HomeMy WebLinkAboutPermit Building 1994-7-18 (2)
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
, TAX LOT:\lln II'PfX) ,
SUBDIVISION! _ ful.l~_O~
~~,!\0 ~HONE: 1 V~ . \d--{ ~
:::~~~~~ ~~~~,
CITY:U\\j\l (\ 1 ,'orV . -, STATE: \0 X1..f-)1\
DESCRIBE WORK:~f\'l\\ Q. ~Q~J..,t \ ~O t\\c1 Q f\C'L
NEW ~ REMODEL '~ADDITION ' .' DEM~ISH OTHER
ZIP:
Ol~1 ?J
CONTRACT~'~ NAM~ ~J ADQRESS . .
GENERA",-l..J'l'Lt j,( \ Q .\'\. .
PLUMBING: ~}[C\Q \ P.~~OQ \
MECHANIC~"~W <(-~. .
ELEcTRICA;'. 0.\ _ OJ'~U (' J
CON ST.
CONTRACTOR'
~ ll\q~
5\~?{1
~ \. f\C\~
\ ()~'l L\';)
Q a~, NE
~?,.~~
5.A\~
QUAD AREA: ~ ~Q /
· OF BLDGS: \
OCCY GROUP:, ~ '3 -\ ~
\
9 J'
· OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND USE: \ \ '- \
, OF UNITS: \. ,
CONSTR. TYPE: V IV
HEAT SOURCE: W \-t
f_
RANGE:
EXPIRES
~.\~.
q. \.t.{.
84Q..
FLOOD PLAIN'
ZONING CODE: If'')\C...;
, OF BDRMS' '- ~
SECONDARY HEAT:..
SQUARE FOOTAGE: ~\oC\3
To request an Inspection, you must call 726.3769. This Is a24 hour recording. All Inspections requested belore 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\It Rough M'echanlcal ...: Prior to -
~ cover.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
~ Footing - After trenches are
L,LS. excavated. .
o Masonry - Steel location. bond
beams. grouting.
~ Foundation - After forms Bre
erected. but- prior to'concrete
placemer'!t.
o Underground PlumbIng - Prior
to filling trench.
~ Underlloor Plumbing/Mechanical
l2.l _ Prior to Insulation or decking.
rD Post and Beam - Prior to floor
~ Insulation or decking.
(g] Floor Insulation - Prior to
decking.
IVl Sanltsry Sewer - Prior to IlIlIng
l...tC::I.ltrench.
~ Storm Sewer - Prior to filling
trench. ..., .
, .,
~ Water Line - Prior to 1I111ng
LL:::>I.trench.
r\::'I. Rough Plumbing - Prior .to,,',
~ cover.
f'ViI Roug'" 'Electrlcsl - Prior to
~ cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materlala and framing Insp.
~ FramIng - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
~Drywall - Prior to taping.
o Wood Stove - After 'nstallatlon.
o Insert - After fIreplace approvl!Il
and Installation of unit,
129 Curbcut & Approach - After
forms ere erected but prior to
placement of concrete.
181 Sidewalk & Driveway - After
excavation Is completo, forms
and'sub.base material In place.
o Fence - When completed.
[] Street Trees - When all required
trees are planted. ' . ......
~ FInal Plumbing - When all
- plumbing w9rk Is complet.e.
r"l'l Final Electrical - When all
Ip.. electrical work Is complete.
@'Flnal Mechanical - When all
mechanical work Is complete.
r.::t1 Final Building - When all
L..Z::t'7equlred Inspections have been
approved and building I.
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o PlumbIng Connections - When
home has been connected 10
water and sewer.
o Electrical Connection - When
blocking. .el.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, and
venting have been Instal/ed.
Lot faces
L~t~pe .
15:.. Interior
Lot sq, Itg.
Lot coverage
Corner
Topography _
Total hel~hl~ ~
BUILDING PERMIT
ITEM t1~_ F'T.
Main ~
~lcO
Panhandle
Cul.de,sac
x S/SQi:)
0l0.
14./0
,
Garage
Carporl
.::r1~~. \' :1~, '\r:-l::t'}~'(-...~~~f1?(,f.:""
',;' " Setbacks. . '. .
,I'F~L HSE GAR ACe'
IN .
Is
Iw
I E I
: &j[t
". THE. PROPOSED WORK,tN THE. '
. "'HISTOJ:\ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this eppllcatlon must be signed
and approved by the Historical
, Coordinator prior 10 permit Issuance.
APPRov"n. .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thla permllls 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 of
buildings, and may be suspended or revoked at any time
I upon violation of any provisions of said ordinances.
Plan Check Fee: "L'\f-\ J ./
Date Paid: \} ~
Receipt Numberu y
Received By: ~
~~~lLti
Total Value
Building Permit Fee
State Surcharge
Total Fee
'1l~5'JO
li'dJ
1-, VI.
1011+ ~
(A) Z!fJ[(i!f 'J.- '
SYSTEMS DEVELOPMENT CHAR~~~
(B) c9.V: . f)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
FEE
/i.oO.uJ
0,...... I {ouro
4.C:IJ + (3.00
(C) 172.~c)
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
NO ~
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
Totar Permit
.5Ot
(0)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State surct'Jl'\
Sidewalk U It
Curbcut It
Demolition
S'flf Surch'R~ _ \)_
\ l< g f.\ V \.Cl t\. UU
Total Miscellaneous Permits
(E)
4.ro
C1.CO
'r~.OO
l(o.SU
/0.00
.f3~
~
~
'\-l)9:)
f). \~C\4
- ~
Date
Systems Development Charge Is due on all undeveloped
properties within the City II mils which are being Improved.
ADDITIONAL COMMENTS
~')o :tIn C'L ~O 0 u...Yl. ~~
~~\" \CJ.a.D (~ )
~cAN\QX \CHorf
~~ \
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certHy that all
Information hereon Is true and correct, and I further certify
that eny and all work performed shall be done In accordance
with the Ordinances of the Clly of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure wllhout permission of the Building Safety Division.
I further certify that only contractors and employees who
ere In compliance with ORS 701.055 will be used on this
proJect.
I further agree 10 ensure that all required Inspecllons are
requested allhe proper t1me~ Ihat each address Is readable
, .
from the street, that the permit card Is located at the front
of the property, and the approved set of plan will remain
11the, site at,~1I times durl~ons ctlo
. Ig ature~/;f!I
Date' 7-1#-q./l.
, ~. (
VALIDATION: jffflA r-:t1'
RECEIPT NUMBE?j . ' I""'lit'l
DATE PAID I ~1'6 ".. '.
. ~. ~\ . . ~':';'7 j ".a.r1' ~ <"""""1i..
:~:~~;DR:~i;1\l~ 'tJllbCfP'-
,{ ..-.. .....,
TOTAL AMOUNT DUE (excludlptl"elep{r~ ..... '
(A, B, C, 0, and E Combined) r,r Ilu.'1" .":'" <I"'.r' -;:-J-,
I...... I ._ -
I
. JUBNU, .
CITY OF ~INGFIELD SYSTEMS DEVELOP~T CHARGE ~l~
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: #A-4,4 ~ r ..~ .I~.
/ /.
LOCATION: ~~\ C-~ LJA.
DEVELOPMENT TYPE' "') F /?
..
BUILDING SIZE: ~.-
1. S.rORM nRAINAGE
I OT SIlF -
SQ. Ft.
IMPERVIOUS SQ, FT.
~/?r;,
X $0.209 PER SQ. FT. $ "7StC.1'7
2. SAMlIARY SFWFR-r.TTY
NO. OF PFU'S
(See Reverse)
3, TRANSPORTATION
/V
X $43.26 PER PFU
$ 71 6. '" If
NO OF UNITS X TRIP RATE X COST PER TRIP
J X /, c) / X $436. 19
$ .p:.40.5"~-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SAMlIARY SFWFR-MWM[
NO. OF PFU'S /7; x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 3/? 7" 2
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ 3'1,' C)
. ' IQIAI -MWMr. snr. $ 2-lr.<J:-.4"4:
SUBTOTAl (ADD ITEMS 1.2.3 & 4) $ / rc.o. 92.
5. AnMINISTATTVF FFF~
BASE C~GE (Si1BTO /,\(ABOVE> X .05
~~ ~/.
%9 /;L~ Date:
~ary r ;g, P .EJ /
SDC ,Coo inator \./
.~
$ "l Y:O$
-,: - / -f2.- 9'7'
IQIAI snc.
$ ;2.05"'ii.??
B2.SDC
FIXTURE UNIT CALCULA TION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only tA-JET 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:
CREDIT CALCULATION TABLE:
calculate credits separates,
I Year
Annexed
2.
2
1
2
3.
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
4
z..
'Z.
2..
If
/'i'
Based on assessed value. If improvements occurred after annexation date in table,
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
/
/
z.
2.
TOTAL FIXTURE UNITS
=
Vear
Annexed
Rate per $1,000
Assessed Value
1985
1986
1987
1988
1989
1990
1991
1993
=
'31':.c. CJ
'J,.f{:. X $ /O.07J-r::>
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
$2.46
2.14
1.77
1,37
0,97
0.61
0.44
0.15
= ----
CREDIT TOTAL = $ ~60