HomeMy WebLinkAboutPermit Building 1994-1-7
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP' /.gCJ 2-
':<:::Jf"In
LOT:
.
SPRINGFIELD
WilL,.,
hCf4L.J ,T~5SI(A DP../lJe
02- -;2- ~
BLOCK'
OWNER: sr~UC A-jJ,f) ,<;If1AH
ADDRESS'- 69'14 ~T F 5 SI( A
<; PR.IAJGFlt:LD
CITY:
DESCRIBE WORK:~Yi1ILV
NEW
REMODEL
K 1 A)AJ~t
nR.l{J~
STATE: --12.1<.
~()oll1 AnOfrlfJAJ ,
- I
ADDITION )(' DEMOLISH
.-
7P to\
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JOB NUMBER
93/B0:5
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' "<: "Z..b-D
SUBDIVISION: 5 PI< I ^) 61<./ D h;::
,
PHONE:
74_7- >N?09
D;C:7_~
R~&J/I..f)
- OFFICE USE -
LAND USE: \ \\ \
# OF UNITS' /
CONSTR, TYPE: -J.1..."AJ
HEAT SOURCE:
RANG~'
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cove~ .
r\7f Rough Electrical - Prior to
~ cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp,
~ Framing - Prior to cover.
FVl Wall/Ceiling Insulation - Prior to
I cover.
~ Drywall - Prior to taping,
D Wood Stove - After t~stallation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
. excavation Is complete, forms
and 5:ub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. '
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES
GENERAL: r t<A16 BUILOtt<'): 2'1(j'S JfFFf~9J/IJ., tU{;(,afJ~'I50UI301?l.j.
. I J.A . " ,
PLUMBING: II
MECHANICAl' l\ 1, A.
ELECTRICAL: 13U1lDf.i5 (Leer::l1~ aOAJ~o~-J BJbc~(~:l]OS) 10/!j<14
OTHER
QUAD AREA: ~0rr:
# OF BLDGS' \
OCCY GROUP:<P"':?J.:!:.-\v'\
# OF STORIES: . ~ I
WATER HEATER:
PHONE
7.:<6- SSCfI
185 - 09~~
FLOOD PLAIN'
ZONING CODE:
LOu
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ---c:!1,!JO
To request an Inspection, you must call 726.3769..Thls Is a 24 hour recording. 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
F::7I' Site Inspection - To be made
1p after excavation, but prIor to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
~excavated.
d Masonry .:... Steel 'location, bond
~ beams, grouting.
o Foundation - After forms are
erected but, prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
~Post and Beam - Prior to floor
LP insulation or decking.
~Floor Insulation - Prior to
'T'" decking,
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
o Waler Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
plumbing work Is complete.
fiV7f Final Electrical - When al I
~ electrical work is complete.
o Final Mechanical - When all
mechanical work is complete.
r')(f Final Building - When all
~ required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
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.
r.
Lot Type . \_THE PROPOSED WORK IN THE (
-~!
Setbacks
X- Interior I P.L, HSE GAR ACC I '.'HISTORICAL DISTRICT, OR ON W
IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed,
Panhandle Is I and approved by the Hls!orical
I Coordinator prior to permit issuance.
Cul.de.sac W
E I APPROVED:
Lot faces ~
Lot sq, ltg, '8(lJ}2.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT,
Main :;;?:.ZC:>
X $/SQ, FT.
<:;"'ro.2.."
=~ VALUE
/Z 3 W-
., -
Garage
Carport
~~
'J,)"L
S,--
J7S;,<\.~
Total Value /17 / J 7, ""
Building Permit Fee II",$()
State Surcharge S:S.3
Total Fee (A) 1/( 6:?
SYSTEMS DEVELOPMENT CHARGE (SDC) 1fs
, (B) 1\ t5? +2:.
,
PLUMBING PERMIT
ITEM "\
Fixtures
FEE
Residential Bath(s) N'
Sanitary Sawer 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/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (El
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
pI ,'{5
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express conditlon 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 tlme
upon violation of any provisions of said ordinances.
'1.J.SS
/'7-/7-'73
Plan Check Fee:
Date Paid:
Receipt Number- 1/ /7<b
RaceiYY: ,~
PlaM_~~~~;L f/!
_1- t-?t-
o Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
U~ ~n\\\\; (>t~\\\~~
I ~ -'2Z- J~~
By signature, I state and agree, that I have carefUlly 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 agree to ensure that all required inspections are
requested at the proper tlme.- 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 the site at all times during construction.
Signature 0 Eio.;~/)Au'() A. C~AI6)
t:::-/
Date / ~ / I? / q 3
. .
VALIDATION:
RECEIPT NUMBER
//~/~
/-?-9 V
,9./.c,/S-
/h -~
L/' .;roo
-,
DATE PAin
AMOUNT RECEIVED
RECEIVED BY
,I
;,j
.
.OB NO. '1'~ I go (,,:. "
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: SIP-VE. i 5A1?-AH klt-J/.JP-E
LOCATION: t:,qt./ L/ -Ie.-S-SICA 'OR...
DEVELOPMENT TYPE: L lJ.f!-. ~ A-t>-P i //0"-/
BUILDING SIZE: I~:,/ j." INC'i-vOes l'AvgLOT SiZE
/'30'2--0'2--"')...-'2;, - 3'1--00
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
'2rao
X $0,203 PER SQ_ FT.
~ 57- ~)
"- ----
2, SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
X $42,08 PER PFU
~-)
"---- ,..../
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $424.31 ~ - )
'-- .-/
X X $424,31 $
X X $424.31 $
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $15.125 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) $ 5 '2.!..!.
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
\.,/> ~L'J,.. 11-/'1.-(; jq,?
'-l Ki P Burdick 'I
SDC Coordinator
~ 7- &.:!:- ")
'--- ,..../
TOTAL SDC $ 55 <I:!:::-