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Home My WebLink AboutPermit 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'