HomeMy WebLinkAboutPermit Building 1993-8-16
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SPRINGFIELD
RE:bIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
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JOB NUMBER ~3c>~
225 Fifth Street
Springfield, Oregon 97477
ASSESSORS 'MAP:
'2/5'"0
1:?--<?3 -2.7-/0
L,,4 LIRA"
? ~ce-7.; ':::?/51
,
TAX LOT: ~ ~SI'~
LOCATION OF PROPOSED WORK'
LOT:
BLOCK'
OWNER: -#~L.7/ ~75C.:.
ADDRESS:
CITY:
STATE:
".
SUBDIVISION:
*
, 'q
PHONE:
ZIP'
DESCRIBE WORK: ~~a..~1-' ~~~~~~fi~.:- ~ ~/.,.7 /# Mt~
NEW
REMODEL.
ADDITION
DEMOLISH
OTHER
CONTRACT~~~ .' ADDRESS
. GENERAL: _. _. '/?d.~:J~r-
PLUMBING'
CONST,
, CONTRACTOR'
'.~;>69~
MECHANICAl'
ELECTRICA" ~~ ~~'y'
r - - - ~
.J ~,
. .,
- OFFtCE USE -
EXPIRES
~~~
PHONE
.'" '/;-_=?,/2e:>
1~'Nw -l,-::""_ - - I ISO
OUAD AREA: LAND USE:' FLOOD PLAIN:
. OF BLDGS: I . OF UNITS: I ZONING CODE: ~OI2.....
_'M2> . .!f-.f/I . ~
OCCY GROUP: CONSTR. TYPE: \/IJL___ . OF BDRMS'
. OF STORIES: \ HEAT SOURCE: H~.h4 .. SECONDARY HEAT:
WATER HEATER: ? RANGE: <r SQUARE FOOTAGE:
I To request an inspectlon, you ,must call 726-3769. This Is a 24 hour ;~cordlng; All Inspections requested before 7:00 a.m. will be
I' made the' same working day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSp,ECT.IONS
o Temporary Electric
o Rough Mechanical. -. Prio(~to
cover. -
d}ROU9h Elnf)a~' ~
T cover, 'v\.;V ~ r .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Sitc Inspection - To be made
after excavation, ~rior to n
setting forms, . oJ( jl~t~
I
~ Underslab Plumbin Electrical
. Mechanical ,- Prior to ~r.
, 0 Footing - After trenches are'
excavated.' .
o
Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams. grouting,
o
F'raming - Prior to cover.
o Foundation - After forms are
erected but prior to concrete
placement.
o Wall/Ceiling Insulation - Prior to
cover.
o
Underground Plumbing - Prior
to filling trench,
o Drywall - Prior to taping.
o
Undertloor Plumbingl Mechanical
_ Prior to insulation or decking.
o
Wood Stove - After Installation.
. ~\ .
,0
Post and Beam - Prior to floor
insulation or decking"
o Insert - Aft'er fireplace approval
and instal,lation of uQif.
o Floor Insu1:!.!ion - Prior to
decking.
, '-.
Cllrbcut & Approach - After
forms are erected but prior to
placement of concrcl.~,
o
[2ffsanitary Sewer - Prior \0 filling
, trench.
D Sidewalk 1$1 Driveway - .A,lter
excavation Is comp:e:tt, forms
and sub-base materia; in ptaGe.
~'Storm Sewer - Plior 10 filling
~ trench. "
~ Water Line - Prior to fflllng
. trenctl.
D Fence - When com;:le:ed.
o Rough Plumbing - Prior to
cover.
o Street Trees - Y'ihen a!! ~e9uired
im.,;~ are planted, ... '. ...
o
Final Plumbing - When all
plumbing work Is complct,c.
o Final Electrical - When 311
. electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
~nal Building - When all
required inspections have been
approved and b~ilding is
completed.
o Other
MOBILE HOME INSPECTIONS
K7l Blocking and Set-Up - When all
~ blocking I:; complete,
~ Plumbing Connections - When
home has been connected to
water and sewer.
.I8J Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
~ Final - After all required
inspections arc approved and
porches, ukirting, decks, and
venting have been Installed.
. f":'
~IS THE PROPOSED WORK IN THE '" -..
Lot !ype Setbacks
Interior I P,L, HSE GAR ACC " . HISTORICAL DISTRICT, OR ON ".\
THE HISTORICAL REGISTER?
Corner N If yos, this application must bo signed
S and approved by the Historical
Panhandle .Iw Coordinator prior to permil issuance.
Cul-dc.sac
, IE APPROVED'
Lot facos
Lot sq, flg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, VALUE
Main ~~ -=r.j'..an>
Garage
Carport p~
;1j9c?5 /e:::>3""
Total Val ue ?? t:2yrJ
Building Permit Fce ..3~ ?C>
'Slate Surcharge J.93
Total Fee (A) ~~3
SYSTEMS DEVELOPMENT CHARGE_(~DC),.,_
~' ~
(B) (_ 9q~ ./'
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT,
? '"1 ~&J
, 2~ct:J
Water
Storm Sewer
FT,
Mobile Home
J c:; ,tff:>
Plumbing Permit
r~"::::;CO
..
<.:2S
~~.z..S'
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnscrtlFlrcplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
/05~
~&.-
5. 2.:5
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
~ ~-::;~
TOTAL AMOUNT DUE (excluding e~trical) ? ~C;. :::.
(A, B, C, D, and E Combined) (.:f)3r,,:) ~(o4~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gran~c,9 0n 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 timo
upon viol<;ltion of any ~rovjsions of said ordinances.
Plan pheck Fee:__
, /.
Date Paid: _
Receipt Number:_,~
Received By: . ~
Plans Reviewed By
Date
Systems Development Charge is ,duo' on all undeveloped
properties within the City IimJts which are being improved.
ADDITIONAL COMMENTS
5&~- ->~ C~./ _,
l/~7T pb/776 ~...ec /ff/CS
~~E,
Ai-r
~
By signature, I state and agree, that Ih~ve carefully examined
the completed application and do hereby certify that all
~nformation hereon is true and correct, and I further certify
that any and all work,P'.~rformed shall be done in accordance
with the OrdinLlnccs 01 the City of Springricl(I, and the Laws'
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY .will be made 01 any
structure without pern:ission of the Building Safety Division.
I further certify that only Gornractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure tha.t all required inspectio.ns are
requested at the proper time, that each address is readable
from the street, that the pe~mit card is located at the front
of the property, and tile approved set of plans will remain
)2::":~~==~~
Date # .
VALIDATION ~L\a
RECEIPT NU~R ___' , ,,,' \
DATE PAID ~'Ih'~ -0-
AMOUNT R~C~q(?fl~. ~)~lo1Q/
RSCE,VED BYv.).U...X k
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DEVELOPMENT SERVICES
ADMINISTRATION
PLANNING / BUILDING
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726-3753
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 vith
the approval of the attached permits for a home to be located at
2/50 LAt./~A * 2-/9 , Springfield, Oregon, Ci ty Job Number
q.2naa"2 I will meet or exceed the belov listed minimum setbacks.
I --'''''''''' , , .....,
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
I' 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 below, that I have been provided vith the
folloving information:
Manufactured Home Blocking Requirements
Minimum Requirements for Permanent Steps
- Electrical Connection
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CITY OF
.IUGF[ELO SYSHJ\S OEVELOPl~T
WORKSHEET .
(COlil1EIlCIAL t. RESIOENTIAL)
Clltd1GE L13cA,C?3
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NM1E'Olt COIWAN\': J:to.~Tr:-,_bQ,0.f\. ,,^g_&l':::f'~ ~orJ\E:. ,p,."b:: 11= '2../9.
LOCATIqr:: SDc. -T;;F72:. Et.\)~1B.~MOP->IL-e. U-01V\S I'? Mo\liG~\;-.\,
O[VELOPHEllT TYP[:
OUILOWG SIZE:
,LOT SIZE'
SQ. F t.
I, STOm,1 OIlAIllAGC
II'\PERVIOUS SQ. n. X SO.lOG PER SQ_ Fr.
(See Reverse For Runoff Coefficients .If Actual Imperv. Area
Is e-
Is UnknQ'.;n)
2. Sr.r:!TM,Y SE;iEi,-(!TY
1:0, 0;' pru' s I Lj- . X S3G - 55 PC" PeV
(See Reverse To O.~LClTIinc Total prU'S)
Is ?"?q"~ 1
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U0 0:- UU! T:) X 1~~:~' :U~TE ::: CCST P[!1 TR! P
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SUOTOTAL '(ADD ITEl':S 1,2, & 3) S
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4. [lOJHlH STRATIVE FEES.
'O,'\SE, CHARGE (SUBTOTAL ABOVE) X ;05
h ,?'OIj. I
T8T:~.~_-C ~I',' S~:~
rC........90
.....L...';...-
S. ,SANITMY SEWER-M'''/I'\C
'. ", llO. OF PFU'S
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x 513.25 PER PFU ,+ 510 1-IWHC ADMIN. FEE s 14 C; ~
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::;::'C(Use PFU Total From It~~ lAbove)
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SOC Coordinator
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TOTAL-MW~lC SO~ Is 1e'J'J~ !
TOTAL sacs q tq L, i!!.-.
NW11C CREDIT IF APPLICABLE (SEE REVERSE)
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