HomeMy WebLinkAboutPermit Building 1998-3-6
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING 'SAFETY
Job Number: 980110
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 5172 FORSYTHIA ST
Assessors Map #: 18020421
Lot: Block:
Tax Lot #: 01800
Subdivision:
Owner: JERRY/MARIANNE HIBMA
Address: 5172 FORSYTHIA STREET
Phone #: 746-8625
City/State/zip: SPRINGFIELD, OREGON 97478
Describe Work: ADDITION TO RES & CARPORT
ADDITION
Contractor
Canst.
Contractor #
Expires
Phone
Electrical:
MORTHAN HOMES
2278 10TH ST SPRINGFIELD
OWNER
0093876
OR 9747700
09/17/98
726-3082
General:
QUAD AREA: 3RSC
OCCY GROUP: R3
SQ FOOTAGE: 204
OFFICE USE --
LAND USE: 1111
CONSTR. TYPE: VN
ZONING CODE: LDR
INSUL PATH: Pl
To request an inspection, call the 24 hour recording at 726-3769.
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 >lork day.
REQUIRED INSPECTIONS ---
FOOTING - After trenches are excavated.
F~UNDATION - After forms are erected but prior to concrete placement.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
SLAB - To be made after all ins lab building service equipment, conduit
piping, and other equipment items are in place but prior to concrete
ROUGH ELECTRICAL - Prior to cover.
FRAMING - Prior to cover.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
DRYWALL - Prior to taping.
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: S
Solar Approved: Y
N S
House 18
Item
Main
Garage
Total Value
Building Permit Fee
Surcharge/Admin
TOTAL FEE
Total Height: 10
Setbacks
Setbk From NPL: 10
W E
10
BUILDING PERMIT
Square Feet x
204
$/square Feet
64.66
Value
13,191. 00
0.00
14,295.00
110.50
8.85
(A)
119.35
Job Number: 980110
Page 2
--- PLUMBING PERMIT ---
Item
Storm Sewer
Fee
25.00
Plumbing Permit
Surcharge/Admin
25.00
2.00
TOTAL CHARGE
(C)
27.00
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
CITY SYSTEM DEV CHG
0.00
86.78
TOTAL MISCELLANEOUS PERMITS
(E)
86.78
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
233.13
--- 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.
Plan Check Fee: 71.83 Date Paid: 01/27/98
Received By: LISA HOPPER
Plans Reviewed By: DON MOORE Date: 03/04/98
Building Site Reviewed By: LISA HOPPER
Receipt Number: 28591
-- - ADDITIONAL COMMENTS ---
PAVE DRIVEWAY IF NOT EXISTING PAVEMENT
PLANS REVIEWEDD AND APPROVED BY MICK NOLTE, MORTIER ENGINEERING
DRIVEWAY REQUIRED TO BE PAVED
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 I and I further certify that any and all work p'~rformed
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 describ,.d herein,
and that NO OCCUPANCY will be made of any structure without permis.3ion of the
Community Services Division, Building Safety. I further certify that only
contractors and employees who are in compliance with ORB 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
Willl:,/e~ai~the ::.:: at all times during construction.
fJl 7trne / ;rkM~ {p 1CM8
Si~~~ Date /
Job Number: 980110
Receipt Number:
Date Paid:
Amount Received:
Received By:
--- VALIDATION
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Page 3
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CITY' OF S PRGFIEID~f:sysTEMs~.I5N~ro "NT!;CAX~GE:1~\~t~~t;,~.r:::-;.;"'~.
WORKSHEET
NAME OR COMPANY:
36UV C HAJtIA,Uu'<; /-II.RHA
LOCATION:
I)f 7 Z/;:;::,,e. SY TN /4
DEVELOPMENT TYPE:
A/J/JI//v"-' 70
5, F." /2.. I
BUILDING SIZE
LOT SIZE
SO. Ft.
1 . STORM ORA I flAGE
1I1PERV IOUS SO FT.
"3G;.c:'
X $0.226 PER SQ. FT. $ 82..C.s'
2. SANITARY SF~FR-CfTY
NO. OF PFU'S
(See Reverse Side)
. X $46.86 PER PFU
$ 19-
3. TRANSPORTATION
'NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $472. 49
$ -t9--
X
X $472.49
$
X
X $472.49
$
4. SANiTARY ~EWFR-MWM(
NO. OF FEU'S
X
PER FEU + $10 MWMC/ADM FEE $
.0
.-
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $
TOTAL-MWMC SDC $
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ ,\z.~r
5. ADMiNISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
$
4. I"';
f)t,
Date: 1-30 :-18
SDC Coordinator
TOTAL sac $ 8(,,7 f?r
~"'J:<'.:.;""~ --.,- :$-.....:..:::;._::.;~:.~..:.... -;",':"-1:;'"'"'7,...~ - ---:-- 7 - - - - - - - -- --- . .-...--. -. ..- n . "n.._' -- n. -..... -.......valt;:IIL = n^lUr~~UnI1S~'~'
j;,~;,,'/(NOTE::.,.For remodels, calculate only I NET additional fixtures) .. . .
~":.'~; :Y:"'''":.':;~~'':'''''.'!"'S'.~'~:'~ ,;.....:: '_ , . . .. . '.- - .' NUMBER OF UNIT - . r FIXTURE .~.' '
.:,' FIXTURE TYPE~" ... NEW FIXTURES EQUIVALENT UNITS
\
Bathtub. ... ..................................................................
Drinking.' Fountain.....................................................
Floor Drain...... ....... ............................... ... '" .... ...... .....
Interceptors For Grease/Oil/SolidsiEtc.................
Interceptors For Sand/Auto WashiEtc..................
Laundry Tub/Clotheswasher............ ..... ..... .... ...... ...
Clotheswasher. 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailerl..................
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 BasiniLavatory, Single...... ............................
-. ---Toilet:-Public-Installatio, ,....................... ..... .... ........
Toilet, Private...... ............................... ... ......... ......
Miscellaneous:
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
TOTAL FIXTURE UNITS
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
'I
I
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983'
1984
1985
1986
$3.97
3.89
3.83
3.70
3.55
3.39
3.20
2.91
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
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)
Residenri31...; ...... ...... .... ....... 0.4
Commerica!......................... 0.9
Industria!............................ 0 5
Governmenta!...................... 0.5
IMPERVIOUS AREA = TOTAL lOT SIZE X RUNOFF COEFFICIENT
'I
Rate per $1,000
Assessed Value
$2.56
2.17
1.73
1.31
0.92
0.74
0.61
0.45
0.31
0.17
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