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Home My WebLink AboutPermit Plumbing 1991-9-16 '....".. ,: RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769""'; Office: 726-3759 .. SPRINGFIELD LOCATION OF PROPOSED WORK: '"'2?~' - , \ A.SSESSORS MAP: I? -;::, '"3-"2.~" -:::a. <../ " /A/C'?"'2.' Lc-~N..4'-?f-D ADDRESS: go /:'~A-~/~.;'" ~... - '?7PPth~. -/ DESCRIBE WORK: /N-P'.NL' ~~~~-J /':9 . ~~J~ LOT OWNER: CITY' NEW REMODEL ADDITION ELECTRICAL: ~/' BLoCK: STATE: ~. JOB NUMBER 9'//&8::> 225 Fifth Street Springfield, Oregon 97477 TAX LOT: t::!J ~ S-e:>O DEMOLISH OTHER SUBDIVISION: PHONE: ---;.72t:::-7~ YS- ZIP: ~/ ~ --> '7 _5'"~..~~. EXPIRES . P'HON E S--~;2, ~~ 3/"3' , . - OFFICE USE - ~UAD AREA' LAND USF' FLOOD PLAIN: 1/ OF BLDGS: # OF UNITS: ZONING CODE' OCCY GROUP: CONSTR. TYPE: # OF BDRMS: # OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGE: SQUARE 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, inspections requested afte~ 7:00 a.m. will be made the following work day. D Temporary Electric , 0 Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing! Electrical! Mechanical - Prior to cover. D Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. , 0' Foundation - After forms are erected but prior to concrete ' placement; D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical - Prior to insulation or decking. D Post and Beam - Prior to floor insulation or decking. D Floor Insulation - Prior to decki ng. IVl Sanitary Sewer - Prior to filling ~ trench. o Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - p,rior to cover. o Rough Electrical - Prior to ' cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wall!Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stove - After installation. D Insert - After fireplace approval and installation of unit. 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. D Fence - When completed. D Str~et, Trees -:- When all required' trees are planted. . o Final Plumbing - When all plumbing work is complete. [J Final Electrical- When all electrical work is complete. o Final Mechanical - When all mechanical work is complete. D Final Building - When all required inspections have been ap'proved and building is completed. ~ Other ~~~ t ~Y-~ -) Z'"C2/'C ,O/~~ MOBILE HOME INSPECTIONS D 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. D Final - After all required inspections a're approved and . porches, skirting; decks, and venting have' been installed. Lot faces Lot Type Lot sq. ftg. Interior Lot coverage Corner Topography Total height Panhandle Cul-de-sac BUILDING PERMIT ITEM SO. FT. X $/SO. FT. Main Garage Carport Total Value . Building Permit Fee State Surcharge Total Fee (A) I P.L. IN Is Iw IE VALUE SYSTEMS DEVELOPMENT CHARGE (SDC) (B) % Y. ?e:> PLUMBING PERMIT ITEM Fixtu res Residential Bath(s) NO Sanitary Sewer FT. L.~ Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Cu rbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE .....2 -5'. COO> ~.c;. -e:> /.7S ~..2'> "3~. ~5 .".'~ Setbacks IS THI 10POSED WORK IN THE HISTOFm~AL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. , HSE GAR ACC 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 City 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 ordinances. Plan Check Fee: Date Paid: Receipt Number' Received By: Plans Reviewed By Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS By signature, I state and agree, that I have carefully examined the completed application and 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 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 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 remain on the site at ~~s du~ng construction. Signature ~~_ ~- ~6 - ;1/ Date VALIDATION: RECEIPT NUMBER -:< / 3>.1 ? DATE PAID 9.~-9' / , AMOUNT RECEIVED -3 ~~~.s- RECEIVED BY a~e~ . , .,. JOB NO. '71/~~? CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (tOM~ERtIAL & RESID~~TIAL) .' . NAME OR COMPANY: 1~~2. c.c-~~y-~~ .... , LOCATION:-270 Q -57. . DtVELOPMENTTYPE:~Ah.____/ C-Y/~7: ~~~ . w p _ - r,.- BUILDING SIZE: LOT SIZE 1. STORM DRAINAGE IMPERVIOUS SQ. FT. X $0.186 PER SQ. FT. $ , (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) " ",' ~~~~ SQ. Ft. \ " 2. SANITARY SEWER-CITY NO. OF PFU' S 9 X $38.55 PER PFU (See Reverse To Determine Total PFU'S) $ -;;;~'. q ~ -. -' 3. . TRANSPORTATION "':.> " NO OF UNITS X TRIP RATE l COST PER TRIP X. X X $388.61 X $388.61 $ '. $ X . X $388.6'1 $ (Se~ Attachment C To Determine Trip Rates) SUBTOTAL (ADD ITEMS 1,2, & 3) $ ~Y~.9. S' 4. ADMINISTRATIVE FEES BASE CH~RGE (SUBTOTAL ABOVE) l .05 $ /7. ~s: TOTAL-CITY SOC. i..%"Y 3~ 5. 'SANITARY SEWER~MWMC ". -~. . . . NO'. OFP'FU' S . x $13.25 PER PFU + $10 MWMC ADMIN. FEE $ . (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ Kip Burdick SDC Coordinator TOTAL-MWMC SDC $ TOTAL SDC $ FIXTURE UNITCALCULATIOerABLE: Number of New FixturesX Uni' For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES Bathtub.,...............,.".........."".,............,....,.............. . Drinking Fountain..,.,..,.,..,........"".....,.. ......".". ........ Floor Drain.......... ,........,. ...,..."..",......"" ..........."".... Interceptors For Grease/Oil/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc,................. Laundry. Tub /Clotheswasher,......., ...... .................... Clotheswash'er' " 3 Or More....................:...:.:....::..... - Mobile Home Park Trap (1 Per Trailer).......,.......... R.eceptor For Refrigerator /Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.; Shower, Single Stall..........,., ,.,. ~...:.,........;, .:............. Shower, Gang.......",.........,...,.,.............."...,..:........, Sink, Bar, Commercial.,..., ,...,..,........,.. ....."" ,.......... Urinal, Stall /Wall.......,...,........".".......,.,............,....... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation,...........................: Water CIc).set, Private..,...,..........,.".., ,.....",.........",.. Miscellaneous: . . I .~. . ~... ......1, " ..) I . 'j I ( TOTAL FIXTURE UNITS ... vivalent :: Fixture Units (NOTE:. ) UNIT FIXTURE EQUIVALENT' UNITS 2 1 2 .' 3 '6.- 2 6 6 1 3 2 1/Head 2 2 1 6 4 <. .2..... I y ? 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 1979 or befDre 1980 1981 1982 " 1983 1984 $2.66. 2.64 2.53 2.41 2.19 2.04 1985 1986 1987 1988 1989 1990 Rate per $1,000 Assessed Value $1.69 1.35 . 1.15 0.92 0.59 0.23 Credit for Parcel or Land Only If Applicable Improvement (if after annexation date) X $ (Rate X Assessed Value) . X $ (Rate X Assessed Value) CREDIT TOTAL RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential......................... .'.............................. 0.4 Commercial............ ............... ... ............,... .....,.. 0.9 Industrial..................,....:.,....:............................ 0.45 Governmental..........."............;......................... 0.5 1/ 4 IY/f = $ IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT