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Home My WebLink AboutPermit Building 1994-3-4 ~:\ ~. , -..... ' ~ESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 _. SPRINGFIELD ~ ~ATIO,N OF PROPOSED Wg.B,K: 1\!l3"11 Do<<-^,ot.1 ASSESSORS MAP' .100...:)<'1\ (, ~A.... ^ LOT: t CONTRACTOR'S NAME GENERAl' ~.N'",.e-~ PLUMBING' --. MECHANICAl .~ ELECTRICAl' - QUAD AREA: . OF BLDGS' OCCY GROUP' \R~)w ); \ \ . OF STORIE'" WATER HEATER: .. JOBNUMBER~~ 225 Fifth Street Springfield, Oregon 97477 <.pRINf1=/cLd) nfJ't . . TAX LOT: ./ ~('";E=) SUBDIVIS!ON: -#,.. M ~.A'" BLOCK' PHONE: 7Y/ - /7.< F: STATE: f)P.r-NntJ ZIP:?, 7t 7 7 DEMOLISH OTHER ADDRESS CONST. .. CONTRACTOR' PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cove~ . lZl 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, QtJ Framing - PrIor to cover, D Wall/C.ellln9 Insulallon - Prior to cover, D Drywall - Prior to taping. D Wood Stove - After Installa,t1on. o Insert - Atter fireplace approval and Installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After , excavation Is complete. forms and s.ub.base materIal In place, D Fence - Whe." completed, o Street Trees - When 'all required . ' trees are planted. . . EXPIRES i FLOOD PLAIN' ZONING CODE: ll1tL.-/ . OF BDRMS' SECONDARY HEAT: ) SQUARE FOOTAGE: \. 5f:J! 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, .. \ , - OJl[FF.ICE l\SE - LAND USE: I . OF UNITS: CONSTR. TYPE: HEAT SOURCF' , VfV OWNER: R.oW! -r r",vLnr:t I . ADDRESS:'''' 17Ci OoJ2AJor:A J'T CITY: )fril.)~r F,r;-Ld, ~ DESCRIBE WORK' f.r '" it..A1 e NEW ~ REMODEL ADDITION D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms, D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. ~ Footing - After trenches are excavated, D Masonry - Steel location, bond .beams, grouting, GrI Foundation - After forms are . erected. but. prior to concrete placemer'!t. D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical -.Prlor to Insulation or decking. D Post and Beam - Prior to floor Insulatfon or decking, D Floor 'hisui'atlon - Prior to decking. D Sanitary Sewer - Prior to filling trench, o Storm Sewer - Prior to filling trench, . D Waler Line - Prior to filling trench, D Rough Plumbing - Prior to cover. RANGE: D Final Plumbing - When all plumbing work Is complet,e, [E] FInal ElectrIcal - When all electrical work Is complete, o FInal MechanIcal - When all mechanical work Is complete, rI7I Final Building - When all )4-J required Inspections have been approved and building Is completed, I DOther MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer, D 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 Inspections are approved.and porches, sklrtlng, decks. and venting have been Installed. Receipt Number: ' ~y: ~~ / Pp.IIJ evlewed y~~ SYSTEMS DEVELOPMENT CHARGE (SDC)<$.. (B) ~\<+"2...~ Lot faces ~ Lot sq. Itg. t~ Lot coverage Topography Total height 11- ITEM' Main Garage Carport ~ Total Value Building Permit Fee State Surcharge Total Fee PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PlumbIng Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan Lot TY' Interior ./ Corner Panhandle '.' Cul.de-sac X $1 SQ. FT. 14.\0 (A) N' FT. FT. FT. (C) N' Wood StovellnsertlFlreplace Unit Dryer Vent MechanIcal Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge I P.L. IN Is I'w IE VALUE . \ . ~~?jk-- , / ~ S<!=> ~ 7. ~ 7/.9~ FEE Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrICal)~Y: s-3 (A, B, C, 0, and E Combined) Setbacks HSE GAR Accl /7' I I I. \.:., /b :l.~ 1~ . ." " I ~ IS THE PROPOSED WORK IN THE r . .....HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical , \9oordinator prior to permit Issuance, . . . . APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERIVIIT This permIt Is granted on the express conditlon'that the saId constructIon srall, In all re~pects. 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 rev.oked at a'ny time upon violation of any p'rovlslons of said ordinances, Plan Check Fee: 1-1 .:~ ~ /, !-)"B Lf1= " Date Paid: .... "7-- 'Y"7'y Date S stems Development Charge is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS 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 certif~ 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 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, and the approved set of plans will remain on the site at all tImes during con/~Ion, Signature 0~-r_M.~/ ~. V - Date J - ~ Ii? ~9Y . VALIDATION: \'~~q?,- . RECEIPT NUMBER _ f DATE PAIP -=) L\- -q Y AMOUNT RECEIVED ')...\ 1..\. '0-~ jJ ^ ^ ^_ <:l......-. , AJ - RECEIVED BY -/. . . .B NO. 9<4009 '2..- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: Roe>E:.lC--r S. IAYL-Ol'<- LOCATION: "Z.?I'1 Do~~cc..i-\ S.,-. DEVELOPMENT TYPE: L.Df!- - A-DP\ TlOt-t BUILDING SIZE: ~-,(n.?;i~,(INC:LUDEO? "'"AYe!>) LOT S~ZE \"10-:>':''2..-1"2..:2.- Oi'=:>OS SQ. Ft. l. STORM DRAINAGE IMPERVIOUS SQ. FT. Co"''''' X $0.203 PER SQ. FT. ~??8~ .......... .-/' 2. SANITARY SEWER-CITY NO. OF PFU'S X $42.08 PER PFU ( ~ (See Reverse) ..-/ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X X 4. SANITARY SEWER-MWMC NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE $ (Use PFU Total From Item 2 Above) X $424.31 X $424.31 X $424.31 ~-) ----------- $ $ - MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ TOTAL-MWMC SDC ~ SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ \ -:l:Jr::. ~ . 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 12_~LuL ~h:>/qt.j- 6' Kip Burdick '! SOC Coordinator r;:- Co 1~ ~ TOTAL SDC $ \ '4 7. (,,~