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Home My WebLink AboutPermit Building 1991-12-11 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 . SPRINGFIELD ;?#/~e?~ ]);p , LOCATION OF PROPOSED WORK' '96? /7 -03'-.3 '-/ -/~ 7~/?7 ,P~/C.G ~~. ??,~p /' DESCRIBE WORt<. -;z ~;or_ ~/7./~/9 ~ ADDITION X DEMOLISH ASSESSORS MAP' LOT: OWNER' ADDRF"'" CITY' NEW REMODEL , BLOCt<' STATE: ~. . JOB NUMBER 9#3'5'2 225 Fifth Street Springfield, Oregon 97477 TAX LOT' SUBDIVISION' t!?~.:<~ PHON'" 6~-9~.:<'~ ZIP' 5~~~ REQUIRED INSPECTIONS ["l] Rough Mechanical - Prior to cover. rvl Rough Electrical - Prior to LLJ cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. OTHER CONTRACTOR'S NAME GENERAl' / /V7 ~SRd!"'"~ . , CONST. ADDRESS / CONTRACTOR' ff':f?2"Y ,--"!'r~./(z>. .. .'.". '! ~Zl.~~ bi,.~S; /<"-i?tZ~'5-L PHONE 9::r ",. '.-. ..._$2: PLUMBING- MECHANICAl - ELECTRICAl' EXPIRES . - OFFICE USE - QUAD AREA: I P.. NIAJ LAND USE: 111I FLOOD PLAIN' . OF BLDGS: I . OF UNITS- I ZONING CODE: LOe.... OCCY GROUP: ~ CONSTR. TYPE: \/N . OF BDRMS' . OF STORIES: 'J. HEAT SOURCF' SECONDARY HEAT: WATER HEATER' RANGE: SQUARE FOOTAGE: <;( S. ( 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 Inspection - To be made after excavation, but prior to settlng forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. rY:l Footing - After trenches are I.t!-J excavated. D Masonry - Steel location, bond beams, grouting. rn Foundation - After forms are erected but prIor to concrete placement. o Underground Plumbing - Prior to filling trench. lKJ Underfloor Plumbing/Mechanical - Prior to Insulation or decking. rV'l Post and Beam - Prior to floor ~ insulation or decking. rv1 Floor Insulation - Prior to L,A-J decking. D Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to filling trench. IKJ Rough Plumbing - Prior to cover. ILl Framing - Prior to cover. rI7I Wail/Ceiling Insulation - Prior to l...,A-J cover. !ZJ Drywall - Prior to taping. o Wood Stove - After installation. o 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. o Fence - When completed. o Street Trees - When all required trees are planted. 121 Final Plumbing - When all plumbing work is complete. rill Final Electrical - When all L.AJ electrIcal work Is complete. IVI Final Mechanical - When all L...".6J mechanIcal work Is complete. II7l Final Building - When all ~ required Inspectlons have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Sat-Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. .0 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 lnstalled. Lot faces Jil- Lot Type . Setbacks tHE PROPOSED WORK IN THE Lot sq. ltg, Interior I P.L. HSEIGAR ACC I ISTORICAL DISTRICT, OR ON IN (.1 I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Panhandle Is I and approved by the Historical Topography Iw I Coordinator prior to permit issuance. Total height Cul-de-sac IE I APPROVED: BUILDING PERMIT ITEM SQ. FT, X $/SQ, FT. Main Garage Carport ~p7J :>r5"/ ~~ 7'" Total Value Building Permit Fee State Surcharge .... Total Fee (A) VALUE '37 ~y-;;p I '2J/, ".&> / t? 5'5'"" ~-o> I. .~Ifi" SYSTEMS DEVELOPMENT CHARGE (SDC)~~ (B) j ~'2-\ b; PLUMBING PERMIT ITEM Fixtures -::a;. Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' I Wood Stove/Insert/Fireplace Unit Dryer Vent Bxr~&/~ ~//;) Mechanical Permit /'S1"..w, Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Mlscelianeous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, c: D, and E Combined) FEE ....-;('.-?_~ ~L?_ ae> I. 6'(; 3/. ~~ -:?" -... /-5". <>r;::> 1,,::;>.'- . '7.) -:?5'7$"" (.IJt),LfL 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 constr'uction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: )~? /b Date Paid: //-/.::l.~ / Receipt Number: ~"""3D77 Received By: .4 ~ .. d--?_.-P~~ Piafi)""Aeviewed BY- /' ~ ~. '9-9/ 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 wlthout 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 a~.. al~:s during c n ructlo SignaturQ ;::t': J1f... Datp / 2.-/// ./ <? / / ./ " VALIDATION: '7~ - _ P'7T'f:::::. "'j~) l7 ...-:L)U-' J-;)- 1/ -0 I fr,nol..../i f).O/"t/ f.. ,.-v/ d / a , RECEIPT NUMBER DATE PAIr> AMOUNT RECEIVED RECEIVED BY .\". .... .' JOB NO. <=t II?:> '-\ L... 'CITY O"SPRINGFIELD SYSTEMS'~EVEL~ENTCHARGE ,:,.:~:,:., . "';:' ; ::.:;WORKSHEET . .. (COMMERCIAL &. RESIDENTIAL) .- J ,. ~ ... . "NAME OR COMPANY: 10"", "P...uc.'!'O.- . ,.- . , , -~.- .... -.. .. - ... . .-. . LOCATION: <=t (,,1 RAINeO",", '-'DfZ- . -........-'--.. . --.. 'I;"':'~~ ':~~--I L.. - 0'-\ 7.00 . .. DEVELOPMENT T,YPE: L..D~ ':;-At>p,.,.,o!<-J . ........-- --- -.- . .' ... . :"'C";" ..t.. ~.._..... r":'::::":": J ~ -' BUILDING SIZE: --...;.......-. .--_._- LOT SIZE _.~ "';':-L~~.':-, ,:; :. - SQ. 'Ft. ....- -'"'-'--- .. I. - STORM DRA I NAG E "')~:j',""':;-"__::;~~T:~;.' ~-~.'--:,.""...1 .','" '.,' (..._- -~,.~_.. ",-. . . ... .., ,........-.. .., .._...;, ' , .'.. . 04S X $0.186 PER SQ. FT. ~ 3<.:>- If Actual Imperv. Area Is Unknown) . , -_. "IMPERVIOUS SQ. FT. __d\q (.,. .':'" ~.~JSee Reverse For Runoff C~fficients .- 2. "SANITARY SEWER-CITY .-.- - . "- ,. ...... . -'." " 'f I, --'--NO. OF PFU'S -7- -.. . - . .. - (See Reverse To Oetermine Total ..... -. ~ . -- ,...-~.-.- _ -..., X $38.55 PER PFU .. . " -- ..: '$ '1..lo"\ 'b~ PFU'S)--_. -'.. .. __h"'" '" 3. 'TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X X 5388.61 - X 5388.61 $ ~ s -- I' .' dC "" X X 5388.61 .. .. . .,~ .(See Attachment C To Determine Trip Rates) 'C"," .--.. - - _. -- SUBTOTAL (ADD ITEMS tu.t2.. ~:?~. '. t... - . .t~.'i.; .-, 'j-: ~ . " , . . ~ ~.~ . . ~~ ~':l; . ' .. :::",5: 4. -<, ADMINISTRATIVE FEES -t.,;::l .,~~ $ & 3)' $::'oCo~ -- 1,2, '_~.:.:.!-"~..... :.' ..~1....~ ': . -...... ~ -. :"1" .. ..i BASE CHARGE (SUBTOTAL ABOVE) X .05 "." s' \S~ TOTAL-CiTY SOC S S>u "'2- _ .. '.J ! 5.,'SAtmARY-SEWER-M~MC.':i;U~:;"_";':,ZI,;::-'.-, c" .':'_~:._..' " . NO:",OF-PFU'S. -:--+: ,:..->il~J.13_:25':'PER~PFU .j:":;$i"O)j..n:,i:::-AoMik~:FEE ;{;.~; , ....".. _..~_. . .. --!'e,_. -it... :. -(use..PFiifdt'a1~F~t:fIUbf~'{Abovel. 0 '. . . .....-.:-:-:-..; .:-:':--:..~-=_- ..-:-:""'~ :,1._ ~~. '",_'l~ '~,..J: .:~:.:.!:-::~- ..'"~' ,.~ ~'-_:..~. :.:';~~"""'':-'~~~~..:. .....:. -..... ~ .,<V__ ,. . _ M~MC. ~R_;OII:~1::~f.~L..rH~hh~s;EE:~~YfR~~1\~;:., ::):)~.'<:"", 'Y'.::-: .: :c ...<...' .' ", .' TOTAl-MWMC SDC S ~ ~ ~.o- :.~;~ .I\/I'S/"\I'.". - .,.:...)-:-".. .:1I Kip Burdick' .....tl "". I,.., ,. ,.,...:_,..<-;.'~'.:TOTAL SOC S ?'2.I~ SOC Coordi nator':~ -"'. . .. .... ..~.. ," . - - :, . .- '" .--;. - - {:". ' .', . ...... ,... ,.' ....:..'";""r.::;.-vr....',:~. "t. " . ~ .: . ;..1'f.~."'!.-.........:;r~...._~._::~\.,':.. "'"1':"'.~.1 :;,....; '..;. " ! '-......, .,.:'u I\!- "":, ~ ::,..~J~~.!~ ,j.,'j,,~\!~l..~~..,.,:i. :'.' ,,1-i. ,~.'.'~' t . ,;\-:-.~!:..-(:\:..:\...;1... .:... . ". '. ;".' ; . . i'. ' '. " :"'~.' .. . ~ \ "';-' . ; , " I - , . . .' .... . . ,.~.:.. . . l_ ;J.. JOB NO. "lll? '-\ L.. CITY O~PRINGFIELO SYSTEMS OEVELO~NT CHARGE . WORKSHEET (COMMERCIAL & RESIDENTIAL) . NAME OR COMPANY: 10...... ?1'Uce. LOCATION: 9 c.., RAINBow 'Dl'-. I,"-O~-~"+ - n.... 0'-1"2.00 DEVELOPMENT TYPE: L..D~ - A: DD "' ON BUILDING SIZE: LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. \qc.. X $0.186 PER SQ. FT. (See Reverse For Runoff Coefficients If Actual Imperv. Area 2. SANITARY SEWER-CITY NO. OF PFU'S ( X $38.55 PER PFU (See Reverse To Determine Total PFU'S) 045' ~ 3<a- Is Unknown) $ '2.-Cc"'l 't.5. 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X 5388.61 $ ~ X X $388.61 $ $ -- -- X X S388.61 (See Attachment C To Determine Trip Rates) SUBTOTAL (ADD ITEMS 1,2, & 3) $ ::'0 Go, ~~ 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 $ \S~ TOTAL-CiTY SDC S~:U b':= 5. SANITARY SEWER-MWMC NO. OF PFU'S x S13.25 PER PFU + $10 MWMC ADMIN. FEE $ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ TOTAL-MWMC SDC $ ~ TOTAL SDC $ ?"2.\ ....... V'.~.a..:.........D...... \\/IS/""I (j Kip Burdick 'I SDC Coordinator FIXTURE UNIT CALCUlItiION TABLE: Number of New FixturesAJnit Equivalent = Fix1Ure Units (NOTE: For remodels, calculate only the ~ditional fixtures) . / NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub........... ... ........... ................ ............. ................ Drinking Fountain.. .... ...... ....... ......... ...... ........... ........ I'loor Drain....... ........... .... ....... ............ .......... ............. Interceptors For Grease/Oll/Sollds/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 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 TOTAL FIXTURE UNITS = CREDIT CALCULATION TABLE: calculate credits 'separates. 'I 7.- '-I- ., Based on assessed value. If improvements occurred after annexation date in table, 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 2.84 2.53 2.41 2.19 2.04 1985 1986 1987 1988 1989 1990 Credit for Parcel or Land Only If Applicable X $ (Rate X Assessed Value) X $ = (Rate X Assessed Value) CREDIT TOTAL = $ Improvement (If after annexation date) RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.. ........... ........................... ....... ......... 0.4 CommerciaL................................................... 0.9 Industrial.......... ............ ............................. ........ 0.45 GovernmentaL................................................ 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT S1.69 1.35 1.15 0.92 0.59 0.23 .,