HomeMy WebLinkAboutPermit Building 1992-10-23
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RESIDENTIAL
PERMIT APPLICATION
I..:
Inspections: 726.3769
Olfice: 726.3759
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SPRINGFIELD
LOCATION OF PROPOSED WORK: ..f!lo/l/( A j".f.Chl'f_'lXiLo'Ji4_l!e RJ,I
ASSESSORS MAP:_L7-0'" "27 I."
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2007 Nloss -SJ'pc-F'I
E /"f~.P,.,~ ()}{'. '9 ?I!c ~
flu. (JI'/(U
LOT'
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OWNER:
ADDRESS:
CITY:
,.
DESCRIBE WORK:
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NEW _~ REMODEL
ADDITION
BLOCK'
STATE:
s i~" ,co.1!-
jV) ~1r} tn..-R-
. JOB NUMBER
92,/~o~
DEMOLISH
on.IER
225 Firth Slmcl
SpdllUllc1d. OICOUll U74"~~ (S
,&/5(:t?Ji..J&/?-1J ~_5 ,PEd,_Of?..
lAX LOT --O_4$-(7:0
SUBDIVISION: ~,
PHONE: ~
" e
ZIP:
.;> 7J/C! ?
5 ,,/, <<-f'
CONS'r:
CONTRACTOR'S NAME ADDRESS CONTRACTOR H EXPIRES
GENERAL: C.,/l4~_LL,d:_.().-' ~$.f&..Y;"nO?;,~~g"fe#:e-- ~9$-'9 f-ls-fJ..._
PLUMBING: DM I3l?o.l&).kLf2k-~-~9-)ll.~'i) jJl.P..rLI.i#.9_N.sfv.P....~'I~;",)-
MECHANICAL:
PHONE
..5'-1.2, -.;19,,0_
~~f"-ITb
ELECTRICAL: ("l A h Vl .' '" ;;/ "'_~-(I!.L~.~r*~~P!.. .f).tc:~;o,.f.d.__S;<2~j)
7t1/~P9sg
QUAD AREA:
I QJULl)
\
H OF BLDGS: _
OCCY GROUP: -\Z~
H OF STORIES: 1
WATER HEATER:_f..
~
- OFFICE USE -
LAND USE _I \ .~n
H OF UNITS: -.-:(_
CONSTR. TYPE: _v_fI:l___
HEAT SOUHCE: ~ F' )
PJ
RANGE:
FLOOD PLAIN: .
ZONING CODE: _If)_eJ
H OF BDRMS: ,-:~'
SECONDARY HEAl: -\71-:-n-a:::-
SQUARE FOOTAGE: _ ':::t:::-'C_L_
To request an inspection, you must call 726.3769. This Is a 24 hour recordIng. All inspections requested belore 7:00 a.m. will be
made the same working day, Inspections roquested after 7:00 a.m. will be made ttlC following work day.
o Temporary Electric
D Sito Inspection - To be made
after excavation, but prior 10
setting forms.
D Undcrslab PlumbingfElcctrical1
Mechanical - Prior to cover.
~1 Footing - Artcr tlcnches arc
r excavated.
CI Masonry - Sleel location, bond
ucallls, grouting.
D Foundation - After fonns me
erected but prior to concrete
placcment.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor PlumbingfMochanical
_ Prior to insulation or docking.
o Post and Deam - Prior to floor
insulation or decking.
,',
o Floor Insulation - Prior to": '
docking.
1
''-l71 Sanitary Sower - Prior to filling
~ trench.
O Slorm Sewer - Prior to filling
trench.
.}tlwatcr Line - pri~r 'lO."lIlill!;
trench. ' . .... ... '. .
\ ..~, ..
o Rough Plun~bing'--~T)ribr.to
cover. .
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REQUIRED INSPECTIONS
D Rough Mechanical' - Prior 10
cove~ .
o Rough Electrical - Prior 10
cover.
o Electrical SOl'vice - Must be
approved to obtain pCIITl<l1Wnt
elcctrical power.
o Fireplace - Prior to f<lclnq
rnaterletls <lnd fralllln{l Im:6.
1=1 Frnmin{l - Plior In (;(IV'~1'.
O WallfCoilinu Illsulntiol1 - Pliol to
cover.
o Drywall - Prior to tapinn.
o Wood Stove - Aflcr Installalil)ll.
o Insert - After fireplace apploval
and installatIon of unit.
o Curbcul & Approach - Arter
'forllls ille erccted but priol to
placement of concrele.
o Sidewalk & Driveway - Allcr
excavation is complete, forms
and sub.base malerlal in placp..
D Fence - Wllf,lll (:(llllplllllld.
o Shool Tre05 - When :tll /I)!IIJiICr!
trees mo f>lanted.
o
Final Plumbing - Wilen all
plumbing work is complete.
CI Final Electrical - When all
eleclrlcal work is complete.
[]
Final Mechanical - When all
Illcchanlcal wQrl< ir. complete.
[~ Filwl Uuildil19 - WhIm all
required inspcctiul1:> have bel:1l
Olpplovcd <lnd bllildinO i~
I:olllllleled.
1.=1011>0'-..
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MOBILE HOME INSPECTIONS
~/l' [)locking and Sel.Up - When <'111
~blocking is complete.
,Vf'PlulHbing Connections - When
Y-~-home has beon connected to
waler and sewer.
I)(] Electrical Connoclion - When
~IOCking. sol.up, and plumbinu
inspcctions IltlVe been npproved
nnd the home is connected to
the t;crvlce panel.
A- Final - Aller all required
nspecl10ns are apPJOved nnd
porcher., 5ldrlino. dcd(5, nnd
venti no IHIV.: IJ(:en ill~~larred.
Lot faces
Lot Type .
Interior
Lot sq. ftg.
. Lot coverage
Corncr
Topography
PanlH1nclle
Total height
Cui-dc-sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
~Mf"AV
Tqtal Value
Building Permit Fcc
State Surctlarge
Totar Fcc
(A)
~1
c. THE PROPOSED WORK IN THE
,ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
,
. ..
Setbacks
PL. HSE GAR ACC
N
.:'1
2-___
W
-----
E
VALUE
:ZSco ~
~~
~ ..~~~.T. ~~Uf~E~OPMENT CHARGE,!?PCJ.\ (\
~""'/~b'~'''' .;. (6) 8~'-1
PLUMBING PERMIT
ITEM
Fixtures
Residontial B;lth(s)
~._._-
Sanitary Sewer
FT.
r-T.
'Waler
'Storlll Sewer
; ~. ..,,;:-.
. ",~. .
Moliile HOlne
1"1:
d~!
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hoocl
Vent Fan
N'
Wood StovellnsertlFircplacc Unit
Dryer Vent
Mcctwnical Permi I
Issuance
Slate Surchnrne
Total Permil
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
ft
Curbeut
It
Demolition
State Surchargc
FEE
~-CD
a~~~~
'-1- w
-5.
U69J
_0~5
l25.ca5
.
1Q5~
~Il_
_:>l:::).~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DU~ltldin9 ercctlicaij) J~-)::)~
(A, B, C, 0, :1I'l(1 E COlllbinQ(1) ___ ~ .<61.38.93)_
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition Ihat the selid
construction shall, in all respects, conform to the Ordinance
adopted by the Cily of Springfield, including Ihe
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tfme
upon violallon of anY~rov" s of said ordinances.
Plan Check Fee: ,.-
Date Paid: \..f\ ~
Receipt Number'~V
Received By: /T \
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Plans Reviewed By
Dale
,.j
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
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ADDITIONAL COMMENTS
By signature, I stale ancl agree, that I have carefUlly examined
the completed application and do hereby certify that all
informatlon 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 Stelle of Oregon pertaining to the work described
tlemin, emd that NO OCCUPA.NCY will be made of any
structure Wlltlout permission of the Building Safely Division.
I further certify that only contractors and employees wtlO
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections arc
requesled 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 ~~.u:l p.ffV--
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Dale /tJ-?~ - - cr-::L
VALIDATION:
RECEIPT NUMBER
~~~~
/e> -2""3-?<.
~ 3.8: "7.5
nECEIVED BY ____ ~~ -;'.--- _.'
r
DATI;: PAID
AMOUNT RECEIVED
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SPRIAIELD
DEVELOPMENTSERWCES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD. OR 97477
(503) 726,3753
MOBILE HOME AND M~<UFACTURED HOME AGREEMENT
UNITS TO BE; PU,CED W A PARK
As required by the City of Springfield Development Code and/or the State of
Oregon, I understand and agree, as sho.n by my signature on this form, that vith
t~.e a.EJ1rOV~f the attached );el)ll,i ts for a home to be located at .
<'V 1,"')( (1/..1/1/Q..J #61Ir1 , Springfield, Oregon, City Job Number
L1~ ~LJ I vill meet or exceed the belov listed minimum setbacks.
Home Setbacks
10 feet from a park build ing
20 feet from any public street
5 feet from any rear space line or interior space line
'.
I 5 feet from the edge of a park street
I
I 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 sideva1k
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
~~;j
Signature
~,
1~-'2. ?-72....
Date
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CITY OF Sr.A/HGFIELO SYSTEf1S OEVELOPI,\ENT
. WORKSHEET .
. '(COHI1ERCIAL t. RESIDENTIAL)
CHARGE
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NAI-!EOrl COl'lI'ANY: _to_o.~T.;.._,bQM~ t'A.l?J7L'=.f.'- ~OWlI::.P",~
LOCATlOll: SDL -Ic,l?1S PA-II) vJl-1v.~ MoP-"I.-12. \-\-orviS t":> Mo\JtG1:> '\'-\,
DEVELOP1,\ErlT TYPE:
[JUILDING SIZE:
1. STORl.! DRAWAGF.
mrERVIOUS SQ. FT. . X SO .18G rER SQ. Fr.
(See Reversc for Runoff Coefficients If Actual Imperv. Area
LOT SIZE'
.SQ. Ft.
Is 0-
Is Unkno\in)
2. SANITARY SEWER-CrTY
NO. Of rfV'S I + X 538.55 r[R PeV
(See Reverse To Dctcnninc Total rrU'S)
Is ??"\ I~I
3. IBfdISI'(llnr'D.r);l.
110 or Ui~ITS x T!m' rZ!lTE x COST PER TRIr
. }. _' c:.jl..L__ ::: S:S3~Gl
Is '2.:2-";,0.;:..1
x X $382.G1
s
-.'
v
. X. S3S3.Gl
Odcminc Trip Rate;;)
SU[JTOTAL '(ADD
ITEI1.S 1,2, & 3) S 1(P1.1~
(See Attachmcnt C To
4. ADl1TlHSTRAT!VE FEES.
'BASE, CHARGE' (SUBTOTAL ABOVE) X ~05 Is "7'O'j. I
TOT,\~-CilY Sl)C. .s ceo ~
5. SAN ITARY SEWER-H1.JHC.
\ :'3~~U::jio~'OF PFU'S . "",..f- x S13:25 PER PFU + S!!l11Wl-IC ADMIN. FEE S 1'-1 C, ~
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; ...'. ,:',~, ~lWHC. CREDIT IF .ArPlICABL((SEE REVERSE} . , .' ...
::",::;E'R<;-~iP ,",~,~:Y'~?~f;;:- .. . , eTOT,~~::is::c:s ~: ~I
,'. ..:,:;:;)",:,.;,.:.'......::~ric Coo'rdinator . ::',' ,., .' '. ",," ,.... ",~";",,.C'
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