HomeMy WebLinkAboutPermit Building 4-8-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOT:
k~
SPRINGFIELD
BLOCK'
OWNER: mCLUv"c::....*^Q~} lkuS"d ~~.
ADDRESS: 11-\ S \/'0. ~V()OI('1Z^"lOO SLt~ \--L.> 2n~
CITY: \c; LI t?kv-...JL STATE:
\ - '- ()
o f:t. ..
DESCRIBE WORK:
NEW ,.y REMODEL
ivr-:-t:z - (1) J\ Q~' 't'&d~~
- - '\
ADDITION OEM L1' H . <:;> ER
~
.........
" C? d_ ,,'
~~/I . "r:.7~
1
"
JOB NUMBER
q::J Dd J~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: rM)i i--4.~'
SUBDIVISION,\l'tJq CL.J
PHONE:
L-f"X4 -4'XLQ
ZIP' CfjLto/
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR #
GENERAL: ~'r/A..rjr1 ~~~2-L ,:s '} L./ \A). I,:)nv~ ,ti c... C{...ld qj Llof
Jo-/"'f(x.) i..,.. o't.."".,)JhHGCJ .':J . \
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA: ~~~ .J
# OF BLDGS: \
OCCY GROUP: \{ '"?rt- tv\
(
y./
# OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE: \ \ \ \
\
V!\./
t....,.
# OF UNITS:
CONSTR, TYPE:
HEAT SOURCE: -H-P
RANGF' ~ ~
EXPIRES PHONE
I::J-/
n 1>(1) ,h=L3 4;)" -J~~
FLOOD PLAIN:
lJ)\2-.
4--'
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT: _
SQUARE FOOTAGE:c9 6t3~
, Torequl!st an inspection, you must call.,726-3769. Thi::; isa 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,
.,
f)<j Temporary' Electric
r
o
Site Inspection - To be made
after excavation, but prior to
setting forms,
~d~Hs~mbin~ectrical/
. t"'r1or to cover,
. "'- - I lI"
l"5<f Footing - After trezChes are
" excavated, Mt)<JO ITfI
o
Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior to concrete
pi acement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to insulation or decking,
o Post and Beam - Prior to floor
insulation or decking,
M Floor Insulation - Prior to'
~decking,
1'Vl Sanitary Sewer - Prior to filling
~trench,
RJ( Storm Sewer - Prior to filling
~ trench,
'WI Water Line - Prior to filling
~ trench, , '
~ Rough Plu~bing - 'Prior to
~ cover.
~
, REQUIRED INSPECTIONS
I":If'Rough Mechanical' - Prior to
~cover,
!VI Rough Electrical - Prior to
~cover.
1.><1 Electrical Service - Must be
p ,approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp,
J2S[ Framing - Prior to cover.
r><1 Wall/Ceiling Insulatio5' - Prior to
- cover,
.uJ Drywall - Prior to taping,
D Wood Stove - After installation,
o Insert - After fireplace approval
and installation of unit.
f\:I1' Curbcut & Approach -:-- After
~ forms are erected but prior to
placement of concrete,
K7f' Sidewalk & Driveway - After
~excavation is complete, forms
and sub.base material in place,
D Fence - When completed,
/~treet Trees - When all. req!Jired
~trees are planted, ,
rvT Final Plumbing - When all
~ plumbing work is complete,
I\7f Final Electrical - When all
I.c.....!. electrical work is complete,
l\/r Final Mechanical - When all
~ mechanical work is complete,
I'\/f Final 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
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed,
~. --
./'
SduJlf
Lot faces ~~~ Xvpe \,
Lot sq. ftg, 2.~ ~ Interior I P,L.
Lot coverage ~ Corner IN
Topography < 2.~~ Panhandle Is
Total height \\05 " Cul,de,sac Iw
t)4/ IE
BUILDING PERMIT
~ ($'"0
;1!7s.,., 2Jtf~'O~
, c~",I3--r' I' ., '1_
(~~. ~ lo-f . ~~j;J:i9-
SYSTEMS DEVELOPMENT CHARGE (SDC) #5
\ (B) #Z.(O09~
PjJJMBING PERMIT
ITEM
S7~r~(~3 1~9-,i'}=-
(C) 2LJ79(c~
MECHANICAL PERMIT
ITEM
SQ, FT.
.?~~~
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
Fi xtu res
Residential Bath(s) NO ~
"-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
Furnace
Exhaust Hood
Vent Fan
27
X $fSQ, FT.
Si-Pb
VALUE
JdS,Y3g
FEE
/~:z. pO
NO
2-
4-
or
~C70
(
/'L~O
Dryer Vent
Wood StoveflnsertfFlreplace Unit
,~~
Mechanical Permit
Issuance
State Su rcharge
Total Permit
_2~OO
/&60
..72, + j,':Z'O j?2-i;'/.2.-.')-=
~a"..
(D) ::5 5~ -
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk _I./~ ft
Curbcut i:if ft
(
Demolition
State Surcharge
2'Z.40
/~/O
,4... r:S-,o
Setbacks
HSE GAR ACC
(HE PROPOSED WORK IN 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,
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,
~::;) /j, 4~
Plan Check Fee: ~ 1'-',
g ;;)..1>> ~I.../
1/7LfD
fUR
Date Paid:
Receipt Number:
ntI~f
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS-
J}ffi{ll' L ~ 'llnollUQ W
~.-t /: 4D)Ih'qj~ I [)
\ ~~~QJ{: \qlo() ----
.J.IeAJ} /lIAM/I ~ j -".,1 ~..; .--- ::~ ,1~ " ~
~~/". ,- ~ /:,.a' C,r
. ..- -- - .
--=---
.. I
~MA% ~ H~,(T.~~
~!1flIO
I J'
By signature, I state and agree, that I have carefully examined
the completed applicatLon and do he~bY certify t-li~t all
information hereon is t~e and correct, 'An-eM f'urther certify.
that any and all work performed s,hall be,done in accordance
with the Ordinances of the City of Sprin'gfield, and the Laws
of the State of Oregon pertai ni ng to the work descri bed
herein, and that NO OCCUPANCY will be made of any
structure 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 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 m~s ~~onstr~ction,
Xgnature ~~
Date o1r- J<( -94-
f/
VALIDATION:
RECEIPT NUMBER
12.~~
S--I' ~ -9;1
DATE PAID
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) -~,-.~~' ~
(A, B, C, 0, and E Combined) a)l.2-<ffJ/';l...
-.r .
:J~ 7Cb.,<t-
AMOUNT RECEIVED
RECEIVED BY
~
--
o YYki!l.!m!!~!!~
Job No. ~m .~
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
N~f:~Ut'1UY) L(1[)lU0q PHONE: 4Bf-'4Pi6
ADDRESS: ~ UJ .&C'CLf11 0 n '1 \ It.. STAT~: (C~f2IPq'7i()/
LOCATION OF PROPOSED BUILDING SITE: I \l--
Street Address if ~nown: ~ \ \ 0 ~ R)fSJ. ~ u f\ ) . .
p,atlName:IICX::p_, TaxLotNumber: I 9(YdO~~()MCY'
~ WiLlS
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Sim!le Familv - Detached
NO OF UNITS
Manufactured home not in a park
$ 4CO ,cO
Single Family home
1
X $400 PER UNIT =
B. Sim!le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
$
C. Multi-Familv Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
A i)/\ dJ
$lUJ.
$0
$ 4flf) {YJ
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SOC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
\ lOO Jell
Community Services Oi ision
City of Springfield
./
Q ciA /C{LJ-
Date
-----
lOB NO. 9 t../ 0 '2.1 '?
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANy:MA1~S:>'-~E:.A:M \-\C0SIr.J& TNc',
LOCATION: 4\ Ct,'1... rO!2-C;...,,-I-\-IA. \ '6 O'2.O?'1-'Z-- - oo~oLf ~ ,L{o6
DEVELOPMENT TYPE: L-\)f2- - Rec?IPf::..N"T(A\... CAfZ..f:. fAGILITY
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
LOT SIZE
SQ. Ft.
Lfo8t>
X $0.203 PER SQ. FT.
, ~'Z-q 9.~
'--- ~ '
2. SANITARY SEWER-CITY
NO. OF PFU'S ,
(See Reverse)
'2fo
X $42.08 PER PFU
0q~~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
y.
X Q. \~ X $424.31
X X $424.31
~l,b~
'-- .----'
$
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S ~~ x $15.125 PER PFU + $10 MWMC ADM FEE $ '-fo"?'2..-2-
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ Ca"L ~i..
TOTAL-MWMC SDC 0<-fC~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ ~YB5~~
X $424.31
$
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
k:~~ ~L~ -z,!7-B/Q'1
\j Kip Burdick I
SDC Coordinator
0~yv
.,,,
TOTAL SDC $ "2.,lt,oq --
--
...--/
FIXTURE UNIT'CALCULA- IN TABLE: Number of New Fixtures Y
,
For remodels. cafcul~te only the NET ctLlditional fixtures)
lit Equivalent = Fixture Units (NOTE:
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EOUIVALENT UNITS
L4
?::>
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
&../-
~
Bathtub..".. ,.....,."..."""""""".""",,',.,"',.,..,.,""',.,'"
Drinking Fountain......,..."",......,..",..", ,..' ,....., ." .......
Roor Drain, ........', ,.....,.",.."...."...,.",.,..,.,",...,',.. ,.,...
Interceptors For Grease/Oil/Sollds/Etc.................
Interceptors For Sand/Auto Wash/Etc.......,..........
Laundry Tub /Clotheswasher.,............. ...c................ ,
Clotheswa~er - 3 Or More..................................,..
Mobile Home Park Trap (1 Per Trailer)..,......,c.......
Receptor F9r Refrigerator fWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc.. '
Shower, Single' StalL............. .........,. ........ ,... ..........
Shower, Gang,.............................,... ..........,.... ..........
Sink, Bar, Commercial. .......... ,....... .....,..." ...... .........
Urinal, Stall f\N all.......... ,..,..............,..,.",..,.........."....
Wash Basin/Lavatory, S ingl e...... ............................
Water Closet, Public Installation.........,.........,.........
Water Closet, Private, ,...... ......',...,..' ...,.......,......,..,.,
Miscellaneous:
'2-
7-
"*
'-I-
\'2..
TOTAL FIXTURE UNITS
2lo
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
1980
1981
1982
1983
1984
'1985
$3,21
3.13
3.08
2.96
2.82
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
Credit for Parcel or Land Only If Applicable 7:J I ~ I X $ IC\. &..\ 1. (p 1.- ~ 4-
(Rate X Assessed Value)
Improvement (If after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = $ ~l.-?~
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
R esid ential... ............ .................... ,....; ............... 0.4
Commercial.... ..... ........ .........................,.....,..... 0.9
I nd ustrial.. ................. ......................... ,....., '....... 0.45
Governmental.... .., ...... ...................,..........., ,..... 0.5
IMPERVIOUS AREA == TOTAL LOT SIZE X RUNOFF COEFFICIENT