HomeMy WebLinkAboutPermit Building 1992-7-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
.
LOCATION OF PROPOSED WORK:
"?2 ~ ?
/,R-02-c>71- 2/
P/?5~;?,#./~
ASSESSORS MAP'
LOT:
OWNER: -;?~j!r'l"';';;.p
ADDRESS:_ ~ '
~~
,. r.." /'
DESCRIBE WORK: ~H":>?' ffu'C7-
CITY:,___'__'_
NEW
REMODEL
... .'-..
ADDITION
BLOCK'
~~/if:>t;; ".;:.~
. '
JOB NUMBER ~~
225 Fiflh Slreel
Springfield, Oregon 97477
TAX LOT: --L7~~
SUBDIVISION:
PHONF'
STATE: ---cff!.?=; ZIP: q~
~
E~/~~ ~~:' C-/YZ4-rp~
...." , ':'. \.. ......~,
OTHER '-
......--
DEMOLISH
CON ST.
CONTRACrOIl'S NAME,...,. , "ADD~E~~~y/ff<. ,CONTRACTOR'
GENERAL.~/~ij~':'~4J? ~._~
PLUMElING: _,_u___,
MECHANICAL'
ELECTRICAL:
QUAi:! AREA:
. OF BLDGS:
.~\(~
-I \.
OCCY GROUI':
. OF STORIE',;:
WATER HEATER:
- OFFICE USE -
I \ l \
LAND USE:
.:: . OF UNITS: ~- rJ
C~NSTR. TYPE:_\!
: HEAT SOURCE: ,JhpG'"
~ ' \ l..... ....
RANGE:
EXPI n [S
I"HONE
~-5"'2~_/?~~
FLOOD PLAIN: _ _,/) .
ZONING CODE: m ,---
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.In. will he
made the saine working day, inspections requested after 7:00 a.m. will be made the following work day.
r~-l Temporary Electric
D Sile IIl~pcctlon - To be Illade
after c;,',:avation, but prior 10
settinH t01l1l5.
D Undcrslab Plumbing/Electrical I
Mechanical - Prior to cover.
K7f Footing - After trenches are
~ excavated.
D Masonry - Steel location, bond
beams, uroutlng.
~ Foundation - After forms are
~ ereeteel l)ut prior to concrete
plaeernunt.
D
Underground Plumbing - Prior
to fillin9 trencll.
D
Underfloor Plumbing/Mechanical
_ Prior to insulation or uecking.
~ Post and BClIm - PrIor to floor
.J..D.J. insulation or uccldng.
D Floor Insulation - Prior to
deckinu.
D
Sanitary Sewer - Prlor 10 filling
trench.
D
Storm Sewer - Prior to filling
trendl.
D
Water line -.I?rior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D 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.
~Framing - Prior to cover.
D Wall/C'eiling Insulation - Prior to
cover.
~rYWall - Prior to taping.
D Wood Stove - After installation.
D Insert - Alter fireplace approval
anel installation of unit.
[J
Curbcut & Approach - After
forms are erected but prior to
placement 01 concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
D Fence - When completed.
D Street Trees - Wilen all required
trees are planted. -
D
Final Plumbing - When all
plulllbing worl< is cOl11plete.
D Final Electrical - Wlwn all
electrical worl< is complete.
D Final Mechanical - Wilen all
mechanical work is complete.
~ Final Building - WIlen alt
~equired Inspections have been
approved and building is
completeej.
D Other
MOBILE HOME INSPECTIONS
D (]locking Clnd Sel-Up - Wllerl 4111
blocl<inU i~ complete.
D Plumbing Connections - WIII]rl
home Ila5 been connected to
. water and sewer.
D
Electrical Connection - When
blocking, set-up, and plurnl)ino
inspections have been approved
and the home is connected to
the service panel.
D
Final - After all reqlJircd
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
LoL Type.
Interior
"
Lol sq. fig.
Lot coverage
Corner
Topography
Panhandle
Total helghl
Cui-dc-sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
Main
Garage
-..." .
Carport
'.
-
~L~ ,~~~
Total Value
Building Permit Fee
Slate'Surcharge
Total Fee
(A)
as THE PROPOSED WORK IN THE
~ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be sl~Jned
and approved by the Historical
Coordinator prior 10 permit issuance.
Setbacks
I P.L. HSE GAR ACC
IN
Is
Iw I
~--~
VALUE
7~-
hz10
. ,~/3
(/,5. b3
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
. This permit Is granted on the express condition that tile said
constructIon shall, In all respetts,conlorm to Ule Ordinance
adopted by the Cily of Springfield, including Ihe
Development Code, regulaling the construct'ion and use of
buildings, and may be suspenoed or revoked at any time
upon violatlon of any provisions of said ordinances.
. Plan Check Fee:
<;/,(/, ~ 3'
.
tt: ~"2 :2-92
Date Paid:
Receipl Number' ""'5"""2'2'<:::!>
Received y: _ ~ ~
, ,~~~ .
P n Ffevle~rL<
- ,
~~z.._
SYSTEMS DEVELOPMENT CHARGE (SDC)~
(B) (f ~'Z-~
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFireplace Unit
Drycr Vcnt
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
01Alo Surchargo
Sidewalk
fl
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
1785
ADDITIONAL COMMENTS
--"loT ~~R'cD -M A ~1/'!!LE
~7'I-r' F: .
~~~cAC /f16M/-LT
----6 ,~~/.(/A'.M.
By signature, I state and agree, that I have caretully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further eertHy
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 thc WOIk dcscribed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certlty thai only contractors and cmployees WllO
are In compliance with OAS 701.055 will be uscd 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 fronl
of the property, an f1a oved set 0 f plans will remain
on Ihe site al I Iii s rl g c~, Iruulcllon.
/ ~IO:.IU~:A: ~-k
Da1UO .- / ") r-L-? /7.-
VALIDATION:
RECEIPT NUMBER
5532-
~u_____
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
CITY OF
JOB NO. '12.08(,,0
SttINGFIELO SYSTEMS DEVELOPMI CHARGE
WORKSHEET J
, (COMMERCIAL & RESIDENTIAL)
NANE OR COMPANY: '&tum,~ V.4I>be.W""r.>
LOCATION: 5'2..(,'1 1=DRSYT/-frA.
DEVELOPMENT TYPE: !..O(l.. - A-tJP f 11.01'1
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. /(p'5.. X $0.186 PER SQ. FT.
(See Reverse For Runoff Coefficients If Actual Imperv. Area
/9>0'2..0";2-1 - 0&;"00
LOT SIZE
SQ. Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S X $38.55 PER PFU
(See Reverse To Determine Total PFU'S)
s
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
..-
X
X
,..- X $388.61
X $388.61
s. -.
$
X X 5388.61 .
(Se~ Attachment C To Determine Trip Rates)
. . SUBTOTAL '(ADD ITEMS 1,2,
i' .-r-'
& 3):~.:'O.':.!
.'
"
4. ADMINISTRATIVE FEE~
'BASE. CHARGE (SUBTOTAl ABOVE) X :05
G/~
- -
TOTAL-CITY SOCS; ?'2-~
5. SANITARY SEWER-MWMC
NO. OF PFU'S
,---
x $13.25 PER PFU ,+ S!O'MWMC ADMIN. FEE S r--
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
V. ~L...L
'~ Kip Burdick
SDC Coordinator
s
-
eo/Z'-!1-z.-
, ,
TOTAL-MWMC SOC S ,b-
TOTAL SOC S ?L-""..=:.