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HomeMy WebLinkAboutPermit Building 1994-7-7 " RESIDENTIAL PERMIT APPLICATION Inspections: '728.3769 Office: 726-3759 . LCCA~ICN CF PRCPC\*RY'CRK: ('? /"5" c ASSESSCRS MAP' . II ffi'1l) , (7!~J7?/ck r /~A-L.St/!/. 72<;5' t!?c. c. s '-""~?fr.6/ ,~15'~~ ", , DESCRIBE WCRK: ? 4f.Cb/?7~~~~ .;f!-7L?;~ ~~/ ~~/') ,/" ~A'??'c;; ~ NEW ~ REMCDEL ' ADDITICN "". DEMCLlSH CTHER I.. , . LCT' CWNER: ADDRESS: CITY' ('.I(t..~,..f..4 -. . . BLCCK' . STATF' 8?? . . JCB NUMBER CJo/t98S' c:s 225 Fifth Street Springfield, Cregon 97477 $?'k-~ <::?~ --T:~LDT:~) , SUBDIVISION: /7:?AJ.A7 /4 ~~A ,/ , (~ -Yo PHCNF' 92r:=~ /C',/V9 ,ZIP' ?7? "3'<. /" CCNST. CCNTRACTOR'S NAME AD~.,. .....-Le. ~ CCNTRACTCR # EXPIRES PHCNE ,/7 /7'_ _c...c;>' J ~-A~::>~ ...' GENERAI./..-;;>A5l!5Zf~~j" ~r-&1 .q?~ .r;>~..,r.~~ ...",r:> '" L-r ./ ,. PLUMBING' . ~,'.' .- MECHANICAl' ' M . ~ .~ '~:l~ ELECTRicAL' c.A-.-'u=-", ~~J"'CiI!:>. QUAD AREA: \~\\,h ) # CF BLDGS: \ CCCY GRCUP'\V.~ I' # CF STCRIES: \ WATER HEATER: P ./ - CFFICE USE - LAND USE: \ \ t;=:{) 00 CCNSTR. TYPE:--r=E': HEAT SCURCE: 'L..-- U # CF UNITS: RAN~C. FLCCD PLAIN: ZCNING CCDE:-1f'A2.. # CF BDRMS: J). " -, SECCNDARY HEAT: t:J" SQUARE. FO,CTAGE: To request an In.pectlon, you must call 726.3769. This Is a'24 hour recording. Allln.pectlons requested before 7:00 a.m. will be made the same working daY,ln.pectlons req.ue.ted alter 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS D R~U9h Mech~nl~al ....: Prior to cover. . . . D Temporary Electrl.c D Site In.pectlon - To be made after excavation, but prior to setting forms. D Underslab Plumblng/Electrlcall echanlcal - Prior to cover. Masonry - Steelloca lon, bond ,beams. grouting. D Foundation - After forms are erected-but- prior to'concrete placement. D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical -.Prlor to Insulation or decking. D Post snd Beam - Prior to floor Insulation or decking. .. . , "- D Floor Insulation - Pilor to decking. ~ssnltsry Sewer - Prior to filling , trench. Storm Sewer - Prior to filling trench. ' .rz:;rwater L1n<, - Prior to 11II1~g r trench. I , .. Q. Rough Plumbing - Prior to l ~\' ~ cover. <.~ \ . l: D Rou~hEle~tricsl, - Prior to . cover. .. , . D Electrfcal Service - Mu.t be approved to obtaIn p~rmanent electrical power, 7. ""':1' D Fireplace - Prior to facing materials and fra'1'lng In.p. ~ - Prior to cover. D Wail/Ceiling Insulallon - Prior to cove~ . D Drywall - Prl.or to ~aPlng. D Wood Stove - After l~stallatlon. D Insert - After fireplace approval. and Installation 01 unit. .' D ,Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation Is completo, forms and'sub.bas"materlalln place. D Fen~e. - When completed. o Street Trees - When all required . trees are planted. D Final Plumbing - When all plumbing W9rk Is complet,e. D Final, Electrical - When all electrIcal work Is cOf!1plete. D Final Mechanical - When all meChanl?sl work Is complete. nal Building - When all required Inspections hr;;:rve bee epprovedan?-t~I~ln . completed. \.)}.Iv D'Clher MOBILE HOME INSPECTIONS ~IOcklng and Set.Up - w~en all T ~IOCklng I. complete. ' ~IUmblng Connections - Whe~ 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. ~al - Alter all required . nspecllon. are approved and porches. skIrting, decks, and venting have been Installed. Lot faces L~/~pe. Interior '\ '.' : "',1':," :i::" 'j ~ :....,1. ~...i:a." ,l:' ..~' THE PROPOSED WORK IN THE. ' , ISTOI:lICAL DISTRICT, OR ON THE HISlORICAL REGISTER? If yes, thla application must be signed and approved by the Historical , Coordinator prior to permit Issuance. Lot sq.' fig: IP.L. IN Is. Iw k Setbacks . 'H~E'GAR'ACcl I 1 I Lot coverage Corner Topography Total height panhandle Cul.de,sac BVILDING PERMIT ITEM sa. FT. x $/SO, FT. = VALUE Main ~~ ~~ ~ ---.. I /..70 /q'./O '. /69-<.- Carport ~ /~,/o :2 .y2."J( - Total Val ue 4\ \\1> ~ t:'{J.5D \.~Z:+ c-j.~~ (A) .~.~ Building Permit Fee Stale Surcharge , Tolal Fee SYSTEMS DEVELOPMENT CHARGE ~DC) (B) !1Y{ 0:90 -,'.... ~ . PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home r9s.co 6JS.()C) IS.CO Plumbing Permit State Surcharge Total Charge loSpu !q~ \.3.a~ 'K).@.() (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnserl/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) t?! \OS~ dl( )~ \.c::;. & r:;. ~..LS MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge ~ C:,Lu_::. Curbcut fl Demolition Slate Surcharge Tolal Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrlcal;{~ .~::'\ (A, B, Co 0, and E Combined) (t{y,\()"\t> J . APPROVED' ' 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: _ ~""'7' )/;S.;. ?>~ C". ~ ~C{ /' Date Paid: Receipt Number: Received By: Plans ,Reviewed By 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 appllcallon 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 that NO OCCUPANCY will be made of any I ' 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 tlme,that each address Is readable from the atreet, that the pem;lt card Is located at the front of the property. the a proved set Of~la s will remain on the sl s _ Ing co~1 /f / SI ~Pu-LUl~~/ Date' V l VALIDATION: ~p.c. / ~ 7'7 t' RECEIPT NUMBER e1T~ /'3~2. DATE PAID ?-. 7~~ 9" , ~ ~~~r'J~8.\~, (g:\l~~)1 RECEIVED BY ~ l.o2.4.ros) ("f-~.... ! CITY OF ~rW;GFI[LO SYS,TG1S_ OEV[LOPi.\[i,T C:::,i,i..a:. . \VOR1\SHEET" . (COI1l1CRCIAL t, I\ESIO[1lTlAL) . - HN:E.O[t COi.lIWIY: J:J.o.~J"J:,__.bQ_0f>, r-^.9_& L~f_ \40 WI t::. . p"U LOCATlO!I: SI)(, -to '17c. p~~\l).\"J;':(/!J 0I,OP..>I\'-'12. \-k:vIS t':::> !-/\o\ll2-c:> '\f.-I. DEVELOPMENT TYPE: [JUILDING SIZE: ,LOT SIZE. .SQ. Ft. 1. STOm.! ORA I WIGE WPERVIOUS SQ. FT. ' X SO.lSG PER SQ. FT. (See Rever~e For R~noff Coefficients If ^ct~~l I~perv. ^re~ Is & I~ Unkno'"n) 2. SMI lTM(,( S;:,iF!Z-C lTY r:o. OF rFV'S I~' ,X 538.55 rc~ rFV (See Rcver~e To O~tel~ine Tat~l rFU'S) \:; ?"?9"~ I ~,. 1;~!~'~L~:J.~.:~T::'I_~.G.;:. r:~ C:- I~::!T:; X T::::' :~:,TI~ X (CST P[::. Till[) l-.;~: --'-"- --- ~: j3::::.C~ \ ...,...... :J'.. I .~ 1..;";'-' . '!. ~::;::.. G ~ .~ ____ :( ~::::.G~ (See ^t.:::'c::~C:i: L i'o u~t(;;::::r.~ Tr'~p R2.~2::) , SUGTOTAL '(ADD IEi,tS I,Z. & 3) S IG:..~'::" 4. AOI'IlIH5TRATlVF meS. '[J,'\SE CHARGE' (SUSTOTAL t,sO\'E) X ;05 k '1;>'31::' I 18-:-:..:.-(17':' ':-~:.- Q" ~ C. .-r ,'" .......-- -. 5. SAtlTTARY SE'.Jm-M''';I'!C. x 513.25 PER PfU .+ 51':) 'H\.:HC A!)XIN. FEE) l"l C; ~ _ "H ,110. Of PfU'S. ,..f- ."~ . -':. "" .... ." L....... . ~~. '... '. . .' .,' . ....-. -. '-".. :Y:;~:;:'.:~:(Use PFU Total From 1t~; 2 Ab~ve) - . '... . _.~ .';.'. .... . . .... '.:'-- ---..'- :. .... ", '-".- -.. - ~ .' ",' . 'H - '--', ."- .'-. ..' '~.. ". :., : ., . -, ..... ...~n__,. ..;:;:.,'. ,. ,(1 ,Kip [lurdick. SOC coordinator .'? ':-'" TOTAL-MIme SO~ Is 1"7 '? ~ 1 TOTAL SOC ~ G, e .... ..... . .... - ........." ~:....-::.-:-._,. ... . ..-.... '" .' '" ....:..-....... . /lcr>T ~/~;~I' 7":?;:!"I ~~.? .:....:':............. . .;.::::.::.: :.~,:' ':.":'; ~.. ":'~':" !.:::: .:" . ;..:." ,.......;.; ....;'. . . @ Y..':tiR'.!!!!~!~!!~ JObNO.~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAMEJ~ (AAUAv PHONE: qg~ ADDRf5S22B f~~AT8~ZIP~ LOCATION OF Ii'ROPOSED SUI ING SITf{j =I! "n":l.. Street Address if Known: rlfJ.J.J.11{) .I 0l'N. . I Platt Na~. Tax Lot Number: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back.! A. Sinl!le Familv - Detached Single Family home Manufactured home not in a park NO OF UNITS 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 NO OF UNITS ( X $280 PER UNIT = $ o'fl).CO df(J,CD $ 0'. ~ WPRD SDC 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. ESSED (If SDC reduced for Credit) o~ I~~ . , '.. ".'.,..'. .. SPRINGFIELD 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 shovn by my signature on this form, that vi th ~h ov~the attached permits for a home. to be located at . ~-W-~.~ ' Springfield, Oregon, City Job Number ) .. 1 vIll meet-or exce:o the belov listed minimum setbacks. Home Setbacks 10 feet from a park build ing 20 feet from ,an~ 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 sidevalk 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 sidevalk 3 feet from an interior space line or rear space line I further state, by my signature belov, that I have been provided vith the folloving information: Manufactured Home Blocking Requirements / (~~~"'P' ~'"<. J - Electrical Connection 7- 7- ;l~ Date . fi lL'!i!I~I!!E!!~!!~ . Job No. q1\fB=) SYSTEMS DEVELOPMENT CHARGE NAM~~D\ Qrili\rro:~H~ ADDRESS: ~O &\':D ~fL ~ LOCATION OF Ii'ROPOSED BUIWI~,Q)i~ . ~ 111'1 (\ 1\ ~ I D,' '" Street Address if Known: ~\ 'ct ), 'rt.. J IA L W ax Lot Number: ~ no~ rMrO PHONE: f'\4f).~ STATE:OC ZIP d.l1lJ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dweliing type definitions are on the back,) A. Sinl~le Familv - Detached Single Family home NO OF UNITS B. Single Familv - Attached NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS l WPRD SDC Manufactured home not in a park X $400 PER UNIT _= $ . . X $370 PER UNIT = '$ X $277 PER UNIT = $ X $280 PER UNIT = $<;:Q rom $!), P{).(J) $ (1" ~C60.()() 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) ~o~L~~ City of Springfield ~ 14 1CM- Date ! CITY 017 srRU;Cfl[LD SYSTGtS DEV[LOI':,\Ei;i L::""e:c: . . WOR!(SH~ET' e. Q4'w\O (COI111CRCI^L t. RESIDENTI^L) /-. 1.6tJ LClUvt1, \ IWI[ art COi'lIW1Y: J:)_o.~J"/:,,_.lQ.0" f\Ag_& L~f'_ ~o ~ E:. . p,,\-~ tJ:-r::!)[) 7 LOC^TIOll: SD(, -ro '17lS (',.'...\\) \r.1i-lVN ,v\,OP.>Ii-12. \-.k:v\S I'? ~/\o\J;2..!:>\~. (, O[VELOPI'![lIT TYP[: [lUILOWG SIZ[: .LOT SIZE' .SQ. Ft. 1. STom.! ORA Itl^GF, Il-!f'ERVIOUS SQ. n. x $0.185 PER SQ. FT. (See Rever~e for Ru~off Coefficients If Acttial I~~erv. Area Is & I~ Unkno',;n) 2. SM:IT,~rcY S::',ir!~-CfTY r:o. 0:- rru's I Lj, , X $3S.55 P[~ Pet! (See Rcver~e To U,~tet71ir.e Total prU'S) I, ??"1"~1 ,'. IS!:'~L~;j.~.:~j:~,i_~.G:. r:'J c;: I~::!T~ X T:~:~' :~.':\T;: X (CST PC? TRU) \ .-----.- ~.... -: l-~ --.- .'-- -<- ~. r: "';'........ r ~ ._ _ -,OJ'.J. '-. I. ~ ~. :>'. I t~_t..,:..';' -I .: v r-,..,.... ~. :. .J :..:~:~ . '~ ~ .~ ____ :~ ;:::3.G: (See A"'c;'-~"''' L' 'I"~ l\~~'-..--;n"\ -I.....:... ~I ......,\...' \"..._ ............ i.J L;:-:"'';. ,..II,'..: 4 ':-' ..~...,--j . SUGTOTAL '(ADO IEi'IS I,Z. & 3) $ ,("'-:..~;.. 4. AOIHlllSTRAT!VE Fr.E5- '(l,~SE. CHARGE (SUSTOTAL ASaVE) X ~05 h ?'Ol~ i 107 "'~_-( ~ -;':' "'... ... C,-r ,- .....-- .- 5. SAtln^RY SEWER-Ifril-\C .110. OF PFU'$ . ,.f- x 513.25 PER PFU .+ Sl~ l1\o:HC ~~IN. FEE S /4 ~ ~ .' '.' . .. ....- -- ,'-. . " .... . ...... -' ..; '::'" . ~ , ~ /~1 /1').-- "s '.-'" TOTAL-MIme SO~ Is I~S~ j TOTAL socs qq L, i!!.., , ..:1- ", ..--~: "'~ ..(jKlp Burdick SOC Coordinator .. .' ~;;.;...: :.. :. . .. -:-'-'~.-:_.' -.... . "-a.:"", ,'.. .. ...~ .._..... 0' ~~~\ .. , ", ,,' .~.:;;'".:. ::", .t.,' .:.,'..;,:,:.:,.,... ; .... ,", ':- . ':':', \':-'-: ,".' ...... '. . ':-:", . . fi !!!ill'!'I!!~!~.!!!; )obNo. Cl~D~ SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME:~t ~\\'t\'i{\)~HONE:_ .9A~.l~ ADDRESS: - s'n-- STATE:f.f..ZIP!l!l1o.L 'U LOCATION OF "'ROPOSED BUIWI~~!TU -U /Ilk:!.. Street Address if Known: 01.mtJ( /)f.J.J1J1.1l- -tt'rii'Y..- J PlattN~ .~LotNUmber. . , 1. DEVELOPMENT TYPJ; (Check appropriate dwelling(sl. SDC Calculations and dwelling type definitions are on the back'> A. Sim.le Familv - Detached Single Family home NO OF UNITS B. Sinl!le Familv - Attacheq NO OF UNITS C. [v\ulti-Familv Aoartment NOOF UNITS D. Manufactured Home Park NO OF UNITS ( WPRD SDC Manufactured home not in a park X $400 PER UNIT ;r" $ X $370 PER UNIT = . $ X $277 PER UNIT = $ X $280 PER UNIT = $ ~etJ ,cO $ r1fj),Cf:) $ Vf . $)fXJ 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 lor Credit) b ~~€) Community-Services Divl!li~in - City of Springfield ~ \ lo I P1-1~ Date