HomeMy WebLinkAboutPermit Building 1996-7-25
RESIDENTIAL
PERMIT APPLICATION
.
I.",
. Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPO~D~OR'" II!) I
ASSESSORS MAP' \ I I U?J~
LOT'
.\
BLOCK'
.
0. \ 0\ (f)5
JOB NUMBER
225 Filth Street
Springfield. Oregon 97477
() 0 ~n j j 0 " . 0
. ~AX LOT' 1A~(
SUBDIVISION:
OWNER:jj, P V O~ ILl. c8nllO. PHONE: ~ 9I)~
ADD~~Kt 1~ )0 1J f (J /12- J?\tJLn J j .2- j r f
CITY:~1 . Jtoflfl.J STATE:JJAorym ZIP:~)
DESCRIBE WOR~rt .!-\ \ 0 ',fJy:LU J f) iJ)\ +0 0tnt !7J? f'UT2J ./
NEW REMODEL ADDITION \ DEMOLISH OTHER
I /
CONTRACTOR'S NAME
GENERA" ''\ l
PLUMBING' ll)1 f 1 f\Q)f_
MECHANICAl'
ELECTRICA' .
ADDRESS
CONST.
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USE:_ FLOOD PLAIN'
. OF BLDGS: . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: _ SQUARE FOOTAGE:_
To requesl an Inspection, you must call 726-3769. This 15 a 24 hour recording. All Inspections 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.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspoctlon - To be mado
after excavation, but prior to
setting forms.
o
Underslab Plumblngl Electrlcall
Mochanlcal - Prior to cover.
o
Footing - After trenches are
excavated.
o Ma.onry - Steel location. bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
. to filling trench.
o
Underlloor Plumblngl Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
o Wate' Line":'" Prior to filling
. trench. .
0'ROUgh Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
cove~ .
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert":" After flreplace approv41
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete. forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees Bre planted.
./
~ rlnal Plumbing - When all
plumbing w9rk I. complete.
D Final Eloclrlcnl - When all
electrical work Is complete.
o
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - When all
requIred Inspections have been
approved and building I.
completed.
OOthe'
MOBILE HOME INSPECTIONS
o Blocking and Sat.Up - When all
blocking Is complete.
o Plumbing Connoctlons - When
homo has been connected to
waler and sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspecllons have been approved
and tile home Is connected to
the service panel.
o Final - Aftar all required
Inspections are approved and
porch os, skirting, decks, and
venting have been Installed.
.'".
lol TyP. .' .IS THE PROPOSED WORK IN THE.
Lot faces Setbacks
lot sq. flg. Interior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner II yes, this appllcstlon must be signed
Is I and approved by the Historical
Topogrsphy Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cui-de-sac IE I
APPROVEf"
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT, a VALUE
Main
Garage
Carport
.,
Total Value
Building Permit Fee
State Surcharge
TOlal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE ~DA;)
(B) , O~'6.0\ \
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permtlls granted on the express condition thai the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Sprlngfleld, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlms
upon violation of sny provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT ADDITIONAL COMMENTS
ITEM ~ nEb)
Fixtures 1\ .
Residential Bath(s) N' ~
Santlary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit ~ /,){) CO
State Surcharge -1.50
.:3% ''-10
Total Charge (C) ~An
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stoveltnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
\.l~ryr~f\~
d~~
l,'~
.3~.j\
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
By signature, I stalo and agree, that I have carefully examined
the completed application and do hereby certHy 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 Ordlnancus of the'Clty 01 SprIngfield, and the laws
of the State of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure wtlhout permission of Ihe Building Safety Division.
I further certify that only contractors and employees who
are In compllanco wtlh ORS 701.055 will be used on this
project.
I further agreo 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.
~gnature~/t~ ~J--J ()
pi ,', I~
Date
VALIDATION:
RECEIPT NUMBER
,~~~)
'~J~'3 !
DATE PAID
AMOUNT RE
RECEIVED
JOB NO. '1& I 005"
ATTACHMENT B ,.
CITY OF ~INGFIELD SYSTEMS DEVE[ ME NT CHARGE
WORKSHEET
. NAME OR COMPANY:
I-ttrLG: '"
6o~p
LOCATION:
1/2. (
DAreL~l-(c
M€..
DEVELOPMENT TYPE:
/lltEt...i (?LUjVl!JI",6
BUILDING SIZE:
lOT SIZE
<;0. Ft.
1 . STORM DRA TlffiGE
IMPERVIOUS SQ. FT.
X $0.216 PER SO. FT. $ -
2. $ANTTARY SFWFR-rTTY
NO. OF PFU'S
(See Reverse Side)
t
X $44.75 PER PFU
'Z.~
$ '31"3-
3. TRANSPORTATTON
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $451. 26 $
X X $451. 26 $
X X $451. 26 $
4. SANTTARY SFWFR-MWMC
NO. OF PFU'S x$20.69 PER PFU+$10 MWMC/ADM FEE $ -
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $
TOTAl -MWMr SDr $
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $
5. AruiTNTSTRATTVF FF~
BASE CHARGE (SUBTOTAL ABOVE) X .05
$
cID6
I,"" :;--
1~'J ~ Cj) L.t-' S Ttf:Ie...
Troy MeA 11 i ster
SDC Coordinator
Date:~;,~~;I~~ .
TOTAl snr
/
$ 328 ~
FIX I UHI: UNII l;ALl;ULA IIUN I AtSLI:: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate o'llliihe NET additional fixturesl .
.. I NUMBER 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..................
Laundry Tub/Clotheswasher.. ... ........................ ... '"
Clotheswasher . 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Recepior For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL.... ........ ... ....... .......... ........... .....
Shower, Gang..........................................................
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall... ................ .... .... .............. ........ ......
Wash Basin/Lavatory, Single....... ...... .....................
Toilet, Public Installation...... .... ..... ................. ........
Toilet, Private.... ..... ........... .... ....... ......... ........ .......
Miscellaneous:
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
'L
-t
TOTAL FIXTURE UNITS
=
7
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $ 1 ,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
19BO
19B1
1982
19B3
1984
1985
1986
$3.72
3.64
3.58
3.45
3.30
3.15
2.96
2.68
1987
1988
1989
1990
1991
1992
1993
1994
1995
$2.34
1.95
1.53
1.11
0.73
0.56
0.44
0.27
0.13
I.
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 = $
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
ResidentiaL.. ................ .... .... 0.4
Commerical......................... 0.9
IndustriaL........:.................. 05
GovernmentaL..................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT