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HomeMy WebLinkAboutPermit Building 1993-3-11 (2) RESIDENTIAL PERMIT APPLICATION . Inspections: 726-3769 Office: 726.3759 SPRINGFIELD LOCATION OF PROPOSED ~ORK' 68 8 c::, ASSESSORS MAP: IR( )~():.ld~ LOT: I 7 BLOCK:~' OWNER D 'f D ADDRESS:' t.,?, / W d~~ CITY: - E--I~_CkR - / DESCRIi3~ WO~K: ,~~ pr'\ \ O-L~ I ~) ~ 0 D.iCiP f\C' 9.... i,EW ~ REMODEL \JADDITION DEJdUSf-' OTHER ~ ~ , STATE: _{JA D Sf' ~ ,0 /F- 3'tof . q,~ 2dz JOB N'.!MBER 225 Fifth Street Springfield, Oregon 97477 SI-~ ~ TAX LOT: (YjJ O{ J ) SUBDIVISION:(,!asr d'd.i~-H-fs - 1St- PHONE: h 9J;:f 17 s-1 ZIP' 97?ojL -- CONTRACTOR'S NA~ GENERAl.: /77/ ~ '''/ /- ADDRESS ~1~ CONST. CONTRACTOR' os;-~z.....9 EXPIRES #~ PHONE 6.?8!..ZSf PLUMBING' MECHANICA' . ELECTRICA' . QUAD AREA' 4R-SG . OF BLDGS: I OCCY GROup~':!J-'rM . OF STORIES' I WATER HEATER: _r ./ c'b( w~ G-, -,~ I - OFj'CE ~SE - LAND USE: 1111 . OF UNITS' \ C.ONSTR. TYPE: ~(\,) HEAT SOURCE:.fJdP RANGE: 9...) FLOOD PLAIN' ZONING CODE: L.l"'1e-J . OF BDRMS: ~ SECONDARY HEAT: 0' SQUARE FOOTAG4~~_ To request an inspection, you must call 726-3769. This is a 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. c/J Temporary Electric ~ Site Inspection - To be made ~ after excavation, but prior to setting lorms. ('S'''') o Underslab Plumbing' Electrical' Mechanical - Prior to cover. ~Footing - Arter trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting. 1\;7( Foundation - After forms arc ~ erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. ~ Underlloof"'Plumbin~chanic~ ~_ Prior t'b--,n::,uldIIVn bl ul;L..r\lllg. r\:A" Post and Beam - Prior to floor ~ insulation or decking. .c7I Floor Insulation - Prior to J.A...ldecking. ~ Sanitary Sewer - Prier 10 filling ~ trench. ~Storm Sewer - Prior to fltlir.g ~ trench. "C71 Water LIne - Prior to filling ~ trench. ~ Rough Plumiling - Prior to ~co\'er. REQUIRED INSPECTIONS J ~ Rough Mechanical - Prior to ~ Gover. 'CARough Electrical - Pdor to ~ cover. ~ Electrical Service - Must be ~approvcd to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior to cover. ~Wall/Cciling Insulation - Prior to ~ cover. ~ Drywall - Prior to taping. D Wood Stove - After installation. D Insert - After fireplace approval and insta1:atlon of unit. ~Curbcut & Approach - Arter r~orms are erected but prior to placement of concrete. ~ideWa!k & Driveway - .After !,2SJ... ~xcavation is complete. forms and sub.base matl3rial in place. o Fence - When complet~d. @treet Trees - When all IeQu;re,j ..J trees are plan tee. -. ~ Final Plumbing - When all ~ plumbing work is cornplet.e. ~ Final Electrical - When all ~ electrical work is complete. ~ t-inal Mechanical - When all ~ mechanical. work Is complete. ~Final BUilding - When all ~equlred 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 y.Jater and sewer. D Electrical Connoction - 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 porches, skirting, decks, nnd ventlng have been Installed. Lot faces 1,)', Bpe . Setbacks Isa PROPOSED WORK IN THE Lot sq, ltg, Jc:~c;' Interior p.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON ~' I THE HISTORICAL REGISTER? .> Lot coverage 33~ Corner N I If yes, this application mus Igned 7?/; N, Panhandle Is '20' I and approved b e Historical Topography ~ Iw 14' I Coordinator to permit issuance. Total height Cul-de.sac I IE 10 I BUILDING PERMIT 1$ FT. r ~r -ta-, X $/SQ, FT. Rn.-W I~,/O VALUE , !gt-ft~ - ;J:~; ITEM Main Garage Carport f I ~lt;..!r) -J+~.. i"i'--;- 4t.:.2,2.t' 23/' ~.t;..rh SYSTEMS DEVELOPMENT CHARGE (SDC) *' 1-1 <;.1 (B) '# U6i - Total Value Building Permit Fee State Surcharge Total Fee (A) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' 2.- Sanitary Sewer FT. 'Water FT. , Storm Sewer FT: Mobile Home FEE $tJ.~ Plumbing Permit State Surcharge ~.&tl Ib~~ Total Charge (C) MECHANICAL PERMIT /,-,tH) -:f.S"() q,o-o Furnace Exhaust Hood Vent Fan N' ,~ Wood StovellnsertlFlreplace Unit Dryer Vent 8~ Mechanical Permit 22...;>"0 )0,00 J .I~ ~~"'~ Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk 9/ 32... ...2"'2J's -L4. ~ It Curbcut It Demolition State Surcharge P/..A;U A1r.vI.eJ A1111L~r. 2~'). 4/,37 Total Miscellaneous Permits (E). TOTAL AMOUNT DUE (excluding .e,lectriCal),.21 J(P?-~ (A, B, C, 0, and E Combined) . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is grc;nted 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. , ."7 ik1 ""tJ ' :3 ~O . orflQ Plan Check Fee: -k-LL~ _ z." 7. S'-! '2 - 2-6 -'1 '? . - '7 ~ -1 &?JC:;; ~'C' 2.. Date Paid: Receipt Number. Rece~: (}.../~ PI~~~ 3-/0 -'7.:1 Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMEN:rS \~t;h ~T: fry 57?) ./ dnm.LDn-t~: ICJ.ffl(") ell)) fJ'isfG t;L... 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, and I further certify that any and all work performed shall be done in accordance with the Ordinancf;:s of the City of Springfield, and the Laws of the State 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 cert!ly tl1at only contractors and employees who are in compliance with CRS 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 ~::u:~e 7J;::071fJJn~ Dato :1// r /57 \ / , ( VAll DATION: RECEIPT NUMBER 77/-7 Y/0> ..v 29-7 ?.. ~.3 ~~- DATE PAID AMOUNT RECEIVED RECEIVED BY , -- - -------- -----~- -- - c~r: ~s+ &.0 ~ /~5.cNJ 5~ 7,2S , 7 ~ ~~/S-2,';2.S" -~- - ---- >. ~ - - - +- - ,(~- - - I - P!- 7E-/ 6-~d.~ ~4.~ ~ /S5~aJ 0r;A-J ~ ~~ ~~~-.......... . . JOB NO. o,~O-z.<l2- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: -04 1;> HeMe":? :f"NL LOCATION: "giG. Fo~SYTHIA DEVELOPMENT TYPE: LofZ.. - Nc.N SflZ If(O-z.62-1---Z- - tJ5foCJO BUILDING SIZE: 1. STORM DRAINAG~ IMPERVIOUS SQ. FT. LOT SIZF SQ. Ft. "1:J'>7(" 0 X $0.192 PER SQ. FT. c; (p '-f f:, I'?) --- --- 2. SANITARY SEWER~CITY NO. OF PFU'S (See Reverse) /1 X $39.78 PER PFU C-II (,oi) --- ---- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP / X I, DOS X $401.05 C '-ftJ~o0 -- - X X $401.05 $ X X $401.05 $ - SUBTOTAL (ADD ITEMS 1,2, & 3) $ 17G.<I ~ 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 TOTAL-CITY SDC (( 9'l?~) , --- $ l'ift;z '{3 5. SANITARY SEWER~MWMC ,,, NO. OF PFU'S fq, x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ZSS- (Use PFU Total From Item 2 Above) V<- ~,,'t3.. LJc.. . \J Kip Burdfck SDC Coordinator ~'/ I /12;, $ '-/ q 73=... TOTAL-MWMC SDC~~~ , - TOTAL SDC $ '20 ~I ~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) FIXTURE UNIT CALCULATlctfrABLE: Number of New Fixtures X un.uivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT EQUIVALENT 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 fWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single StalL..............,...........,...........,.,....... Shower, Gang.....................,........."..........,.,............ Sink, Bar, CommerciaL...........,...........,..........."....... Urinal, StallfWall..,..,............,.,.......................,.......... Wash Basin/Lavatory, Single..,........................,...... Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: f 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 I I I :2. 1.- TOTAL FIXTURE UNITS , , FIXTURE UNITS 'J. 'L 7~ 'J_ 1... ,. /<(, 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 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2,60 2.46 2.33 1985 1986 1987 1988 1989 1990 1991 Rate per $1,000 Assessed Value $2.16 1.90 1.60 0.25 0.87 0.50 0.16 Credit for Parcel or Land Only If Applicable JLt:l7~ Z.~3> X $ /7.57 -r, - (Rate X Assessed Value) X $ = (Rate X Assessed Value) =$ '/07_2.- CREDIT TOTAL ~ / Improvement (n after annexation date) 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