HomeMy WebLinkAboutPermit Building 1995-5-30
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ADDRESS" lto ~'5:' 0 ...D-rYLQ il ~ r; - ~ <::; T .
CITY: ~\ ncC-\--i -P.LGl 1 (\ R-
DESCRIBE WORK:' ~ (~J\f\r19
REM~~EL . ADDITIO~
RESIDENTIAL
PERMIT APPLICATION <
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
~SSESSORS MAP: I ?t!?2-
LOT: 1::f<J f,~ :;;-
(. ,
OWNER:
NEW
v
CONTRACTOR~S NAME
GENERAL: ~) n...Q.J\..J
PLUMBING:
/"') btJ ",) e'Y?
f
MECHANICAL:
ELECTRICAL:
Ablp_
~(ecJ-M '~
QUAD AREA:'- ~R.~(\..
\
OCCY GROUP: "^
\
1/ OF BLDGS:
1/ OF STORIES:
WATER HEATER:
SPRINGFIELD
I,
BLOCK:
STATF'
fZ)f<
JOB NUMBER
'?50~2-1
/
...
DEMOLISH
OTHER
225 Fifth Street
Springfield, Oregon 97477
-ST.
TAX LOT:
SUBDIVISION::,
~/~3~
ALC,o;.;4 z -162-
PHONE:
1~(P- S?/~~
ZIP:
Cj'1lfi :?
ADDRESS
CONST.
CONTRACTOR 1/
PHONE
--:. OFFICE USE -
\ \ \ \
LAND USE:
1/ OF UNITS'
CONSTR. TYPE:
H EAT SOURCE:
RANGF'
\L~
EXPIRES
FLOOD PLAIN:
ZONING CODE:
If\ \2-
1/ OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: .....~7JJJ
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
setting forms,
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting,
!Xl Foundation - After forms are
erected'but prior to concrete
placement.
rvJ Underground Plumbing - Prior
~ to filling trench,
o Underlloor Plumbing/Mechanical
-,Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation";'" Prior to
decking.
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to flillng
trench.
o Water Line - Prlono filling
trench. __
o Rough Plumblng-- Prior: to
cover. ~
REQUIRED INSPECTIONS
o Rough ,Mechanical - Pri?r to
cover.
IPI Rough Electrical - Prior to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
IZI Framing - Prior to cover,
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After I~stailatlon,
o Insert - After fireplace approval
and Instailatlon 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.
o Final Plumbing - When ail
plumbing w(HI< is complete,
IV1 Final Electrical - When ail
~ electrical work is complete,
o Final Mechanical -When all
mechanical worl< is complete,
rA71 Final Building - When all
L,.LU required 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 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.
o Final - After all required
ins'pectlons are approved and
porches, skirting, decl<s, and
venting have been installed,
Lot Ty
..J{ Interior I P.L.
IN
Corner
Is
Panhandle
Iw
Cul-de-sac
IE
Lot faces /'x
, Lot sq, ftg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT.
Main
VALUE
Garage
Carport
q7~
/4:/,e:; "~( 2.2-
Total Value 7 j(. S~
~~ 3.?~
Building Permit Fee ~.::z
State Surcharge
Total Fee (A) ~.Y'7
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) t$11?. ~ ~
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
S;<!nit~ry Sewer
Water
FT.
FT, L 5" f
FT. //0 /
Storr:n Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.~NEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
,
. :".~
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
FEE
25.tnJ
?"'~ ~
. ~
~
~.'2:L
/. ~~.
---?~.. ~
TOTAL AMOUNT DUE (excluding electrical) 522.74
(A, B, C, D, and E Combined)
'I't',
.. ,.i~X.~ii:{:~~::;
;;".- ,
Setbacks -
HSE GAR
ACe' I
I
I
IS THE PROPOSED WORK tN 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.
~5"1
5':~1
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the exprEffiS 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: ~ .1"3
,5//2/5'r
/~ /
Receipt Number: /7)(a3
Received By: /.p!;;:r::...,
r~~~B~+-->
Date Paid:
~ -"::2.~-~5'
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
~if\ ~n\t01 \ ~ q ,
\\N f\ (\1--,~ 1 i(\ooJi(~
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 certl.fy
that any and ali 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, the approved set of plans will remain
on the site t limes during con tr tlon.
Date
VALIDATION:
DATE PAID
/??~
r:?O"'~ .s-
?<? 2'.?"<.
~ ~';"r-'_-
~
RECEIPT NUMBER
AMOUNT RECEIVED
RECEIVED BY
-,
.,' t): . -'~'. .
... -='
" .
. , '
'B NO. qS()(o-zA-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: 0A.G\C. S. Ko~}-\l.-E:.R...
LOCATION: 4c'2..'? CA-rY\I2.L-l--tA -VI. \(O'Z.~\44--C>''='3lo
DEVELOPMENT TYPE: L-P{2.. - AD-!> G-A-~&E:.
BUILDING SIZE: '2~,('Z'O (tt.-1C.lAJD~~ &..'llS~) LOT SIZE SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
7~+
X $0.209 PER SQ. FT. ~1o?'60
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
X $43.26 PER PFU
~
( $
"----
-~
/
-------
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $436.19
X ' X $436.19
X
X $436.19
c;--)
------ ~
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $17.19 PER PFU + $10 MWMCADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
$
~-)
'--- ---
$ lc."?~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05 ( 'is '0
~ ~. ~~ Date: S/I1/~~
U Kip Burdick 'I TOTAL SDC $ If'Z-C2,.
SOC Coordinator