HomeMy WebLinkAboutPermit Building 1993-10-18
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK: 2/ ~
ASSESSORS MAP: //7 /? <: ~Z?
LOT'
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SPRINGFIELD I'
· 0
JOB NUMBER ~\~
225 Firth Streot
Springfield. Orogon 97477
:- .1
4 r H-d/5, c::;;.,A:-:.c...~.,c;~ DA'
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TAX LOT: 44 a-n
BLOCK'
SUBDIVISION'
OWNER:;::r::..~ 7t#i2JZ,.7'
ADDRESS: ~ <&>.?--7 "15" "7r
CITY: S~ Jt,-, "},..;7 H~ 6- U
DESCRIBE WORt<" /ZA 13>, ~ If,-,; ~ ~ ~~ ~
NEW L REMODEL ADDITION DEMOLISH
STATF'
ttJ~.
PHONE:2-~7-??</
;;>
ZIP:
97~ 7,/
OTHER
~/'t.,/ /'"c.,~
'"
CONST,
CONTRACTOR'S NAME ADDRESS..... f.~" " CONTRACTOR'
C _ ~,I I' = -S-?::. 0, ,/~ /7 L
GENERAL: CA'-1!'Z"P-"T- PI r#' ~~t:3 ~tPAt-"'46'r , ~ 117 (;:? "J 0
~ _/J- 1/_/ . i /I~~/ """~ 9?',u / //~
PLUMBING: C/(:,l5""V;ru - r-rfi-t2-/Z-/S: <Ot.J ;ft-..~~ 'l?-2.C4 ~-r-. :J
MECHANICAl ,-
ELECTRICAI,)k;/Z; "-nr?K tTZI3e-. 19,,):;-;;:"97/.fl>~ -S/'S 'J
QUAD AREA _~~ 1. tJ
. OF BLDGS' \
OCCY GROUP: ~~,\-}J\
\
. OF STORIES:
1/
WATER HEATER:
- OFFICE USE -
\\~
. OF UNITS' \
CONSTR. TYPE: ~~
~<2~
LAND USE:
HEAT SOURCF'
V
RANGE:
EXPIRES PHONE
,,-/;"-14& 11f7-'1t:i'Ct!
6P9-??~~-
'7;r1-/~ 1..
FLOOD PLAIN'
ZONING CODE: ~_ O~
. OF BDRMS: - ~
-
SECONDARY HEAT:
SQUARE FOOTAGE: J4l ')q.
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 Temporary Electric
o
Fooling - After trenches are
excavated.
o
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.
D Floor Insulation - Prior to
decking,
~'Sanitary Sewer - Prior to filling
~ trench.
o Storm Sewer - Prior to filling
trench.
rvl. Water Line - Prior to filling
~trencr\.
o Rough Plumbing - Prior to
cover.
~\ I
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to (acing
materials and framing Insp.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - .After installation.
o Insert - After fireplace approval
and installation of ur-it.
. 0 Curbcut & Approach - Arter
forms are erected but prior 10
pl~cement of concrele.
o Sidewalk & Driveway - After
excavation Is complete, ferms
and sub. base malerial in place.
o Fence - When completed.
o
Stroet Trees .-- When all reqiJired
trees are plantP-d.
o
Final Plumbing - When all
plumbing work is complete,
D Final Electrical - When all
electrical work Is complete.
o
Final Mechanical - When all
mechanical work Is complete.
1\71 Final Building - Whon all
7' required Inspections have I)een
approved a1{ kli~dl~
completed, \:-W\"'t'"' I 1../
DO'her
MOBILE HOME INSPECTIONS
1'\71 Blocking and Set-Up - Wtlen all
~ blocking Is complete.
'Ql Plumbing Connections - When
~ home tlas been connected to
water and sewer.
~. Electrical Connection - When
~ blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
_ r/i Final - After all required
~ lnspect!ons are approved and
porches, skirting, decks, and
venting have been Installed.
J
. , , THE PROPOSED WORK IN T~E
Lot faces Lot Type Selb~cks
Lot sq, ltg, Interior I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Panhandle Is I and approved by the Historical
Topography Iw I Coordinator prior to permit issuance.
Total height Cur-de-sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
VALUE
Main
Garage
.~q~
\1) .\0
2iJ5:L
Carport
Total Value
2%i3
=a~~
~LQL_
Building Permit Fee
Stale Surcharge
Total Fec
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC
~,
(B) ggLi~ J
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
c9SDO
[).S,03
1~0J
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT.,
Mobile Home
Plumbing Permit
I do r:u
~.a5
,la!6~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
, cD
In~.
~O.W
-~
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricJ;;..Q45:z.::5)_
(A. B, C, D, and E Combined) "-- \. o.C\lo40)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is wanted on the express condition that t said
construction shall, in all respects, conform to tllC dinance
adopted by the Cily of Springfield, i uding the
Developmcnt Co(lc, regulating the constr ion and use of
buildings, and may be suspended or voked at any time
upon violation of any provisions said ordinances.
Plan Check Fee: _#
Date Paid: <v ;~
Receipt Numbt""/
R7
~Ians Reviewed By Date
Systems Devclopmcnt Charge is due 'on all undcveloped
properties within the City limits which are being improved.
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A~DITIq,NALA ~~I\fME_t-!TS. . . '*
D.1-mYCf, ~ll\Ot t\\~
\ .:\f\~ (11 'l\\~D OYH O~
-l fYbn, _ ~':\ M-t-
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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 Stale of Oregon pertaining to the work described
herein, and tllat NO OCCUPANCY will be made of any
structure willlout permission of the Building Safely Division.
I further certify tllal 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 strcet, ttlal the permit card is located at the front
of the properly, and the approved set of plans will remain
on the site at all times during construction.
Slgna'urc ~.~
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VALIDATION'
RECEIPT NUMBER r;DI'a~) \ r I (}(',~ / )
DATE PAID )81/f?/"i.~ \ W.tZ'l/':?)
AMOUNT RECEIVED~~~'( ?-:;:-,) ~p'lI()4f))
RECEIVED BY \' ,
~J'r"J~~~""W;
. 11"11 . ~
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....~',;f.~'$".. .iO',' .
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Job No. q5 1870, ,
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME:~~ \\ L 0_l O~<no \\T) PHONE: (,4/I-M~'
ADDRESS: .\.Q~f\ \~~\\\ODt ; ~p STATE:~ZIP CV\4'11
LOCATION OF PROPOSED BUI~D\IN~DSITE: l 0 ~ n.! 1'1 '1'\. ,LL r\ Ie:'
Street Address if Known: C"\l ~ tN '\ \ \)\ \....,'--" -B- rt CJ
Platt Nam~ f\\\i\'\r\ ,\{\~Tax Lot Number: \ f'\()3 ~ ~ \0 [M({)
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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 =
$ Ilf[),UJ
'; Af{)~
$JZf
$ 9Pnr:D
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)
..
\;.~;~~W~L)
City of Springfield
If) / IR/q~
Date
.- ,..
CITY OF srrW;GFIELO SYSTU1S OEV[Lor:,\[ii1 C""-,i,u<.:.
. WORl<SH~ET'.
, (COlmERCI^L t, RESlOEllTI^L)
!
rW1E' 0[( COi-ll'NIY: J:~Lo.'.,l':L0._,bQ,0,," Nlg.'o l':::.f:. ~o 1J\ I::. ' R,u ~ ~ l~
LOCi\TlOll: SI)C -to 17.:" Et.\)~Jl:!.vtJ 01.01"'.011-12- \-k:v\S I"? t-/\O":G;::>\~ '
OEVELOPMEllT TYPE:
[JUILOING SIZE:
,LOT SIZE"
SQ. F t.
}, STORr,I OR^ HMGC
H1PERVIOUS SQ. rT. . X $O.18G PER SQ. FT. Is &
(See Rever~e ror R~noff Coefficients If Act~al I~~erv. Area I~ Unknown)
2. SMI lTN('{ S~,iFr~-c iT\'
1:0. 0:- pru's I Lj. . X $3S.55 PC:: P:-U
(See Rcver~e To O,~Le17.lir.e Total PFU'S)
Is ,?~f', '1~ I
,', . 1:~..':'~L~;~.~.:~i;~\ 1_;.G;:.
r:~ C:. 1..'::!::; X T:::;' ::,:,n: X (CST r[~ TRU'
\
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1-.""'"': l..:
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I ..., ...... - '::'.. i
.'i 1..:-';'-1
---- ..-- ..--
'!. j:~S.0l
'J ____ :( S:::3..G~
(See j\--"c:.....,,.,.... l' '1'..\ 1\1;.-.........~r.' -,.....:... l:"'\-''-n...'
l"....... ............... v 1,.......\.'..:. ...1.1.: I IJ-I ....;.-----j -'
) -( ...; ''::-
SUBTOTi\L ' (1\00 IElIS 1, Z, & 3 S I,;) ~
4. AorHlHSTPJ',TIVE FE~S
'nf,SE (HARGE (SUBTOTAL ABOVE) X ;05
h ,?s'::..1
TG7....~.-C~~.:. :::~~::.
co ~
.. C.--I" ,-
.........- -
5. SM1ITMlY SE\.IER-M'ril'\(
'H,IlO. OF PFU'S
, r..f-
x 513.25 PER PFU .+ 510 'H\.IHC mY&IN. FEE: 5 14 C; ~
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.,~<;';:;,:hUs~ PFU T~tal from Item i Above)
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TOTAl-H\.IHC S~~: Is 1"1 ') ~ 1
TOTAL socs qq ~ <I:!:-
.~ ~lWHC CREDIT IF APPLICABLE (SEE REVERSE)
. .::~~.: :~. :. -' ;
~Ho,.__".
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U' .Kip Burdick.
SOC Coordinator
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