HomeMy WebLinkAboutPermit Building 1994-7-18 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
OHlce: 726.3759
..
LOCATION OF PROP~E~ WORK' ~
ASSESSO'lS MAP' h::u'd..D~r{'X")
LOT: ~\ 0 BLOCK:
.
qq.\D~'d-.
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
. TAX LOT:"U/.o ~rr)
SUBDIVISION' ~ur Qf\ 6.o.AdoJ;)
OWNE'p. (J\~ 0)\ r f\'tlJ '(\\)\~ 1:\0 J) ~~(\~HONE: t \~ . \d--{ Lolo
ADDRE~~: ~~ t j~~ ~~::J fY1 \ \. ~D\ 0 0 j-' .
CITy:~\'1\ i Di ~'(j(V - STATE:!)JJJ rz~1\ ZIP: al~-' 7")
DESCRIBEWORK:~f\~^Q, ~()N\l\Jf{ \ ~ot\\nQf\C'.sL-
NEW::t-.- REMODEL ~ADDITION.' DEM~ISH OTHER
CONTRACT~'~ NAM~ E J ADDRESS.
GENERALl)'('1-u( 1 Qf\ l\'t'\.. ..
PLUMBING: ~~t1.. \. n~\joQ \
MECHANIC),. . fu..u(t 0 f\ TN-).
ELECTRICAl\' cA \ \ ~ A f ~.o.M 'iLl' [' .J
CON ST.
CONTRACTOR'
RIl\q~
5\~?n
B\'\<\S
\ ()~f"j~
qa~~~
~o~.~\Ho
q ~ "?'{drW ~
L\15.A\~
QUAD AREA: ~ ~~ ./
. OF BLDGS: \
OCCY GROUP' ~?, -\ N\
. OF STORIES" \
9 ~
WATER HEATER'
- OFFICE USE -
LAND US". \ \ \ \
· OF UNITS: . \ . ,
CONSTR. TYPE: V IV
HEAT SOURCE: \0 \1-
f-
RANGF'
EXPIRES
,\.\,;\ .
q.\l\.
,\.\ Q..
Q4
FLOOD PLAIN'
ZONING CODE: ~\(.....,
. OF BDRMS' 5
SECONDARY HEAT:.0 .
SQUARE FOOTAGE: ~ ~L
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.
o Temporary Electric
O Site Inapecllon - To be made
after excavation. but prior to
setting forms.
O Underalab Plumblng!Elactrlcal!
Machanlcal - Prior to cover.
~ Fooling - After trenches are
~ excavated. .
o Maoonry - Steel location, bond
.beams, grouting.
~ Foundation - Aftor forms are
erected but- prior to concrete
placement.
O Underground Plumbing - Prior
to filling trench.
~ Undarfloor Plumbing/Mechanical
LZ>l _ Prior to Insulallon or decking.
~ Post and Beam - Prior to floor
L..2!.J Insulation or decking.
~ Floor Insulallon - Prior to
decking.
fVl Sanitary Sewar - Prior to filling
L..Al. trench.
~ Storm Sewer - Prior to filling
trench. .
f'V1 Watar Line - Prior to filling
~ trench.
f"lVI Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
r'V'I R~ugh Machanlcal ~ Prior to
l....Cr.l cover.
[Q Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
IZlDrywall - Prior to taping.
o Wood Stove - After Installation.
o Insort - After fireplace approval
and Installanon of unit.
I:2S 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.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
[2g.Flnal Plumbing - When all
- plumbing work Is complete.
. .
I"Tl Final Electrical - When all
~electrlcal work Is complete.
~Flnal Mechanical - When all
mechanical work Is complete.
r::t1 Final Building - When all
~equlred 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 Final - After all required
Inspections are approved and
porches, skirting. decks. and...
venting have been Installed.
Lot faces
~;rype .
-?- Interior
Corner
Lot sq. fig.
Lot coverage
Topography _
Total height ~J
(?,:J:
BUILDING PERMIT
sa. FT.
\\~~.
5loD
Panhandle
Cul.de.sac
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' &..-
Sanllary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permll
State Surcharge
4.~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
'3
Wood Stovellnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State surchtj'f')
Sidewalk -:1i:t;; ft
Curbcul Co ft
Demolition
S~ Surchar~ '" __ n
I A~ . Y\UJ\. t'O I ).
'.:,"'.'.'._' .'1 1:; ii'I1:-:1: ,,. 'j ; ~ r;'i'!:;i';~.~,. .
:c :",: ,. ': ,.,..... ;;:..IJ.l:..,....
Setbecks .
I' P.L HSE GAR ACC'
.'1 N'.
Is
Iw
IE
FEE
I&;O.W
lloO.aJ
gO'
na .?O
<\.~O
C\.m .
~~.CO
~o.S')
I :~ Yo
4f,) OJ
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrICal)OJ'JIU':fJJ-
(A, B, C. 0, and E Combined) .
X s/sa. FT. - VAWE
5\0 .?Q ~o?' \~
\~ .\D', -'\~IJ>
l \':llQ
~ r::o
ID4'1+ n:'\S: ~ ~
?'1(-,~ .d M
SYSTEMS DEVELOPMENT CHARG~ ~.QG)n
(B) &()"K~' I
1J O. r:!:J)
10.00
.5Ot.%3 i.33
~')_'63
". 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.
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 Clty.of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordlnancas.
Plan Check Fee:
-~
Date Paid:
. ~"
Receipt Number: .
Received By:.\. .
Jlm t\\~ .lui
Plans Reviewed By I
'), /8.q(
Date .
Systems Development Charge Is due on all undeveloped
properties wllhln the City IImlls which are being Improved.
ADDITIONAL COMMENTS
~-xh\~r . ~U~\Ji::f)
.\.. ~+- T'. \DOCD(...QJst)
\ el\\\ t\~ ){,' \'t\ \ n()
~~\
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that sll
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 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 wllhout permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance wllh 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
~f ha property, and the approved set of pia S will remain
o the site at al)jimes dur~onst etl n.
I ature -..4/~~ t/ '<-.' 'A. fP
,!~/-;r~ f;~
Date
(\~. \'V
/
ATTACHMENT Bl nAiQ5" _
. ~BNO. ~ ,~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN~CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY:
LOCATION:
DEVELOPMENT TYPE:
#~h ~ .~,
/ i"
?~ fJ,.
.,p~
BUILDING SIZE: ;J.;----
1. STORM ORAINAGE
tOT SI7F ~
SQ. Ft.
IMPERVIOUS SQ. FT.
~/?c;,
X $0.209 PER SQ. FT. $ '7'S~, i?
2. SAtllIARY SFWFR -C ITY
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
/V
X $43.26 PER PFU
$ 71 6'. (" F
NO OF UNITS X TRIP RATE X COST PER TRIP
I X 1,01 X $436.19
$ ~~o..>~-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SAtllIARY SFWFR-MWMC
NO. OF PFU'S IV: x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ 3/'1.?2
(Use PFU Total From Item 2 Above)
HWHC CREDIT IF APPLICABLE (SEE REVERSE) $ 3'?,' CJ
. . IQIAl .MWMC SQC $ .3-K"~.....z.
SUBTOTAl (ADD ITEMS 1.2,3 & 4) $ 1'1(.0.92.
5. ADMINISTATTVF FEES
BASE C~GE (S;aBTOJPOVE) X .05
:;?'/; -;;7' ,J I _ .
%~ /r~ Date:
~ary rig. P.EV
SDC Coo inator .
$ 7Y:os
7-/.;z.- 9'9
TOTAl SOC
$ ;L05"'8.? l'
B2.SDC .
- FIXTURE UNIT CALCULA TION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only tialiEI 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:
z
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
4
2...
2.
2..
5f
J?
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table.
calculate credits separates.
J
I
z.
2.
TOTAL FIXTURE UNITS
=
Year Rate per $1,000 Year Rate per $1,000
Annexed Assessed Value Annexed Assessed Value
1979 or before $3.46 1985 $2.46
1980 3.38 1986 2.14
1981 3.32 1987 1.77
1982 3.21 1988 1.37
1983 3.06 1989 0.97
1984 2.92 1990 0.61
1985 '. 2.73 1991 0.44 ,I
1993 0.15
-
Credit for Parcel or Land Only If Applicable "$,.f(;. X $ /0. 07J-0 = J7!~ 6
(Rate X Assessed Value) -----
Improvement (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ ~60
r'