HomeMy WebLinkAboutPermit Building 1995-6-26
RESIDENTIAL
PERMIT APPLlCATI
Inspections: 726,3769
Office: 726,3759
..
SPRINGFIELD
.OB NUMBER qC;-otJtK
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: / I?An (7"" L,~
ASSESSORS MAP: II? -r:JZ - O~A
3
VV Ay / J:;.tJ,z, Aj'<:; ,c/,o-~ _ ,.,.&>
TAX LOT' //00
SUBDIVISION:a~ 1/'-"""'..../".,.,./
LOT'
Z-
BLOCK'
~ J u(
OWNER:, .'1) "lV' l>
ADDR""''''' 1"/7.A
~ --.J BJA/lI r. IS
~.q.~;:.. '::D .?
CITY:
j::::'- u~ r=.v ..:2
II nr.
rA-AJd.
PHONE:--9I::.J -A2.PJ_~
ZIP:
Q~n9'
STATE:
~e
DESCRIBE WORK: ' ..t.'.'" ~~.R.., ds.'J I ~A-AI/ J "-~J ~
NEW
x.
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL:G.~
PLUMBING:
'(
"
DEMOLISH
OTHER
~"'J\.L';!r'
ADDRESS
Sl::)2..4./J,Ayo/
CONST.
CONTRACTOR'
4~ 4/2'
It
PHONE
?.P~-ZI "N
If
MECHANICAL'
ELECTRICAL: --:t:::>~ "Rlii!I::>--.J
OUAD AREA'
o ~ t;~ /
I
f{h,.
. OF BLDGS:
OCCY GROUP:
. OF STORIES: ~
y/
WATER HEATER:
.,., 1\
- OFFICE ~E -
LAND USE: --LIt;'!;
'. OF UNITS: l
CONSTR', "TYPE: ~rJ
:([
HEAT SOURCE:
RANGE: _f:
EXPIRES
//-9J:(
w
1/
FLOOD PLAIN'
ZONING CODE: ~ti--
?J
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: _'I g2.-.
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, Inspectlons requested after 7:00 a.m. wIll be mace the following work day.
D Temporary Electric
o Sito Inspection - To be made
after excavation, but prior to
setting forms. ()"'A4 ~
W'?nderslab PIU.x~~ct"call
Mechanical - Prior to cover.
,,-
rr-YFootlng - After trenches are
L.1..LJ excavated.
o Masonry - Steel location, bond
beams, grouti ng.
~undatlon - After forms are
erected but pr.i~.Jo-"onc~'f:lf
placement. ~ --!>
, ,
'1 ___ ~_-.-1
o Underground'pfumblng - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
~eCking, ,
r-l : -". '. i~'.2r - Prior to filling
~renc .
~torm Sewer - Prior to filling
trench.
~ater Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prlor to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
D Wood Stove - After Installation.
o Insert - After flreplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
/
~dewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work Is complet.c.
o
Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
requIred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
~Iocklng and Set,Up - When all
blocking is complete,
~Iumblng Connections - When
home has been connected to
water and sewer.
rI Electrical Connection - When
L\:..L1)locklng, set-up. and plumbIng
Inspections have been approved
and the home Is connected to
the service panel.
rI Eki~1 - After all required
L.....-I1nspectlons are approved and
porches, skirting. decks, and
venting have been Installed.
LOI faces
Lot TYP.
1 Interior
Lot sq, fig,
Lot coverage
Corner
Topography
Total helghl (~:)
BUILDING PERMIT
SQ, FT,
Panhandle
Cul.de-sac
.IS THE PROPOSED WORK IN THE
"HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes. Ihis application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I P,L.
IN
Is
Iw
IE
Setbacks
'HSE'GAR'ACCI
I
I
I
I
ITEM
X $/SQ, FT. ~ WU[(:i)
5~,
Main
Garage
w
Total Value
Building Permit Fee ' [~~ J
State Surcharge ;- '0C!t>
Total Fee
(A)
~qoc)
\o~Od)
_90.ro
4.?O
\o\.~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~~4-7 ~
PLUMBING PERMIT
ITEM
Fixtures
:e::~_e,:I~~::rt~: 1\0)_
Waler ' ' FT.
Storm Sewer
FT.,
Mobile Home
Plumbing Permit
Stato Surcharge ;-~~
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk ..uR.- ft
Curbcul F ft
o~_.""~~ ~O~'~
State Surcharge \)
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C. 0, and E Combined)
FEE
~
~SPO
&~~
'~~ro
b~
el~
if
\O~oo
d)()~
5.Q.$
Q(n.~
~,
W'~
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:
Receipt Number'
ReceIved By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
A--r~: If 111J1C, 00
(l17.1l{(1IJ,07f.- daft ~
. .. .
~~~~
By sl~n~~tate ~~ave caref~IIY 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 Sprlnglleld, 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 pe~missi.on of the ,Building Safety Division,
I further certify that only contractO'rs 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 tho site ~ime: durin construction.
Signature ):~ '
("p - ;J-..(r f?
Datp
VALIDATION:
/~~/??
DATE PAID b -26- "?~
AMOUNT RECEIVEn (\ ,f1tY 1 .~o
./2~
RECEIPT NUMBER
RECEIVED BY
-'
,
.,
.
.,
~~ " ,
.. ""... Wilfamalane
'(,-g' Park & Recreation District
Job No. q'!{J~g
NAME:
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
~\rt ' ,\u,ll1N\
- - -
~t-
PHONE:~\.4-~
"
ADDRESS: \11
STATE:~ZIP <tt4.n4:.
- '
LqCATION OF PROPOSED Bl(lre~G~TE: l\ "I..' ~. -:-'\
Street Address if Known: ~ \. \lUL. \ \ ' w I J
Tax Lot Num~~ 1ID\~ (){IOO
Platt Name:
1. DEVELOPMENT TYPE (Check appropriate dwellirig(sl. SDC Calculations and dwelling type
, definitions are on the back.) , , ,
A. Sinl!le Familv - Detached
Single Family home
NO OF UNITS I
B. Sinc:rle Familv - Attached
NO OF UNITS
C. Multi-Familv Aoartment '
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
I Manufactured home not in a'park ""
X $400 PER UNIT .r" $ 'A:{)O J..U,
.
X $370 PER UNIT =
'$
X $~77 PER UNIT =
$
X $280 PER UNIT =
, $
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 CrediO
, ,$ 4{Ql!?
$" t5
, $4-0000 '
~~W
r.........,.......;.....:h, ",..,.,.:",~ n;,,;t"il"\n
6> I 2C I --'75" '
n""
< ,~..~,';;, ~
~-._ ~,'\%," ,.:t$-!fJ{tJ.~:.,.~~~-..
0<" ".._~,~.....
.
.B NO. CfSOS86
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: DAVID d .JANICE- .JULUfY1
LOCATION: I (j & D CAl..e WAY / 'is 07-- () S -z-4- - II 60
DEVELOPMENT TYPE: L-OIZ - ^-l/2.W MA-NUFItc../Uf'(cb t-/ONlE::.
n....e. p,W,
BUILDING SIZE: r.., ~ 1-1. 10 X ~o LOT SIZE
1. STORM DRAINAGE
SQ. Ft.
IMPERVIOUS SQ, FT,
Zc)"'P 2-
X $0.209 PER SQ. FT, E'?? '~
2, SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
N,A,
X $43.26 PER PFU
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
f
X /,01
X $436,19
X $436. 19
X $436.19
X
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S AlA, x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
(~)
G 44<150;)
....... ----
$
$
$ -A-
$
~
"- -----
$ 'i515~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05 ( LY~7~)
l~'-;R., ' ~~ Date: 5/., /95
-(f Kip Burdick I 1 TOTAL SDC $ "l/Q4:]
SOC Coordinator
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