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Home My WebLink AboutPermit Building 1994-5-27 (2) RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK:_ ASSESSORS MAP' LOT: .::r9 . SPRINGFIELD BLOCK' OWNER: IrIA~ ~ _/.A/~. ADDRESS:' fr''9 'I <_. ~ ~ ~ S".... CITY' -r'p.c/7-. , STATE: _,.o..b_ DESCRIBE WORK' 11....:><:,"7-, "i?3C:;/"))&-A~"""'~ . NEW -f-- REMODEL ADDITION DEMOLISH OTHER . (~4DS3 \ JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: SUBDIVISION: '14 t/>R,I/C;;-.,u>))I.A./.$ . PHONE: _?#L;/-L ~ ZIP' "7.L1 ~, , , - CONST. CONTRACTOR . iI! 'if / '79>.- '~~j7~7 ADDRESS q17:507 GENERAL: J.lAf'7JJif.. EtJj":z::v~,, "((".t.L~~. fl~~T' . /'. 'J .eIb~l>1 a.!', PLUMBING:...4.t16E..db> VI<LU&7 - 4'~ ..... LI/'71V $'.....~. MECHANICAl' ELECTRICAL: ~)J,.n €L,~-I - n~~~~ . . M4-"bP..d < CONTRACTOR'S NAME QUAD AREA: 3~ . OF BLDGS: I OCCY GROUP: J\~+ M L . OF STORIES: WATER HEATER: EXPIRES ?~~/"FI' 9/"OV.J<;h PHONE 9-,> ~ ::'.L:> ho!?3-3?.v , , . . . .:t;i "Jl'7~.r J . ~ ~.r- .:)/3 ~ REQUIRED INSPECTIONS d Rough Mechanical - Prior to ~ cover. . ..r71" Rough Electrical - Prior to ~ cover. [""yf Electrical Service - Must be ~pproved to obtain permanent electrical power. o Fireplace - Prior to facing materIals and framing Insp. ~Framlng - Prior to cover. RJ(wall/Celllng Insulation - Prior to ~ cover. ~ryWall - Prior to taping. o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. D Fence - When completed. ~treet Trees - When 'all required ~rees are planted. . r/~/~~ FLOOD PLAIN: ZONING CODE: ~ . OF BDRMS: - 3 SECONDARY HEAT: 0' SQUARE FOOTAGE: \ \dl!~ 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. '- OFFICE USE - LAND USE: III I . OF UNITS: ,. CONSTR. TYPE:..1L.A..J "Ii? HEAT SOURCE: \.l.JIT y./ RANGE: r<v( Final Plumbing - When all I.L:>I, plumbing work Is complet.e. I'<v'1' Final Electrical - When all ~eJectrlcal work Is complete. rvf Final Mechanical - When all ~mechanical work is complete. i"'>7r Final BUilding - When all ~requlred 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 water and sewer. . o Electrical Connection - When blocking, set.up, and plumbing Inspections have been approved and the home Is connected to the service panel. . . . . ~ . . ., o T~mporary Electric ~Slte Inspection - To be made J6J. ~fter excavation, b~L,e[.lO! to settlng forms. 'SC7~) o Underslab Plumbing/Electrical I Mechanical - Prior to cover. K:7t' Footing - After trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting. ~Foundatlon - After forms are ~rected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. "f\::7r Underlloor ~lumDlns.Jj1yl_eChanicW ~ - Prior to fhsulauon or decking. K7I Post and Beam. - Prior to floor ~ Insulation or decking. K/r Floor Insulation - Prior to 7""\ decking. ~Sanitary Sewer - Prior to filling ~ trench. . I"CIf Storm Sewer - Prior to filling ~ trench. ~ Water Line - Prior to filOng ~ trench. - .. ; ~. ~ ~ Rou.gh"PI~mblng - Prior!" }2SJ...cover. ! o Final - After all required Inspections are approved and porches, sklrtln.g, decks, a'nd venting have been Installed. -,liJ Lot sq. Itg. ~O Lot coverage 25'~, Topography L 2~ Total helgh{~1' ') BUILDlN'G- PERMIT '113:\_ ~~~1b = lo3LlE14 ~lP.~) , ~ ~;~oql.p Lot faces Lot Type . X. Interior Corner Panhandle Cul-de-sac ITEM Main Garage Carport Total Val ue Building Permit Fee /O,<P +17.4.s: State Surcharge .'" . " Total Fee' I ',' " (A) I P.L. IN Is Iw IE HSE /13 91- PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' 2- //'d'J f'C Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge 4.f>O+ ~:o-o /Z.fJ 0 Total Charge (C) /72.$0 MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' '1 Wood Stove/lnsertl Fireplace Unit Dryer Vent Mechanical PermIt Issuance State Surcharge Total Permit ,5'0 7i 1> ~ (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcha~ Sidewalk r'jU It Curbcut ~ ft Demolition State Surcharge /~ ~ILJ Aatt/[T, 4-~O 5,0-0 :'1',~ / r..." 5".0 .J c;:J ," II /.33 '2'7.g;J rOn~ l~qn ~.S~ Setbacks 5 , l- THE PROPOSED WORK IN THE -"HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical . Coordinator prior to permit Issuance. .1:,..... ':_. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition Ihat the said constructIon shail,.ln all respects, conform to the Ordinance adopted by the ,City of Springfield, Including the Development Code, regulating the constr.uction and use of buildings, and may be suspended or revoked' at any time upon violation of an~o 'si lns of p.g!d ordinances. . ,aU 22J:D.BS" Plan Check Fee.. -1 ~" . .' . .. . @y . - 2 ~I ' Date Paid: I '.,..1: ' ;\ . 5' !I.. Receipt Number' ~~'-). . Recelve~)l"L--" \ f\D... ) .. /?/~, ". .:..)/5-44 'Plans Reviewed By . ,Y ~7e ., I 'Systems Development Charge is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMM~NTS I "lJ.,tD(\(\L ~lnOq l''O.lJr,w \ ~ T: IU()(X') Ca/i-r) ~~O~: (Clf.r,r) -' PAn-! .1 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 certlfy that any and all work performed 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 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 compllan~e with ORS 701.055 will be used on this prolect, I further agree to ensure that all required Inspectlons 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 pi s will remain on the site at all times dU~ con ct . X;gnatureJ-1/ pt~ Date VALIDATION: / c:::::::: REC~IPT NUMB..E9 (I,,~~) DATE PAID tC))J r .l.f1- AMOUNT REC~ (,3\ \ 5 ~\l() RECEIVED Byl'/) IJYJ. J , Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrlcal~::J--.\ \ . a') (A, B, C, D, and E Combined) 715'1{) 3f~.y:J '2 '7.e;Z ,~,__<i'?. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) . J J"1-~,.H , . o !!.'!i!I!m~!~!!t! . Job No. CMO~31 SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: t_t\(\ 4f\o f\ r1\t). PHONE:.J44 IrfJJa(o ADDRESS: ffi~ 0D 52t\tl ~j<KSTATE:~ZIP q'14rV) ~lVUiul fJn'LlJLJ LOCATION OF ~ROPOSED BUIt.qI~ ~E=n Street Address if Known: ( ) ~ r1'-1 Platt Nam~ ~(\ lot Number: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back'> A. Sinl!le Familv - Detached - l Single Family home NO OF UNITS B. Sinl!le Familv - Attached NO OF UNITS C. Multi.Familv ADartment NO OF UNITS D. Manufactured Home Park NO OF UNITS WPRD SDC _ Manufactured home not in a park $4t1\p0 { X $400 PER UNIT _= . X $370 PER UNIT = , $ X $277 PER UNIT = $ X $280 PER UNIT = $ $ALD ?J $ W $ 40a~ 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) ~ ~~.t)~i0 Community Services filision City of Springfield ,,'l / ~'"L crt Date JOB NO. '1-'fOS:J/ . . CITY OF SPRI NGFI ELO SYSTEMS DEVELOPMENT CIlARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NME OR COMPANY: JlIVe. L &-J. au., '/ ~ LOCATION: '3:1-'19 C-~ j)~ DEVELOPMENT TYPE: t;,t:.D BUILDING SIZE: LOT S!ZE SQ, Ft. 1. STORM DRAINAG~ IMPERV IOUS SQ, FT. 2. / 't' ~ x 50.203 PER SQ, FT. 0 ~7. yv 2, SANITARY SEWER-CITY NO. OF PFU'S (See R,everse) /l X 542.08 PER PFU ((' '? s 7.;;' ........... .-/ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP I X /,0/ X 5424.31 X X 5424,31 ~ -F2~,~ ------------- s X X 5424,31 s 4. $ANITARY SEWER-MWMC NO, OF PFU'S /7 x S15.125 PER PFU + SID MWMC ADM FEE S 2 ff..<,2S- (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) S 3,,2,/0 TOTAl-MWMC SDC ~ '-.......! .-/ SUBTOTAL (ADD ITEMS 1,2,3 & 4) S /~r9.$'o 5. ADMINISTRATIVE FEES rf 93. 9~ '-.... .-/ TOTAL SDC S 1'?'73. ~r :F~XTURE UNIT,CALCU~TION TABLE: r~lJmt'N 01 Ncw r;x1lJ.:ii X Ullit EqlJivalcllt = Fix1ule Unils (NOTE: For remodels. ('.1Icul~le only the. ,,<I<li:;oll;II fj'llJfl':') . , I~UI.~GEn OF l':,nT FIXTURE FIXTURE TYPE NEW FiXlunES EOUI"ALEIH UNITS -;2.. ~ 1- 13athtub........................., ....,..',.'.." ,,,.....,.',...,.',,. Drinking FOulltaill.....................,.. ........,...'...... Floor Drain..............,... ... ...", .... ,.,',. ....... ..,.. ......... .,.. ,. Interceptors For Grease/Oil/SDlids/Etc................. Interceplors For Sand/Auto Wash/Etc......,........... Ulunclry Tub /Ootheswashcr.,................. ................ OOlheswaliher - 3 Or More..................................... MobDe Home Park Trap (1 Per TraDer).................. Recep!or F9r RerrigeratorfWater Station/Elc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Singl e. Stall........... ..... ....... ................. .... ..... Shower, Gang........................................................... Sink, Bar, Commercial...:......................................... . Urinal, Slall{l'-/all....................................................... Wash BasinjUlVatory, Single.................................. Water Oosel. Public Installalion............................. Waler Closet. Privale............................................... Miscellaneous: / 3 G 2 6 G 1 3 2 t /Head 2 2 1 6 4 2.. ./ .2. :2. 2. .2. 'if TOT.'-.L FIXTURE UNITS = /'1' CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation dale in lable, calculale cred~s separates, $3,21 3.13 3.08 2.95 2.82 2.68 2.51 Year Annexed 1986 1987 1986 1939 1990 1991 1992 Rate per $1,000 Assessed Value " r I Year Annexed 1979 or before 1980 1981 1982 1983 1984 '1985 Rale per $ 1,000 Assessed Value $ 2,24 1.93 1.57 1.18 0.79 0,44 0.28 .. Credit for Parcel or Land Only If Applicable Improvement [rt after annexation date) 3.2/ X $ ~,~ (Rale X Assessed Value) X $ (Rale X Assessed Value) CREDIT TOTAL = 3.2, /0 = ----- = $ 3,.?,/O RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential............................. ............. .............. 0.4 Commercial...................................................... 0.9 I ndustrial.......... .............. ....... ...... ...................... 0.45 Governmental................................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT . . The following project as submitted has the fallowing zoning, and does nol require specific land use 225 FIFTH STREET approval. } SPRINGFIELD, OREGON 97477 Zonino t...---D~ ~~~~~~IO~2~~~~T: 7t~i03769 ~dlyJ-q4 Au;horized Signaturo '1'1.' COHPLETE FEE SCHEDULE BELOll 1. .LO!=ATI,ON OF TN!;TALLATW~ . ~,Y'0 r:\~ci~ Y\ .D'n~""A;" A. LEGAL DESCRIPTION Lt'~OB DESCRIPTION W KIiI"',"'R.AI".....G -.-- ... \ \d\2>t1 Permits are non-traftsferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days.' 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor ~\\'F (\ \=IFcrl-eIL Address I d C,I i') -:2, o:! 5-\. City l'Y\~t?,\."-. Phone 41":;-JI~9 Supervisor License Number IOoIDS Expiration Date \ 0 -, -q", C. Temporary Services or'Feeders Installation, Alteration or Relocation Constr Contr. Number f.s,?,i4S' Expiration Date q-I-i-CJ'-I Signatu~e of s~ervising Electrician ///JI7.~_ ~_AA~ ,~ Owners Name ,I,/~<?J').IIl"'1 6--v'1. ~-o/c,. . " / Address rr99 ~. .~.;l. ~ ~ Ci ty 5'r>.FL-,... Phone 744 -t.9~ . OllNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE~--------~~~ry~~-------~---- RECEIPT t: l ~ . Ifl"-l )~ RECEIVED BY: ~ f'\l [V k _ ~ - . ELE~CAL PERMIT ~LICATION , City Job Number ~1'D~ 31 New Residential-Single or Multi-Family per dwelling Service Included: 1000 sq.ft, or less Each additional 500 sq. ft or portion thereof . Each Manuf'd Home or Modular Dwelling Service or Feeder Items ~ ~ B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D. Branch Circuits unit. Cost Sum $ 85.00 ~ $ 15,00 3D $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $ 40.00 $ 55.00 $ 80.00 see nB" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 \\~~ 5.' 1'5.j-3~5 .J.6l'-\ ..=.Y}u