prior to / cover. ~ Electrical Service - Must be approved to obtain permanent electrical power, o Fireplace - Prior to facing materials and framing Insp, '~F,.m;ng,- P';N to co'e', ~ Wall/Ceiling Insulation - Prior to p- cover, if- D",wall - p" 0' to tap' ng, o Wood Stove - After installation, o Insert - After fireplace approval and installation of unit. ~ Final Plumbing - When all ? plumbing work is complete, ~ Final Electrical - When all I electrical work is complete, [SZ[Jinal Mechanical - When all / mechanical work is complete, fFinal Building - When all required inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking is complete. o Plumbing Connections - When home has been connected to '.1 ~ water and sewer, ~- " Curbcut & Approach - After forms are erected but prior to placement of concrete, ~ Sidewalk & Driveway - After ~ excavation is complete, forms and sub-base material in place, o Fence - When completed, o Street Trees - When all required trees are planted, " o Electrical Connection - When , blocking, set-up, and plumbing 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 Lot sq, ftg, Lot coverage Topography Total heigh~?-{ ( 84" ') ........, BUILDING PERMIT \ ~((), 4 \ 9___ ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee Lot Type _ 'Interior _ Corner :X. Panhandle _ Cul-de-sac X $/SQ, FT 802D \4.\0 (A) "-....., I P,L, IN Is Iw IE Setbacks HSE GAR Accl I I I I f\ VALUE 0 -}g.U5 ~ m A9f1 dm.Cl:) R.40 101 ~) SYSTEMS DEVELOPMENT CHARGE (SDC).J.l2 .I:l 01 -Ft--' (B) 't{''l-DlolD - PLUMBING PERMIT ITEM Fixtu res Residential Bath(s) NO OJ Sanitary Sewer FT, Water FT Storm Sewer FT. Mobile Home Plumbing Permit State Su rcharge Total Charge MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan (C) Dryer Vent Wood Stove/Insert/Fireplace Unit NO o Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State surc~,a.sgL Sidewalk;0 ft Curbcut ~ ft Demolition Stat~urctia, rg1\\ (\ \ _ AYQJ\ . ~t" r\'(\, L FEE J/dJ.cV L(t'2n~ cO R.CO ! fof:)q) f.oOO 4.5d Lf.OC) ,-~.60 dJ~ .50 1/) ,00 t ,,~ 33. {~~~ ~',lA-~ l~.cO - - " 4n.LV .S THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR O~ THE HISTORICAL REGIS~T\_~J If yes, this apPlicati?n r:nust e signed and approved by\ the istorical Coordinator prior to f-'cm,it issuance, 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 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, Date Pai : ~: Plans Reviewed By o.4~' Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, ADDITIONAL COMMENTS ,_9\-+ \ '. (r~ t:trJ \ ctt\X\ 0 K ~lq'I,-~ --' .~ yo.:A1\ \ 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 ce~tlfy 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\vithout 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 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 times during construction, Signature ;d<~./^-_n-l, ~~Q-, Date 3-3-91" VALIDATION: I \a~ RECEIPT NUMBEA _ - \ ' C, ~ DATE PAID (~jr y~- ^~ ,---;"'4 AMOUNT RECE)<!:~!!;i), /-JCj GO .=n/ RECEIVED BY( -;;) (l~ .... Total Miscellaneous Permits (E) . TOTAL AMOUNT DUE (excluding electric~~.ra (A, B, C, D, and E Combined) , '- ~ I J . ~ I r r' \Iud NO. CJ'IDZ-70 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ++e ~ 'L C-6U $1. J:f-.1C. I , LOCATION: '2 '?'2-0 L-oG\-l. 1>f2. DEVELOPMENT TYPE: 'L-C>-e. - N E.1A1 Sf (L BUILDING SIZE: 1. STORM DRAINAGE IMPERVIOUS SQ. FT. ,LOT SlZE ,SQ. ,Ft. '2(Pt...<O X $0~203 PER SQ. FT. 0??~ '-- .--/ 2. SANITARY SEWER-CITY , NO. OF PFU'S (See Reverse) \~ X $42.08 PER PFU 0SI~ 3. TRANSPORTATION , , NO OF UNITS X TRIP RATE X COST PER TRIP X I. 0, 1 X $ 424 . 31 X X $424.31 X $424.31 (4~B~ '- ..--/ $ $ SUBTOTAL I $ ~y-o~ . TOTAL-MWMC sOC 0-+e,""9 (ADD ITEMS 1,2,3 & 4) $ \ <4 (p I (o~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES BASE CHARGE'(SUBTOTAL ABOVE) X .05 _ ~.~~~' ?/'-t/~cf \~ Kip Burdick f SOC Coordinator Cq~ TOTALSDC $ 7-0(00 01 FIXTUREUNIT CALCUL-. ~ nON TABLE: Number of New FixtL , For remodels, calcul~te only the NET additional fixtures) (Unit Equivalent = Fixture U~its(NdTE: FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT FIXTURE EOUIVALENT UNITS 1- 2 1 2 3 6 2 6 ,6 1 3 2 1/Head 2 2 1 6 4 ,-+. Bathtub... ......"., ,..""..""",.",.""".,..,',.,',..,""",....."., Drinking Fountain,.., ,.. ,.."", ", ,.....', ".' ,. ,." ".""". .."". Floor Drain..... ,..., ,..,.., ,..,....."..,...,."..,. --,..""."...... ,... Interceptors For Grease/Oil/Sollds/Etc................. , Interceptors For Sand/Auto Wash/Etc..,...,........... Laundry Tub /Clotheswasher.... ..... ....... ... ......... ....,.: Clotheswa~her - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor F9r Refrigerator {Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, S ingl e 'Stall........ ......................................... Shower, Gang.. ..................................................,'. ,... Sink, Bar, CommerciaL........................ ,.... ...... ....... Urinal, Stall (Wall..... ...: .......................................,...... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private,.... ...... ......... .... ......,. ........ ....... Miscellaneous: -z.. \ "2.. 2 "'2- 2- ~ TOTAL FIXTURE UNITS \<6' CREDIT CALCULATION TABLE: calculate credits separates. \ Based on assessed value. If improvements occurred after annexation date in table, 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 $3.21 3.13 3.08 2.96 ~.82 2.68 2.51 1986 1987 1988 1989 1990 1991 1992 $ 2.24 1.93 1.57 1.18 0.79 0.44 0.28 -:L,"'\ X $ \,".' '2...103 Credit for Parcel or land Only If Applicable -;;7 c-- v \0 -;7 ~ (Rate X Assessed Value) Improvement [If after annexation date) , X $ = (Rate X Assessed Value) . r 0 '3 CREDIT TOTAL = $ ~'-t - RUNOFF COEFFICIENTS FOR STORM DRAINAGE Resid ential.... .... .......... ........ ...... .,........ ............... 0.4 Commercial.... ..... ............................ ..... ............ 0.9 I nd ustrial............ .... ........ ... .......... ...... ....... ......... 0.45 Governmental................................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT