HomeMy WebLinkAboutPermit Building 1993-10-6
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RESIDEN,TIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK: _.!lX'3
ASSESSORS MAP:
LOT: _~'::ID
,
OWNER:
CITY:
SPRINGFIELD
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JOB NUMBER
~3\~ql.
225 Fifth Street
Springfield, Oregon 97477
BLOCK:
TAX LOT'
SUBDIVISION: naJ, 7}) LP
(~
STATE:~
DESCRIBE WORK:~ ~
~j~_,-+- p~ &J
ADDRESS: '_.23-~-~.
~
NEW
x
REMODEL
ADDITION
DEMOLISH
OTHER
CONST,
CONTRACTOR'
~ t;7)~Lj
,
~'30IJn
t;' (;70 'it-:J...
'-:w - '-lil
GENERAL:
PLUMBING:
~~;;:~~::L2ft::r~
OUAD AREA: jBJ\) l~
. OF ElLDGS: \
, 0 ""::l...J._)J\,
OCCY GROUP: ..!:.:\.\......LL
. OF STORIES: -.--;-ls
WATER HEATER:__
- OFFICE USE -
LAND USE: ~ ~ \ \
.. OF UNITS: \
CONSTR. T'IPE:.J..l..c..f\,) "
HEAT SOURCE: f="'u
RANGE: _ G
PHONE:
3ur-Lf ?,~.=?
ZIP:~I
EXPIRES
i-qLf
(P-1~
~-qlj
\D-q~
PHONE
3115-<./31.fl
(pRJ?-IY.3.L
7'l1"-)/,, /7
(08'& -~L
FLOOD PLAIN'
ZONING CODE: Lrl~
. OF BDRMS:~
SECONDA,RY HEAT:
SQUARE FOOTAGEry{ tJ { tJ L
To request an insp.ection, you must call 726-3769. This is a 24 hour recordIng. AlIlnspectlons 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 aay.
o Temporary Electric
o Site Inspection - To be made
after excnvation, but prior to
setling forms.
o Underslab Plumbing I Electricall
Mechanical - Prior to cover. .
~ Footing - After .trenches are
~ excavated. '
o Masonry - Steel location, bond
beams, grouting.
~Foundalion - After forms arc
~rected but pripr to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
~ Rough Mechanlcal- Prior to
~ cover, 'Z$rf,D etA; F,,IfJ,
~ ,..':"<;"
Rougl,l E_lectric311 - Prior t.o
cover.' .
l5<! Electrical Service - 'rv.ust be
.. ppproved to obtain permanent
electrical power.
o Fireplace - Prior to facing
. materials and framing Insp.
~rraming - Prior to ,cover.
;::::7!"'Wal1/Ceiling Insulat.io.~ - Prior to
~cover. '
~ Drywali - Prior to ~aplng,
.~Undc~f1oOl'1:'lumbin~ ~hanic~
~ _ Prior t~n orcrccKlng. 0 Wood Stove - After Installation.
f")Zf' Post and Beam - Prior to floor
~nsutation or de<;king.
;;::::::;;r Floor Insulation - Pllor to
~decking.
, 'C7f Sanitary Sewer - Prior to flIl,ing
~ lrenctl.
, '
F\:II' Storm Sewer - Prior to filling
~ trench.
,rvrWatcr Line - Prior to flll1ng
~trench.
rvrRough Plumbing - Prior to
. ~ cover.
o Insert.....:. After fireplace approval
and Installation of unit.
~ Curbcut & Approach - Arter
ft.rms arc erected but pllur to
p:acement 01 concrell~.
~ Sidewalk & Driveway - Aller
~ excavation is completo, forms
and sub.tJUse material In place.
D F.::ncc - When complp.ted.
~Slmct Trees - When all l'eQuirecl
~tlP.CS are plan'ted. , ~
~ Final Plumbing - When alt
~plumblng worl< is complete.
~ Final Electrical - When all
~electrical work is complete.
J><1 Final Mechanical - When all
_' ~..echanical work Is complete.
~Flnal Building - When all
~ required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Sel,Up - When all
blocking is complete.
D Plumbing Connections - When"-'
home has been connected to
water and sewer. -
D Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home i~> connected to
the service panel.
[] Final - After all required
inspections are approved and
porcllcs, skirling, decks, and
venting have been installed.
.
ia3.QID
4.~7.LO
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2...,...
51 1.3~
SYSTEMS DEVELOPMENT CHARGE (SDC) .#3
(B) tlz,c./ 3'f'i!.
Lot faces
J!L
IO/II{.,
Wo
~J
Lot sq, fig.
Lot coverage
Topography
Total height
BUILDING PERMIT
SQ, FT.,
~052..
&rOC(
ITEM
Main
Garage
Carport
--
Total Val ue
Building Permit Fee
If
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Lot Type
~Interior
Corner
Panhandle
Cul-de-sac
X $/SQ, FT,
5(.,,1.0
\..." ID
(A)
N'
.z.
FT.
FT,
FT,
(C)
Dryer Vent
Wood Stove/Insert/Fireplace Unit
N'
3
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk 5&: fI
Curbcut 30 ft
Demolition,
State Surcharge
W'dAM""t........ )~ 0lJ.e..
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.
I P,L,
IN
Is
Setbacks
HSE GAR
'")' liS'
atl <) ,
~~' ,,'
}O' 'l(,' I
w
E
VALUE
115,32.",
8''5' r7
FEE
~~o
~~
./2;~~~
&::>0-0
.
..f. S' a,
1~
/Sd4P
:? 8-0
.~7:.S0
/(}f)' <>
J. !7t1
+1,3'b
1~70
/4.~O
4-mJ .frO
-:z, <)~'~1
ACC I
\
I
IS! PROPOSED ~ORK IN ~HE .,."
HISTORICAL DISTRICT, OR 01'< h i1 '
THE HISTORICAL REGISTE~
If yes, this,application must be signed
and approved by the Historical
<?oordinat~r prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This 'permit is granted on the express condition ttlat the ,said
construction shall'-i-n all respects, conform 10 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.
Plan Check Fee: _3ilo, S'S-
, _ !Y/'" A3
"r-Ome
Pia s Reviewed By'
Systems Development Charge is due',on'aIJ undeveloped
properties within the City limits which are being improved.
ADDITIONAL C,OMMENT~
'- ~ \ '. ~ -rl:-> ()\~
"- 9\"'r\Q~ '. \\rt-,~
\ \)(\lli \
"--
(\Ap~h~) .;s~~
. .~....
..;........
By signature, I state and agree, that I have carefully examined
the completed applic<1tion and do hereby certify that all
i.nformation hereon is true and cor"rect, and I further certify
that any and all work performed shall be done in accordance
with the Ordinanct:s of the Ci~y of Springfield, ,and the Laws
of the State of Oregon pertaining t9 the work described
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 7C?1.055 will be used on this
project.
I further agree to ensure that aq required inspectio(1s 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
:~g:::u::eat,af:~p ?]gt~ction
9 -C\ ":Q3
Oat'""
VALIDATION: nLJI!!!t
RECEIPT NUMB,R (D10].r
DATE PAID _ ( ). ( t! .G(..l..\.
AMOUNT REC5iVErj -::) f)<4 P)9-,h
RECEIVED BY "['J\ !J')r\... "
~~
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l'l.'J' ..! ~
Ill'
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Job No. 9.3/3'1: 7
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: /5t.U~..v ; ~~z..
PHONE: <4'5 - ~~4'7
ADDRESS: ~?:J,t:/AK.tu~ /?';:"');d.~~ STATE:.t')tf.ZIP q'7~/
LOCATION OF PROPOSED BUILDING SITE:
Street Address if Known: q~ 3 ; ,:vR//~~f ~I....
J-s-r --10
Platt Name: ,A").4r,V l7".eE- Tax Lot Number:
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.)
A. SinQle Familv - Detached
.v-Single Family home
NO OF UNITS /
B, ~inQle Familv - Attached
NO OF UNITS
C. Multi-Familv Aoarlment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
X $400 PER UNIT =
$ 4rro "0
X $370 PER UNIT =
$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ foO CV
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet. $
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) $
~/~tIVJU-
Comm'unity Services Division
City of Springfield
\D / Lo / q.s
Date
~O., ~..
~.
e
:'. ,JOB NO. 9 ~ , :.., 1
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: /E.L.-L-I &ON e; PLArZ
LOCATION: q f:? f='A/I<W""Y PL.
DEVELOPMENT TYPE: Lpi< - Alew SF=1e
CaAl'!:rr.u.
Lor t./o - OM::.. -r1<E.E,
BUILDING SIZE:
LOT SiZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
?:J1o ~
X $0.203 PER SQ. FT.
(7q~~~
'- --
2. SANITARY SEWER-CITY
NO. OF PFU'S
, (See Reverse)
Icr
X $42.08 PER PFU
~7qq 53)
............. .-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/
X /, Of X $424.31
X X $424.31
~Z8 ~)
'- --
$
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S jq x $15.125 PER PFU + $10 MWMC ADM FEE $ Z"l1 ~
(Use PFU Total From Item 2 Above) ,
X $424.31
$
MWMC'CR~DIT IF APPLICABLE (SEE REVERSE) $ -e-
TOTAL-MWMC SDC ~
"""--- ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ 'Z.? \ l?:, '.2.
5. ADMINISTRATIVE FEE~
BASE CHARGE (SUBTOTAL ABOVE) X .05
V' .~, d~.~J.e.- elf I/?, /q-;
GI Kip Burdick / f
SDC Coordinator
~ 1\ c:. 91)
'-- .-/
'-"
TOTAL SDC $ 'Z.cf '?+ -
-'
FIXTURE UNli ,CALCULA TI-' ABLE: Numb~r of New Fixtures X U....uivalent = FlXlure Units !N9:rE..;.
For remodels, calculate only the NET additional rlXlures) ..,..
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub........... ........ .................. .......... ,................ ,.....
Drinking Founlain....,..",......,....,..,.,....",......, ..........',
Roor Drain,.......,..,........,....,......"".,....",..",..""..,..,..
Interceptors For Grease/Oil/Sollds/Etc........,.......,
Interceptors For Sand/Auto Wash/Etc,~,..............,
Laundry Tub /Ootheswasher.....:...,:,...... :..., ....,: .~. ,'..
OOlheswa~.e!-. 3 Or More.....................................
Mobile Hdme Pi!rl< Trap (1 Per Trailer)..................
Receptor F9r RefrigeratorjWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single ,SIaIL...................,....................,......
Shower, Gang,..............,........,...,....,.........................
Sink. Bar, COmmercial................,............,........,......
Urinal, StalljWall......................"".."".."..,..,.......,..,..
Wash Basin/Lavatory. Single..................................
Water Oosel. Pubiic Installation............................,
Water Ooset, Private,...................,'.........,..,......,....,
Miscellaneous:
J 2
1
2
3
6
.. ' /, 2
6
, , 6' ,
1
'. 3
2
l/Head
J 2
2
? 1
6
2. 4
'2.
Z;
2.
2.
'7,
<;?
','
TOTAL FIXTURE UNITS
("I
CREDIT CALCUlATION TABLE:
calculate credits ,separates.
I
Based on assessed value, If improvemenls 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
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~or Parcel or Land Only If Applicable
,,1f"provement (If after annexation date)
X $ #.A
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $~A.
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential..................,...........,."......:.~.,.....:,..... 0.4 .
CommerciaL........................,.....",..............,..,' 0.9
IndustriaL......................................................... 0.45
GovernmentaL....,...................,........................ 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT