HomeMy WebLinkAboutPermit Building 1994-10-14
OWNER)1n~ ,r -L l \. H:. : t' be.... Vl k.s
ADDRESS: . S~ ,C1. () 1)e,\ 'A ..,1. 10
CITY' K"?r \h~{\.{ \ /J '
DESCRIBE WORK: 6c '" 1- ~ .
NEW REMODEL
",
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: /71!J 2
LO-r.
.
SPRINGFIELD
_<~ 60
~ 3" -:7--1
,
7)/f7Sh
~o.- (
BLOCK:
STATE:
aJl.
-'1;'
..,',
ADDITION X" DEMOLISH'.
I'..,,:
OTHER
e-
JOB NUMBER
7~11~ I_
f
225 Fifth Street
Springfield, Oregon 97477
7;C /D
, TAX LO-r.
/') /d2...5"
SUBDIVISION: Moul\~Q,,"" J/.t.... I'lob.'/c..
Hc.Y"\.L (:. .. t-a 4-k (;, - .., ~ "7
PHONE:
7.t../7- ours.-
,'iIP: 9 '/tl? !JY
:.1,'
" '
. :. .-." .~. ",
I,',
CONTAACTOR'S NAME
f'1'u0r\ (' '\L .
GENERA' .
PLUMBING:
MECHANICA' .
~ ELECTRICAL'
~w~
aUAD AREA: ~\2...~
" OF BLDGS'
OCCY GROUP:
" OF STORIES'
M
\
WATER HEATER:
,
,
ADDRESS'
S7.e~d DA ~Sli
/
:'\
\
"
CONST.,
CONTRACTOR"
. '.~ l~.l'~:~;:'~;':':"
, ,EX;~I,R'ES '
" ....'.
.,' .
,
: '.:',": ,"'. ' . ~"" ~'" .
PHON'E':;:-:' .
. .' ",
/:J /6
- OFFICE USE -
\\~
" OF UNITS' )
CONSTR~ TYPE: \} ~
LAND USE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN: _
ZONING CODE:~-U~
- -
" OF BDRMS:
SECONDARY HEAT:
SaUARE FOOTAGE: ~V)
To request an Inspection, you must call 726-3769. This Is a 24 hour recording, Alllnspecllons 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
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal1
Mechanical - Prior to cover.
rvf Footing - After .tf.enches are
~ excavated. , .
0, Masonry - Steel location, bond
beams, grouting.
l"\:A-1=oundatlon - After forms are
~ erected but, prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
o Rough Mechanical ~ Prior to
cover. '
I"v'1 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.
~
~ Framing - Prior to cover.
i
o Wail/Ceiling InsJI~t1on - Prior to
cover.
o Drywall - Prior to taping.
D Underfloor Plumbing/Mechanical' ,
. - Prior to Insulation or decking. 0 Wood Stove - After Installation.
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 'IIl1ng
trench,
O Water LIne - Prior to filling
trench.
o Rough Plumbing - Prior to
coyer. ,
o Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior 10
placement of concrete,
D Sidewalk & Driveway - After
excavation Is completo, forms
and sub-base material In place,
o Fence - When completed.
..' )-t.,
"
,
o Street Trees - When all'requlred
trees are planted. '
o Final Plumbing - When all
plumbing W9rk Is complet,e.
I'\,./J FInal Electrical - When all
~ electrical work Is complete. C
D Final Mechanical - When all
mechanical work Is complete,
IU Final Building - Whon all
~requlred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whe[l all
blocking Is complete.
D Plumbing Connections - When
home has been connected to '
water and sewer.
D Electrical Connection - When
blocking, set-up, and pluroblng
Inspections have been approved
and the home Is connected to
the service panel. '
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot TYP'. .:-,:" , ,
, .. '\
, "
Lot faces ....
J:
Lot sq. ftg. Interior I P.L.
IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul.de's~c
. " \, E
.: '..' l~ .I~'1 _"j ~... ";;,' i
.-\0' "/' ....
. - '"l' ,
, ..
" ;. '. . ~ . . .
"
.S THE PROPOSED WORK,tN THE. "
"....HiSTORiCAL DISTRICf, OR ON '
.','THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.'
Setbacks '
HSE GAR ACC'
,
'"
BUILDIN'G PERMIT
ITEM SO. FT, X $/50, FT, = VALUE
Main
Gacage
5~ -1.,4/0 ",4'7/2-
Carport
. !'
Total Value
3D. 50
2,>7 :
, f' ...
C;4~S
~ ,
SYSTEMS DEVELOPMENT CHARGE (SDC)~
(B) * 'b-z.~
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
.
Residential Bath(s)
Sanitary Sewer
, Water
NO
FT,
--
FT,
FT.
,/
/
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
..
Total Charge
(C)
MECHANICAL PERMIT
Furnace
E.xhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
/
, ,
:.'Mechanlcal Permit ",,: ,',::,
" ,d, .,~.'::'..'.::' "'::: ',:::', . ". . :;;\;/:.
\':,. ,;. "Issuah~e '.... :"./:, '
~ '.,
"
\
'-
, ,',
t::...
, ,
State :Surcharge
Total P\3rmlt
, -..;
",iI',;
,(0.)
I
MISCELLANEOUSPE:RMITS
Mobile Home
:~
State Issuance
State Surcharge
Sidewalk
/
Curbcut
ft
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,... L-S-d
~l3'i~ i
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the e~press 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.
3' ,8J
Plan Check Fee: 2- .
<7/'2- ? /9.,i.
,
/4.15 2-
Date Paid:
't ~_ .
Receipt Number:
Received -;;: " ~A
~~/'-1..;. ~
Plans ~evlewed By
. I/)~~f
( 0 e
Systems Development Charge Is due on all undeveloped
.."
properties within tho City limits wlilch are being Improved.
ADDITIONAL COMMENTS
~/ CKl.. /It)~ ~/f /~.tbV7
pJ{.L .~~/~ ~' ~~
~r-:
, ('
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certHy 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 Ordlnanc~s 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
struc,ture 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.
J
, 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
on the site at all times during structlon.
~a~~_
Date ' )~ ~ c.f /9.y
, ,
;.,..... .'
VALIDATION:
RECEIPT NUMBER / -S- O?-=.;-
DATE PAID /t:::' ~.. ~ ~
AMOUNT RECEIVED .I-:-3~.2.... ~-s--bJ
RECEIVED BY.
~~-
LG-'/'-
v
, '
..
~ ,
.08 NO. '1'-\\ 'i~9
CITY OF SPRINGFIELD SYSTEMS'DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
.
AITACHMENT B1
#
.
NAME OR COMPANY: \)p.~l2-e::. I-L r=~\\Z-l?A-"\~~
LOCATION: SfoCoC> V~ \ s--( -:t:t: \ D \ f (Y"2. ?? 4 L\ - 0 \ ~ -z.. S
LPlL
DEVELOPMENT TYPE: !\l17P..... b-A-P-AC:rE::. ADD\ lION
BUILDING SIZE:
\<6~-z..\
LOT SIZE
SQ. Ft.
1. 5.TORM D~
IMPERVIOUS SQ. FT.
-:1;?/B
X $0.209 PER SQ. FT.
$ ,9~
2. SANITARY SFWFR-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 $436.19
X $436.19
X $436.19
$
-
X
X
X
$
-
, .
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SANTTARY SFWFR-MWMC
NO. OF PFU'S -- x $17.19 PER PFU + $10 MWMC ADMIN.FEE $
(Use PFU Total From Item 2 Above)
-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
IQI& -MWMC snc:
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$
$
$ ,9~
5. ADMTNTSTATTVF FF(S
BASE CHARGE (SUBTOTAL ABOVE) X .05
$
::,"?
y-: '~L~
fD~~ary Hornig, P.E.
SDC Coordinator
Date: 10 /t..f Ic;tf
TOT~
$ '3 z. "'2-
B2.SDC .