HomeMy WebLinkAboutPermit Building 1992-6-12
RESIDENTIAL
PERMIT APPLlC^TION
Inspection", 726.3769
Office: 726,3'1:;9
...
.'~Io.
LOC/irION OF' PROPOSIOD wonK: '-1 ~ 0
ASSESSOH;; [,lAP: __12-~-09 !\ \
BLOCK:
LOT: __,_
ADI)nE~~~~:
CITY:.._ _,
DE:;CIlIUI'
o [1A~-t\mL
REMODIOL ' ADDITION -X- DEMOLISH
CONST.
NAMr: J.....~$ADD?\S.S\ ~ . rCt~~3ACTOR . EXPIRES PIIO~I'
~~,~..1 _ _ t~~1~~~=>-rd,~-..-JOJJK_Jl/~2-_14b512~
~ - - --. C1l~y.u-, 55\o~ -~-bJ~t~ L&'j~IWp.,
~\)(-~- fa ~(';- '_~=-=_-~
NEW ___.
GENI,FlAL: ,
f'LlJMIJINC:
MECHANICAl
ELr:CTRICAL:
OUAD AFlFA 1~
. OF IJLDG';___\_
OCCY GH(JI)I' _~._~
"OF STorlll-::' '___~*__
WAJ"Ul. Hf:AI i 11: ._. _
OTHER
,
- OFFICE USE -
~AND USE: -J. l" \ \
. OF UNITS: __J, . '\
CON,;TR. TYPI:: - V..JV
HEAr SOUIlCr:: .,E.U___
.
JOB NUMBER
(1nf\~ ( )
,W____
FlANGE: ___
~
225 Fiflh Street
Splingficld, Orc!.]on 97477
SUBDIVISION:
ZIP: Xll~t-, B
FLQOD PLAIN: m- -- -- -
\' ()~
ZONING CODE: ~._._ _
II OF BDRM~;:
SECONDARY Hr:AT:..
SQUARE FOOTAGE: _,
Iq~~
To "'~C1lJe~;1 81l im~pecth)ll, you 1IIU:;t call 7211-3769. Tills Is a 24 lIour recording. All inspections requested helore 7:0n :1.10. will IH~
Olill,1t; Ille :.;1111'': w011dl1U day. in~;peclions Icquestecl after 7:00 LUll. will be made the following work clay.
[J
TiJlllplll ,dy Eh:~lIi,;
[J
Sit(: 111:,pcclion - To I)c Ill;'!(le
all.,;, 'J..I.<J'I..til..n, IILll priUI to
Sl.:ltifliJ 10nllS.
[]
UlHkr:;lilb PlulIlhing/Electricall
Mcchallical - Plio. to cl.'ver.
K-/f' FOOlill~1 - Aftcr lfcnchet; me
~ cxcavall:ll.
'tv1 MaSOIllY - Stfwr rocation, bomj
lL-"\.bCWl1:5, ~lroulinD.
K-I'FoUlu!;:llion - Aller fOrlllS me
L"J erected l)ut pliOI' to COllc/ele
placl::lllo':nl.
[]
UI1Ch:I{J10und Plumbing - Prior
to filii/I':.! Ir~ncll.
191 Ullch:~llllo.qtrrnlllln'J.P~ll:han.jc':"p
~~_ PI I..,. <lil.Jjl~IIl,'lfon 1)1 Ileclull{l.
~Post :lnd Beam - Prior to flOtH
~ inslllalflln or tlcching.
~FIOOI: IH~ulalion -- Prior to
)L-" (j()CI<.IIlU.
'~'l Sanil;:uy Sewef - PrIor to tilling
1- tr~nch.
r"V1 Storm Sewer - Prior to lilling
~lrCI1,;IL FJ!U.XH /YVr-rJ
l=t Wall':l Line - Pdor to filling
L- trench.
M ROllqh PlllmbinD - Prior to
)L--'l cover.
REQUIRED INSPECTIONS
~nlHJgh Mechanical - Plior to
~ct)ver. . ,
KA'Rotlgh Electrical - Prior to
~cover.
I~ Electrical Service - Must be
approved 10 obtain permanent
electrical power.
D Fi.-eplace - Prior to facing
materials and framing Insp.
t8j' Framing - Pdor to cover.
K::?f Willl/Ceilill~J Insulation - Prior to
~ cover.
~DI'YWall - F'riOI 10 taping.
l~ Wood Stove - Afler Installation.
[J
Insert - Alter fireplace approval
and lnslnll,dion of unit.
[J
CurbcUI &. Approach - After
fOllns an~ (:It~clL:tl but prior 10
placement of concrete.
D
Sidewalk & Driveway - After
excavation is complete, forms
and sub-iJa~,e malerial in place.
D
Fence - When completed.
D
Slroel Trees:"" Wilen all required
trees are planted: -
""~ Fin;:lI PluOIhinO - WII(:n all
~plul1lbing worl< is GO/Ilplt:le.
rv1" Final Elcctrlcnl - WhtJn all
~eleclrical worll is cOlllph:1C.
1':71' Final Mechanical - WlllJn ,Jlt
~ Illectwnical work is cOlllplellJ.
lQ( Final Building - When ;111
~requlred int:ipcctlom. Ilav..; b(:l;fl
approved and buildinU i:.
completed.
D Other
MOBILE HOME INSPECTIONS
D
Blocking and Set.Up - WIII:!1 all
blocking is complelt:.
D
Plumbing Connections - WII':f,
Ilome has I)cen connl~(;lud tt)
water and ticwcr.
D
Electrical Connectioll - WIllJIl
1)locking, sel-up, and phfllltJjn~J
inspections have bcc:i'l npprov,:d
and the home is connected III
the service panel.
D
Final - After all requircc!
inspections are approvcd anll
porchcs, skirting, cl~c1\:->. ami
venting have been installed.
Lot Type. - '.
Lot faces Setb"cks tl"HE PROPOSED WORK IN THE
I PL. 'HSE GAR'ACC ISTORICAL DISTRICT, OR ON
Lot sq. flg. Interior IN' THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is. and approved by the Historical
Topography Panhandle Iw Coordinator prior to permit issuance.
Total height Cul.dc-sac LL-__----L
APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ, FT,
VALUE
Main
Garage
Carpor!
eel) r:d) .
J
j 79,50
010
1~8+~
SYSTEMS DEVELOPMENT CHARGE (SDC).,q3
(B) ~<fo;f..
Total Value
Building Permit Fce
Slate Surcharge
Total Fee
(A) !
K PLUMBING PERMIT
ITEM
Fixtures /
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
FEE
A?/I-l. I ~&JO
Plumbing Permit
Ie:; ~O
75'
/5". 7S
Slate Surcharge
Total Charge
(C)
~
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slovc/lnsertlFlreplace Unit
Dryer Vent
_~T .&..1& J~mA ,
Mfu.
15,C'V
Mechanical Pennll
Issuance
/0.=
.7~
2-C)'.7!;
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
It
Domolltlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
'Z.'7/)?- 2..
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition Ill;)! Ihe said
construction shall, in all res.pects, conform to the Ordinance
adopted by the City of Springfield. including the
Development Code, regulaling the construe lion and use of
buildings, and may be suspended or revoked at any timo
upon violation 01 an, provisions ~sald ordinances.
Plan Check Fe';: . \ \ 10 . \ Q
Date Paid: .~ ,\4 .q'2-
" .J\. LJ c::A.
Receipt Number' ~ '-.J 1
R~IIXA
Plans Revlewe~~ 71~:L
Systems Development Charge Is due on all undeveloped
propertles wIthin the City limits which are being improved,
ADDITIONAL COMMENTS
PkTH #-.J
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certHy that all
Information hereon is true and correct, and I (urlher eartHy
that any and all work performed shall be done in <Jccordnnr:c
with the Ordinances of the City of Springfield, and the Laws
of the Slale of Oregon pertaining to the WOtI~ described
herein, and that NO OCCUPANCY will be lT1ildQ 01 :lny
structure without permission of the Building Sa(ely Division.
I further cerllfy that only contractors and ClIlployr)(!s who
arc In compliance wllh QRS 701.055 will be used on Illis
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 tt~'c front
of the property, and the approved set or planG will remain
on the site at all t1mex.s ~; lconstrucllon.
~naturee//_- "fl) .-/
Date
VALIDATION:
RECEIPT NUMBER ~.8 6
- -
L..-/.?-9:d
AMOUNT RECEIVED 2-:;>0-<<'
~~'"--
OATE PAID
RECEIVED BY
CITY
, JOB 110. 9'2-0111
OF SI>RINGFIELO SYSTEMS OEVELOtllT CHARGE
WORKSHEEf
(COMMERCIAL & RESIDENTIAL)
.~ . .;'.-
NANE OR Cor'lPANY: Mft. i. MR.':>. Roe.E:.~T f-IA-c..K
LOCATION: ,'2.4-'1 'F'oJ!-S-<-rH IA
\ 'r, 0'2- 0'2. '2.\ ~ o-z-oOO
DEVELOP~IENT TYPE: \-oe... - .An\)I\IOI-l
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. --z.oib X SO.186 PER SQ. FT. hi ?'/)~
(See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown)
LOT SIZE
SQ. F t.
2. SANITARY SEWER-CITY
NO. OF PFU'S _ X S38.55 PER PFU
(See Reverse To Determine Total PFU'S)
Is -
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X $388.61
X $388.61
Is.
X X $388.Gl
(See Attachment C To Determine Trip Rates)
SUBTOTAL '(ADD ITEMS 1,2,
.
S
$
& 3) $ ~~?3-
4. AQMINISTRATIVE FEES
'BASE CHARGE. (SUBTOTAl ABOVE) X ;05
Is I~
TOTAL -C iTY SDC $ '-/-01.-j:.
5. SANITARY SEWER-MWMC
NO. OF PFU'S
x S13.25 PER PFU .+ S!OMWMC ADMIN. FEE S
(Use PFU Total From Item 2 Above)
~ ~eR-.:.ck
\l Kip Burdick
SDC Coordinator
s/l., /'fv
(
S
TOTAL-MI.JMC SDC Is ~
, / ~ -z.o.f
TOT AL SDC LIU -
MWMC CREDIT IF APPLICABLE (SEE REVERSE)