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Home My WebLink AboutPermit Building 1994-11-28 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT: OWNER: ,'1AM~'>- v'\ LAD II F;. //75 I?c-/] l2.c'r {!tJ ,'. ADDRESS: CITY: F U"'-1-"'-. _", v ()V J) I <C<:. 'K: DESCRIBE WORK' 'NEW .>\ REMODEL ADDITION CONTRACTOR'S NAME GENERA" '~<:L'i> 6. LAe....~ PLUMBIN('" 17",.~ / P.., \1 -S MECHANICAl' (A 2,-,-<: ELECTRICAl' -I/-SVC t;.. .. 5/1v11 ~ A-J . 72.$ / 72~ /"t/_ ~J/=_ '--Wy~~ JOB NUMBER 7'1 / 1~1-- BLOCI" STATF'. c::..;J?. I'" DEMOLISH OTHER 225 Fifth Street Springfield, Oregon 97477 PHON~' ?V3 -S Gc;J... ZIP: G'7'16/ ADDRESS tl7'5 tie-, Reel t'PuI CONST. CONTRACTOR' 5''5'3/i'-( PHONE J'O-d5-.J. IlJl. v"f.!J>.(L ( +- tfrt"o .<.E~ 1-' QUAD AREA: \ ~~\ \J . OF BLDGS: \ OCCY GROUP: ~ '1t""'~ . OF STORIES: . , F\ Y. WATER HEATER' .... EXPIRES 1-/(-'1'$ ffi~'L3 3. ':).C\ \. 0 --m-\\\o-S - OFFICE USE - LAND USE: \VtD . OF UNITS: ~ CONSTR. TYPE: -il.rv I~)H HEAT SOURCE: ~ RANGE: FLOOD PLAIN' ZONING CODE: -M~ e.- . OF BDRMS: \ II SECONDARY HEAT:-" {/f' SQUARE FOOTAGE: a~ To request an inspection, you must cafl 726.3769. This Is a 24 hour leeordlng. 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. o Temporary Electric D Site Inspection - To be made after excavallon, but prior to setting forms. D Underslab Plumblng/Electrlcall Mechanical - Prior 10 cover. G;1PFOOtlng - After trenches are \ excavated. o Masonry - Steel location, bond .beams, groullng. rl14 Foundation - After forms are ~ erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. I(]T Undarlloor Plumbing/Mechanical \_ - Prior to Insulation or decking. r:iA Post and Beam - Prior to floor rlllSul,allon or decking. riZiI Floor Insulation - Prior to T decking. r\Z9 Sanitary 'Sewer - Prior to filling ~ trench. ~ Storm Sower - Prior to filling T trench. '. . [:lit Water L1no - Prior to filling l trench. IZJ Rough PlumbIng - Prior to \"' cover. REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to \ cover. rc;ti' Rough EleClrlcal - Prior to , cover. P Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior: to cover. ~ ' I Wail/Ceiling Ins41atlon - Prior 10 cover. ',' ~ Drywall - Prior to taping. o Wood Stovo - Alter Installation. o Insert - After fireplace approvllI and Inslallatlon of unit. ~ Curbcut & Approach - After \ forms are erected but prior 10 placement of concrete. 7 Sidewalk & DrIveway - After excavation Is complete. forms and sub.base material In place. i D Fence - When ~ompleted. D Street Trees - When all required trees Bre planted. rl27I Final Plumbing - When all l..f-J plumbing w9rk Is complet.c. fPl FInal Eleclrlcal - 'Nhen all '\ electrical work Is complete. C ~ Flnat Mechanical - When all ~ mechanical work Is complete. P Final Building - When .11 required Inspections have been approved and building Is completed. rOther 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 plun;Jblng 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 Type. _ ~_Interlor ---- Corner Lot faces Lot sq. ftg. Lot coverage Topography Total height d!:l:: Panhandle Cui-de-sac BUILDING PERMIT SQ. FT. ~}'lUL 4'\1, .. \.IS THE PROPOSED WORK IN THE "'HISTORIGAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permIt Issuance. Setbacks I P.L. HSE GAR AGC IN Is Iw IE X $/SQ. FT. - VALUE Z'lo.10 1122Q \ \~, \D \o1\'i5s I ITEM Main '. Garage Carport Total Value Building Permit Fee Slate Surcharge +30,6 Total Fee (A) I~l _3 ' to ~~,\\ (B) SYSTEMS DEVELOPMENT CHARGE (SDC) I :3 -f'~. ~, PLUMBING PERMIT ITEM Fixtures ~'k cl Residential Bath(s) Sanitary Sewer FT. Water FT. FT. Storm Sewer Mobile Horne Plumbing Permit State Surcharge -\ ~O IrJ Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge -!: ?:P 10 Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition \s>>\~c~e ~)C '. ~ Total Miscellaneous pen TOTAL AMOUNT DUE (excluding electrical) (A. R. C, D. and E Comblocd) FEE Od.\)~ ;:\~'(J ~ &5.vt> 3~'5.lLO q~ \ti.CO lope> ~., .00 10.00 <:9. \ lo ~~. \{ 0 ~.co (E) #27:13, 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: -. (l , ) ~ ~ ~~~~vJ- \DD'a2teb M Plans Reviewed By , l Systems Development Charge Is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS \ ~-\- \'. \\ I~OO l~\" '\ ~ {\J\ \lJl \"{\.'-}; b: \0. \Pc) . \ .tt'rl1{\ \ "",. By signature, I $tate and agree, that I have carefully examined the completod 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 Ordinancos 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 streot, that the permit card Is located at the front of "the property, "and the approved set of plans wlll""r~maln on the site at all times during construction. . Xatur. /~ .~.-Z~ Datp ~~2"< - 't.lI ~:~:::::MBER, J~~~q DATE PAID II. mL-f AMOUNT RE~Ell.Er:t1 ~~~.s ,43 RECEIVED flY (X'~ .~~~O. '11/ f9/ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE , WORKSHEET (COMMERCIAL & RESIDENTIAL) -~. ATIACHMENT B1 NAME OR COMPANY: /J~ ? If M..l / LOCATION: 1(;,{! 1C,C:, JY. ~ kr DEVELOPMENT TYPE' J)~/~~! (~/) , NO OF UNITS X TRIP RATE X COST PER TRIP :z... X 1.01 X $436.19 X X $436.19 ~ $ X X $436.19 $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ ;.1"17.77 4. SANTTARY SFWFR-MWMC NO. OF PFU'S 5:1. x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ S'o.o1i (Use PFU Total From Item 2 Above) .' MWMC, CREDIT IF APPLICABLE (SEE REVERSE) , IQIAI -MWMC snc SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ -to.?'ii ~/~9. ,,~ $ 3.2.97.f''g' 5. AnMTNTSTATTVF FFFS BASE C~GE (SUB~T~OVE) X .05 ~ /~. Date: /tJ-;2. 7-'?7' /Ma~;Jidtn;g: P.E.U . SDC Coordinator ~/' <jf.9"!) IOlAI snc $ :s ?c..tf..r.'> B2.SDC . . . fi !!!i!I.e!!!!!~!!!; Job No. q4:WU NAME: ~~ \t~~ ~~'l'~~ SYSTEMS DEVELOPMENT CHARGE lL. () W..O.,.RKSHEET O{~ PHONE: 2A-3.S~d1fl STATbll~,P Ql4D(. ADDRESS: LOCATION OF "'ROPOSED BUILDING_SITE: f\ \ llx\ Street Address if Known: ~-t-'1 ~d\ - \.' ~N Q...~ Platt Name: .G.H\rfili~ .If ./ Tax Lot Number: Jjffi? !L... ~ \ 031cO ~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the backJ A. Sim!le Familv - Detached. Single Family home Manufactured home not in a park NO OF UNITS X $400 PER UNIT _= $ . B. Sin!!le Familv - Attached NO OF UNITS d X $370 PER UNIT = . $ 140.cD C. Mt.llti-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SDC $~ $Ji $ ~J) pu 2. SDC CREDIT (If applicable) SDC-payer must fumish proof of WPRD Credit approval. See sac Credit Worksheet 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) ~ )~cW Community Services\D~ision r:...,...,1 <:'.......:.."......(;....1,..1 JL;_~~ /31- Date