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Home My WebLink AboutPermit Building 1994-7-18 (2) RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Orllce: 726.3759 . SPRINGFIELD . JOB NUMB~R.ff:1ICX'"Jf_ 225 Flllh Street Springfield, Oregon 97477 TAX LOT:\J(n ('J:'f.J..CX')' SUBDIVISIONl _ fu" ~ ~f')~. OWI:lE'R:C)\\\'\ i(\ oj'\ r f\t~ '(\'\ l:\Q Jl ~~(\~HONE: t \~ . \d-{ ~ ADDREp~: 'R>~rw;~ J...,f'J ~~~..rd \ '" CITY<.1(\ 1\ 11\ ) ,- {) (\I . . STATE: X) (C)f\ \ ,\- DESCRIBE WORK: ~ DD.'\ <L ~() N\1 0 L, \ ~ 0 t\\ c1 Qf\C'JL,- NEW::t.- REMODEL . - ~ADDITION . OEM ~ISH OTHER BLOCK' ZIP: Ol~ -, C(J) CONTRACT~'~ NAM~ f.l ADDRESS' GENERAl' \)'\.'L( J.U Qi\ f\,\\.. . PLUMBIN; ~()Jlli \. "pj. \lo ~ -" MECHANIC~,:.~__udo!":\ tJ\:t-). \ ELECTRICA;\' ~\ \ Q ~ ~ O_~ lUJ' ) CON ST. CONTRACTOR # p., lllq c:=\ 5 \'\ ?ll ~ \. f\C\~ \ . ri2fl L\';=) Q~~\1~ to~'~\\ lo ~~~.~' . ,~.Ai2R QUAD AREA: ~ ~Q , · OF BLDGS: \ OCCY GROUP:. ~ '3 -\ /IJ\ \ . OF STORIES: WATER HEATER: _9 J - OFFICE ~SE - LAND USE: \ \ \. \ :::S~::T;PE: 0 J HEAT SOURCE: \0\-\ f- RANGE: EXPIRES fj.\'A' q. \.l\. 84~' FLOOD PLAIN' ZONING CODE: J..D\c"'" . OF BDRMS: ~ SECONDARY HEAT: SQUARE FOOTAGE: ..::\ loQ3 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 ~ R~ugh M'echanlcal ...:. Prior to ~ cover. o TemporarY Electric D Site Inspection - To be made after excavation, but prior to setting forms. o Underslsb PlumbIng/Electrical/ Mechanical - Prior to cover. r<vI Footing - After trenches are ~ excavated. o Masonry - Steel location, bond .beams, grouting. ~FoundatJon - After forms are erected.but- prior to'concrete placement. o Underground Plumbing - Prior to filling trench. ro'I Underlloor Plumbing/ Mechanical Lbl-.Prlor to Insulation or decking. rD Post and Beam - Prior to floor ~ Insulation or decking. ~ Floor Insulation - Prior to decking. IV1 Sanitary Sewer - Prior to filling l.."..O( trench. ~ Storm Sewer - Prior to filling trench. . ~ Water Line - Prior to filling LL:S.. trench. r'V'I Rough Plumbing - Prior to ~ cover. f';J\ Rough Electrical - Prior' to ~ coYer. , ~ Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - prior to feeing materials and framing Insp. ~ Framing - p~lor to cover. ~ Wall/C'elllng Insulation - Prior to cover. ~DryWall - Prior to taping. o Wood Stove - After l~stallat1on. D Insert - After fireplace approv41 and Installation of unit. ~ Curbcut & Approach - After forms are erected but prior to placement of concrete. ~ Sidewalk & Driveway - After excavation Is completo, forms and .sub.base material In place. D Fence - When completed. D Street Trees - When all required trees are planted. ~Flnal Plumbing - When all . plumbing work Is complete. . . ~ Final Electrical - When all ~ electrical work Is complete. @Flnal Mechanical - When all mechanical work Is complete. r::tl Final Building - When all L..Z:J"i'equlred Inspections have been approved end building Is completed. DOther MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. D Electrical Connection - When blocking, set.up, and plumbing Inspections have been approved and the home Is connected to the service panel. D Final - After all required Inspectlons are approved and porches, skirtIng, decks, and venting have been Installed. Lot faces Lot sq. Itg. Lot coverage Topography _ Total helgh~~ \ BUILDING PERMIT ::1: \~T: J~ltD Garage Carporl Total Value Building Permi I Fee State Surcharge Tolal Fee , L~t ~pe. K Interior _ Corner Panhandle Cul-de.sac x S/SQi) 0l0. 14./0 ';..".:,- '~:l:, \"'j:' '~l'l.:"':~.~;~.IJ4't1.;i!~f,' . :',:1\:." ';;.:',:. .... '-::'_ ;;",'.l;:t'<X;". '.S THEPROPOSED WORK, IN THE _ . ""HISTOJ;UCAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes. this application must be signed and approved by the Historical Coordinator prior to permit Issuance. h~L .. I' , . N' Is Iw IE Setbacks . HSE GAR Ace'l I I I I : 1jJJt APPROVED: . " 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 or buildings, and may be suspended or revoked at any time , upon violation of any provisions of said ordinances. Plan Check Fee: ~'f-\. J ./ Date Paid: oJ ~ Receipt Numberu y Received BY:~- ~s:>a~!ili ?l5'JO 34Lf ~ 10:41+ ~ (A) (,..~'J[{i!f?-' SYSTEMS DEVELOPMENT CHAR<A~p,~ (B) ~J PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' c!J- Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan FEE J/.rJO .CD I (aUro +80 + a.ex; (0) 172..~c) N' ~ Wood StovellnsertlFlreplace Unit Dryer Vent Mechanical Perm I t Issuance State Surcharge Total Permit .50\ (D) MISCELLANEOUS PERMITS Mobile Home State issuance State sur]r~ Sidewalk U It Curbcut ' W It Demolition S'fl{' Surch'fl\~ C)_ \, }<~ k\ V\~ t\. u.u 4.ffi <:..t.ea ,-:1,.00 l(n .SU 10.00 .f3~ ~ ,...t() .rsJ I aHa' 4;l)qJ. Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excludln9 electrlCal)0 I U.l.f2- (A. B, c. D. and E Combined) . I). ~.ctt Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS ~~ trn e-X . ~O 0 II JQ \l.Ctv - lA'\' \"'. \C). U:D (.li51 ) '--- ~N\Q)( \ q (nn- ~~ \ By signature. I stale and agree. that I have carefully examined the completed application and do hereby certlry that all Information hereon Is true and correct, and I further certify thai any and all work performed shall be done In accordance with the Ordlna~ces 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 furlher 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 reada~le from the street, that the permit card Is located at the rront of the property, and the approved set of plan ill remain on the site at all times during constructlo Signature~ /f:.. ~ Date' ?:7l-;.i/ / VALIDATION: '?flA r) RECEIPT NUM~R _ l,--,....,,-.x DATE PAID ., . \B'14-- AMOUNT RECt']E~;aB3C;S. I ~. RECEIVED BY ~ \.l_) ATTACHMENT Bl ,/111 '\1"\1\4- . . .OB NO. V\'t- I I! \ CITY OF SPRINGFIELD SYSTEMS DEVELOPME~CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ;!;L4,4 ~ .~, \c:..., / /. LOCATION: 0,~cx-~ 1),/7. 3. IBANSPORT ID.illi NO OF UNITS X TRIP RATE X COST PER TRIP X /, of X $436.19 $ ~4-0..>~- X X X $436.19 X $436.19 $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ 4. SAtilIARY SFWFR-MWMr. NO. OF PFU'S _/7: x $17.19 PER PFU + $10 HWHC ADMIN.FEE $ 3/'1,~2 (Use PFU Total From Item 2 Above) HWHC CREDIT IF APPLICABLE (SEE REVERSE) $ !d, c. C) .' IQIAI -MWMC SDC $ ;z...lr~. ~2. SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ / '1(.0,92. .5. ADMINISTATIVF FFFS BASE ~GE (SU~JfABOVE) X .05 ~~: ~~. Date: ~-/1l--99 ~ary r i9. P.EV SDC Coo i nator $ '1 Y:os IQIAI Sor. $ ,U)~'iJ.? r B2.SDC . .., . '. .. t-IX TURE UNIT CALCULATION TABLE: Number of New Fixturcs X Unit Equivalcnt = Fixture Units (NOTE: For remodels, calculate only t~ 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, Residential Kitchen........................ Urinal, Stall!Wall.. :.. .....,.... ........... ..,..... ... ...... ..... ....... Wash Basin/Lavatory, Single....... ..... ............ ..... ..... Toilet, Public Installation.................. ...... ...... .......... Toilet, Private,.. ... ..... ..... ........... ..... ........... ............ Miscellaneous: :2. 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 4 2... '2. 2.. l1' /'1' CREDIT CALCULATION TABLE: Based on assessed vaiue. If improvements occurred after annexation date in table, calculate credits separates. ) I :z. 2. TOTAL FIXTURE UNITS = I - Year Rate per $1,000 Year Annexed Assessed Value Annexed II 1979 or before $3.46 1985 1980 3.38 1986 1981 3.32 1987 1982 3.21 1988 1983 3.06 1989 L 1984 2.92 1990 1985 2.73 1991 1993 Credit for Parcel or land Only If Applicable 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 'J,~r:. X $ /O.t77J-o (Rate X Assessed Value) X $ (Rate X Assessed Value) 3?':.c; CJ ------ = = CREDIT TOTAL = $ 3-;1.60