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Home My WebLink AboutPermit Building 1994-12-15 (2) OWNER: \'J\~\~~ ~~'t._" ADDRES~' '\)r'\ 9-...(~ ~\ Q -~ ' TJ. ")()- Q.X\.L ~ DESCRIBE WORI<' ,Q... '\='. Vo [\\0.0 f\l'Q..J NEW f- REMOD~: ( . , , CONTRACTOR'S NAME .l\ .....^~ ADDRESS GENERAL:(\C\.l\OG~. WJ\\ lQl)J, PLUMBI~G: ~\~ MECHANICAL: .~ ELECTRICAL: ~ ~J RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 O(fJce: 726.3759 LOT' CITY: QUAD AREA: ~,,{=; · OF BLDGS' \. OCCY GROUP: t\~~ · OF STORIES: . ~ (1 WATER HEATER: . BLOCI" . C\4 \447 JOB NUMBER STATE: " 11\ \) ~ t7r\ ZIP: C{f'f\QS f"V( R~ugh Mechanical....:. Prior to ~ cover. ~ Rough -Electrical - Prior to ~ cover. f'V'f' Electrical Service - Must be ~approved to obtain permanent electrical power, f'V'( Fireplace - Prior to facing ~ materIals and framing lnsp. ~ Fr8~lng - prior, to cover. I ~ Wall/C'elllng InsJlatlon - Prior to ~cover. D Underground Plumbing - Prior K7'1 to filling trench, ~ Drywall - Prior to taping, 1'\:7( Underllo~lumbl~echanlc~ ~ - Prior tvlh::JulBtjOn ur Ut:CKlng. D Wood Stove - After Installation. ~Post and Beam - Prior to floor )C>{ Insulation or decking, ADDITION DEMOLISH' 'j 'OTHER CONST. ;-> CONTRACTOR' ? 111.8 ~~h . 'J!{oPR4 / - OFFICE USE - LAND USE: \ \ \ } · OF UNITS: \ CONSTR, TYPE:-1LN HEAT SOURCE: ~ G RANGE: G . EXPIRES /./S.q"" Shq(~ I~ '~::\~=4 0'?~'Y~ PHONE FLOOD PLAIN' ZONING CODE: -.U'1 '--' . OF BDRMS: L\- SECONDARY HEAT:' f\J SQUARE FOOTAGE: a~ (p 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, REQUIRED INSPECTIONS ~omporary Electrfc 1':71' Slle Inspection - To be made ~ after excavation, but prior to setting forms, (S t}1 t ) D Undersrab Plumblng/Eleclrlcal1 . Mechanical - Prior to cover, r<;;>( Footing - After ,t, renches are ~ excavated. " D Mesonry - Steel location. bond .beams. grouting. ~Foundatlon - After forms are L..6.llerected but prior to concrete placement. K7f" Floor Insulation - Prior to ~ decking, 0;;;r Sanllary Sewer - Prior to filling ~trench, ~ Storm Sewer - Prior to filling ~ trench. ~Water Line - Prior to filling ~trench. !\/rRough Plumbfng - Prior. to ~cover. D Insert - After fireplace approvsl and Installation of unll, I':7f Curbcut & Approach - After ~ forms are erected. but prior to placement of concrete. rtA-Sldewalk & Driveway - After )6.J excavation Is completa, forms and sub-base material In place. D Fence - When completed. /r"?'nstreet Trees - When all required ~trees are planted. . r'V1' Final Plumbing - When all ~ plumbing work Is complete, . . ~ Final Electrical - \N.hen all electrical work Is complete. (. ~Flnal Mechanical - When all ~mechanlcal work Is complete. R71"Flnal Building - When all ~ ~equlred Inspections have been approved and building Is completed. ,k8r Other. _4A-S l./~ MOBILE HOME INSPECTIONS D Blocking and Set,Up - When all blocking Is complete, D PlumbIng Connoctlons - When home has been connected to water and sewer. D Electrical Connection - When blocking, set.up, and plu"lblng InspectIons have been approved and the home Is connected to the servIce panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. ,'~ . .' '" ,; ;....';.~:~.\f:~.i- _S THE PROPOSED WORK. IN THE - ' Lot faces 4- Lot TYP. Setbacks. Lot' sq, -ftg;' , tf!:5S'D v-'Interlor !P,L. HSE GAR Acc'l HISTORICAL DISTRICT, OR ON IN I 'THE HISTORICAL REGISTER? Lot coverage ~o Corner j~ II yes, this application must be signed $,7?.. Is I and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit Issuance.. Total ~elght 2~,S" Cul-de-sac /B /6 IE /2- I APPROVEr>' . $/SO. FT. a VAWE a\D'?O ffim. \~.\l)" . _~~ l ~ :'v~. ,,; C +1 ;~-~ S5Z f:S SYSTEMS DEVELOPMENT CHARGE (SDC) $.23?1.", .' Total Value Building Permi I Fee Stale Surcharge ZS,81+-1S':rtf Tolal Fee (A) (B) PLUMBING PERMIT ITEM Fixtures . Residential Bath(s) N' ~ Sanitary Sewer FT. -Water! FT., Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge 1,'" + 5,76 (C) Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' 4. Wood Slove/lnsert/Flreplace Unit Dryer Vent ~A5 iJ.tL~;fA),t{ Mechanical Permit lssuahce State:Surcharge j,S"3 r-, '12. Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk 7/ . It Curbcul 2/0 fl Demolition State Surcharge TOlal Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, Co 0, and E Combined) FEE _1'5' 2.f"Q /s-,.{! .2,1:)7. ~ I c" ,0 .. 4,5'0 /2. ,tU> 3<:t-d _C),co _-:?t),S'o /0,"'0 ~ 'IS 4'2.'S" :2.tJ. '"S /::1.., ,'10 31-.~S _3??~S BUILDING VALUE, PLAN CHECK. AND BUILDING PERMIT' - . This permit Is granted on the express condition that the said construction shall;ln all respects, conlorm to the Ordinance adopted. by the ',City .of Springfield, Including the Developm'ent C'ode, regulating theconst;uctl'on and use of buildings, and may be suspended or revoked at any time upon violation of any proviSions of said ordinances, Plan Check' Fee: ~~' ~ 'qzr " , ")1: } 1 .nl') , Date Paid: f_ Receipt Number' '. ~ "!l~ Rec;0 ~I.~,. Plans Pievle~ " - . '/~/''? , . Date ' J Systems Development Charge' is due, on .all undeveloped _'. . ~ f I properties within the City limits which are being Improved, ADDITIONAL COMMENTS ; , Jrtt,\,\ \ (M()J/r~ w~J J " -I ~ c\N\9 "1.--: \C.\l DC) \~+I'. r05,~')() (lJ1J1j)(),'do, ~'\~0 \ 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 Ordinances of Ihe 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 certify that only contractors and employees who are In compliance with ORS 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 on the site al all times during co~strdc~n, Slgnatu~ 0().U1 10~ I Date' ( 2..1 W !3-,'L/ VALIDATION: RECEIPT NUMBER /-1Y7fl::<:J- DATE PAIr> /:2.-y5"-?Y AMOUNT RECEIVED 39-.'2.. 4,:'S'~ RECEIVED BY f~~ ~~. ATTACHMENT B1 -. . .JOB NO. 9'?/-f<f17 CITY OF SPRINGFIELD SYSTEHS'DEVELOPHENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ~ ~/t..c.. LOCATION: ~x8'7 F~ DEVELOPMENT TYPE: 51'~ BUILDING SIZE: 1. SIQBM nRAIN~ IMPERVIOUS SO, FT. ~1c, 1 2, SANITARY SFWFR-r.ITY NO, OF PFU'S ' 23 (See Reverse) 3, TRANSPORTATION, LOT SIZE SO, Ft. X $0.209 PER SO, FT. ~/S, G~ X $43,26 PER PFU ($ff'?,~ NO OF UNITS X TRI~ RATE X COST PER TRIP X /,~/X $436,19 X X $436.19 (!4-fO. S~ $ X X $436,19 $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 1'15'/./3 4, SANTTARY SFWFR-HWMr. NO. OF PFU'S 23 x $17,19 PER PFU + $10 Mv.'MC ADMIN.FEE $ -905-.:37 (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) 1J~./3 . IQIAI -HWMr. snc ~j ,...2:~ SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 2 2.~ d.3 7' 5. AnMINISTATIVF FFFS BASE CHARGE (SUBTOTAL ABOVE) X .05 .~~ fbl 7~~ ~' Date: /HaryiH~rmg. p, . /' SOC cro6rdinator ~3.~?-) 9 -;2. 7-'1'7- TOTAl sac $..2 :5 i/. 19 B2.SDC . FIXTURE UNIT CALCUL.ON TABLE: Number of New FiX_~ Unit Equivalent = Fixture Units (NOTE: For remodels, calculate only the liE! additional fixturesl NUMBER OF NEW FIXTURES FIXTURE TYPE 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 RefrigeratorlWater StationlEtc......., Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall.,..................,................,..........,.. Shower, Gang"... .......................................... ........... Sink: Bar, Commercial, Residential Kitchen.......,..........,..,.. Urinal, StallIWal1. .:...."",..".,.,..."...,.....,.,...""......,..,. Wash Basinllavatory, Single,..",....,........,..".."...... Toilet, Public Installation",..."".,."... ,........,.',......, ,. Toilet, Private.."",.."",..",...".., "..",...,..,......."".,. Miscellaneous: ,TMv,rt>.I!'.s ,S,INk .< I I s :? TOTAL FIXTURE UNITS UNIT EOUIVALENT 2 1 2 3 6 2 6 6 1 3 2 llHead 2 2 1 6 4 ..z = FIXTURE UNITS 4 z. 2. ~ /2 z~ Based on assessed value. If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: calculate credits sepa'rates. ~Year I Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983 19,84' 1985 $3.46 3.38 3,32 3.21 3,06 2,92 2,73 1985 1986 1987 1988 1989 1990 1991 1993 Credit for, Parcel or Land Only If Applicable 3.46 X $ 2S.'l1o (Rate X Assessed Value) X $ (Rate X Assessed Value) Improvement (if after annexation date) = = Rate per $1,000 Assessed Value $2.46 2,14 1.77 1.37 0,97 0,61 '0.44 0.15 ?'?,/3 ----- CREDIT TOTAL = $ 'iT'?,/3 . o yy"i!I!!!!,l!!~!!~ ., Job No. q41111 SYSTEMS DEVELOPMENT CHARGE WORKSHEET PHONE: ~ .\\\tn NAME: (!n.nOlilil ~ ADDRESS: \ D(Q.&P' ~\o'2t)-, F ~ STATE:~IP~ - LOCATION OF PROPOSED BLJILD~A~: r-J. ,.~. . ........ ' '. . Street Address if Known: _ I 0 ~~. I i-UY, } . . , P1"'N,~ ~, ~'" 'o<N"ffi""IID1DZ.2lJ'>SW 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back'> A. Single familv - Detached \ Single family home NO Of UNITS I .. B. Single familv - Attached NOOf UNITS C. Multi-familv Aoartment NO Of UNITS D. Manufactured Home Park NO Of UNITS WPRD SOC Manufactured home not in a park $400~ X $400 PER UNIT _= X $370 PER UNIT = '$ X $277 PER UNIT = $ X $280 PER UNIT = $ $110 .ro $Rf $1Dn~ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAL WPRD NET SOC ASSESSED (If SDC reduced for Credit> \iffi) ~ "^ I? ) Community servic~~ \8v \s/Q4 Date