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HomeMy WebLinkAboutPermit Building 1993-9-28 61~ _ . ~ RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 . . ~p 'I'll JOB NUMBER 9~\41 s 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOS1D WORK' ~ 3.7) ASSESSORS MAP' \~n~()C{\ ~ TAX LOT: (7)tECO LOT' Sd-. - BLOC;' t SUBDIVISION: (irldQ(\T&ifYlL<SL. OWNER:\. nlO~. (:\n\t1DbU'1_t..4d PHONE:-l')<Aq~ 1'lldL.. ADDRESS:'0_b \~\ ,--~")UV ~&(r'd . { . CITY' 91 ~C\~~ (j STATE: 1\2r.QC\~ ZIP' q l10L (\. - DESCRIBE WORK~ ;\ 'f\f). f\ L~<t\(){\f\ Q ~ c:t-- CD JU.rrf2.,T-: NEW REMODEL ADDIBN DEMOLiSH O~E~ . - CONST. CONTRACT9f1'S NAME AD~~\r CONTRACTOR # EXPIR,E"A, PHONE GENERAL: b.~\Q(\~~:'1i~ \ . .\ ~h~0~\S:_J lo\tNtr7 6'.1~o~q.0~~2, PLUMBING' . .. ( nlM-tt .5 'l q4 (,xq .f)~(/)Z ... MECHANICAl' ELECTRICAL' 1-!fJi:.lTfIt::.l FLu-::n:.IG QUAD AREA: 4~ # OF BLDGS' I' OCCY GROUP: ~~-ttv\ # OF STORIES' \ WATER HEATER: _7- ~ 8'6~LU.cl!\""<.'^f, lo?1\?l) \Q..1~~ ,~4\.q,\~) - OFFICE USE - LAND USE: ~n # OF UNITS: \ CONSTR. TYPE: V J..-I HEAT SOURCE: F f ~ t.J RANGE: FLOOD PLAIN' ZONING CODE: LD fL-; # OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: I ~4:'P> 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, Inspections requested after 7:00 a.m. will be made the following work day. o T,pmporary Electric D Site Inspection - To be made after excavation, but prior to setting form r:::f) Underslab Plu 9 lectrlcall. \. MechanIcal - Prior over !Fooung - After trenches are excavated. 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. o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. ~sanlta.-y Sewer - Prior to fililng 9.....trench. u-:Rstorm Sewer - Prior to filling ~trench. . . .J()water Line -"prior to fiillng ~ ~rench. o Rough Plumbing - PrIor to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. o 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. D Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o D.-ywall - Prior to taping. o Wood Stove - After I~sta"ation. o Insert - After fireplace approval . and Installation of unit. ~curbcut &: Approach - After . forms are erected but prior to placement.of concrete. ~/ Idewalk & Driveway - After. excavation Is complete, forms and sub.base material in place. o Fence - When completed. ~ Street Trees - When all required r trees are planted. o Final Plumbing....;. When all plumbIng work Is complet.e. D Final Electrical - When all electrical work Is complete. '. o Final Mechanical - When all mechanical work Is complete. ~f/nal Building - When all required inspections have been t approved an1l. bUildin~ completed. \.:OJ\....~ 1 , o Other MOBILE HOME INSPECTIONS lfi Blocking and Set.Up - When ail ( ~ blocking Is complete. ~Plumblng Connections - When home has been connected to water and sewer. ?1Electrical Connection - When blocking, set-up, and plumbing Inspections have been approved and the home is connected to the service panel. mal - After all required inspections are approved and porches, skirttng, decks, and venting have been installed. Lot faces , Lot sq. flg. ----1... Lot coverage Topography Total height BUILDING PERMIT ITEM SQ. FT. Main Garage 1ft7<X ~tf\1 o '\~ Total Val ue Building Permit Fee State Surcharge Total Fee Lot Type X Interior Corner Panhandle Cul.de.sac X $/SQ. FT. . . I, IS THE PROPOSED WORK IN THE . HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. ,. '. Setbacks 'HSE'GAR'ACcl I I P.L. IN Is Iw ~ APPROVED' = VALUE Q I 4-9, r/Y). ~"IO ILoC\Lpca ~Q 1'C\ . l=)S. <i\G\ (0 Ul'i5C\l11") !o~.5() ,0..4 ~ II \ ~3 N' FT. FT. FT. Fu mace MECHANICAL PERMIT (C) Total Charge Exhaust Hood Vent Fan (A) Dryer Vent Wood Stovellnsert/Flreplace Unit N' Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk I 00 Curbcut (31 Demolition State Surcharge fl fl Total Miscellaneous Permits (E) SYSTEMS DEVELOPMENT CHARGE (SDC) *' . (B) 1j. 'Z II (" C?!.. PLUMBING PERMIT ITEM FEE ~S~ ~ S .DUO f\ 0 (yS. ')~OU ..3 . f'LS ()b.r)~ o \C6~ a1). tV 5.a~ IY.U] \"t.W TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D. and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition th the said construction shall, in all respects, conform to Ordinance adopted by the Cily of Springfield ncluding the Development Code, regulating ttle con ruction and use of buildings, and may be suspended revoked at any time upon violation of any pravi 'on of said ordinances. Plan Check Fee: ,,,-, Date Paid: .\:": '\(' Receipt Numb .,..RIans Revi ewed By Date Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Systems Development Charge is due 'on all undeveloped properties within the City li~its which are being improved. ADDITIONAL COMMENTS , ~~ H l\ (\J:::)\ oi Q H~)Lrt.PL( 'YO 0 .r ) '- ~+-C \~.qlon \_~MOJL G010 / \qr,q .../). I ~ ( (-4ocx-9-- \'0 "" t.~ 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 thai 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 street, that the permit card is located at the front of the property, and the approved set of plans will remain o the site at all times during construction. natureJ_J/~.u;........ '&. NaA.1~,^ c::y . 2.8 ,Cj3 VALIDATION: \'f\A In RECEIPT NUMBE, 1 1\ ftLl DATE PAID '--"'\ .fn4 ~ AMOUNT REC~\ I ~ - - )- RECEIVED By~R r ... ""-.-.. .....>-...""". . .08 NO. Q?IL\-2S CITY OF SPRINGFIElD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ~I \ e.L Go LDSBLlI2.Y LOCATION: ~:?B ~\"'- - \~02...0~'Z-? - 0 \<iSoo DEVELOPMENT TYPE: LP~ - t-lE-W N\Pr~Ll. I-l.c> M:.fO ..tOMe -:'10... CM4' DW BUILDING SIZE: 'Zfl~IDI.I"'.5"\.. \'1.<;~1-' .\~V...o LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. -z.q'-t, X $0.203 PER SQ. FT. ~?qe2.<1:.) '- ...---- 2. SANITARY SEWER-CITY NO. OF PFU'S ,(See Reverse) 3. TRANSPORTATION IS X $42.08 PER PFU (;'5ro.fl) "- ......-/ NO OF UNITS X TRIP RATE X COST PER TRIP X X $424.31 ~"'Ze "'6::) '- ...-/ $ $ \ X 1.01 X $424.31 X X $424.31 4. SANITARY SEWER-MWMC NO. OF PFU'S I 'to x $15.125 PER PFU + $10 MWMC ADM FEE $ 2&"2 '2.2- (Use PFU Total From Item 2 Above) $ '=>1 'Z~ MWMC.CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWMC SDC ~ '- ../ SUBTOTAL (ADO ITEMS 1,2,3 & 4) $ '2.0 \? ~ 5. ADMINISTRATIVE FEES . BASE CHARGE (SUBTOTAL ABOVE) X .05 ~~. _O~ c.k- "1/oz,(J /q,~ . :U Kip Burdick '/ SDC Coordinator ~ 00''':-) ........ ...-/ TOTAL SDC $ -z. II <0 o~ ..r' .' J .. . o y'y'i!I.!!!!!!~!!~ . Job No. CJ314tLS. SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME~~' b.D\[\JJ'\:)\D\ to. PHONE: LD~q-f(r'\\j)~ ADDRESS: cjf)\4~.\ \ ~l).-J,CPRJI bX\J STATE:~ZIPg'J4(j]) (j 0 LOCATION OF PROPOSED BUILqI.,NG SITE: ~111 ,'Il)j /l, Street Address if Known: 5Ll~) I J' .rn~ 7 J A~ Plan Name: Grlcltn'~'(f(\(O Tax Lot Number: \m::\'[)~Q::\ ()\fY"L) di 1. DEVELOPMENT TYP~ (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back.) ;;< A. Sinl1le Familv - Detached Single Family home I Manufactured home not in a park $ 4ffJ.oO NO OF UNITS X $400 PER UNIT = ~ B. Sinl1le Familv - Attached NO OF UNITS X $370 PER UNIT = $ C. Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SDC .A",^ 00 $ -n ^--J . 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) $0 $ 4{J() pC) ~~~ D Community Services Di~Sf City of Springfield C\ / p)~ /l~ Date stGFIELD .... ~ .. .. The following projoct as submitted.~as the followin zoning, and does not require specifIc land use approval. 225 FIFTH STREET ~.17 /' SPRINGFIELD, OREGON 97477 Zoning \IV''''- INSPECTION REQUEST: 726i'i~t~69ti, 1.SLC,?:> OFFICE: 726-3759 1~1~ Aulhorizs<i Sign&ture~. ~.' 'J9*:?:':::::B rEE SCHEDULE BELOV 1. ~~I9li I S AL nON ) \.. 'J L..l ..."""l J n A. J~Aq~~~6 bf'60() ~P~:~~~t~:~fe:bl: ~~ire if work is not started within l80 days of issuance or if work is suspended for 180 days. ELECTRICAL PERMIT APPLICATION q3\~ City Job Number New Residential-Single or Multi-Family per dwelling Service Included: uni t. Items Cost Sum $ 85.00 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 15.00 ~ Pr) $ 40.00 Services or Feeders Installation, Alterations or Relocation: B. 2. CONTRACTOR INSTALLATION ONLY Electrical contract~ 0 y\*~ Address ~ ~ lJ.'"). M ~ City h-~t.NL- Phone laq. \~ Supervisor Llcen~e Number ~tL\~ . \D. \.c\S lo3~f) \ Q. .@.1) .Q3 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 200 amps or less 201 amps to 400 amps 40l amps to 600 amps 60l amps to 1000 amps Over 1000 amps/volts Reconnect Only Expiration Date .. Temporary Services or.Feeders Installation, Alteration or Relocation C. Constr Contr. Number $ 40.00 $ 55.00 $ 80.00 see "B" above 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts Expiration Date Signature of Supervising Electrician ~~ Owners Name:.1\; oQ brldlltJtt}\ A. ~ D. Address~tJ \~ \ t\lf'.\ \.qCC \\) City ~ UQJ,\Q . Phone~?A-/}1~ OVNER ~STALLATION Branch Circuits New, Alteration or Extension Per Panel $ 35.00 One Circuit Each Additional Circuit or with Service or Feeder Permit I $ 2. 00 ~ E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited. Energy/Comm $ 36.00 5.. SUBTOTAL. OF ABOVE c9rJ . cD 5% State Surcharge "+. i (.) TOTAL. ja/,f n. if ) The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: r~.- -------- '--Z'~ Y In. +\'~ DATE~-~----q~~7 r RECEIPT I: RECEIVED BY: .