HomeMy WebLinkAboutPermit Building 1994-11-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
OUlce: 726.3759
LOT'
.
SPRINGFIELD
c:: <.0 ,/ to R. leAf'
BLOCI'"'
'.
:1 AM€-;<;: 6. l AR~\:r.
1/7 S (.).. (l,1!.;<.L<. r<Q
OWNER'
ADDRE"'"
CITY'
/7. U 'I '" A;JJ
DvPL-<<:..'I.
DESCRIBE WORK:
'NEW)( REMODEL
ADDITION
STAT'"
oe.
DEMOliSH
OTHER
i.. Qc1fJ<)'p'Z"7<j~.2 , (YZ.. 9 Cf..7 i
TAX LOT: .:! ~~~..,...... ' :
"':' r -, -, T'" / ~/ .1
SUBDIVISION: -6.R.-C\.JA OA f!PAo.~E 1k.
PHON'"
'<</7~S~<'f':l.
ZIP: q 7 4-0 l
CONTRACTOR'S NAME ADDRESS
.
GENERA" ':"l~,^", e.- <:... f>.. _ LA(>~ \~ 117S Jk'.~e(C7 e{)
PLUMBING' tJ,.1 L~..u~, A"-"'-'1t:"L1
MEGHANICA" LAP... ~ Ih ~A-Lt / (7r 4<,)2,o:..L LV)
ELECTRICAL: ~J( t-- d-.Hltw.m..R I: ie.c."".
CON ST.
CONTRACTOR'
S:5'3"K" 1../
~~m\o
S<;' 38"'f
'8=l41..~
EXPIRES PHONE
/-1/- 9$ 1'fJ-S{9:J....
Lo'\\')'C\:'\ \~'iS. \C\.~
/-(( - 9 S' ']y?-5tCJ.;l..
~.S.q,\,., \~\\\QS
- OFFICE USE -
QUAD AREA' \\<.l\J\tj LAND USE: \,\1[\ FLOOD PLAIN:
. OF BLDGS: t · OF UNIT~' ~ ZONING CODE: ~~
OCCY GROUP' R~-\ M CONSTR. TYPE:.....J.\ tV . OF BDRMS: '--0
d.. HEAT SOURCE: U ')~ ~
. OF STORIE'" SECONDARY HEAT: _1
I~':....... WATER HEATER' G RANGE: ~ SQUARE FOOTAGE: .In't '6-
I
To requesl an inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested belore 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 Plumblng/Electrlca"
Mechanical - Prior to cover.
~ Footing - After trenches are
\ excavated.
o Masonry - Steel location, bond
.beams, grouting.
9'{ound8uon - After forms are
erected.but prior to concrete
placement.
o Underground Plumbing - Pllor
to filling trench.
m ~nd~rfloor Plumbing/Mechanical
~ -.Prlor to Insulation or decking.
~ Post and Beam - Prior to floor
~ Insulation .or decking.
~ Floor Insulation - Prior to
\;:--.J decking. . .
~ Sanitary Sewer ~ Prior to filling
~ tr~nch.
~ Storm Sewer - Prior to filling
Lf-J trench. ~
, .
~Water Line - Prior to filling
~ trench.
I!dl'ough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~ROU9h .Mechanlcal - Prior to
cover.
Rough. ElectrIcal - Prior to
cover.
~ .
lectrlcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
t:P1 WalltCefllng Insulation - Prior to
~ cover.
'f'ryWall - Prior to taping.
o Wood Stove - After I~stallation.
o Insert - After fireplace approvlll
and Installation of unll.
~ Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~Sldewatk & Driveway - After
T excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
IJCPFlnal Plumbing - When all
\ plumbing wQrk Is complet.e.
~ Final Electrical - \.f\lhen all
~ electrical work Is complete.'
~ Final Mechanical - When all
l mechanical work Is complete.
I':Pl Final Building - When all
l required Inspections have been
approved and building 15
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set. Up - Whe[l all
blocking Is complete.
o Plumbing Connections - When
home has been connected to .
water and sewer.
o Electrical Connection - When
blocking, set-up, and plufT,Jblng
Inspecllons have been approved
and the home Is connected ,to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lot Type . Setbacks "CttTHE PROPOSED WORK IN THE
, -X'" Interior I P.L. HSE GAR ACC I ISTORIGAL DISTRICT, OR ON
Lot sq. ftg. IN I THE HISTORICAL REGISTER?
Lot coverage Corner Is I If yes, this application must be signed
Panhandle and approved by the Historical
Topography \w 1 Coordinator prior to permit Issuance.
Total h!llgh,t d.!}:::
Cul-de-sac IE I
APPROVED'
BUILDING PERMIT
SQ. FT.
~
4"lL.
X $/SQ. FT. = VALUE
5g J[) l'J2:1Q. \
\~. \() -V;"\()5S
I
ITEM
Main
'.
Garage
Carport
Total Value
Building Permit Fee
State Surcharge +39'0
Total Fee
(A)
I~~.
$-\:t:{.o
\~~~,\\
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
13~W.S''''
PLUMBING PERMIT
ITEM
Fixtures
NoA"'/...d
Residential Bath(s)
Sanitary Sewer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge -\ '~:P 10
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserl/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge -! '5D '0
Total Permit (D)
MI$CELLANEOUS PERMITS
Mobile Home
StatS Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
:E~e~e \,,c . 0
Total' Miscellaneous pell
TOTAL AMOUNT DUE (excluding electrical)
(A, a, c, D. and E Combined)
FEE
~d.\')~
?,A'G ~
~ :::) .\JJr:J
3l\ '5.\J()
q~
\a.CO
lope
~ '1.00
10.00
c9. \ LP
2>~.\l~
~.co
(E)
1+27.13
BUILDING VALUE, PLAN CHECK
AND BUiLDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Gity of Springfield, Including the
Development Gode, 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:
Date Paid: -. q , ) - J
~~:::vJ- \\).2t)~
Plans Reviewed By Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~ ~-\- \', l~h'OO \~\,,,
U<\ M ())(, ''U.ll..> '. \ C\ \.DC)
,,>>M1<\ \
-::.
By signature, I state and agree, that I have carefully examined
the compleled application and do hereby certify that all
Information hereon Is true and correct, and I further'certlfy
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 0/ plans will remain
on the site at a~es during construction.
Slgnatur~ .?--.- rl_ "2. /'
?/
/ t"- 2. "K' - cr '-I
Oatp
VAliDATION: ~
RECEIPT NUMBEr ' \ ~'L
DATE PAID --L. . z;.-?'~
AMOUNT RE~ I , 2J. ~J J "" 3
RECEIVED aD') ~
1
v
-e
ATTACHMENT B1
.'
. NO. 9-'11-/93
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
. (COMMERCIAL & RESIDENTIAL>
NAME OR COMPANY: r.. M~
LOCATION: 14-ok '11-2 /l. ~.~ rd>
DEVELOPMENT TYPE: ~
. }' 1
BUILDING SIZE:
lOT SI7F
SQ. Ft.
1. STORM nRATN~
IMPERVIOUS SQ. FT.
UC.2
X $0.209 PER SQ. FT. ~~
2. SBNTTARY SFWFR-r.TTY
. (iI3::0J
NO. OF PFU'S
(See Reverse)
32
X $43.26 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
L
~(,0
$
X/d) / X $436.19
X X $436.19
X
X $436.19
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $.$"179. ji'?
4. SANTTARY SFWFR-MWMC
NO. OF PFU'S ?2 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 5~o, 0";1
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ --It>. ~'?
IQIAI -MWMr. snc $0/9. (;" ')
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 3.z.J?? sf'
5. AnMTNTSTATTVF FFFS
BASE ?HARGE ~~T~r ABOVE) X .05
~~' M.. - Date: /t:' -.?7-r-'fL
/ Mar H rflig. P.V .
SDC ordinator .
~,~
$ 3?'-~-f.S~
IQIAI snr.
B2.SDC
.'
.
.
~?"YA Wi llama lane
't-g' Palk & Recreation District
SYSTEMS DEVELOPMENT CHARGE
NAM" ,\tl\Qf) ~ 1.l7~KSHEIT PHONE
ADDRESS: \\1 S \\)\)\\\~L 0
. J
Job No.Q4 \4:l3
.5ld1~
l
STATE: QtJZIP .9:J4(J L.
- I
LOCATION OF "'ROPOSED B~L,\J~G SI1EiA () .'. r\
. Street Address if Known: '\'1\)~' \'"1' L-- '-t\. \.' ~ C"\ J. 0 (\ 0 (,L~_)
Platt Name:G.~ 1[ Tax Lot Number: iry)3~~ ~
-
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the backJ
A. SinQle Familv - Detached
Single Family home
Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT .=
$
.
B. Sim,le Familv - Attached
NO OF UNITS
.J-
X $370 PER UNIT =
. $1J(),cO
C. Multi-Familv Aoartment
NOOFUNITS
X $277 PER UNIT =
$
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$1JD ,ClJ
$Rf
$ '74D.etJ
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~c~
Community Services ~~
r:--.......( c........:..........f;^l....t
l\
I_j~ e I~
Date