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Home My WebLink AboutPermit Building 1994-8-26 (2) RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 . ASSESSORS MAP' LOT: .~.. LOCATION OF PROPOSED WORK' --L':L.-~ _..... II ,/ ~;)..'.'\~ ~ OWNER,-')Q~\Il\ '.v. l1.~Uv ADDRESS: . : (y. So ~)f.I,rJ. CITY: CGH I w;: t.~-V f DESCRIBE WORK: li'})Ia1. \Al~cU i~~: \ NEW REMODEL ADDITION CONTRACTOR'S NAME GENERAL: Mr)\~t- PLUMBING: L1\Lr-.\- ~tllw'a.i,'4 MECHANICAl: /1 It ELECTRICA" f...fJv.) \) (j nil ~ // v BLOCK' f'J1./\ o{~ ~ltlPl.hbl :t}l '3t." G, - "'ill. CL./Z,1 JOB NUMB~R!J1lL1J 0 225 Fifth Street Springfield, Oregon 97477 NIl STATF' DEMOLISH ~ OTHER n. ?;::"7"~,.' ..J ~, ..~ ................,;" TAX LOT: IOO;)O!!/ /(')OJJO ~ \...,+ 0+ ~~.". O'r n SWDIVISION: '3q)('I~ - c.lll PHONE: 7Uj ~ <12// / lYf- ZIP: (j)C/) ') I (/)LI#~) ~' -" ADDRESS' , 'f-o CmAhrJ ~. CONST. . . CONTRACTOR # frl-l/J-D PHONE 7t-f74JIL .'.'" EXPIRES 1,- 9C,- , - OFFICE USE - QUAD AREA: ~~ . LAND. USE: 1/'2... C) FLOOD PLAIN' 0 # OF BLDGS: / # OF UNITS' :2. ZONING CODE: ~ OCCY GROUP: . /f:'7},':~#1 CONSTR. TYPE: VN . OF BDRMS' # OF STORIES: '. J HE~T SOURCE: E.U! SECONDARY HEAT: W~~ER '~EATER:----F RAt'lG;=' E SQUARE FOOTAGE: " To request an Inspection, you mu'st'cafl726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be made the same working day. Inspections requ~sted ~fter 7:00 a.m. will be made the followIng work day: ' - - -"- '. "" REQUIRED INSPECTIONS. ~e"-'~ora,.y E;';c;rlc D Site Inspection - To be made after excavation, but prior t settln9r{orY'T~~A ~ . ~nderS~Electrlcal/ Mechanical - Prior .n\l~r: ~Footlng - After trenches are ~ ~xcavated. . D Masonry - Steel location. bond beams, groullng. D Foundation - After forms are erected. but prior to'concrete placement. D Underground Plumbing - Prior to filling trench. D Underlloor Plumbing/Mechanical -.Prlor to Insulation or decking. D Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to decking. [Lt] Sanitary Sewer - Prior to filling trench. [Xl Storm Sewer - Prior to filling trench. . rl/l Water Line - Prior to IIlIlng ~ trench. D Rough Plumbing - Prior to cover. D Rough Mechanical - Prior to . cover. D Rough'Electrlcal - Prior' to cover. D Electrlca' Service - Must be approved to obtain permanent electrlcal_ power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wail/Ceiling Insulation - Prior to cover. ' D Drywall - Prior to taping. D Final Plumbing - When all plumbIng w9rk Is complet.e. D Final Electrical - When all electrical work Is complete. D Final Mechanical - When all mechanical work Is complete. D Final Building - When all required Inspections have been approved and building Is completed. I.KI Other 47E ~~/~ (~?" ~RfP lb~# ~ MOBILE HOME INSPECTIONS o Wood Stove - After '~stallallon. [Xf~IOCkln9 and Set-Up - When all D Insert - After fireplace approv41 . ,/ blocking Is complete. and Installation of unit. (-- '. . . . . ,-~umblng Connections - When D Curbcut & Approach - After 'home has been connected to forms are erected but prior to water and sewer. . placement of concrete. _ / ~ . ~~~~trlcal Connection - When D Sidewalk & Driveway - After blocking, set-up, and plumbing excavation Is complete, forms InspectIons have been approved and'sub-base'ma.terlalln place. and the home Is connected to the service panel. ~nal - After all required ~ i~~pectlons are approved and porches, skirting, decks, and venting have been Installed. D Fen~e - When ~ompleted. D Street Trees - When all required trees are planted. ". ~;.{?~ \' }::;f '; ~ ;'.'~':~::I:.~f:..~ ~:\~ ~1';~~.'~'~('\ ~IS THE PROPOSED WORK IN THE. Lot faces ~ L~t '~ype . Setbacks , GAR Acc'1 HISTORICAL DISTRICT, OR ON . P.L. HSE Lol sq. Itg. Interior I THE HISTORICAL REGISTER? Lot coverage -X- Corner N' /.::> ;. 7/;0/ . If yes, this appllcallon must be signed S ~~.::>;'"IY : I and approved by the Historical Topography Panhandle ~'t, I Coordinator prior to permit Issuance. Cul~de~sac W Total height /'5"' I E /"'~-~ APPROVED' BUILDING PERMIT ITEM . SO. FT: X $/SO. FT. = ~aln Y/J(vE~/" M1W.....~V'~~ VALUE ~'/9/-r; Garage '. Carport . fdL' AK .4/d(lukr h.# /. Total Value F~ 1'~/.7' J c;rrf) ./5"e:Jrt:).- --::<:5'-> /,:?~ _??- ~7. ."p BuildIng Permit Fee r5~ "-;J~p Stale Surcharge' Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) 1.79"2.45 (B) PLUMBING PERMIT ITEM FEE. FIxtures Residential Bath(s) N' Sanitary Sewer FT. s;:,~/5o </.0, ..... ~... Water FT.:2< ~O FT. /70 Storm Sewer ~~,.~ ~.~~ #:>.~ 17~ -=- ,...~~ ii.-9=' r? -!!~ <" /C> , (C) . JR=3. ~ Mobile Home ::::i? ><' 15' / &r:#r/~ ~C.::F' Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent , Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMIT5- Mobile Home -:;::Y /05'" ::?,)( ~ &' . -..::t ~ '!>7;:j ~ State Surcharge ">' 4.<' 7,/:;> Sidewalk lih7 fl -:? It:, fl -:::;> ....""'. ..... <f~'''' /&J -::;N:!> -(-.~ . "3 4) <:::>-s'"" /~.9D State Issuance Curbcut Demolition Slate Surcharge Tolal Miscellaneous Permits (E) 3/5:7'5"' TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the Clly. of Springfield, Including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. //_,.2-r Plan Check Fee: Lea ~/0-t<' /#5~ Received By: A-'~ . /'Z~~ ~/ t'PIW'!1evlewed ByO"". ~ Date Paid: Receipt Number' I!!I ~ -5'- 99' Date . Systems Development Charge Is due on all undeveloped properties within the City II mils which are being Improved. ADDITIONAL COMMENTS .1'J)J15yI, t ,1'11711 AfT ~ ;Jj b2-$-t7 I I~/" [/&/&=~///5TA"'~23:""'''''' 'l 1J.~,-pc./C#n&-~.~"'_~_f _ '~/..9)C;' .0 'O......-~o,~, S5t-~H l /%,t:f>'Y .4A;.. '-, .. ?~/';--"'-- -.-"1' .~~" ~'(~""'e::;.~ .?n ~~-- ' u........-,,/rce.-........ e:r~- ~//,~~~c p~/7' ;?lc~:....r~~~'.: / By signature, I state and agree, that I have carelully examined the completed application and do hereby certify 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 Ordinances of the Clly of Springfield, and the Laws of the State 01 Oregon pertaining to the work described herein, and thai NO OCCUPANCY will be made of any structure without permission of the Building Salety Division. I lurther certify thai only contractors and employees who are In compliance with ORS 701.055 will be used on this project. VALIDATION: . ^.A (j 0 RECEIPT NUM"~" '-\~ \J DATE PAID_}.1./'.. -4 RECEIVED B ATTACHMENT B1 . . NO. 9f//70 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ~ J~ LOCATION: .t:;19.2 J s -tt ,.c~.d.... s/. I DEVELOPMENT TYPE: d~ (~~) lOT S171= BUILDING SIZE: 1. ~ ORAIN~ IMPERVIOUS SQ. FT. 2. SANITARY SI=WFR-CITY NO. OF PFU'S 22.. (See Reverse) 3. TRANSPf1RTATTf1N SQ. Ft. ..2. f(,C..;t s- X $0.209 PER SQ. FT. $ 5"9 "1.51 X $43.26 PER PFU $ 9 5"/. 'Ii! NO OF UNITS X TRIP" RATE X COST PER TRIP 1 X /.0/ X $436.19 X X X $436.19 X $436.19 . s: 3"8' I. /0 $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 2."1- 3::z .S'7 4. SANITARY SI=WI=R-MWMC NO. OF PFU'S 22.. x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ ]3"/'/i' (Use PFU Total From Item 2 Above) HWMC CREDIT IF APPLICABLE (SEE REVERSE) ; $ 5~. ~ ~ _. IQIAI -MWMC 'iOC $ ~ ~ I" l! S SUBTOTAL (ADD ITEMS 1.2.3 & 4) 1;z.-;,~z.p 5. AOMINTSTATTVI= FFFS BAS~ CHARGE (SUB~ ABOVE) X .05 ~ /-4. Date: / Mary) Hornig. R.E), SDC"CoordinatoY $ /}(l,z/ g -2- 5' -99' IOIAI SOc. $ 2702.jf~ B2.SDC ' t"1^ I vnc Villi I \.,HL\.,ULH IIVIII IHOLt:: Number of New Fixtures]l Unit t:quivaient = Fixture Units (NOTE: For remodels. calculate only tt*l.EI additional fixtures) . . . 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).................:' Receptor For Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc., Shower, Single, Stall.....:...................................;.... .... Shower, Gang......; ;"............................................,... Sink: Bar, Commercial, Res'idential Kitchen................,;..;... Urinal, Stall/Wall..:............... .....:. ............................... Wash Basin/Lavatory, Single.................................. Toilet, Public Installation.................. ... ................... Toilet, Private....................................................... Miscellaneous: ,TANI nu'.s $-"'a- 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 ..l 2. 2 2 2 .z TOTAL FIXTURE UNITS = 4. 4 -I z.. ~ 22. CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. I ..., Year Rate per $1,000 Year Rate per $1,000 Annexed Assessed Value Annexed Assessed Value II 1979 or before $3.46 1985 $2.46 1980 3.38 1986 2.14 1981 3.32 1987 1.77 1982 3.21 1988 1.37 1983 3.06 1989 0.97 1984 2.92 1990 0.61 1985 2.73 1991 0.44 L 1993 0.15 Credit for Parcel ?r land Onl,)' If Applicable S ,-I- c.. X $ It;, ..2id = Sc;.33 (Rate X Assessed Va!ue) ----- Improve~ent. (if after annexation date) X $ = (Rate X Assessed Value) CREDIT TOTAL = $ S"~,3 .3 ,. ~) . . o !!y'ill.i!,I!!,i!!~~~ Job NO.~ NAME: SYSTEMS DEVELOPMENT CHARGE WORKSHEET ~~ !l ullAli, <; . I LOCATION OF (il~OPOSED BUI\..9I~<riIl"t .....1. ~ na A ( J fTlrr J At, , -. \ '. . Street Address If Known: ~. ) L1 Dl -,.- "0' ]V'/"" flur ~llt'J W..l-) . . . ( . ".ttN.m'~1,ChtJy~ln'N"-1Wro4tl 001 Q() PHONE: f\4Jl.Q3f1 STATE: ~ZIP i1J1J.1 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the bacld A. Sim,le Familv - Detached - Single Family home NO OF UNITS B. Sinl!le Familv - Attached. NO OF UNITS ~ , C. Multi-Familv Aoartment Manufactured home not in a park X $400 PER UNIT _= $ . X $370 PER UNIT = $ ?4/)r'J NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ $110 ,cD $IY $ 110 ,CO WPRD SDC 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) c~~~~,~QV R I&(o/~ Date