HomeMy WebLinkAboutPermit Building 1995-4-24
..
OWNER: \)c\~'ln J ~J\1~f'r\\~1 -'
ADDR~S~,~?~ _~b~\J\~
CITY ~u~~Jll'Q STATE \\)~"~ ~
DESCRIBE WORK:.0vt6,) ;. ~~E ;6'V/~'$-q .
NEW \ /' REMO'Da.r ' ADDITION
y ci, "
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT:
CONTRACTO~.NAME ,/1 ],
GENERAl:, Vi 1110.1:./
,PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
1/ OF BLDGS:
OCCY GR'OUP:
If; /l.?;(I./
I
m
I
1/ OF STORIES:'
\ \'
WATER HEATER: ..---;-
SPRINGFIELD
BLOCK:
DEMOLISH
OTHER
~
JOB NUMBER
'(~~1l(J
()~o
SUBDIVISION:
PHONE:
""14\ <20~
'(;
ZIP:
ql~,l~
ADDRESS'
CONST,
,CONTRACTOR 1/
PHONE,
- OFFICE USE -
LAND USE:
!'U'll
EXPIRES
FLOOD PLAIN:
UJ0
--
1/ OF UNITS:
CONSTR. TYPE:
,llJ
ZONING CODE:
1/ OF BDRMS:
SECONDARY HEAT:
-
HEAT SOURCE:
RANGE:
-
SQUARE FOOTAGE:
&,tJ1J.
To reguest an Inspection, you must call 726-3769, This Is a24 hour recording, Alllnspeclions requested before 7:00 a,m, will be
made' the same working day, I~spections, requested after 7:00 a,m. will be made the following work day,
,p Tem~orary ~Iectrlc ,
"' "','
D Site Inspection - To be made
after excavation, but prior to ,
setting forms,
o Underslab Plumbing/Electrical1
, Mechanical - Prior to cover.
D Footing - After trenches are
excavated. '
REQUIRED INSPECTIONS
D Bough Mech~nical - Prior to
, cover.'
,. ,
Ix'I Rough Electrical ....;. Prior to
~cover. '
D Electrical Service - Must be
, approved to obtain permari'ent
electrical power: '
D Fireplace - Prior to facing
materials and framing Insp,
D Final Plumbing - When all
plumbing worl~ is complete,
, ,
TY(Final Electrical - When all
~electrical work is complete,
D Final Mechanical - When all
mechanical worl~ is complete,
...
'~ Final Building - When all
~ required Inspections have been
approved and building is
completed,
D Masonry - Steellocatloh, bond
beams, grouting. 1'Vf'
' ~ Framing - Prior to cover.
)ZfFoundatJon - After forms'are
erected but prior to concrete Dille II' I I ti P I
Wa e 109 nsu a , on - r or to
placement. cover. '
D Underground Plumbing - Prior
to filling trench.
D' Underlloor Plumbing I Mechanical,
- Prior to Insulatl~r\or decking,
~ :. .
.' ..~:;";"
O Post and Beam -Pft6.f,to floor
Insulation or decklng.,,".'::~"
o Floor'lnsul'atlon ..4,' Prior to "
decking. , '
" t ,
D Sanitary Sewer - F'>ri6r to filling
trench.' '
D Storm Sewer ~ Prior t6 f1lilng
trench.
D Water Line - Prior to filling
trench. '.', '
D Rough Plumbing - Prior to
cover, . , ' ,
D Drywall - Prior to taping,
o Wood Stove - After Installation,
D Insert - After fireplace approval
and Installation of unit.
\~...,' \'.: .~' "~
"', 'GJ.Curbcul & Approach ~ After
'. " '.forms are Elrected but prior to
pliicement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
, and'sub-base material In place,
D Fence, - When completed,
o Street Trees - When all required
trees are planted. '
o Other
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
Ins'pections are approved and
porches, skirting, decks, and
venting have been installed,
Lot faces . J,L....:.. Lot Type
Lot sq, ftg, 23//;' Interior I P.L.
IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul,de-sac
IE
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT. VALUE
Main
Garage
"
~;\\11oOJ
1-4.\0
tpAl.d:fO
Total Value
Building Permit Fee
State Surcharge 3- 7J +- 2?-c/.
74.-.150
:;; .97
~:17
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC),..k.
(B) ~ 1'9 0'1 ~
j
PLUMBING PERMIT
ITEM
FEE
Fixtures-
1../
Residential ~.ath(s)
NO .--
FT, /'
FT, /'
FT/
./
>
Sanitary Sewer
Water'
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
//
Issuance
State Surcharge
Total Permit
(D)
MISCELL.t\NEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
"2.h'3,S4
..
\
Setbacks
HSE GAR ACC
~+I
2D
IS 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.
..F....".....:,
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.
Pial} Q,~~Ck Fee: AA4~ ,
Date Paid: cq 'c..~'C\~
Receipt Number: ,\ \~c:::;
Received By: ~~
pf:1~~~
4'/2/A. J
--If (jate
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
'r{t{m 1 f'1~\ ~,\rl. ~ 1\1'0 .)
iJr\" ~/" \ \Ct)~, '
, \ \ .. \.A '1-' "_"__\
.-rn~'D rn~t 'ru~{~,<U
lQJ 000 f\J ' (l".A \Ql(l
~ - --. .- ~--
o ,~ r, 0 r\_, , (
~;~lIQI,J~QJ\~~\~. -..
~~ ~ /~#J/T ,~~~~
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 Incompliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspect'ions 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 slt'~at all times during construction.
>&;nature, ./2 ~ ~tt
, , ~~X"~
Date .t?4Vr;! L~ /99iT / ~
'/ - , - '
VALIDATION:
RECEIPT NUMBER / ..7,., 99
~~2 Y"95
AMOUNT RECEIVED 2~.5 Y
/7'
./7/'~ ~
- ,
DATE PAID
RECEIVED BY
#
J '
lOB NO. <45042 (0
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY : VA L D I A. -e::>'R..u M L E. Y
LOCATION: 4eo ~ 9 'bLu~et::-L-1- E::.. \fJAy'
DEVELOPMENT TYPE: l-D ~ - A-t:>P ?(-\-o P
BUILDING SIZE: 1,4 ~ ~4(IN.CL"~E:S €Aves\ LOT SIZE
\ I 0 ~ ?7'2-4'7::> - 0 S Soo
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 6{Co X $0.209 PER SQ. FT. <GID~
2. SANITARY SEWER-CITY
NO. OF PFU'S 0 X $43.26 PER PFU cC~)
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $436.19
X $436.19
X $436.19
cC -e- ~
X
$
$
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ -b-
TOTAL-MWMC SDC
$
~-(T)
'---- ----
$ I/o'?4
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
~ ~~c.--L
(j Kip" Burdick
SDC Coordinator
X .05
Date: 4/S//&:f S
TOTAL SDC
cC ~~)
$ \1~O.2.
,
FIXTURE UNIT CAlCULA TIQN TABLE: Number of New Fixtures Y . <<flit Equivalent =' Fixture Units " , ~.
(NOTE: For rem~dels; cal~~late only the additional fixtures) \j
NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub............ ..... .,.:...'......... ........ ..... ,.......... .........u.. '
Drinking Fountain.., ,..,....""..... ......... ..,.,.. ................. '
Floor Drain....,...,.......,......, .'. ,.,..,....' ,.' ,..... "" ..........."
Interceptors For Grease/Oil/Solids/Etc...... ..,.......,
Interceptors For Sand/Auto Wash/Ete,....... .... ......
Laundry Tub/Clotheswasher ,., .',....' ,.... ."..', '" ...... ,..
Clotheswasher, -.3 pc fv'l.ore..,.,.:.,...".......;..,.... ",' .......
Mobile Home Park-Tr'ap (1 Per Trailer)......4..............u.... "; .
Receptor For Hefrigerator/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:
2
1
2
3
6
2
6
\3
1
3
2
l/Head
2
2
1
6
4
TOTAL FIXTURE UNITS
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
I
- - -- - - - - - - -'
- -. - - - - - -. - -
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3,32
3.21
3.06
2.92
2.73
Improvement (if after annexation date)
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
Credit for Parcel or land Only If Applicable
CREDIT TOTAL = $