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HomeMy WebLinkAboutPermit Building 1993-8-16 ~ <) RESIDENTIAL PERMIT APPLICATION Inspections: 726,3769 Ollice: 726,3759 . LOCATiON OF PROPOSED WORK: ~ \ ~ \t1n~~V\ In BLOCK' OWNER: Q0\\Q.rt-~()~ ~)\\\ \Q r ADDRESS: ' '\ c) YM... ~() Il\~ \\ t 0t ) ~ t ) \t\ '\' (\-\(\0_) STATE: \_Q <D_, C2j~ (irUl UC1Y1-i DEMOLISH OT~ER ASSESSORS MAP' LOT: C'TY: DESCRIBE ~K! NEW REMODEL TAX LOT: , ~: SUBDIVISION' PHONF' ~ ~L.V-~ ~- * ~irrrA L.~ :1 S!!J$ltJ1I9iI-779" ' ZIP: CONTRACT09]SNAME~ ' ~ ADD8ESS GENERAL: -, (Y11 0 (\ ~\ ~~ ') PLUMBING: jh.')jJ AI\ , \ \\ J\ ~ ~, CONST, tQr6Wr l o({ A\ f\ . MECHANICAL: - ~ -----" ELECTRICAl" _ ~D. \L\l~ ~\C'1 L'Y\. , ~ \ QJ\ )\0 - OFFICE USE - QUAD AREA: LAND USE: \\~) FLOOD PLAIN: . OF BLDGS: \ . OF UNITS: \ - ZONING CODE: u\~ OCCY GROUP: \c\'-l\\- ~ CONSTR, TYPE: vrJ . OF BDRMS: - ~ . OF STORIES: I HEAT SOURr'~' F E-./ SECONDARY HEAT: WATER HEATER: ~ RANGE: b SQUARE FOOTAGE:_I~ To request an inspection, you must call 726.3769. This 15 a 24 hour recordIng. AI/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 D Site Inspection - To be made after excavation, but pdo to settl~rm, -V ~nder a u~n ji"EleetrioalV l Meeha leal - Prio~ D Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting. D Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underlloor PlumblnglMechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor insulation or decking. D Floor Insulation - Prior to decking. ~anltary Sewer - Prior to fillIng trench. Storm Sewer - Prior to flll1ng trench. ~ater Line - Prior to filling I trench. . P. Rough Plumbing - Prior to cover. . REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. .; '~}1.\, W~~~hn;:t~If)OVF '0. (~,~vr '> ;, D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D WalllCelling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stove - After Installation. D Insert - After fireplace approval and Installation of unit. . ,'i! D Curbcut & Approach - After forms are erected but prIor to placement of concrete. D Sidewalk & Driveway - After excavation Is complete, forms and sub-base material in place. D Fence - When completed. D Streot Trees - When all required trees are planted. D Final Plumbing - When all plumbing work Is.complet.e. D Final Electrical - When all electrical work is complete. D Final Mechanical - When all mechanical work Is complete. ~Flnal Building - When all required Inspections have been approved and building is oompleled. ~ bv1:- DOther MOBILE HOME INSPECTIONS locking and Set-Up - When all locking Is complete. umbing Connections - When home has been connected to water and sewer. f'. ~Iectrical Connection - When blocking, set-up, and plumbing Inspections have been approved and the home is connected to the service pa~et. ~Inal - After all required inspections are approved and porches, skirting, decks, and venting have been Installed. . . ~ -~ Lot taces Lot Type Setbacks IS THE PROPOSED WORK IN'THE _" I PL. HSEIGAR ACC I , -. Lot sq, flg, Interior HISTORICAL DISTRICT, OR ON IN I I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I I and approved by the Historical Topography Panhandle Iw I' I Coordinator prior to permit Issuance. Total height Cul,de,sac IE I I APPROVED: BUILDING PERMIT ITEM SQ, FT, X $ISQ, FT, ~ VALUE Main Garage lcaCDdJ } Carport Total Val ue Building Permit Fee ~~.co T,~S alP .~~ State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARG_E iSDC) '" (B) ~lQ...,.4( PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' ASgS AS. IS.W Sanitary Sewer FT., FT., Water Slorm Sewer FT. Mobile Home Plumbing Permit Lo5~ ~,~ Lf)R./~5 State Surcharge Total Charge (C) MECHANICAL PERMIT Fu mace Exhaust Hood Vent Fan N' Wood StovellnsertlFlreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge CZf rO'5,CO dnCf:) ~ill Total Permit (D) MISCELLANEOUS PERMITS , Mobile Home State Issuance State Surcharge Sidewalk fl , I Curbcut fl Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrlc~ c9&'1--fl'S (A, B, C, D, and E Combined) <-jq[O ~L) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction st:lall, in all respects, conform to th~ 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: Plans Reviewed By Date Systems Devolopment Charge is due on a,ll undeveloped properties within the City limits which are being improved. .lWRIT~O~.~ O~~~NTS- jl,tLI1J' J.~~I~J~rfU{.or \ l,nJ9W_ ~- ,'f\\if\~-,\'{\l9A,IIT 2 ^ I ~-'Jl\l'1 ~ ') \ en 'N. ('~ ;zQC:)--U.J6.j) ~9{) f\A \) t+ T ~)\ ,\t\[iJ .) - "I(\,PfW-4Pl~ 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 furthor certify that any and all work performed sharr be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work descrlbod herein, and thal 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 construction. Signature 9J~ ~_ Oatp VALIDATION: rvfl'/\ (\ RECEIPT NU~ER '-\,-'\\:" I DATE PAIr> ?6)> \ \ Q - ?-:J, AMOUNT R'f..E~ED 6Qll\ E\)( YY I 0 :'if) RECEIVED ~'" ( _ .. - . -- . . . 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 th~ a~v~l)bt the ~ttach7P Hermits for a home to be located at rVl::Sl,)c:7)~c5J17 , Springfield, Oregon, City Job Number _4..> 1~(.1:r I vill meet or exceed the belov listed minimum setbacks. Home Setbacks 10 feet from a park building 20 feet from any public street 5 feet from any rear space line or in terior space line 5 feet from the edge of a park street 2 feet from the interior edge of a park side"alk 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 Minimum Requirements for Permanent Steps - Electrical Connection (" ~+- _ ~M/UA.I' ~ Sifure Date -, ", ',:-- . CITY OF .IIlCr[ELO SYSTU1S DEVELOPljiWT WORKSHEET · (COliI1ERCIAL t. RESIDENTIAL) Clltd\GE QJ\\ ~~ 06'~ ! 11M-IE Olt COIWAHY: _l':J_o.~Ti)__,bQ,0" r-^.IlJ'O:> L '--\"-- \401J1 I::. '0.0:- LOCATIOll: SD(_ -r;; '2;::' 6:'cl~lHvtJ Mor::.>'L-~ UoMt:.. I':> Mo\Ji<':-::>\r--I. O[VELOP1-!G1T TYPE: OUILOWG SIZE: .LOT SIZE ,SQ. Ft. 1. STORI,! ORA IllAG~ Il-!PERVIOUS SQ. rT, X $O.l0G PER SQ_ Fr. (See Reverse for Runoff Coefficients If Actual Imperv. t,rea Is e- Is Unknmm) 2, SM: IT ARY S [\oiFlt -( r 1" 1:0. 0:: prU'S I Lj. X $38.55 PER P:-U (See Reverse To O,~ten;linc Total prU'S) Is 7,?Q l~ I ~;. JJ~~~L~!~.Q?Tr<TJ.l};:. l:!'J Or: Ui:!TS X TE~-:l !~J\TE X COST PER. TRII) " l-'l"'~ ----.---.- v ('';'~^ r, .', ";,,,'V'J_ '-_ l - 0 ~ I S 7--1--;' -! v '!. ~:~~.Gl :-; ..... ..... -.' ., x S2:3~Gl - , l~'?.'~ (See ^tt~Cli;:C:1~ C To Ut!terr::ine Trip RJ.~c=) SUOTOT^L -(^DD ITEI'~S 1,2, & 3) S 4. ^OlHlHSTRAT!VE FEES '01\SE, CHARGE (SUBTOTAL ABOVE) X ;05 Is -;'0 '::!- I TOT:\~_ -C 11\' S0;: , C ,-/' 9 0 .......-- -. 5. SANITMY SE\.IER-H',11-lC -. .~-,'.: :'..: ,110. OF PFU'S .,..{- x 513.25 PER PFU .+ S10 1-\WHC ADKIN. FEE s 1"1 C; ~ ~... ~'- .:,. . ...~. ",,'. ""~'. . .;, : ::~ ........: -' .:.'... >:;:';"}:'~:(lJse PFU T~t~l F~~~ -it~ll!2A.b~~'e) ,........__ . .......:..'...~~_.. ._....J' "__~ ........~:~~.:....~-.'.~.:_..::.. ;'.: :' .>:, ~lWI1C CR[DIT IF ^PPLICABlE (SEE REVERSE) <..>:.::.:..:-'..... ...........-..-.( ,<~"::....: ."':".. ..,,' ........... .., .'. . -" ~' ,,,' ''-f1'J,1/<f'V ".;;/' '" . ",.(\ Kip Burdick I , ,SDC Coordinator ....-. . .... ,':...._., - ....::: :'.. ~. - :-. . . .~. . ,:','S' :'::..:.:.':: ..-,. .. .,.... TOTAl-MWMC sac: Is 1'7'J~ I TOTAL SDCS qq ~ ~. ',. .~ .. :fZ:5:;~;;~"~~:":' :::':'~q'. ;' ,'.'....'.' 7,' ..:t::... f;:;:. .:.' ..... ....- . . . .. ~ C\C\~\\o.c6