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HomeMy WebLinkAboutPermit Building 1999-6-14 . RESIDENTIAL PERMIT APPLICATION Insp,~ctioll:.: 1:~G.376Q OffiCi::: 72G<\!~)9 . SPRINGf'IELO " LOC'~TION (:1' PIlOPO,"ED WOfl": ~,mD-_l"'U~P.I ASSESSOfl~, r,lAp: _ _ \ '-b3~- - LOT: ___ . ST, SP 13 LOCI<: OWNER __ _R~_' __eBn/Q&- e..AtL.F-y ADDf1ESS:, ICo..a~_f}k~T L~, CITY: _fJJ6f!l.e..- -- DESCIlIBE WORK: _m~l:\oll!t: NEW__ REMODEL _ _ ADDITION STArE: _O_~ . . JOI3 NUMBER _q](CJ_ 286 225 Fifth Street Splinglield, Oregon 97477 . 2.2.S- . -y-\L\TID-- - - - TAX LOT:t&PrV'\XQ ~- SUBDIVISION: _U\llU WH ~ PHONE: 'J:1s ~ 667 f:?___ ZIP: 371.p I --.*,- -- . . IN fA1t.1L w j.J1:j_A~N'.llb DEMOliSH OTHER CONST, CONTRACTOR N CONTRACIOlrs NAME ADDRE~;S GENERAL GOO.!>f,/J . H1\F;.~ISQ.~ _(~.1/~Y. .j, IJ. t( cl " ~, PLUfv113INC: - -.- --- - - EXPIRES PHONE __~c,4<17 __5-7-9S-,___08"-176'l _ 2.O-Z'36f'B__1I-3tJ -'11..._ t. ir MECHANI<~.'\I.: ,___ ELECrnIC"'_ _1::l~J~ _~c...___ QUAD AREA j~ __ H OF BLOCS __ ~ _.__ ~CC_Y GROI",' ~~T~J\ - 01- SlOHIE". .__ WATEn HEAr foR: _ y ./ , - OFFIC~- LAND USE: -1l-~ ) H OF UNIT~,:, _\-.1 CONSTR. 1 YPE: _V..I\J HEAT SOUHCE: -~.Y RANGE: -V, t;, 8 8 -J.~oo ~LOOD PLAIN: -ti'\O' - . ZONING CODE:...wx.--::. ,6), " OF BDRMS: SECONDARY HEAT: --,tt'\71 fA -- SQUARE FOOTAGE: _\,<:::f\Y-.HJI _ To request rUl inspection, you lIlust call 72G.3769. TI1IG Is a 24 llOur recording. All Inspections rcqllcstccl before 7:00 ,1.1fl. will /)0 Illlldc the ~~illllc wOIli.i,IU (lay, in~~pocljons IQqllested after 7:UO a.fIl. will be made the following work day. Cl Tcmpolilry Elcclri.:: o Site 11l~pCClioll - To be made al\(:1 'l.-.;avtltion, !.ul pd..ll to selllllO IOt'llIS. . , ~ Un<!tHsl..b Plumhill /Efuctrical/'.~' ~ Mechanical - I'do 1+ [] FOOlill'.l - Aflo;l Ilenches alC CXC3V:JI,'c1. CI Masomy - Stcld locatioll, boml I)CnllIS, 'Irouting. CI FoullClOIlion - Allf~f fonlls are ereclcll Oul pllOI 10 conG/l)tc plaCI~III"~nl. o Undcl{JIOllnd Plwllbing - Prior 10 lillino trencll. D Underllnor Plumbing/Mechanic;;11 _ Pliol to insulation or dcckinO. o Post :lIld Serlm - PriOl 10 floor insulallnn or occldng. o Floor Insulation -- Priol to dcckintl. ~ o SanitillY Sewcl' - PriOI' 10 fillinU trend.. Stonn Sewer - PI'ier 10 lilling trendl. ~ o Watur Uno - PII", 10 fillillg trench. ROUflh Pllll11binO - Prior to COVE-I". REQUIRED INSPECTIONS I~ Rough Mechanical - Prior to - cover. ~01l9h ~1r:I~C~ior to " CcWC', 'VV-I \". v I.:=J Electrical Service - Must be approved 10 ohtain permanent electrical powl~r. [J Fireplace - Pdo/' to lacing ITllllerlars :1I1d (lilllllnu Insp, I~ Frilmino - Pdl), to cover. I~ W<tIl/CciliIlU IIl~il:latioll - Plior to cover. l~ Drywall - Prior to taping. I~ Wood Stove - Aller In~lallation. [J Insert - After (jrcplacc approval and lnstarl:llioll of unit. o CUI'bcut & .'\pproach - After forms arc eruc!C(1 but prior to placement of concrete. I~ Sidewalk & Driveway - Afte, excavation is complete, forllls unci sub.IJ:lSC lIIatcrlul in place. l~ FCllce - WIICII cOlTlptult:d. I~ Street Trees - Wilen all required trees are IJI~Hltcd. o Final Plumbing - Wilen alt plulllbing wurt, is COlllpldC. rtJ1) Finnl Electrical - When all ~ electri I woll, is c Ilplele. o Final Mechani I - WIlI)n :lll mechanical worl< is I:Olllplct,;. ~Final Buildinu - Wilen :III required insp0ctions lIavt~ 1J'~I:1l approved an buildino i~. completed. DO'hcr MOBILE HOME INSPECTIONS ~1lI0Cking and Set-Up - WIWll :ltj LP blocking is c(lmplcle. ~ Plumbing Connections - Wl1un ~ tWine tlaS bcen conrlf:cl,~c1 to water and sewer. r\t1 Electrical Connection - Wh(~n ~ blocking, sel-up, and plulIlt>illtl inspections /lave bCl~1l appnWiitl and the home is cOrH\l:(;led 1(, 1I1C service pnnel. f1 Final - Artel' all rcquilcd inspections are appr\)Vt~d and porches, sldrting, (jccl~s, and venting Iwvc bcen in~;udtc:(l. I ti).ffi + .~'L ~.S?> :-A .S5 Lot faces . Lo' Type Lot sq, ftg, Interior Lot coverage Corner Topography Panhandle Total height Cui-dc-sac BUILDING PERMIT ITEM SO. FT, X $/SO, FT, Main Garnge L\aD \(').\ [) Carporl Total Value Building Permit Fcc Slale Surcharge TOI<11 Fcc (A) Setbacks ~ HSE GAR ACC N Is Iw IE VALUE _~!}A~ SYSTEMS DEVELOPMENT CHARG~.lSD~ (S) ~~(~() to5~ \ q5+__.:i.~ 'JD~ao PLUMBING PERMIT ITEM Fixtures Residential 8ath(s) N' Sanitary Sewer FT, Water FT, Storm Sewer FT. Mobile Home Plulllbing Permit Stille SUf{;!lilfUC Tulal Chmnc (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mcctlanical Permit Issuance Slale Surctlargc Total Permit (D) MISCELLANEOUS PERMITS Mobile Horne Stale Issuance Slate Surcharge ...3% -- Curbcut II Demoli lion St<llc Surcharge FEE As9b A'S po \~.co .PJ \()~~ A(), 5a5 ,~.t5 Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) ~.~ (A, S, C, D, and E Combined) ,it / ' , 81s THE P~OPOSED WORK iN THE HISTORICAL DISTRICT, on ON THE HISTORICAL REGISTEm If yes, this application mll:;1 be signed and approved by the Historical Coordinator prior to permil issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is gr<J.nted on the express condition lhilt the said construction shall, in all respecls, conlorm 10 the Oldinancc adopted by the City of Sprinofield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked al any time upon violation of any provisions of said orclinanees. Plan Check Fee: Date Date Paid: Receipt Numbet~:'_. 1i:IDYA Plans Reviewed By Systems Development Charge' is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS By signature, I stale and agree. Ihat I have camfully eXi'JlTlined the completed application and do hereby certify that all information hereon is true and correct, and I furl her certify that any and all work performed shall be done in 3ccmclancc with the Ordinances of the City of Springrield. ;1I1d the Li1wS of the State of Oregon pertaining to the WOI It; described herein, and that NO OCCUPANCY will be Ilwdc of any structure without permission of the Building Safety Division. I further certify lhal 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 eacll addrer.$ is readable from the street, thai the permit card is localed ill the front of the properly, and ttle approved set of plan:; will remain on the sile at all times during con:;lruction. ~ignalurc/lJ I/~ ~-(1-?<? Dale VALIDATION: HECEIPT NUMBEH DATE PAID AMOUNT RfE.C1!:1 RECEIVED sQ " , \ . fl. l .. ~t'"JJA Willamalane '(;Q' Park & Recreation District . Job No. Q4COU SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAMC\\ffirv\Q" ') ~Cfu ; PHONE: 040 4[)\~ ADDRESS:2f\l'2Il t\ ~f\t'~~\ STATE:(;:R .Zlpq1\~~-=) ~ LOCATION OF IilROPOSED BUIL9ING SITE: L. # -# Street Address if Known: a) lCi) ~ (j LuLl j ~()fJ-J / Platt Name: TaK Lot Number: / /}^'~{J.')I()()14(Y:J 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), 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 - 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 = $ $ !1PD r.-o $~ro.cO $ 0 ci) ~9D. 4: / 2.~ICf\ Date X $280 PER UNIT = 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) ~ff\ Community Services Divt n City of Springfield oi) 1\ ~ CIT1:aol~..rrnrtU[[\?:6~~(T~~~~~r[LO.l'i\[i;i l::.\I\UL. A.7\C:/IO\ " 2}\~:J LJJ~ UJ.-T (CO'''''CI^,' RESIOEI1TIAL) - C\ ~ rWIE(jt COi'iI'AllY: J:~Lo.t::lTt\__lQ_0." N\.9_o l'=.f"- ~o/'J\ E:. ' P.".u LOCATIOil:, <::JDe. -to '\:7C'. P~~I\)' ,^f~(/tJ !0I,CiP..>Il--P- i-k:vIS I"::> N'\O\l(G':)\f-\ ' DEVELOPMEllT TYPE: IlUILDWG SIZE: LOT SIZE .SQ. Ft. 1. STORr'! DRAInAGE, U!PERVIOUS SQ. n. x SO.ISG PER SQ. FT. (See Rever:e For Runoff Coefficients .If Ac~tial I~perv. Area \S & I: Un~:nQ',;n) 2. SA1:ITARY SEYER-CITY r:o. 0:: rEV'S I Lj, . X S3S,55 r[:( P;.V (See Rever:e To O.~telT1ir:e Total rEU'S) is ?"?::"\ I~ I .>. 1;::..,:.~~~:~.'.:~T::'l_!.Q;:. r:r; c;. C::!T:; X T::~;' :~:.T;: ~ (CST P[::. TrliI) I -------- l'" . """": I-~ ---- ._- --- ?: ~::::.C: I: "..... - ::;'.- I v !~..:..~;._~ v r...,........ r" . .", ~.:.:~:~.'J~ ., :~ ~:::3.G: ---- (See ^t::;,c:::::C:1: L i"o O:2t~r::~n~ Tr~p RJ.~~=) I -(/'-'~ SUBTOTAL '(ADD B:S 1,2, & 3) S I J" - 4. ADIHlHSml\T!VE FEES 'l3,\S;::, CEJU~GE (SUSTOTAL f-seVE) X ;05 h 'Z.7'3I~ I 107....~. - ~ ~ "T':' ,--. - r C. ,--r 90 '-'-"- - 5. SMIITMIY SEWER-M'riIK FEE S /4 C, ~ __; ..,.,IlO. OF PFU'S' ,...f- x S13.25 PER PFU + S!() 1-I\.IHC ADXIN. ,:...~:'~.-'..::7"".' ...._. '::,.'~'~_ .-:.:. _..h.......:..::.... .' ':';;',',,:,~:{Use PFU Total From Ite"!2A.bo~e) . . ".- . -- :.'. '.- . .-:.:- ..._,.' ',- ',-'.'- --,,' ," ;.' ~'.. . ..~ ........ . . .' ..~.o . . ,...... '. - . ~. , .., " - '--', - .'-. :'-'.'. .... . :~. -' :: .:-..: ~lW:1C CREDIT, IF APPLICi\BLE (SEE REVERSE) .0:':'" . ~ . . - <t /~i /1 'V I . ." ,. S TOTAl-MI.JMe SoC Is 1'1C;~ 1 TOTAL SoCS qq L, <C!:-. ~,... . ";;;"',',.". ".(j' . Kip Burdick SDC Coordinator -" . ...--.....: .. ~::'..-;:.~:_,. '-.- .. ...~ --..... ," ......~,.'.. L\,~'-ff\~\1 . . ....,., ..... ..' ..' .... . . .._.. r." .i-:,' ;.:.,: :.~.:' ...... .; _u . ..:..... '.;_.-: ..... '.' .'. ;'~ '.:'-:,'.: ,". ! L:::\I\UL: ~f :W \ CD rW1CQ[( COiWAlIY: J:to.~.JJ\_.~Q.0" N\~J';>L':::f: \-:-I.OI'J\E:. ,p'",e.:t:: lOCATlOil: SDc -ro17...:' 6:.\,IjL~llivJ M(l~>ll-e 0-crvlS t<.:::> !--/\O\Jf2,;:>\f-.\. CITY OF SPRIriGFl[LO SYSTGIS OEVELOP:lc,;;i . \VORKSHEET'. (CO/ll\mCI^l f. RESIOEHTI^L) OEVELOrHEllT TYPE: [JUIlOWG SIZE: LOT SIZe .SQ. Ft. 1. STORH ORMlI^GE Il,:rERVIOUS SQ. n. x so. ISG PER SQ. FT, Is & (See Re\'er~e For Rc:lr:lff Coefficients If f\ctu~l kpen. f\re~ I~ UnknO'o;n) 2. SAI:ITARY SEYER-CITY r:o. 0:- rEV'S I Lj, . X 531:>.55 rCR r::L! (See Rcver~e To O~tel~ine Tat~l rEV'S) Is C;?~\ l~ I ~. . JX~:~r~..;j.~.:~I"~\ 1_!.G.;:. t:r; cr- I~::!T: x T:~::' :~:\T;: X (CST rc~ TRI[' ,__1___.. :': l-.;I..: --....- --- ~: s:::::: _ c: \ .....,,.. _ :;.l '"" I .~ I~~~ .;, - ~ . '!. j::-:::..fj 1 ., :( ;:::j.G~ ----- 'See A'-'c;'-~"''' L' '1'.- 111.'-""-;"" -....;... I:""I..,",,~, \ 1"...... .....:........ v L,;:...L:,;.....d.'- t. ':-- .........--j IT -""I. ".. -. '..J SUGTOTAL '(1'\00 a:s I,Z. & 3) S ,,,,:-- 4. AOlmnSTRI',TlVE FEES 'ni,SE CHARGE (SUBTOTAL ASOVE) X ;05 k '1;>'3':;" I IC.-:-:..~.-::~~": ,--,- ..... GI'" r c.....,... ,'" ..........- - 5. SAtlITM1Y SEI.JErHfriIK, . '..:.. ,rlO. OF PFU'S . r..J. x 513.25 PER PFU .+ 5!O 1-I\.IHC mXIN. FEE S /4 t:; ~ .-~ .'-". '.. ...-...... .. .. , ' .' '." . '.1. . .. .~. . - .--', -- .'-. ",',' ,"s ":'-'" TOTAL -MIme S~C: Is 1"7 '? ~ I TOTAL SOC ~ G. 't!:- , ,;;;,,;':' .':'. .,~. ., K~'P 'Burdi ck .._., ", SDC coordinator ...... . ..." . ~ -:-~.-'.-.-._' ....... .: ~ . .. ".~ --..... ,. ... .,. ., '6.s.qL-~~~ '. . ..... .:':'~..,.. ':'. . .- ~ .... . .;.: .;..:..~":.:.:' ";, , -.. . .:.~.\ -;::::, .~., ,.... ..' '.':., . . @ Y.!!W.1!!:!!!!~!!~ Job No. q4fb95 SYSTEMS DEVELOPMENT CHARGE ADDRESS ~f) Lf) ~CS~~ I TATEG\? zwihtJ3' LOCATION OF filROPOSED BUIL9L,NG SI~ l j :it:j^C::- Street Address if Known: (\ ) /5 u HY) 11A.Il--- L.J......:) f\ \~ ~ T~ L~ "om"'" \ II 039- 'lj () o41CO NAME: Platt Name: 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 NO OF UNITS Manufaoured home not in a park X $400 PER UNIT _= $ B. Single Familv - Attached . NO OF UNITS X $370 PER UNIT = , $ C. Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufaoured Home Park NO OF UNITS X $280 PER UNIT = $dJ9D,dJ $ ~M,CO $p $J2/) cD left' WPRD SDC 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See sac Credit Worksheet. ~:O~-J: ",IT SOC A~:;:J ,~~ ~,~;", n Community Services DiviSiO~ Date City of Springfield