HomeMy WebLinkAboutPermit Building 1994-11-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
OWNER'
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/(75 t?e..(l,R' cl{ eo
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ADDRESS'
CITY'
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DESCRIBE WORK'
NEW V REMODEL
ADDITION
,
.
SPRINGFIELD
BLOCK:
STATE: . c,>.e._
DEMOliSH
OTHER
5~~M 72~/lu. ~~
- .-
JOB NUMBER
91-1"~ L
225 Filth Street
Springfield, Oregon 97477
SP<""'~h~m
TAX LOT: . ~D]~~-.t
SUBDIVISION' I A-..MOA- IfIMt' 4=-
"- --
. PHON'" ~lf]-S(<};1...
ZIP: Q7V0.1
CONTRACTOR'S NAME ADDRESS
G EN ERA! . -f.'A NI. c: " /) I At. Vo ;;:: 1/ 7 \ IO~ .'l-'?,O_
PLUMBING' 0,1/) (e~.J; '\
MEGHANICAI' I-A,e lA'; [)Il YWA-Li
,-
ELECTRIGAI' 1/4LJc t.c ct-HA.,?,pl7f'''<
CON ST.
CONTRACTOR'
1. <') S'.; ?f('-{
33Dl!\ fl
n~?'~4
Ff14~'
EXPIRES PHONE
/-//-</5 J,Y3-j/9.J.
\OJ\t).a..~ Io~~\
\. \i\ ~~ ~b ~\f:1I..
3':)'<:\\0 I~ \\\o~
QUAD AREA: \~ t\ \\0
. OF BLDGS' \
OCGY GROUP: ~ ~'"\- N\
A
,,"
. OF STORIES:
WATER HEATER: _c; ./
- OFFICE USE -
LAND USE: \,\7 i>
· OF UNITS: . ~ -~
CONSTR. TYPE:-li,f\J
HEAT SOURCE: _I" \ilr.\
o
RANGF'
FLOOD PLAIN'
ZONING CODE:~~
. OF BDRMS: ~.
SECONDARY HEAT:--Rf'
SQUARE FOOTAGE:C~JO"\~
To request an Inspection, you must cafl 726.3769. This Is a 24 hour recording. All Inspections requesled 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 made
after excavation, but prIor to
setting forms.
o Underslab Plumblng/ElectrlcalJ
Mechanical - Prior to cover.
~ FooUng - Alter trenches are
T excavated.
o N1asenry - Steel 10caUon, bond
,be,ams, grouting.
rb:'Foundatlon - After forms are
~ erected but- prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~ Underfloor Plumbing/Mechanical
T - Prior to Insulation or decking.
r::z9J Post and 8eam - Prior to floor
LP Insulation or decking.
a9l Floor Insutatlon - Prior to
't-l decking.
. ,
r#1 Sanitary Sewer - Prior to filling
~ trench.
It3J Storm Sewer - Prior to filling
\ trench. .
.w1 Water Line - Prior to filling
\ trench.
rn Rough Plumbing - Prior to
1 cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
\ cover.
rrti Rough -Electrical - Prior to
~ cover.
f'lti?Electrlcal Service - Must be
\ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Fra;"lng - Prior to cover.
r:;tPWall/Celllng Insulation - Prior to
'l cover.
~ Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - Aller fireplace approvsl
and Installation 'or unit.
~ Curbcut 8/ Approach - After
forms are erected but prior to
placement of concrete.
rtlI Sidewalk & Driveway - After
Lf-l excavation Is complete. forms
and sub-base material In place.
,
o Fence - When Gompleted.
o Street Treos - When all required
trees Bre planted.
~ Final Plumbing - When a/l
Lf-1 plumbing wc;>rk Is camplet,c.
~ Final Electrical - ~en all
~ electrical work Is complete. ~
r:a Final Mechanical - When all
\ mechanical work Is complete.
rt:f) Final Building _ When all
4J required Inspections have been
approved and building Is
completed.
DO'har
MOBILE HOME INSPECTIONS
o BlockIng and Set.Up - Whep all
blocking Is complete.
o Plumbing Connections - When
home has been connected to .
water. and sewer.
o Electrical Connection - When
blocking, set-up, and plurQblng
Inspections 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.
leTHE PROPOSED WORK IN THE
"HISTORICAL DISTRICT. OR ON
THE HISTORIGAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Lot faces Lot l'ype . Setbacks
Lot sq. Itg. X- Interior I P.L. HSE GAR ACC
IN
Lot coverage Corner
Is
TopOgMphy Panhandle
Total helg~t d!:l:.' Cul-de-sac \W
IE
BUILDING PERMIT
SQ. FT. X S/SQ. FT. ~ VALUE
0)}'lli..... ~ Q ,j[) i1.2jQ \
Garage" 412- \l\. \D \(),\05s
ITEM
Main
Garport
Total Value
I~l
3 . lo
\~~~\
Building Permit Fee
State Surcharge +30h
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
13~tl:>P.Sr;,
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
N-A 'i.. ~
[?, d.\) cJ:)
Residential Bath(s)
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge -\- '2:.0'0
~~'(') ~
c9 :5 .\.pC)
.3 ~ '5.UG
Total Gharge
(C)
MECHANICAL PERMIT
Furnace
q~
\ ct .CD
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
lope
Mechanical Permit
~ '1.00
10.00
c9. H.p
~~.\lo
Issuance
State Surcharge "* '~:P '0
Total Permit (D)
MISCELLANEOUS PERMITS
Moblre H.Clme
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
:>>\~c~e \')C '. 0
Total Miscellaneous pel:!
~.c:o
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Gomblned)
1127 fJ
APPROVED:
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 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:
Date Paid: -. q , ) - I
Receipt Number'\ W~D~-
~~~~ ~~
Plans Reviewed By
\\}2.b~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
\. <A"\- \'. \ \ L.fl 00 ~~ ')
\.A. (\f\ t) '11.. t'<\.. 'A Q .>: \ C\ \DC) .
\..A)M1<\. \
~~
By signature, I state and agree, that I have carefuliy 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 contractors and employees who
are In compliance with ORS 701.055 will be used on this
proJect.
I further agreo 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 app.(oved set of plans will remain
on the site at all times during construction.
/! /? 2'/
Signature ...:. .
Date ~/-2 1;(--9<1
VAliDATION: ~\.d) I
RECEIPT NUMBER, \.. ,ld
DATE PAID J /. ('H "--T. ,
AMOUNT RECEI(jn/' .~ <J2c...
REGEIVED BY {~ .-/
'-./ - -
~j
. NO. .:L~./ off 2-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
. . , WORKSHEET
. ..' (COMMERCIAL & RESIDENTIAL)
-.
ATTACHMENT B1
NAME OR COMPANY: :J~ ,.hut'.a/
LOCATION: 7-s-8'; 7(,0 d~~
DEVELOPMENT TYPE' tJ~~~
, ,
~2...
;
BUILDING SIZE:
1._ ~TnRM nRATNAr,E
IMPERVIOUS SQ. FT. ,z-1{", 2
2. SANTTARY SFWFR-rTTY
NO. OF PFU'S 32
(See Reverse)
3. TRANSPORTATTON
LOT SrzF
SQ. Ft.
X $0.209 PER SQ. FT. ~/.f~
X $43.26 PER PFU . rfl3(j'''~f~
NO OF UNITS X TRIP RATE X COST PER TRIP
2.
X /.01 X $436.19
X X $436.19
~~
$
X
X $436.19
$
SUBTOTAL (ADD ITEMS 1. 2. & 3) $.2. l' 7fy, 9 "i?
4. SANTTARY SFWFR-MWMC
NO. OF PFU'S '2, ~ x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ S606.CJ~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ '1-<). ~
IQIAI -MWJ>iC SDC $~/9';-':;o~
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ -:J.2 9 r. f~
5. 6nMTNTSTATTVF FFFS
BASE CHARGE (S~B)9~~~OVE) X .05
~~_ ~';'L..." Date: /o-27'-9.pr
/ Mar H oi9, P.LL.)
. . SDC rdi nator
0?c; ~~
IQIAI snc
$ '3~c;~.5f.,
B2.SDC
.
.
o y!iRi!m.l!!~!!!;;
Job No.C\4 ~~
LOCATIO!,! o.F JilRo.Po.SED BUILDI~ SITE:
. Street Address if Known: f")Sh *' '\ ~\)
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAMe~l'\~l'Q _ PHONE &\~.~qW
ADDRBS \\ ~~ ~~.:.r-L \ &~ STATe ~ZIP Ql'fo-\-
\.n. 0'1 ~W-~~
Tax lot Number: l '\~'L~~\ ClG.."?fOI.C>3 \00
Platt Name: G.(C\ ~\\:"
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). sac Calculations and dwelling type
definitions are on the backJ
A. Sim,le Familv - Detached
Single Family home
Manufactured home not in a park
NO. o.F UNITS
X $400 PER UNIT _=
$
.
8. ~imJle Familv - Attached
No.o.F UNITS
~
X $370 PER UNIT =
'$~
C. Multi-Familv Aoartment
NO. o.F UNITS
X $277 PER UNIT =
$
D. Manufadured Home Park
NO. o.F UNITS.
X $280 PER UNIT =
$
WPRD SDC
$....94D~
$ 0_
$ f'14lO ~
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC AS SED (If SDC reduced for Creditl
~)~~
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I
I
Date