HomeMy WebLinkAboutPermit Plumbing 1992-3-9
SPRINGFIELD
.Wirt.~.
\ : ,
LOCATION OF PROPOSED WORK: 'z5'~ 7" ~'77
ASSESSORS MAP: 17~3-~~-?~
M~~ ?s~~~~/f
ADDRESS: ?,~b'
A;P~L-Z;> ~
"" - /
DESCRIBE WORK: ~;::-~~ " T
NEW REMODEL ADDITION
.....'2 .
.r
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT:
OWNER:
CITY:
CONTRACTOR'S NAME
BLOCK:
STATE:
6/~
JOB NUMBER _"9::2~ J ~./
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
~/~~
SUBDIVISION:
PHON E:
7l./?--7~7?
- .
ZIP:
Q7t:V??
?~~~.?~' 7?:> -qr-~~"-
DEMOLISH OTHER
ADDRESS,
CONST.
CONTRACTOR 1/
PHONE
EXPIRES
G EN ERA L: _____ __________________ --uu-';;r2S#c.V-"P~"K~:----~------u----------_:------------- --- ___u_____________
PLUMBING:/~Zj#4-fc::/c:::.--~-PU-~~~~- ~'9/ ?~--?:2.
MECHANICAL:
ELECTRICAL:
~UAD AREA:
/I OF BLDGS:
OCCY GROUP:
/I OF STORIES:
WATER HEATER:
<,'
.........
-\.' .
. i~' ,\
FLOOD PLAIN:
, ZONING CODE:
1/ OF. BDRMS:
", \
SECONDARY HEAT:
SO!-JARE FOOTAGE:
.. ....: .
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, insRections requested after 7:00 a.m. will be made the following work day.
,- I, Temporary Electric
1=1
Site Inspection --:.. To be made
afterexcavalion, but prior to
set Ii ng forms.
o
Underslab Plumbing/ Electrical!
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated. .
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor plumbing/ Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior to 11001'
insulation or decking.
o
.. ,
Floor Insulation - Prior to
decki ng.
!IJ
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Water Line - Prior to filling
trench.
\
o Rough Plumbing - Prior to
cover. "
- OFFI'CE USE -
LAND USE:
1/ OF UNITS:
CONSTR. TYPE:
,.". '0...
",~. "
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
, . ~'.'
o Rough Mechanical ~. P/iQ,I'--:tel
cover. .
.... .......
o
. >.\'
Rough Electrical - Priclr "to .
cover.
o
Electrical ServiCE! - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing -' Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
I
o Drywall - Prior to taping.
o Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
\ I t'\ ,- . .
o
Curbcut & Approach - After
forms are erected but prior to
placement of. concrete.
o
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.,
o
Fence - Wl1,en completed.
o
i
Street Trees .:.- When all, requi red'
trees are planted. '.... ~ '~V~:,~".
D
Final Plumbing -When all
plumbing worl, is complete.
I I Final Electrical - Wilen all
. electrical worl, is cornplele.
o
Final Mechanical - When all
mechanical wort, is cori'lplete.
o
Final Building - When all
required inspections have been
approved and building is
complE!ted.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up -' Wilen all
blocking is complete.
o Plumbing Connections - When
. home has been connected to
water and sewer.
D Electrical Connection - When
blocl,ing, set-up, and- plumbing
inspections have been approved
and the home is connected to
the service panel.
D
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
Lot Type
:~.." l..
Lot sq. fIg. ',..
'.
-. '1.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
"
~I
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
<
'.. .;
Main
1>-. .~
".
Garage
',,' .', -.,
'Carport .....
". '.
Total Value
Building Permit Fee
State Surcllarge
~
..
I-~.L.
Setbacl<s
HSE G:AR ACC
.3 THE PROPOSED WORt<. IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
N
S
, I
Ir yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
w
~ I,.,
E " .
--+---
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
!Ltjg: Z~
VALUE
FEE
.~L?
. t./t!J.~C> .
r
%..... 4'iP
--Z-'2~~
'i~~
. :,P.?':'lqvE.D; '.
"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
I This permit is granted on the express condition that the said
.: construction sh'all, 'in 31'\ resp'~cts,'cclnfo'rm tothe Ordinance
adopted by the City' of 'Spr'ingfield: '~i'~'cluding the
Development Code, regulating the const-ruc,ti'on and use of
buildings, and may be susp'eilded or:revoked at any time
t upon violation of any provis'ions of ~aid ord.i~ances.
-. '. '. Plan ChE;;ck Fee:
i Date Paid:
...
Receipt Number'
Received By:
. ,;~'i: " ".,'" ~ ."...-
....:~.:.' (A) '. ..:;:~;-=,--::~~~~' \' '\:.rlpn.~'.Revie~.e~ 13y
~ ,,-;-... , ...; ..\.... "to
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) Nq',
Sanitary Sewer
FT. I /2
FT.
Water
Storm Sewer
FT. Ii#,
Mobile Home
Plumbing Permit
Sta.le Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
.[
Vent Fan,
NO
Wood Stove/lnserllFircplace Unit
Dryer Vc]nt.
Mecllailical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demoli lion
Stale SurcharrJc
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
Date
Systems Developlllent Charge is due on all undevcloped
properlieswithin the City limits which are bcing improved.
ADDITIONAL COMMENTS
By signature, I state and agree, 1I1atlhave carefully examined
I the completed aPrllicalion and do hereby certify that all
information hereoni~> true and cOrl'ecl, and I further certify
that any and all work performed shali'be done in accordance
with the Ordinances of the City of Sprin~Jfield. ami the Laws
of the State of Oreqon perlaininf) to tile worl< dC~.;cribed
herein, and thai NO OCCUPANCY will be !lIade of any
structure willlOut permission of the Building Safety Division.
I further certify that only contractors and' employees who
are in compliance willl ORS 701.055 will be used on this
projec l.
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 remain
on the site at all times during construction.
Signature>' 'rv1..;Jl CZ ~-^.
Date
""3..-q.- '9"Z
VALIDATION:
RECEIPT NUMBER_ ??L??2~~.-
_?-7~'-;:;L
'-!&?-25-
a~
~
DATE PAID
I AMOUNT RECEIVED
...
RECEIVED BY
i
JOB NO. '?ZtP 3 V;:>
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEEr
(COMMERCIAL & RESIDE~TIAL)
NAME OR COMPANY: /#//J.1G: ~r.4/#A~
,. r, ""
LOCATION: ~~ Y . 212' "5T C' (/7-03 ';2~-Z.'/ /!>/6.00~
DEVELOPMENT TY;E: ~~~~ ~A'A~..:;> P 5~4=/';
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. \ X $0;186 PER SQ. FT. $
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is' Unknown)
t. SANITARY SEWER-CITY
\-::.
,
NO. OF PFU'S II X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
$ '/ 241. ~~
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $388.61
X $388.61
$
$
X X $388.61 $
(See Attachment C To.Determine Trip Rates)".
SUBTOTAL (ADD ITEMS 1,2, & 3) $
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
TOTAL - C ITY SDC
I
s A/'Z~
$ 'fVg. z r;
5. SANITARY SEWER-MWMC
NO. OF PFU'S
, '_,., _.....\ I...~
x $13.25 PERPFU + SID MWMC ADMIN. FEE $
(Use PFU.T6tal From Item 2 Above)
MWMC CREDIT IF APP(ICABLE (SEE REVERSE)
$
TOTAL-MWMC SDC $ -0-
TOTAL SDC $ "?'Y'.t#':2S-
~o
A~~~A~
~.. ~ "Kfjp"Burai#- r
SDC.Coordinator
FIXTURE UNIT CALCUL '-ION TABLE: Number of New Fixture Unit Equivalent = Fixture Units (NOTE: '"
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
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............................................
Urinal, Stall /WaiL....."..,.....................,......................
Wash Basin/Lavatory, Single..................................
Water Closet, Public Installation.............................
Water Closet, Private..,............................................
Miscellaneous: .
/
2 ::z
1
2
3
6
2 "'2.
6
6
1
3
2
l/Head
2 2.
2
1 I
6
4 '-/
,
I
~.
/
/
.
,
/
TOTAL FIXTURE UNITS
1/
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
$2.66
2.64
2.53
2.41
2.19
2.04
1985
1986
1987
1988
1989
1990
$1.69
1.35
1.15
0.92
0.59
0.23
Credit for Parcel or Land Only If Applicable ~t.(:be; X $
(Rate X Assessed Value)
Improvement (if after annexation date) X $
(Rate X Assessed Value)
CREDIT TOTAL = $
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential.................................. ...................... 0.4
CommerciaL.............. ........... ........ ................... 0.9"
I nd ustrial............,.............................................. 0.45
GovernmentaL............... ............... ................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT