HomeMy WebLinkAboutPermit Building 1995-3-15
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Neill
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/7&3
ASSESSORS MAP:
~
LOT:
OWNER:
ADDRf'"''
CITY:
DESCRIBE WORK:
NEW -t-- REMODEL
ADDITION
-8
SPRINGFIELD
.
95()z/D
.'?4
BLOCK'
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LJ1YLQ /
STAT'"
OR.
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
La..I/1,f>./
__ -:.26~ /3
TAX LOT: ...
SUBDIVISION: -U/VAI'N J//t:u,
PHONE:
{<!-(.,-tqs/
.J-.h~
DEMOLISH
OTHER
ZIP: 97<1-; '7
CONTRACTOR'S NAME
1\" V\ vu ">
CONST
ADDRESS CONTRACTOR'
J\J 0 weJt. . <=\12..1 PrfSU>U- ~IA oS
PHONE
7'fh -79'::/
GENERAL:
PLUMBING'
MECHANICA' .
ELECTRfCAI .
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
\ \\\\J\ 0
\l., ~ N\
61
WATER HEATER'
- OFFICE ~SE -
LAND USE: \ \ \ \
. OF UNITS' \
CONSTR. TYPE: ~}J
HEAT SOURCE: r: ("51
t:... .
RANG'"
EXPIRES
111.L.1/5 )'
FLOOD PLAIN:
ZONING CODE: illU
. OF BDRMS: -::z....
SECONDARY HEAT: =1;0
SQUARE FOOTAGE: ,3\01
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. Inspectlons requested after 7:00 a.m. will be made the followIng work day,
o Temporary Electric
~Slte Inspection - To be made
~after excavation, but prior to
settIng forms. ~tJ;?v
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
~Footlng - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
dFoundatJon - After forms are
~ ~rected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor PlumblngJ Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
~ Floor Insulation - Prior to
~decklng.
l\:::1' Sanitary Sewer - Prior to Wllng
~ trench.
)s;71 Storm Sewer - PrIor to filling
~ trench.
dwater Line - Prior to filling
~ trench.
rv,- Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~ Rough Mochanlcal - Prior to
~cover.
~Rough Electrical - Prior to
~cover.
~lectrlCal Service - Must be
approved to obtain permanent
<3 ectrlcal power.
~ Fireplace - Prior to facing
~materlals and framing Insp.
~ramlng - Prior to cover.
rc:7I' WalllCelllng Insulation - Prior to
J.6..l.cover.
@DryWall - Prior to taping.
o Wood Stove - After InstallatIon.
o Insert - After fireplace approval
and Installation of unit.
1\7'1 Curbcut & Approach - After
~ forms arc erected but prior to
placement of concrete.
r\-:;r Sidewalk & Drivews\, - After
~excavatlon Is complete, forms
and sub-base material In place.
o Fence - When completed.
~ Street Trees - When all required
~rees Bre planted.
U1 Final Plumbing - When all
~ plumbing w9rk Is complete.
.~ Final Electrical - When all
~electrlcal work I~ complete.
f)(f Flnal'lMochanlcal - When all
~ mec~anlcal work Is complete.
M 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 Connecllons - When
home has been connected to
water and sewer.
o Electrical Connecllon - 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.
1- " , .',..,'
. . i ~ _ ";1 "'({ :~~~. , IS THE PROPOSED WORK IN THE.
Lot faces L~ Setbacks I I
Lot sq. Itg. I PL. IHSE GAR ACC HISTORICAL DISTRICT, OR ON
_ Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, Ihls application must be signed
Topography ~t~c> Is I and approved by the Historical
Panhandle Iw I I I Coordinator prior to permit issuance.
Total height 2.2i:4" Cul.de.sac lLLLL._
APPROVED:
BUILDING PERMIT
ITEM sa. FT.
X $/SO. FT.
,~~.:>
/fJO
Main
":2/:)5'/
/tJ <; /;,
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge 25".11 + /5, D8
TOlal Fee
(A)
VALUE
_/./ ~2h (p
" /f/!>~i
/3:vrr
')/) 2..7 .r
10 .2.1-
,c::4, <; 7
- .
SYSTEMS DEVELOPMENT CHARGE (SDC)
:2.5~5.7D
(8)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal 8ath(s)
N'
~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Stale Surcharge q, ~ ~ --f- $"", '7 6
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Van t Fan
N' .3
Wood Stovellnsert/Flreplace Unll
Dryer Vent
_~ UAM:.; u.y'rI
Mechanical Permit
Issuance
State Surcharge I.' ~ f ' S 3-
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
/dO fl
'$6 fl
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
FEE
/72. ~o
I~:(I
'2A77'(
.~
t::... 0.0
4. /".0
'9,$--0
<.&0
'::;-.-0
27>0
//?O€>
"'2 .7-1
3"7.'11
1<=j',Oo
I,;'.~I/)
3f,~
TOTAL AMOUNT DUE (excluding electrical) ~!-!--.~'
(A, B, C, D, and' E' Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
conslructlon shall, In all respects, conform 10 Ihe Ordinance
adopted by the City of Springfield, Including the
Development Code, regulallng 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: ::;;>~ 7'
_ 2./2-/15'"
Receipt Number: 1&0 3///
Rece~ved B ' ./(~~
.~
Plan eviawed By
Date Paid:
.J.1r ~~
7'D}"te
Systems Development Charge Is duo on all undeveloped
properties wllhln the City limits which are being Improved.
ADDITIONAL COMMENTS
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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 Ihe City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thaI 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 re~ulred 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 prop~e approved set of plans will remain
on th~~1 tlmy! during con:(u~n. ./
X;gna~~?/J'A/./2 /}/ &wt/Y'/C.
Date Yo/r5
VALIDATION:
RECEIPT NUMBER . ~ \f~f:..
DATE PAID ~ \S .LL.
AMOUNT REC~ s:; g... '" '7
RECEIVED BY
~OB NO. 15'0 Z/O
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
ATIACHMENT B1
NAME OR COMPANY:
LOCATION: Cfo'l
DEVELOPMENT TYPF'
BUILDING SIZE:
D~";H15 f DiA-fJtI€. It/OWAI(
f
PRf:SLo" ,I ME:.
1-.D,il..
,"'~W S.r::/Z..
I.OT SIn:'
SQ. Ft.
1. STORM nRA TJ:lAGE.
IMPERVIOUS SQ. FT. n 81
2. SANTTARY SFWFR-rTTY
NO. OF PFU'S . 7-1
(See Reverse)
3. TRANSPORTATTON
X $0.209 PER SQ. FT.
($ '1''1 ~ )
~
, X $43.26 PER PFU
($ I 1c:.60"=' )
NO OF UNITS X TRIP RATE X COST PER TRIP
X \.0\ X $436.19
X X $436.19
X X $436.19
($ f,I'iO~ )
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3)
z?>
$ :z.,oz.'3-
4. SANTTARY SFWFR-MWMC
NO. OF PFU'S "2-, x $17.19 PER PFU + $10 HWMC ADMIN.FEE $ '-/7'i!1-
(Use PFU Total From Item 2 Above)
$ 55 7j..
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
IQIAI -MWMr snc ($ 'ilP,"'~ )
SUBTOTAl (ADD ITEMS 1.2.3 & 4) $ Z."H(~
5. ~nMTNTSTATTVF FFFS
BASE CHARGE (SUBTOTAl ABOVE) X .05
<1IZ2.0l!o- )
-7..fZ911\
foil LAW5iE.1C-
Date:
3/(3)95
I
-- .
. '_'--:',.1 _.J..... .::;;;;10.' "_.
.::>u...... "-,v,-,, ..........._.::H-'-
IDJALSOC
'10
$ 1.,'51,,3'-
B2 . SDC .
, ~ . .
FIXTURE UNIT CALCULI-ION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units
(NOTE: For remodels. calculate only the tl.EI additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
Bathtub...................................................................... I J (z)
Drinking Fountain.....................................................
Floor Drain............................... .................................
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For SandlAuto Wash/Etc..................
Laundry Tub/Clotheswasher................................... (i)
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For RefrigeratorlWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall................................................. II)
Shower, Gang.. .................. ...... ...... .................. ........
Sink: Bar, Commercial, Residential Kitchen........................ 1I )
Urinal, StaIlIWall..:.... ............. .... ................. ..............
Wash Basin/Lavatory, Single.................................. "'tHL (5)
Toilet, Public Installation........................................
Toilet, Private....................................................... III ('1>)
Miscellaneous: t TAHIT'I""'.s Sh'IJ;:-
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE:
calculate credits sE;parates.
I
UNIT
EOUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
~
=
FIXTURE
UNITS
4-
z.
'2.
t.
:;
1'2.
1..7 .
Based on assessed value. If improvements occurred after annexation date in table,
Year
Annexed
Rate per $1 ,000
Assessed Value
Year
Annexed
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
~3~ X $ 11e.IIC
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Credit for Parcel or land Only If Applicable
ImprovelT)ent (if after annexation date)
=
=
CREDIT TOTAL = $
Rate per $1,000
Assessed Value
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
4557J-
.
.
~
~?~ Willamalane
'tg' Park & Recreatio~ District
Job No. Q5('f \0
- '
SYSTEMS DEVElOPMENT CHARGE
WORKSHEET
NAME.~+-\)1aJ\ n C) ~ "'0. \. 'Xt (..; PHONE: '\ ~ln .lCl<C\l
AOORBS o,rl\.. ~ ~..ui'cib \ ~A STATE f1'--ZJP !IJj 11
lqCATION OF P~OPOSED BUll~Si.SJlt: \\1.._....d-t I 0 ..." ')
, Street Address If Known: UY / J..\! ~ r7Yl11Jl..-----"
- '. - r--
PI~tt Name:!~)oY \~)
TaxlotNumber:~ ~O?'31.\\ ()ldoL~
1. DEVELOPMENT TYPE (Check appropriate dwellirig(s). SDC Calculations and dwelling type
definitions are on the back.)
A. Sinl!le Family - Detached
I Single Family home
(
NO OF UNITS
Manufactured home not in a park
$ 4' . f'I\ .00.
X $400 PER UNIT .;=. 1.1 )
B. Sinl!le Family - Attached
.
\
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Family Aoartment
NO OF UNITS
X $277 PER UNIT =
$
D. Manufadured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$40(J~
d
$ -
$AcD~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approyal. See SDC Credit Worksheet. '
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
I.
~~";;~,~
'?J I \S /C\S
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