HomeMy WebLinkAboutPermit Building 1993-8-20
OWNER: ,Vejl/IV/~ T fYll'IRf"vH
ADDRESS:' / 14 L.f Kell'1 fJ //1/1).
CITY: ~RIA/,! Jj7",t..c1
DESCRIl3E WORKt,,:i~)9 r\ )\~\. cNtr\,~h~
NEW REMODEL ~ADDIT10N ~ DEMOLISH
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
CONTRACTOR'S NAME
GENERAl'
('J 1-0 IV e.'1f?
"
PLUMBING:
MECHANICAl'
ELECTRICA' .
\ ~ 1\)0
QUAD AREA:
. OF BLDGS: -ty,..l-.
OCCY GROUP: no
.' OF STORIES: _ \
WATER HEATER:
~""~
CONST.
CONTRACTOR'
wo,fk
.
SPRINGFIELD
\.
.
JOB NUMBER
Cl3\()qQ
BLOC~'
tfJo1doN
STAT~'
eJ "e.
225 Filth Street
Springfield. Oregon 97477
~f~J^,,4f'/t':LeC oR Q7'fC)1)
~. TAX LO~: n?fY'Y'J
SUBDIVISION'
PHONE:
'7Lft -" 1730
7Y/~ 5~~ W~.
ZIP: 90 {f (J I'}
ADDRESS
-to
po
EXPIRES
PHONE
- OFFICE USE --
LAND USE: \ \ \, \
. OF UNITS: \
CONSTR. TYPE: jJJ\J
HEAT SOURCE: n~.
RANG'"
FLOOD PLAIN:
ZONING CODE:
WU-
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
;)CY"J
To request an inspection, you must call 726.3769. This is a 24 hour recording. Alllnspeclions reQues~cd before 7:00 a.m. will be
made the same working day. Inspections requested .after 7:00 a.m. wilt be made the following work day.
o Tcmpora-ry Electric
r I Site Inspection - To be made
after excC:tvn!ion, but prior 10
setting forms.
o
Underslab Plumbing I Electricall
Mechanical - Prior to cover.
M Footing - After trenches aie
~ excavated.
o Masonry - Steel location, bond
beams. grouting. .
~ Foundation - After form~ arc:
~ erected but prior. to concrete
placement. .
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
1M Post and Be'am - Prior"to Hoor
~ insulation or decking. .
rN' Floor Insulation - Prior to
t.p decking. :'
o Sariitary Sewer - Prior to filling
trench.' .
O Storm Sewer,- Prior to filling
trench. .
O Water Line - Prior ~o filling
trench.
o Rough Plumbing -..:. Prior to
cover, .
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
r"'sfr Rough Electrical - prior to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
elt~ctrical power.
o Fireplace - Prior to fa<:ing
materIals and framing Insp.
~ Framing - Prior ~o cover.
r?( Wall/Ceiling Insulat'ion - Prior to
~ cover.
~ Orywall - Prior to tapi~g.
o Wood Stove - After install2.tion.
o Insert - After flrcplar.e approval
and installatIon of unit.
o Cmb::ut & Approach - After
forms arc erected but prior to
placemcni of concrete.
o Sidewalk & Driveway -. )otter
excavation is comp!e!e, forms
and sub-base maieri2i in place.
o Fence - When completed.
o Streot Trees - Wt\ert an r,~quired
tr0~S arc planted. .
o Final Plumbing - When all
plumbing work is complet.e.
~ Final Electrical - When all
~electricar work is complete.
D Final Mechanical - When all
mechanical wor:.. Is complete.
~Inal BUilding - When all
P~eqUlred inspections have been
approved and build:ng is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blockIng is complete.
CJ Plumbing Connections - When
home ~las been connected to
water ;:;;nd sewer.
C' Electrical Connection - V.Jhen
.--' block.;ng, se:.up, and plllfllblng
in5pe::tions have been approved
and !hc hornc is t;onnectco to
the service pant;!.
o Final .- After a!! required
Ir'\scect!ons arc approved Qr.d
porchl1s, skirting. decks, and
venting have be;:.n installed.
Lot faces
Lot SQ. fig.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SO. FT.
Main
Garage
Carport
fl,RW\.
&38
Total Value
Building Permit Fee
State Surcharge
Total Fee
.
Lot Type
Interior
Corner
Paphandle
Cul.de.sac
x $/SO. FT.
Setbacks
HSE GAR ACe!
.
i. IS THE PROPOSED WORK IN THE
HISTORICAL DiSTRICT, OR ON
THE HISTORICAL REGISTER? NI?
I P.L.
I,;
r~--
VI'
-~--
I E I
~-,
VALUE
~.~ J.3~
(A)
jtyt5)
D.~'6
\rY\.~?J
SYSTEMS DEVELOPMENT CHARGE (SD"!>C)1f=,
(B) /I So U .
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sower
Water
Storm Sewer
Moi.Jii~ Hom~
Plumbing PermIt
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
FT.
FT.
FT.
(e)
Dryer Vent
Wood Stovellnsertl Fireplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
Ii
Curbcut
ft
Demolition
State Surcrlafge
Total Miscellaneous Permits (E)
FEE
TOTAL AMOC!"JT LJU~ (excluding electrical)
(At 9, (:;, 0, and E Comblnod)
II nDIi?J:U;
':,,:
-i
'J
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perl1lit,is granted on the express condition that the said
constru~ction shall, in all respects, corlform,to the Ordinance
adopted 'by the City ,of Sprinqfield, including the
Develop:nent Code, regUlating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of a11' ,gr?\isi'ons of said ordinances.
Pia" Check Fee: :'--)C ~q~
Date Pairl: 1]-.:A!' ~~ T
Receipt Numb 'r:_ _3--;-,.(J Ll----
~(Y\ J
~
R~d By:
.~~eviewe
~r'?-5'~
Date
Systems Development Charge is due' on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Jnformation hereon is true and correct, and I further certify
that any and all work perform~d shall be done i.n accordance
with the Ordinances of the City-of Springfield, and the Laws t
of the Stale or Oregon PQrtaining to the wO,rk described
herein, and that NO OCCUPANCY will be made of any
stwcture withnut pern~;ssion of the Building Safety Division.
I furl her c:ertify that only cornractors and employees who
arc in compliance with ORS 701.055 will be used on ttlis,
project.
I further agree to ensure that all required inspectio,ns are.
requested at the proper time, that each address is readable
from the street, that tile permit card is located at the front
of tho property, a d..t,be approved set of plans will remain
on the site at 1 tl cs durin~truction,
Signature. 'M~",,- '~i)hl,;i.V'J_
Date
t/ iJa;/93
VALIDATION:
RECEIPT NUMBER ..J.117~ IOD~
;;)'() 0.'
DATE PAID -ftTJ.-.9 '3
AMOUNT RECEIVED I Cf-1 .~~ I
/W.laJi.U ~
RECE'VEC BY
f"I'fiW'" "
'.
....
.:,.;_;'J. ..
.
.OB NO. '13/ Qq3-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
','
',' WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: f)f3..IJN/S I M/U?-/IIJA R/~/u)ItN.
LOCATION: /3J./lf Ket.-L.'1' 'f5I-VP, /7032-7<ft-f-03oo6
DEVELOPMENT TYPE: LP,L - AiH> I ,,~ N
BUILDING SIZE:
N~n
LOT SiZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 'Z",;>B X $0.203 PER SQ. FT. C lfs ~0
2. SAN1TARY SEWER-CITY
NO. OF PFU'S X $42.08 PER PFU ( ~)
(See Reverse) ../
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) $ '-f '6 ~-'-
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
Ie::'..:..... ~L...L .., /1-'1 j1?
U Kip Burdick f I
SDC Coordinator
~
TOTAL SDC $
c 7~
;.>0 -
A
"-...