HomeMy WebLinkAboutPermit Building 1995-4-24 (2)
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LOCATION OF PROPOSED WORK: 7"99r::;
I A()AlJl{Y)
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RESIDENTIAL
PERMIT APPLICATION
,Inspections: 726.3769
o Iflee: 726.3759
><ASSESSORS MAP'
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SPRINGFIELD
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BLOCK:
JOB NUMBER
225 Fifth Street
Springrleld, Oregon 97477
:5/-:
TAX LOT: J)!).q(;() rEi!))
SUBDIVISION: /Y/f/hP' A~/770
OWNER:
ADDRESS:
CITY'
d?/t/U!. ,a~ /hh~S
~,::>o ~/..NCC: er-
a ,o~$Cv~bC
Z:::-Uc.
STAT'"
O'e
PHONE:
9.5"'7' r?33~
DESCRIBE WORK:
NEW X REMODEL
-S/Ac/~
-- J1 ~
, ZIP:
.'i? >~ 2..6
ADDITION
..... ~
,/' ;"7''-'''' /c:..-C,/
t'
DEMOLISH
.OTHER
.;"/- ~
,,- "-,,,,,,,,
CONTRACTOR'S NAME ADDRESS
GENERA" bL(~ Atflo /~S ...:;:;:vC
PLUMBING:_~~~
GAkMgAc/ k~hq~,
~/LL.5 (~L<6e-77Z,o- c...'
CONST, . - 7
.___CONTRAF:@R . EXPIRES PHONE
_~'?y3..r2: ''''' /tJ//~5" 9SZTd33~
- ()(JPrt~~ \ 'II f\ /e[", ,'1fI4. f4(J-
. I()~ \I)>:? 1,<1\- ~3t4-2.4'81
~ L~SI "Ti'f)~~ -loR'/,I85I
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t
MECHANICAL:
ELECTRICAL'
/'7
~~~~ - OFFICE US~
QUAD AREA: LAND USE: \ \ \ \ > FLOOD PLAIN:
. OF BLDGS' \ · OF UNITS: \ ZONING CODE: u::lL.
OCCY GROUP: R~ }J\ CONSTR, TYPE: ,nJ . OF BDRMS: ~~
. QF STORIES: I HEAT SOURCE: \?S SECONDARY HEAT: ~ ,
WATER HEATER: f...> RANGE: __9./ SQUARE FOOTAGE: .l!l90
To request an Inspection, you must call 726,3769, This Is a 24 hour recording. All Inspections requested before 7:00 a.m.
made the same working day, Inspections requested after 7:00 8.m. will be made the (ollowlng work day.
, ' REQUIRED INSPECTIONS . \
o Temporary Electric 'r\::/(Rough Mochanlcal - PrIor to ~Fln,al Plumb.lng _ When illl
~over. ~ plumbIng worl( Is complete.
\
\
~FlnahElectrlcal - When all
~ electrical work Is complete.
[/00 Site Inspection - To be ~adC
after excavation, but prior to
o setting forms.
~
o Underslab Plumbing I Electrical!
Mechanical - Prior to cover.
~ Footing - After trenches are
j2SrJ 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,
i"';7f UnderlloI"f:Plumbln),~hanlc~
~- PrIor ~n o'r a-ect\lng.
~ Post and Beam - Prior to floor
.LAJ Insulation or deckIng.
'1'\71 Floor Insulation - Prior to
~ decking.
191 Sanitary Sewer - Prior to filling
~ trench.
~Storm Sewer - PrIor to rllllng
~ trench.
19l Wafer Line - PrIor to filling
~ trench:
J"V( Rough Plumbing - PrIor to
lp cover.
r91' Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
~ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp,
~Fr8mlng - Prior to cover.
1'e71"watl/C.elllng Insulation - Prior to
~ cover.
~ Drywatl - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace a'pprove.1
and Installation of unit.
o Curbcut & Approach - After
(arms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is com pIe to, forms
and sub.base material In place.
o Fence - When completed.
~treet Troes - When all required
~rees are planted.
..vlll be
~Flnal Mechanical - When all
tp' mechanical work Is complete.
r\?(Flnal Building - When all
?t ~equlred Inspectfons have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel'Up - When all
blockIng Is complete.
o Plu",blng Connections - When
homo has been connected 10
wate\an~, sewer.
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
porchos, skirtIng, decks, and
venting have been Installed.
~
~o
Lol coverage 21410
Topography ~2. .r;.
Total htl~lP/~ o.~~
( . . , .
'BUILDIN'GPERMIT
"". -...-..1 ., '.
. -, .'. SO, FT," '
Lol Type
v Int~rlor
Lot faces
Lot sq, ltg,
Corner
Panhandle
Cul.de:sac
.-.., ..
ITEM.
X $/SO, FT.
$/h <All
Main
/Z.~o
'<;~a
Garage
Carport
"x, "-
',.
Total Value
Building Permit Fee
Stale Surcharge "\:::PO
Total Fee
(Aj'
Setbecks
I :L.115 I GAR' ACC i
S I I 7-2> I
Iw 1,.~15~k.1
""~~I-
I ",-,
BUILDING VALUE, PL.A:N'CHECK
AND BUILDING PERMIT
VALUE
7,Q.i1,/:L.
.
" --2....-4? ,
':' . ~ . . ~
%.$.28H:
,~V)O .aJ
~y.W
,-3<<JciO
SYSTEMS DEV~LOPMENT CHA,RGE',(SDC) .lJi,
'. ", " ih-z:? IO,j .,.,....,
. " , (B)
PLUMBING PERMIT
ITEM
FIxtures
ResIdential Balh(s)
, ' I ,)
Sanitary Sewer-
c!l
N'
Water
FT,
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
Stato Surcharge 1- ~O
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
cO
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge "t-~
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk lo3, It
Curbcul ~ It
Demolition
Slate Surcharge
FEE
, ,
~
, '
l1o(),OO
1~.Po
/1 fl-?;()
I n CX:J
4.'50
Co . CD
'"~ .00
In .C::D
J~\ tv
\ (),
\'Eeo
3\.
19. ,L.\t;
J4. ')[)
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludIng electriCal)~(6().7C)
(A, B, C, D, ITnd' E. Combined)
" ,"i: "..,".
~~
. ,
I IS THE PROPOSED WORK tN THE,
. ...HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prIor to permit Issuance.
APPROVED:
- .. This permit Is granted on Ihe express condition thai the said
- construction 'shall, 'In ali"respects. conform to the Ordinance
adoptedC',by .tho .-City .,of ,Springfield, including the
Development Code, regulating the cons.tructlon and use of
buildings, and may'be.susp'ended or revoked at any tlme
upon vIolatIon of any provisions of said ordInances.
.2 ~ _ 50
Pla~.<<heck Fee:.
1/2~/7I
Receipt Number: /(_ /'. 7~
-.. Date Paid:
,
;"'~~~.r
7 r o6t/
Systems .Development Charge Is dueon all undeveloped
p'ropertles within tha.city limits whl<:h are being Improved,
.-... ~.... +
ADDITIONAL COMMENTS
0Al\\f\rirlv lli~
\..A-\-\\ 40CU (~cn.\.w')
"cA~~Ix\tQ::,: \"C\lol'J \) .
. .-
PA1H 1.
S'~~~ ~ /%IfAur
Ij ~R/~c5'/)
By signature, I slale and agree, that I have carefully examined
the completed applicatIon and do hereby certify that air
Information hereon Istrue and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of Ihe City of Springfield. and the Laws
of the Stato of Oregon pertaining to 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 701,055 will be used on this
project.
I further agree to ensuro that all required Inspections are
requested at the proper time, that each address Is readable
from the street, thai the pormlt card Is located at the front
of the property. and the approved set of plans will remain
on the site at all II es during construe n.
~gnature ,.tr~.
4'~~-- .
v
Date
r
VALIDATION:
RECEIPT NUMBER
'7--:(' 7"" ~::>
/ //~'/
3'3'.~ ~~
~~.~ -
DATE PAID
AMOUNT RECEIVED
. .
RECEIVED BY
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAM~~~ ~~~
ADDRESS: \ QfjO U\ i\ I) (\ l, ~). 0 N110 QQ.
J
"
-..
f'\' .
.. ...-~ Willamalane
"tg' Park & Recreatio~ District
- .
LOCATION OF PROPOSED BUILDING SITE:
Street Address if Known: 4C\(\ \ 0
Platt Namck ~~\\.~
.
~
/obNo.
q~
PHONE:
q <(f\ .rr)2ZL
STATEJ()P ,ZIP .ib42i.o
~~AG _)
Tax Lot Number: J.e:O..'7 rn Cy')
~.
1. DEVELOPMENT TYPE (Check appropriate dwellirig(sl. SDC Calculations and dwelling type
definitions are on the back.) . .. .
A. Sinl1le Familv - Detached
{ Single Family home
NO OF UNITS (
-
B. Sim11e Familv - Anacheq
\
NO OF UNITS
C. Multi-Familv Aoartment, '
NO OF UNITS
. D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park ,. cf)
X $400 PER UNIT .:;=, $4f1), ,
.
X $370 PER UNIT =
'$
X $777 PER UNIT =
$
X $280 PER UNIT =
$
4mr:D
$
$0
'$4D{}.CO
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 SDC reduced for Credit)
\A~ )~ ~\"r--k\Qr )
r___,,,_,... "^-;;~~ ~;\~;'M
'I1"::.?~~r
n::tff.lo
.
.B NO. Q'5o"?IP:?
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: RtVE.{i:. '5e.ND I-fOtYlt!:.S INC.,
LOCATION: 49CJ(P n~SYTH/A $,. /S020'/OO - oZ"1ao (f/o)
DEVELOPMENT TYPE: LDI? - NE:.W '5':;~
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAG~
IMPERVIOUS SQ. FT.
'2.6"71
X $0.209 PER SQ. FT. (CoOOOV
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
Ie,
X $43.26 PER PFU
0~7B~
'-- ----
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
/
X /.0 I
X $436.19
X $436.19
X $436. 19
G %J si)
........... ----
$
$
x
x
4. SANITARY SEWER-MWMC
NO. OF PFU'S (E) x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ 3/<=14-1-
TOTAL-MWMC SDC
$ /?~
~
........ ---
$ "'2 t-zA-f>$
MWMC CREDIT IF APPLICA8LE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
r-" ~--p. -~
\j Ki P Burdi ck
SDC Coordinator
X .05
Date:"?l/Z,3 /qt;;
I t
TOTAL SDC
CIOG:,~
.......... .---'
$ -Z "Z,rl;> I 09
,.......,. -
FIXTURE y'~IJ..c::;,I;\~<:?UL-?< T..LQN T ,:\BLE: Number of New Fixture.Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only. th. additional fixtures) .
, NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub............. ..............,. ,.............,.................. ........
Drinking Fountain............ ................... .......... ..U".....~
Floor Drain................ ,.. ...................". ,..... ........... ......
Interceptors For GreaseIOil/Solids/Etc.........,.......
Interceptors 'For Sand/Auto Wash/Etc.................. . '
Laundry Tub/Clotheswasher.....--.......................:..~; . .' ."''1' "
Clotheswasher - 3 Of More.m.,'....,...............,.......-..'..
Mobile Home Park Trap '(1 Per Trailer)..,..:.........::.
Receptor 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
11Head
2
2
1
6
4
=
,
.,
'2.
"2-
'2-
2-
'2-
<i
TOTAL FIXTURE UNITS
11?
I---'-~-~
Year
Annexed
1
2.
7
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984'
1985
$3.46
3.38
3,32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates,
Credit fo'r:Parcelor Land Only If Applicable "? 4<'.. X $ 4,0
(Rate X Assessed Value)
Imprdvement' (if after annexation date) X $
(Rate X Assessed Value) .
.-.---.-.-,
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
CREDIT TOTAL
=
/3 <iJ4
= $ i3 !f4-