Loading...
HomeMy WebLinkAboutPermit Building 1994-5-26 I _ .-~, ~ RESIDENTIAL PERMIT APPLICATION . Inspections: '726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' & I ~) \r")()'~fJ I() ASSESSORS MAP: LOT' BLOCK' t q ADl1rJ) JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LClT: 0A.4{'r) SUBDIVISION\ID'\\n, J~ OWN~. "~J\ \00 0._ -' ~. \.()0. . ~ - PHONe. ADD E . () 'L{ JlW, )-.9 rti t1Ino.JI...< 1 CITY _ {YCi~ ' ". STATE: I 1J/~ ZIP:!:J94 51 DESCRIBE WOR~' \. 'n l \'\\ 0 . \\\l\ ~~ '1 ~ C\- C'OJ\ fY')ft. NEW REMODEL ADDITION' DEMO~H OTHER. \, CON ST. CONTRACT~~'~ ~AME _ ('\ ApORESS ' . :---f _:<:N~ACTOR · GENERAL:~' \ Lo\ I ')~~ '~..:. ~~ f:::JJS/L PLUMBIr:iG: \.'\ ,,\. ' MECHANICAL' - ELECTRICA'\ )( llli.g...lli~ OUAD AREA: ;\'Q.1\0h~ . OF BLDGS:_- OCCY GROUP: ~:) \ f....l . OF STORIES: WATER HEATER: - OFFICE US~ LAND USE: \ \~ ) , I" '. OF UNIT'" CONSTR. TYPE: V f'J HEAT SOURCF' Ts L RANGE: EXPIRES ~~NE ~.fl.q~ '-f1fl.5'J1[ * FLOOD PLAIN: ZONING CODE: illL . OF BDRMS' ~ SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspe~tlons requested before 7:00 a.m. will bo made the same working day, Inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS D R~U9h Mech~nlcal ...:. Prior to cover. D Temporary Electric D Slto Inspection - To be made after excavation, but prior t setting fo ~ Underslab Plumbl Mechanical - Prlo D Footing - After trenches are excavated. D Masonry - Steel location, bond .beams, grouting. o Foundation - Atter forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to decking. ~sanltary s.ewer - Prior to filling rench. .' . Storm Sewer - Prior to filling trench. ! , ~ Waler Line - Prior to filling ( trench. . D Rough Plumbing - 'Prlor to ~ _cover. , " o Rough Electrical - Prior'to cover. D Eleclrlcal Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior 10 facing materials and framing Insp. cRFra;"lng - P~ D Wail/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stove - Afler Ins lallation. D Insert - Atter fireplace approv~r and Installation of unit. D Curbcut & Ap'proaeh - Atter forms are erected but prior to placement of coneret,e. D Sldawalk & Driveway - After excavation Is complete, forms and'sub-base material in place. D Fence,- When completed. D Street Trees - When all required trees are planted.. . D Final Plumbing - When all plumbing W9rk Is complet,e. o Final Electrical - When all electrical work Is complete. D Final Mechanical - When all mechanical work Is complete. ~ Final BUilding - When all required Inspections have been approved anf\~llgl~'A- completed. \J)J~Y \ D.Olher MOBILE HOME INSPECTIONS MBIOCklng and Set.Up - W~en all r blocking Is complete. ~P1Umblng Connections - When home has been connected to water and sewer. ~Iectrlcal Connection - When blocking, set.up, and plumbing Inspections have been approved and the home Is connected to the service panel. ~Flnal - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. ... Lot faces ~t'~pe . Lot sq. Itg. Lot coverage Interior Corner Topography Total height Panhandle Cul-de'sac BUILDING PERMIT I M 1 . SQ. FT. . rx $/SO. FT. Garage c%l 00 Carport , ... . ,. I ' .. i~,..", . ~; J ~ " ': ,;", .~;. , '" 1 '1 '.., ';'j"'I"'> ~ J, "'iJiJ' iI;L' :~tt ;'{~,~,:, \' ,',I:, '. ',,' i:, . ~<t~ >;,,:~o:~~,~,.., Setbacks . I 'P.L. IN Is Iw IE . " ., -I. THE PROPOSED WORK IN THE'_ \. "'HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed arid approved by the Historical . Coordinator prior to permit Issuance. HSE GAR Accl I I I I SYSTEMS DEVELOPMENT CHAI}(ih(iD~) r-.. (B) ~.itt ) ___ BUILDING VALUE, 'PL.AN CHECK VALUE / AND BUILDING PERMIT . / This permit Is granted on the express condition that the said / construction shall, In all respects, conform to the Ordinance " . adopted by the Clty.of Springfield, including the L!l r ~" I ..... Development Code, regulating the construction and use of /~ buildings, and may be suspended or revoked at any time ~ /'" upon violation of any prov of saId ordinances. ~~ ~~ Plan Check Fee' /' ~ Date Paid: Total Value '.J.O ~ Receipt Number' Building Perm' u~.~ ,,/ + 1./ (p ~. q,3 Received By: /' .. (A)' '-tl )~"3 Plans Reviewed By +\% (o5~ '~~ ih__ (C) ~,~) ..~ PLUMBING PERMIT ITEM Fixtures Resldentlal.'Balh(s) '. N' . I Sanllary Sewer Water FT. FT. FT. Storm Sewer Mobile Home Plumbing Permll State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood StovellnsertlFlreplace Unll Dryer Vent M'echanlcal Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home Stale Issuance State Surcharge ~OJo Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) FEE I ~SCD' ~~9.I \ 'SCV RJ \ D5.CO 6ln~ ,,'=) a:; I.~.G TOTAL AMOUNT DUE (excluding electrical) ~ (A, B, C, 0, and E Combined) G:K\Z.,.\o.. ,lCl1h:wJ) , . :u>r~e> APPROVED: Date Systems Development Charge Is due on all undeveloped properties within the City IImlls which are being Improved. ADDITIONAL COMMENTS _ "I(11~f) ;IX, MJ)U.-tMf1)'v1i<'1Y' -t1J Lf\Nir1J1.f! lfr'rrr\ IT.! ~ Q rI-,(Lt) (f f) f! fV'Jvt-J I ) \ 1\ r. '-./ - 0~tl'mff'('\O~)ITf\'11". \AJl f'\\~ J\Or\) t ~ -f1L- d...~(')~tfJ0AO l. ~ 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 01 the State of Oregon pertaining 10 Ihe 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 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 wltl remain on the site a'}L7t1mes dDrlng ~O~uctIO:"" Signature U~~ ~~ Datp , F s:- d 1:.- f'"c ~,. / ~ ;-:~/--\../ \ l' ..~/ _.......-~ ,. ,/' , 'r , VALIDATION: '...J 0,/,',' r /./ ~ RECEIPT NUMBER " : ,^ ..~ Q DATE PAID ,~Ioq~\ _ {~ AMOUNT RECf'.l':JD [(fe"'i;~ '\ (Cfq~ RECEIVED B.t-p1JYJ.. / -""::'n ~~",:'13 'I '... .~ ""., ... ',... . ", ., .. SPRINCFIELD DEVELOPMENT SERVICES DEPARTMENT 225 FIFTH STREET. SPRINGFIELD, OR 97477 (503) 726.3753 FAX (503) 726-3689 MOBILE HOME AND MANUFACTURED HOME AGREEMENT UNITS TO BE PLACED IN A PARK As required by the City of Springfield Development Code and/or the State of Oregon, I understand and agree, as shown by my signature on this form, that with the",~va). Slf the a ttac9~d_~IJI!.i ts fora home to be located at ' C\/ () ~L2IJ~~~ ) , Springfield, Oregon, City Job Number ci }llon I will meet or exceed the below listed minimum setbacks. Home Setbacks 10 feet from a park building 20 feet from any public street 5 feet from any rear space line or interior space line 5 feet from the edge of a park street 2 feet from the interior edge of a park sidewalk Accessory Structure Setbacks 10 feet from a park building 20 feet from any public street 5 feet from the edge of a park street 2 feet from the interior edge of a park sidewalk 3 feet from an interior space line or rear space line I further state, by my signature below, that I have been provided with the following information, Manufactured Home Blocking Requirements Minimum Requirements for Permanent Steps - Electrical Connection a~~ 5- 21:,- 't tf Date Sig"fure ! CITY OF ~~r(!t;GFl[LD SYSTCi.\S ()[V[LOP:.\[iiT Cid\uc:. QU7V)/ -I"l . WORKSHEET'. IU {([}.J (COli/1CRCIAL t. RESIOGlTlAL) ;(taoo "A'." Oil mWNIY, J:tO"cTJ"-.bQ.,^^ rJI.'.&L ~,- Z ~ p"", . lOCATIOil: S[)L -io17iS p,.'...\\). \I.JJ-l(/N M,OP..>'t..-E::. \-k:v\S I'::> ~/\O\l:G'::> '\r-\. DEVELOPMENT TYPE: [JUIlOING SIZE: LOT SIZE' .SQ. Ft. 1. STORl,I ORA Hlr,GE II.:rERVIOUS SQ. rr. X SO.lSG rER SQ. FT. (See Re\'e!"~e ro!" nt!:loff Coefficie~ts 'If t,ctti~l kpen. t,!"e~ \s & I~ Unkno;,n) Z. SM:lT,W( SE,im-C!TY 1:0. 0:: rru' S I Lj- . X S3S - 55 rc:: reu (See Re\'er~e To O,~Lel7.1ine Tut~l rfU'S) I~ C;"?q'~ I :l. 1:~~'.~L~;~.~.:~T..~.l_~.G':. r:~ C;: U::!T:; X T~~::' :~:.Tr X (CST PC::'. T:11;) \ .------- ~-.~ ~: ----..- --- ~: ~:::::_C: I. ~ ~ - '" '. I I.; !~~:- -;' -I . ~. ~2~~.G1 ... ____ :~. ~::;3&G~ (See ^--'c:.-,.,..,.. L' '1'.., !\\;'-,--.;n,. -r-;.... l::;""r~ \....... .....:....... v l..\...~:.:. ......1.: i. ,OJ ...........-J - ) -{~-:;:. SUGTOTAL . (ADO IT :;i-:.s 1, Z. &:; S I '" - 4. AOI-lllH STPJ\T!V[ fEI:S 'IlJ\SE CHl'.RGE (SUSTOTJ\L t,sOVE) X ;05 h ?'SI~ I IG7....~. -:: ~ ~':' ,--.- "'" r C,-r- ,- ....-- -. 5. SAtlITMIY SE'riER-H',il'\C .,....:.. . .... : ..,', NO. OF PFU'S . ,..{- x S13.25 PER PFU .+ S10 'H\.IHC mYoIN. FEE ~ 1"1 C, ~ .~~ .' ..h. '" ',. ..... .' ..:. ._. ..~'. ....~.> . ..... -. '-'.. :y<:: ::.:~:(Use PFU Total F;o~It~~' i Abovei . ..' '... . _.. ..... _..... ...r_ ._.,:. ..... .-...... "'--' .~"-" .. .' '.' . ,. .).;[:~;(';~.:~':' . :-., .:~::.,.;:.--: .~., .....~ .._A"M ,. "" . ''''.', p'_ .'_. .' .~.... ." ,"A". ,. ."S ":'- "':"', TOTAl-H"IMC sac. Is 1'1 S ~ J TOTAL sac i33 L, e ,:. ~lWHC CREDIT IF APPLICABLE (SEE REVERSE) .:-':/-:: .:....:..: . . ...... ......:.. - .:. . . . '. ~.. -- ., '-f /J-'1 /q-y "':":" '. , .'. G Ki P Burdick. SOC coordinator . .. ." .. - '~...: . . . :'.'. :. '. n ..P5P a.A . \~)'~ ....... . . o J!!i11.!1!!!!~!!~ JObNO.~ SYSTEMS DEVELOPMENT CHARGE , WORKSHEET NAMU\o~-Af)ruJ~Q~ . ADDRESS:~ ~g?{) \ ~mWcill STATE~ZIP q'}tsf PHONE: , LOCATION OF IilROPOSED B4'tDI~ ~~E' /) 11 11/1) # r} h/7'\ , Street Address if Known: N.-/l'J..) ( LU/lU...-/ CI '^-.U -- --~--- -- . ~ 5df1fJ~ L~ Nom"'" Jr)/).'J,/lfll/)j''J44[/J 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type delinitions are on the back'> A. Sim!le Familv - Detached Single Family home NOOF UNITS Manufactured home not in a park X $400 PER UNIT _= $ . B. Sinl!le Familv - Attached NO OF UNITS X $370 PER UNIT = -$ C. Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park 2. SDC CREDIT (if applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. $ cOfb.C:O $ LiPD{XJ $ 0' 3. TOTAL WPRD NET SDC ASSESSED (if SDC reduced lor Creditl $~[!J U (..qk - M~/~ Date 1) .0 1/ 1"/.26-/'1' -, );?c..pr#. f,""3~~s NO OF UNITS I X $280 PER UNIT = WPRD SDC CO~~JMc~O f.) City of Springfield , ,-