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HomeMy WebLinkAboutPermit Building 1993-12-22 , ,\ ,J .,F.lESI'DENTJAL 'PERMIT APPLICATION Inspections: 726,3769 Office: 726.3759 . SPRINGFIELD ~~ . JOB NUMBER ~ "3/?S';:>4/ 225 Fifth Street Springfield, Oregon 97477 ~A,,#if4 -, ._" ...,- " ~?,,-.ii;'~=-~. iJK:2C>6 TAX LOT: ~ ~t::>-;::> ~ LOCATION OF PROPOSED WORK: 2/5"0 ASSESSORS MAP: /?-o?-.??-/~ OWNER' d~.47iP5 _ ~/~~ ADDRESS' '7/' '7 {'/~.rAiL~/~~ , :.s~b_ - , //~ / ~r/A?"'A?~ /0A..f'7............r-- . .,. ". r,., "'". # LOT' CITY: DESCRIBE WORK' NEW REMODEL BLOCt<' STAT~' ~/ -1"_ SUBDIVISION: PHONF' /t:;l'?-""'3c:>// --. q~~ k/??t:S' ADDITION DEMOLISH OTHER ZIP' .::::>/V A~ _~9'C: e:- ~p~,... PHONE ~~;;o-~ CONST, CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES GENERAL: $:;. '7Z!>/'1cr ~C~ ./l.:-/-/= "'. .%q~~~-. ~~ "'-<S'-~ 1#':-- - , /~~ . r . # , . / PLUMBING' MECHANICAL' ELECTRICA' ' - OFFICE USE - QUAD AREA: LAND USF' FLOOD PLAIN: A . OF BLDGS' '. OF,UNITS' ZONING CODE: ~ OCCY GROU.P:' ' , CONSTR, TYP'" . OF BDRMS: . OF STORIES: HEAT SOURCE: SECONDARY HEAT' WATER HEATER: RANG'" SQUARE FOOTAGE: 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. D Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumblng/Eleotrlcal1 MechanIcal - PrIor to cover. o Footing - After trenches are excavated. ~ q.;"f1"t::>l'r o ~...a...s~nry - Steel location, bond beams, grouting. o Foundation - After forms are . erected. but prior to concrete placeme~t. o Underground Plumbing - Prior to filling trench, o Underlloor Plumbing/Mechanical -.Prlor to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking, o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. . o Water Line - Prior to filling. trench. o Rough Plumbing:'" Prlo!'to cover. .' . REQUIRED INSPEqlONS o Rough Mechanica) - PrIor to cover. . . o Rough Eleotrlcal - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrIcal power. o FIreplace - Prior to facing materials and framing Insp, o Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping, o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbout & Approaoh - After forms are erected but prior to placement o(concrete. o Sidewalk & Driveway - After . excavation Is complete, forms and s.ub-base material In place. o Fence - When completed_. o Street Trees - When 'all required trees are planted. '. ' o Final Plumbing - When all plumbing work Is complete, o Final Eleotrloal - When all electrical work Is complete. o Final Mechanical - When all mechanical work Is complete. o Final Building - When all required Inspections have been approved and building Is completed. o Other MOBILE HOME INSPECTIONS 1\71 Blooklng and Set,Up - When all ~ blooklng Is complete, rVl Plumbing Connections - When ~ home has been connected to water and sewer. rYl Electrical Connection - When LAJ blocking, set,up, and plumbing Inspections have been approved and the home Is connected to the service panel. IVI Final:':" Afte., all required - . ~ Inspections are approved and porches, skirting, decks. and venting have been Installed. . . (tiTHE PROPOSED WORK IN THE '. ..tY- , Lot faces Lot Type Setbacks --. Lot sq, ltg, ~L Interior I P,L. HSE GAR ACC I ....HISTORICAL DISTRICT, OR ON IN ;lO I THE HISTORICAL REGISTER? Lot coverage ~9c> Corner /P If yes, this applloatlon must be signed ~~ Is /3 I and approved by the Historical Topography Panhandle lw. ~ 1,...;., Coordinator prior to permit Issuance. Total height Cul-de.sac IE I?N/#. APPROVED: f- 9::2<3. ~G 6 ~ .$."CJ ... .... ~ ''3. ,(::r ?""-:-~"3 SYSTEMS DEVELOPMENT CHARGE (SDC) 99t:s. "/0 BUILDING PERMIT ITEM SQ, FT, X $/SQ, FT, r#~~~.-rs- ~~~ ,~~ ~~/C:> ~J::;'I;" /P./C> Main Carport ~,-- -"'?'j""f . Total Val ue Building Permit Fee State Surcharge Total Fee (A) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary Sewer FT, Water FT. FT, Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsertl Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It It Curbcut Demolition State Surcharge j~('-'~"'4' ~A!: .:5~ C. . Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) VALUE ;J ~ =?ere> , //::2~.- '!/~~ /?pe:>" -... FEE "'2 < Dr:> '7< -~ , /5.. -=> .b..~ -- "?i'~~-::> ~~,2 5" /A~ dOC> -:2b. ...e> ~?S ?'~. ~.t> 1,//0. '2 -S- /5"~ S3 BUILDING VALUE, PLAN CHECK 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 City of Springfield, Including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordInances. Plan Check. Fee' Date Paid: Receipt Number" Received By: - ~~~~ ~? <PJll'1'~evle'wed'BY( A - ~ 1'2 -2?-.., ~ Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved, ADDITIONAL COMMENTS ~R.P""~';~~&,~/_ ~~.t'L~ ~~-:'__ ~~""'/4IY~) {PAn 4>/' -;z ~ ~r:-f ~L!? /#?-# Jr//J1V7? By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that alt Informatlon hereon is true and correct, and I further certify that any and all work performed shall b~ 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 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 on the site at all times during construc~' Signature V r::7- ~ ./ ~~I Dat~ ,,/[;-- ').-~ - 1f.3 ' VALIDATION: RECEIPT NUMBER //::::?/C> f //-::2// DATE PAin /~- ;l ~ . '9 '3 ~"""" ""~.YC::> AMOUNT RECEIVED i"~..I"" RECEIVED BY ~~-_...... , . CITY Ol~ srRlt;GFI[LO SYSTGIS O[V[LOi',,\[i;; l::I,i\uc: . WOR!(SH~ET'. } ~~ (COI1IiCRC I ^L t, RES I a [liT I ^L) r/'e::ttJVf 7 '3'/$ '? 'Y , ./ ! rWl[' Oft COIWAfIY: J:~Lo.0-J".t\_,hQ,0" r-Ag.o L':::.f_ \:-!.O:-^ ~- ' p."d.:t.I;1f~. ' LOC^TIOtl: SD(, -rol?.F- 6:.':!~ltvrJ Mm".:>Il--l2. U-c:v\\S I".::> t--/\O\J~';:>\f...\ ' ~E2~ OEVELOrl'lEllT TYI'[: (JU I LD mG SIZE: ,LOT S I 2E_ SQ. F t. 1. STORi': DRMil^GE. HWERVIQUS SQ. FT. - X SO.lSG PER SQ. FT, Is e- (See Rever~e For R~naff Coefficients 'If ^ct~~l Ic~crv. ^re~ I~ Unknown) 2. S1',r:TT/\rZY SE~iE!~-(rTY 1:0. 0:- rru's I Lj. X S35.55 P[:i P::U (See Revcr~e To U~tClninc Tat~l PFU'S) Is ,??~l"~ I .j. JJ~:'~~~~J.1.:~T..:.I_!.G:. r:r; C:. L'::~T::; ~ 1:::;' ::.:\11: :( CC:T p[:~ TRIi' 1 .-----.- \-,;1..: ----..- -.- ~: S::::.c: I: .., ~.. :J '. I ,. I,~:-';'-I . '! ~3~::..G~ ., :~. S:::~.G~ 'See ^t:::'c::~c:1:-Ci':J lh~;_".::!""::~n~~ 1";-:,0 r~~""'~ \ _ .......--J - SUGTOT1\l'(JiDD IBIS 1,2, &. 3) S '0'-'j... 4. ADIHIHSTPJ\T!VE FFtS 'uf,s;:: CEJ'.RGE (SUBTOTAL ASOVE) X ;05 I::; 7SI~ I 107:..~_-::~~':' ,--,- ",n ~ C.-r ,- .....-- - 5. SAtIITARY SEWE,Hf";!-\( , ,'q,llO. OF PFU'S '.. -_. ". - . ," .,:<<;':,'2:(use ~F~ To~~i q' ,..f- x S13.25 PER PFU .+ S10 1-II-IHC ADXIN. FEE S /4 '? ~, ,"- ~. .. -., . ,"-, . ,....." F~?~.~ t:"!2~bove) -".- . -... ;.'.-~.' .-:.:- "'-., . ::'..---~'::.'" :. '", .' ~lWHC CREDIT IF APPLIC!\BlE (SEE REVERSE) ~'./.-' .>-:. --....-;:- . ..; .' '. . -"- ... . . . ~ /;'1 /1'2/ '.. .. -.--', -- -'_.:.,.~.. '-:-.. '. ..' . ". '-', ',. .,,' .qS ":'-'" TOTAL-MW~IC SD'~: Is l'1c;~ I TOTAL, SDC i.93 L, <I:!!-. , ./- ... q--, ' "'~ , q,..;." ..qO .Kip Burdick:. sac Coordinator ..... . ." - .' ....-. . . . .h I I' .'. :~:-'..;.--~:. ..... . .,-.. .. ...~-_._.. '" ~'. t. :~~::.:',t;;~~::<E', _. .... -. . ,", " ':.;'. " ., .~ . Job No. 93 /~:;:> '7' SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: t!~G5 ~/~ ADDRESS: 7'7</ /Y ~:R7'~;;UZ;:>~~ ~..R:,PSTATE:~ ZIP "7)>~ PHONE: 70/::>- -'7&::>// LOCATION OF PROPOSED BUILDING SITE: Street Address if Known: "'7/5"'0 L.avJI94 ~n , ~-;;u~/.:. -./ ~ /' Platt Name: Tax Lot Number: 1. DEVElOPMENT TYPE (Check appropriate dwell i ng(s), SDC Calculations and dwelling type definitions are on the back,) A. ,Sinl!le Familv - Detached Single Family home NO OF UNITS B, Sinl!le Familv . Attached NO OF UNITS C Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS / WPRD SDC _ Manufactured home not in a park X $400 PER UNIT = $ X $370 PER UNIT = $ X $277 PER UNIT = $ X $280 PER UNIT = $ "24'~.-'" $ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) ~~;S;rViC~~-'7 City of Spri ngfield $ ./\/.L. $ .21!>;?, '-0 /2 / '2~ / <9.". Date - . , The following proJect all .vb . ad h h ,., , zoning, end doe. not ro' , ost 0 , 225 .FIFTH STREET approyal, ~q ro s .lIe lmEeTRICAL PERMIT, APPLICATION SPRINGFIELD, OREGON 97477. ., , . INSPECTION REQUEST: 726-3769 l,."ft,n . . Ci ty Job' Nlimber 93/87Y OFFICE: . 726-3759 . Onto .' I . . . .. .:t:k I COMPLETE FEE SCHEDULE BELOV 1. LOCATION pF INSTALLATIO~uthorized Signs~ure '\ /1 \I ' ;) 1::)0 L..", IV-G ~ '] 0 b A:' Nev Residentla;:-Single or " Multi~Family per dwelling unit. LEGAL DESCRIPTION Service Included: 17.t:J~--z.:7.k:>. ~ ......V~ Items Cost Sum . JOB DESCRIPTION I J-OO A Xr-.JiC -<C. 1'1. ct" hoi.,",""'e.. Permits are non-transferable and expire if york is not started within 180 days 'of issuance or if york is suspended for 180 days; 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor R......,......l..w Address 4JJbSlJe",L.VV',-, G ' City F-rJ I [r . Phone' 'ifl3 71 ~ . ..s Supervisor License Number '.3 4 fj:J.... EKpiration Date to - <1. ~ Constr Contr. Number .~C 1...U-J..;yf::,L EKpiration Date '-I, (1-. - ~r~re of YSi,~g .. !doers Name ~I A./Y.?~ t71/5~ Address City Phone OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: ------------------------ DATE: RECEIPT .: RECEIVED BY: /~~9V 00 ~.., /" /,,.7 . 2 "/ . 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof. ,Each Manuf'd Home or Modular Dwelling Service or Feeder ~ B. Services or Feeders Installatfon, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 85.00 $ 15.00 $ 40.00 .SQ $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts D.' Branch Circui ts $ 40.00 $ 55.00 $ 80.00 see "B" above Nev, Alteration or EKtension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Service or Feeder Permit ~. $ 2.00 ~ not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5.. SUBTOTAL OF ABOVE 5%.State Surcharge TOTAL . $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~.OO ~ ' LJ ~I'D