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Home My WebLink AboutPermit Building 1991-9-30 RESIDENTIAL PERMIT APPLICATION Inspections: 726,3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSORS MA,P: LOT: /71? ; " ~ ;;J.3tO 2'7 . ;;>//0.30, SPRINGFIELD" JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT:,~ 2. 0-0 SUBDIVISION: OWNER: /1 Ji 1 ~~4!fVl' F1Azer;:' (&/1/) PHONE:7?/~,- (., JCJ J ADDRESS:" ~3t.O tJ~ ,,( F~Eyt/;;Jj 'k I B-tv&( ',~ CITY: ~QIl.J'.JrilElJ -. , STATE: ~ &~ ZIP: .97C/77 DESCRIBE WORK: ~I rtllhn~AfiVf (:).. (l/J~ ~AK'A-)~ NEW J/ REMODEL ADDITION DEMOLISH 'OTHER BLOCK: . , CONTRACTOR'S NA~' "/I " ADDRESS , GENERAL: ~}.s LEAJ- 'u i!.u rb/JA/V) { c:... ,PLUMBING: ~I J/A ' ! I ' ~/ 1/ MECHANICAL: A)/.4- '.A ~. ELECTRICAL' .-tV/.4-- " , I . CONST. CONTRACTOR # EXPIRES PHONE ~ s: ~/II 7~tf,-dJrld. , ," ~;?,~Q(>r(J, -P-$9/J 73, !;J~ at./,--9A QUAD AREA: ~ RNW J M # OF BLDGS: OCCY GROUP: # OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: LLU FLOOD PLAIN: ZONING CODE: l-Ide.,. # OF UNITS: CONSTR, TYPE: ' HEAT SOURCE: '\/1\/ # OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: s.;:) ~ RANGE' 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, D Temporary Electric o Site Inspection - To be made after excavation; but prior to setting forms, D Underslab Plumbing! Electrical! Mechanical - Prior to cover, !K] Footing - After trenches are excavated, ' D Masonry - Steel location, bond, beams, grouting, D Foundation - After forms are' , ,erected but prior to concrete placement,. D Underground Plumbing - Prior to filling trench, D Underfloor Plumbing! Mechanical - Prior t() insulation or dec,king,' D Post and Beam -: Prior to floor insulation or decking. " D Floor Insulation - Prior to decking, , D Sanitary Sewer - Prior to filling trench, D Storm Sewer - Prior to filling trench, D Water Line - Prio'r to filling trench, ' D Rough Plumbing',- Pri<?r, to cover, " REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. D Rough Electrical - Prior to cover, D Electrical Service - Must be approved to obtain permanent electrical power, D Fireplace - Prior to facing materials and framing Insp, ~ Framing - Prior to cover, D Wall!Ceiling Insulation - Prior to cover, D Drywall - Prior to taping, D Wood Stove - After installation, D Insert - After fireplace approval , and installation of unit, <, o Curbcut & Approach - After , forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place, D Fence'~ Whe~ completed, " D Street Trees -When all required " trees are planted, ~"." D Final Plumbing - When all plumbing work is complete, o Final Electrical - When all electri?aL work is c.omplete, D Final Mechanical - When all mechanical work is complete, [E] Final Building - When all required inspectio,ns 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 " 'inspeCtions are approved a,nd porches, skirting, decks, and , ..venting have been installed" Lot faces IY. Lot Type' Setbacks 'THE PROPOSED WORK IN THE ..... I P,L, , , GAR "ACC I' Lot sq, ftg. X Interior HSE HISTORICAL DISTRICT, OR ON IN /S I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is and approved by the Historical Topography Panhandle Iw ~ Coordinator prior to permit issuance, Total height ~" Cul-de-sac IE 1," n-", APPROVED: ITEM SQ, FT. X $/SQ, FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT BUILDING PERMIT Building Permit Fee ~ ~4- <J ~,SC> ~ .~~ S0,3~ 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, Plan Check Fee: ~'Z,( ~ _ 73 9-1'-~/ Receipt Number' 2/,/,7 ~ Received By: ." ~~~ [<1~~ Date Paid: Main Garage ~2..5 cat.)'?Je/tc7 ~.r. Carport Total Value State Surcharge Total Fee (A) ~-2J>~/ Date SYSTEMS DEVELOPMENT CHA,GE (S~g) ~ (B) ! IJ 'l- - Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, PLUMBING PERMIT ITEM FEE ADDITIONAL COMMENTS I) ~ 'I\~~- Fixtures Residential Bath(s) NO Sanitary Sewer FT, Water FT. Storm Sewer FT, , . Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Vent Fan NO 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 without permission of the Building Safety Division, I further certify that only cOritractors and employees who _ are in compliance with ORS 701,055 will be used on this project: Exhaust Hood Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Su rcharge Total Permit (D) 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 :~g:::":~~~ Oat, 4p-~ /9'1/ . MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft ft' Curbcut Demolition State Su rcharge VALIDATION: RECEIPT NUMBER "'2 / LtS~ 7-76-7/ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) jbl. B6 DATE PAID AMOUNT RECEIVED ~ 8C RECEIVED BY /. L ~",~~~ /,//..- - ii' .,. Total Miscellaneous Permits (E) CITY Of:.RINGFlELD SYSTEMS DEVEL.NT CHARGE it q (1630 WORKSHEET ' , NAME OR COMPANY: 'tA(Il_~IA-/Vl Ff?-AZE-:E LOC.A.TION: -J- ?Di/J . Ce..1'.J IE "..U\..(f A- L iro '~t..-"7 Y 4 - 607-00 DEVELOPMENT TYPE: L-Vf!- ,- AZ::>Pi TI ON : 0A-g.A&c BUILDING SIZE: t-. ( -I -z, S LOT SIZE SQ. Ft. 1. STORM DRAINAGE - -c.. $ CI.., '" S IMPERVIOUS SQ. ~T. -S~7 X 50.186 PER SQ. FT. -, I (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER-CITY NO. OF PFU'S X $38.55 PER PFU (See Reverse To Determine Total PFU'S), $ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X X $388.61 X $388.61 $ ..- $ lX,$388.61 $ (See Atta~hment C To Determine Trip Rates) a7 (,5 , ' -,. ... " , - ...'. " - SUBTOTAL (ADD ITEMS 1,2, & 3) S I 4. ADMINISTRATIVE FEES BASE'CHARGE (SUBTOTAL ABOVE) X .05 ';'. ... . 8~ $ 4- ,-;:- TOTAL-CITY SDC $ tD2- ~ 5. CRED ITS IF DEVELOPMENT IS PROFESSIONAL OFFICES OR INDUSTRIAL: 1 f ~ TOTAL-CITY SDC X (50%) = ADJUSTED CITY SDC $ {~/IT 6. SANITARY SEWER-MWMC NO. OF PFU'S ' x $13.25 PER PFU + S10 MWMC ADMIN. FEE $ ,~ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERS~) ~':-~L~ '1/~/'7f () Ki P Burdi clc , SDC Coordinator $ TOTAL-Mlmc SDC $ TOTAL SDC $ !b7- 52 ,.\1,.'. ,\ , . ., J ~ '(