HomeMy WebLinkAboutPermit Building 1994-7-18 (2)
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATIO~ OF PROP~E9... WORI<' ~
ASSESSOR~ ~P: \'CO'd-D\.oC'Y'")
LOT"~ BLOCK'
--
iIIt: ,
JOB NUMBER C\4 \r0<6
4t~ 225 Fifth Street
~JI Springfield. Oregon 97477
AC\ \\ rt2I\ \Jn0.LJ
, TAX LOT:\!(n (1f.J{X),
SUBDIVISION\ _~ l..10_0~
OW~E'p. cr\~(\ Qj"\ r f\'tO '(\\~~ 1:\0 J) ~~(\('.pHONE: t \l.\L\ . \d-Holo
ADD~E~:t~~r;~J 3QfYi \,htMJ' .
CITY:~)\ t (h w;!) ~ STAT~JlliJl X)f~)1'\ ZIP: ql~"1 tp)
DESCRIBE WORK: ~.f\~^ <L, ~O "f\fu{ \. ~O t\\cl Qf\(\9-.-
NEW ~ REMODEL '~ITION' DEMb),ISH OTHER
CONTRACT~'~ NAM~ C J ADDRESS'
GENERAl' 'l'Ci,.l..lC\ Qf\ c1\\'\., "
PLUMBIN; ~}f<\Qri \. n~~)OQ \
MECHANIC~ ,fu.-l..\ ct 0 f\ T f\1-).
ELECTRICAD. ~ \ \ Q A fJ oJ,t \'\J' ~ )
CONST.
CONTRACTOR .
~ \ lIq l?')
5 \~?{)
~ \.'\C\S
t n~'l~
Q:i~1d~
~oro .'5\ "lo
C\ '(\'?>-ldrW ~
L\15.Ai~
QUAD AREA: ~ ~\' ~
. OF BLDGS' \
OCCY GROUP: ~ '3 -\ Iv\
. \
. OF STORIES:
WATER HEATER: _9 ~
- OFFICE VSE -
LAND USE: \ \ \, \
· OF UNITS' '\ J
CONSTR. TYPE: 'tV.
HEAT SOURCE: W-\4,.
L-
RANGE:
EXPIRES
~.\t;\ .
q.\t\.
"n Q..
Q4
FLOOD PLAIN'
ZONING CODE:
Ll)\rL-
~
. OF BDRMS'
SECONDARY HEAT:_
SQUARE FOOTAGE: _ \\6\3
To request an Inspection, you must call 726.3769. This hi a24 hour recording. All Inspections requested before 7:00 a,m. will be
made the seme working day, Inspections requested after 7:00 a,m. will be made the following work dey,
, , ,
REQUIRED INSPECTIONS
rv1l R~ugh M'echanlcal ...: Prior to
L.Ot cover.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
O Underslab PlumblnglElectrlcall
Mechanical - Prior to cover.
r'VI Footing - After trenches are
~ excavated. .
o Masonry - Steel 'location, bond
,beams, grouting.
f'JI Foundation - Atter forms are
~erected'but prior to'concrete
placeme~t.
o Underground Plumbing - Prior
to filling trench,
rc7I Underfloor Plumbing/Mechanical
LbI. -,Prior to Insulation or decking.
rD Post and Beam - Prior to floor
L...2SJ Insulation or decking.
iXI Floor Insulation - Prior to
decking,
fV1 Sanltsry Sewer - Prior to filling
L...O.ltrench.
~ Storm Sewer - Prior to fllJlng
trench. .
~ Water Line - Prior to filling
l..L::S.trench.
. .~ " -'
~ ~ough .PI~mblng 2.-~Prlor~'to ~_
~ cover.
I'JI Roug'hElectrlcal - Prior to
l...,.O.,l cover.
~ Electrical Service - Must be
a"pproved to obtaIn permanent
electrical power.
o Fireplace - Prior to faCing
materials and framing Insp.
~ Framing - Prior to cover.
r-;JI Wail/Ceiling Insulation - Prior to
~ cover.
&DryWall - Prior to taping,
o Wood Stove - After I~stallatlon.
o Inaert - After fireplace approv~1
and Installallon of unit.
~ Curbcut & Approach - After
forms are erected but prior to
placement 0.' concrete.
~ Sidewalk & Driveway - After
excavation Is complete. forms
and'sub.base material In place,
o Fence - When completed.
o Street Trees - When.'aU.reQulred
trees are planted. --t'~, r'o 0-
,0 o~ \:...)'. 0
~ Final Plumbing - When all
- plumbing w9rk Is complet,e.
Rl Final Electrical - When all
~eJectrlcal work Is complete.
@Flnal Mechanical - When all
mechanical work Is complete.
r=1l Final Building - When all
LZ:I'i"equlred Inspections have been
approved and building Is
completed.
OOthsr
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 Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
-
Lot faces
L~I~P.
K Int~rlor
Lot sq, ftg.
Lot coverage
Corner
Topography _
Total height ~
~,
BUILDING PERMIT
~:I~ J~l ~\
Garage ,,) IV
Carport
Panhandle
Cui-de-sac
X $/SQ~
&.tlJ
14.f0
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
. :.'r1t:. \.'~/!.: , oj\r/r ~,";J ~.~..~~~,~,\''''''
;,' , Setb-cka '
h~L. HSE GAR ACe' I
IN' I
I S I
Iw
IE
:~
SYSTEMS DEVELOPMENT CHAR~O~~)cn
(B) CI I
'115'/0
,~t{~
IO~l+ ~~
(A) 0'J[ii!f'J- '
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s) N~ ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
FEE
U oQ.crJ
Plumbing Permit
State Surcharge
Total Charge
IloUro
+80 +- B.O?
(C) 172.~U
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N' ~
Wood Stove/Insert' Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
.5Of
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
Slate issuance
State surCh~~
Sidewalk lJ ft
Curbcul I (IJ ft
Demollllon
S~ Surch'R~ \) ,
" l<9.k\ Y\~ ~UD
Total Miscellaneous Permits
(E)
4.m
q.CO
<~.oo
f(n.SU
10.00
.f3~
&1S3
.!)[) 3:)
Bqo
4;-Uq:J
."'""!4t::".--:-~
TOTAL AMOUNT DUE (eXCIU~1 e{f)t~.!tl) ~. ..
(A, B, C, D, and E Combined ~'
. ,- ~ ':~.... -
.--
,'",../',
'.S THEPROPOSED WORK,tN THE. '
'-HISTOI;UCAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
APPROVED: '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thla permit Is granted on the express condlllon 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\t-\ J ./
Date Paid: .J ~
Receipt Numbo~ y
Received By: ~
~S1\~lLti
"). \'2:> ~
- ~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
~~tm~ _~dOLt.'Y1~Ltv
,~~--\,' \OW) (~)
"- cAN\OK.: \ v{loo
~~ \
~(\~~...~'0~ N'tJ
~0 ~ )~U\C1 POO~
By signature, I state and agree, that I have carefully examined
the completed application end 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 Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein, and thaI NO OCCUPANCY will be made of eny
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 .In
\. , the site at ~II t~es during ~ruc
~gnature b~t'/:_(
Date 7- I#,..q// -
, /j
VALIDATION: '\~
RECEIPT NUMBER ,~, ,- -rA .\.
, t'J ~ -:-:;.rt; ,
:::~A;DRECI(I~Dc:.--; ,.... ,y. ~-;"'... ,- ,..
RECEIVED By<l\\ to ') o'~-.7fIO.q:z-.
I
JUts NU.
CITY OF ~INGFIELD SYSTEMS DEVELOPMIIT CHARGE C\~()CE5
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ;/-,L ~ :/~,
LOCATION: l1,~<tfL:;:-~ /)/7.
DEVELOPMENT TYPE: ") ,c /?
BUILDING SIZE: ~,-
1. STORM ORAINAGF
I nT SIZE -
SQ. Ft.
IMPERVIOUS SQ. FT.
.2./?'c;,
X $0.209 PER SQ. FT. $ -?TSC:" f''7
2. ~ITARY SFWFR-rITY
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
} X U)! X $436.19
/7
X $43.26 PER PFU
$ 71 6. " F
X
X
X $436.19
X $436.19
$ ~40..>:s-
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SANITARY SFWFR-MwtlC
NO. OF PFU'S /"6 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 3/ 'I, ~ 2
(Use PFU TDtal From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ !>?, c. CJ
, ' IQIAI -MWMr. SDC $ :Llr~.~,z
SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ / '7(..0.9,2.
5. AOMINlSIATIVF FFFS
B~ ::leOVE) X .05
~~~c~t~at~rE~
$ "lY:O$
Date:
;z: - / ~- 99
IQIAI SI'll:
$ ;2.05"'8.? iT
B2.SDC .
~
FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only t~ additional fixtures) .
NUMBER OF
FIXTURE TYPE NEW FIXTURES
Bathtub......,..........,....,.....,....,.,..,.,..........,....,........,... .
Drinkin9 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, Sin91e Stall.................................................
Shower, Gang......................................................:...
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..:....................................................
Wash Basin/Lavatory, Single.................,................
Toilet, Public Installation.....................,..................
Toilet, Private.......................,...............,...,...........
Miscellaneous:
UNIT
EOUIVALENT
z
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
FIXTURE
UNITS
4
2..
'Z.
z.
li"
/'i'
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
/
I
z.
2.
TOTAL FIXTURE UNITS
=
Year Rate per $1,000 Year Rate per $1,OOD
Annexed Assessed Value Annexed Assessed Value
1979 or before $3.46 19B5 $2.46
1980 3.3B 1986 2.14
1981 3.32 1987 1.77
1982 3.21 1988 1.37
L 1983 3.06 1989 0.97
1984 2.92 1990 0.61
1985 2.73 1991 0.44 J
1993 0.15
Credit for Parcel or Land Only If Applicable 7,~r- X $ /0. tnJ-o = 5-?.~6
(Rate X Assessed Value) ------
Improvement (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ ~6 0