HomeMy WebLinkAboutPermit Building 1997-2-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD -",
LOCATION OF PROPOSED WQRK: -1G /~:ji~ b'~~ ~t::. e
ASSESSORS MAP' /:/ ~- 7f'~' ~o/
, - ,. - ,
LOT:
BLOCK:
JOB NUMBER %/,S;s>~
225 Filth Street
Springlleld, Oregon 97477
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TAX LOT:
SUBDIVISION:
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PHONE:
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OWNER: --Eq-""/7"- ;(7( -- ~~
ADDRESS:' ~~? 7/8 #~~~!/111
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CITY:
P'l
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DESCRIBE WORK: ~
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NEW
REMODEL
PHONE
CONTRACTOR'~AME ._
GENERAL: ~~~##'f
PLUMBING:
MECHANICAL:
ELECTRICAL:
STATE:
ADDITION
DEMOLISH
ZIP:
~?Y?e
OTHER
ADDRESS
. . CONST.. '.
CONTRACTOR It
REQUIRED INSPECTIONS
o
Rough Mechanical - Prior to
cover.
EXPIRES
- OFFICE USE -
QUAD AREA' LAND USE:_. FLOOD PLAIN:
It OF BLDGS: 1/ OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: It OF BDRMS:
It OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG E: __ 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 alter 7:00 a.m. will be made the lollowing work day.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing I Electricall
Mechanical - Prior to cover.
o
Footing - Aft.er trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After lorms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbingl Mechanical
- Prior to Insulation or decl<ing.
o
Post and Beam - Prior to floor
Insulation or decl<ing.
o Floor Insulation - Prior to
deckl ng.
o
Sanitary Sewer - Prior to filling
trench.
O Storm .Sewer - Prior to filling
trench.
O Water Line - Prior to tilling
trench.
o
Rough Plumbing
cover.
Prior to
-,
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
D
Framing - Prior to cover.
WalllC'elling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - Alter Installation.
o Insert - Alter fireplace approval
and installation 01 unit.
o
Curbcut & Approach - After
lorms are erected but prior to
placement 01 concrete.
o
Sidewalk & Driveway - Alter
excavation Is complete, lorms
and sU~J-base material in place.
o Fence - Wilen completed.
o
Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing worl< is complete.
o Final Electrical - When all
electrical worl< is complete.
o
Final Mechanical - When all
mechanical worl< Is complete.
o
Final Building - When al/
required Inspections have been
approved and building is
completed.
D Other
~~~~
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MOBILE HOME INSPECTIONS
...
o Blocking and Set-Up - When al/
blocking is complete.
o
Plumbing Connections - When
home has been connected to
waleI' and sewer.
o
Electrical Connection - When
blocking, sel-up. and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o
Final - Alter al/ required
inspectioris are approved and
porches, sl<irting, decks, and
venting have been Installed.
, . '~,' ~ i:'
',..'
':,:
Lot faces
Lot Type
Lot sq. ftg.
Interior
Setbacks
I P.L. HSE GAR ACC
IN
Is
Cui-de-sac
W'
I;:; 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 is.suance.
Lot coverage
Corner
Topography
Total height
Panhandle
t. '.-_
E
---.
APPROVED: ...:...-
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
VA LU E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This perrilit Is granted on the express condition that the said
cSlnstruction shall, in all respec!s, conlorm to the Ordinance
adopted by the City 01 Springlield, including the
De'velopment Code, regulating the construction and use of
buildings, and may be suspended '01' revoked at any time
upon violation of any provisions 01 said ordinances.
Main
Carport
#Y> ,/6?1r!' 6~~_ ~,?2y'.~y
#A~ /f2-~(:~L ~f.ptF /&J~~~~ ,
//~"yg.~'1-
Building Permit Fee If/'?''~- /!>!.....~~
1-5 ~.
-1-7 · tt:> L
SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Value
~~~~e!
~Pl'ajd2:;-
Receipt Number:
State Surcharge
Received By:
Total Fee
(A)
-.----.-. ---.---------
Plans Reviewed By
Date
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
NO
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
By signature, I stale and agree, that I have carefUlly examined
the completed application and do hereby certlly that all
Inlormation hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances 01 the City 01 Springlield, and the Laws
of the State 01 Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission 01 the Building Salety Division.
I lurther certily that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections are
q:lquested at the proper time, that each address Is readable
(rom tile street, that the permit card Is located at the front
01 the pr.operty, anfjld the a ~roved se't of plans.will remain
on the site at all times ring construction.
Signature ~AA( ~
Date j/l/z-= Z!3. f97 .
V
MISCELLANEOUS PERMITS
Mobile Home
. State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
VALIDATION:
. RECEIPT NUMBER 2l/7::?t6
DATE PAID _.7 -"2;$'" '/'--;;
AMOUNT RECEIVED po. e::::> / .
~."ECEIVED BY _~~ ".
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) P ,~/
(A, B, C, D, and E Combined)
I,
~
I',
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Job.' No.
C\ \(\~~? _
SYSTEM DEVELOPMENT CHARGE.
WORKSHEET '.
NAME; ro l)\~ L~\)~ '\\\t\
ADDRESS; 'O"0~46 \_~f)~
PHO~E: l 1-4- ~ 53(0 .'
STATE: ep zip: a..11-?~
. \
LOCATION OF PROPOSED BUILDING SITE:
Street Address: 19.1~olo.' \~~O_~.
. I . .
~r~) ,'Tax'Lot Number: ~j+#-(J()803
1. DEVELOPMENT PE. YCheCk appropriate dWelling(S;. SDC calc~lations and dw~lIing t
ype definitions are on th~ back.). . "
, \.
A. f?inale-Familv Detached
Manufactured home not in a park:
X '$1,000 per unit =. $'IOOn ,cO
H. _Sinale-Familv Attached
NO. OF UNITS
X $924 per unit = $
/ C.' Multi-Familv Aoartment
NO. OF UNITS
.X $69'2 per unit -. $'
D. Manufactured Home Park
-
NO. OF UNITS
, 'WILLAMALANE SDC
. X $699 perunit =
(
$ .
$ \ O(D .cO .
. g,.
$ I cooeD .
2. SDC CREDIT (if applicable) SDC~payer must furnish proof of
_ Willamalane Credit approval. 'See sac Credit Worksheet. .. $
. .
3. TOTAL WILLAMALANE NET SDC ASSESSED .
I' - \
.' (if SDC r~duced for Credit)
\lb~l_ '.' '
Development Se 'ces Department
City. of Springfield
/2../ ~~/?~
. Date
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