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Home My WebLink AboutPermit Mechanical 1993-7-21 c./J- O/l /,e... S~J dl S"O La-u. ra ..F-/Y.(a Sl}~!, .I,'eir! · (j/J ~~M L I . RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 LOCATION OF PROPOSED WORi'" --- ASSESSORS MAP- /7/J_< LOT' OWNER' ADDRESS: CITY' DESCRIBE WORK: NEW "^ REMODEL ADDITION CONTRACTOR'S NAME GENERA' . PLUMBING' . SPRINGFIELD BLOCK' STATE: /JI( . JOB NUMBER C(":j / ~ '3'7 225 Fifth Street Springfield, Oregon 97477 #2.2..'2.... TAX LOT: SUBDIVISION' .AI' / A->'"1 '-1 l'~ (/ PHONE: 7,:M, - 93/g ZIP: ;~ V~ .... d6 ~ ,/.."b~r I~~ OTHER DEMOLISH ADDRESS CONST. CONTRACTOR' EXPIRES PHONE MECHANICAL' otvl /6t #'~J' tv. S-fl /J -<.L fh-.J P' ELECTRICA' ' 10 SVs- ;;;;-<73 3(;{( -~ (,I./'( - OFFICE USE - QUAD AREA: LAND USF' FLOOD PLAIN: . OF BLDGS' . OF UNITS' ZQNING CODE: OCCY GROUP' CONSTR. TYPE: # QF BDRMS: . OF STORIES: HEAT SOURCE: SECONDARY HEAT' WATER HEATER: RANGE: SQUARE FOOTAGE: To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All 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. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab PlumbingJ ElectricalJ Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to fitling trench. o Underfloor Plumbing/Mechanical _ Prior to insulation or decking. o Post and Beam - Prior to floor Insulation or deckIng. o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water LIne - Prior to filling trench. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to ~ver. o Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. o Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms Bre erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation is complete, forms and sub.base material in place. o Fence - When completed. o Street Trees - \'\Ihcn all required trees' are plantect. o Final Plumbing - When ali plumbing work Is complet.e. o Final Electrical - When all electrical work Is complete. , 1><1 Final Mechanical - When all , "'jechanlcal work Is complete. o Final Building - When ali required Inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set-up, and plumbing Inspections have been approved and the home Is connected to the servIce panel. o Final - After all required Inspections are approved end porches, skIrting, decks, and venting have been installed. . lot faces lot Type lot sq. flg. Interior I PL. IN lot coverage Corner Is Topography Panhandle Iw Total height CuI-dc-sac IE I \1 . . is THE PROPOSED WORK IN THE . HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. Setbacks HSE GAR ACC BUILDING PERMIT ITEM SO. FT, X $/SO. FT. VALUE Main Garage Carport Total Value Building Permit Fee Slate Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. FT. Water Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace ;-t~~l' Exhaust Hood m~" J Vent Fan N' Woo.d Stove/lnsertl Fireplace Unit Dryer Vent Mechanical Permit /5 <:70 / C), (.J"O 75" 2S".7S Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) -2 oS": ? S- APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition thai the said construction shall, in all respects, conform to the Ordinance ildoptcd by Ihe 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: Receipl Numuer- Received By: Plans Reviewed By Dale Systems Development Charge is due on llll undeveloped properties within the City limits which arc being improved. ADDITIONAL COMMENTS ~ 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 further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfleld, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who arc 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 lime, 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 ::~::u:~~;~~;( Date Y2Y9, VALIDATION: RECEIPT NUMBER 96 CJ 2...- -:?/?-~~ ~ ( 2 c::; ,7 S- ,~f7~- DATE PAID AMOUNT RECElv~n RECEIVED BY ~'" CITY OF .IUGFIELD SYSTH1S OEVELOrt..T C!lARGE, WORKSHEET 'd-I<;"O '(J..~~ . (CO","RelA' , ",SIDEllTIAL) ~c9- \ LV rWIE OI( COl'll'f\NY: J':Lo.".l.:L.:.__.bQ.I0.t>. t'A.9-"'" L'=.l"-- ~ow\ I::. . PA-~ . LOCATlOrl: SDC -rc;7~_e..\-j.JL\0J!:lY:N MOP.:>I I.-12-W-orvlS I ":> M~\JtG~\ k.\ . DEVELOPMENT TYPE: [JUILDING SIZE: LOT SIZE' ,SQ. Ft. 1. STORl.\ ORA WAG F II'IPERVIOUS SQ. FT. X SO.18G PER SQ. Fr. (See Reverse For- Runoff Coefficients If f\ctual I~perv. /',rea Is 0- Is UnknO\m) 2. SANITARY SEWER-CITY 1:0. a:: rFU'S I + X S3l3.55 PER PfU (See Reverse To Octenninc Total rEU'S) Is ??q I~I _i . IrY~L~!~D.!~Ti~TJ_Qj I. r:o Or- UUITS X Ti(I[l !u\TE X COST PER TRIP \_----- ;, . t-:":'I L~ ::: S32S.Gl Is -z.:7. ";,0'::"1 v X j:SS.Gl i, .--.' v '!. S3SS.Gl To octeminc Trip R;!tc::) SU[JTOTAl '(ADD c. (See ^ttacl;~ent C ITEMS 1,2, & 3) S ( to:'" ~~ 4. AD1HNISTRATIVE FFES '[JASE CH/',RGE . (SUBTOTAL /'illOVE) X ;05 Is "7'OIj. I TOTr.~_-CIIY S~C 90 .:; See- 5. SANITARY SEWER-MWI'\C '.' :...., NO. OF PFU'S ,.--., -. ,'. , ,..f- .x S13.25 PER PFU .+ S!O 1-I11HC ADXIN. FEE s f"1 C; ~ .....',...,... ....: ..... i . .~_ ........ ">:..<':"(Use PFU Total From Ite~2l\bove) ,., ,. . '._ . :," , .'.._ . ".'.' :...... .'.:: ':-'~ .~, ,;.'-,,' .' c.' ~".: . ... '. '~ "' ':,;.; . .' " .. ~. .~. ......- . . NW11C CREDiT IF APrUCABlE' (SEE REVERSE) -J ,-:;,,::' . - '-f /"1 /1 'V ;;.:' . .~ . -. . ~ TOTAL-MW~lC SDC ~ 1"7r;~ 1 TOTAL SOCS qq C, ~ ~."-" . ,..(1 Ki P Burdi ck SDC Coordinator . <"~~._'.. ~: -.-, '.-, ,~,- . .,. .', .. -~~:.-' ..-.~"...._~: -'-- .... ~., . H " .. . .:--.-..' '" ~153-:'. (0 Wv ! q y~5~ CITY , OF S.rlGFIELD SYST[l-IS OEVELOPI'l"'- CllAlIGE WORKSHEET -I L (7 (COHI1CRCIAL t, RESIDENTIAL) .:::P- d \. J NAlI[' Oft COIWAN\': J'::Lo.~T.:.___"=Q-'.fi.,0~_<?J';, L~f"" ~OW\ I::. . p",f-j::: LOCATI~rl:....2Pc.. "'Io?__Le:::d.JL\0J!:lV~ !V\OP.>II.-lC. U-orvlS I":> Mo\JtG~\f-.\. ~BP~ DEVELOPMENT TYPE: [JUILDING SIZE: .LOT SIZE' .SQ. Ft. 1. STORr.1 DRAINAGE Il-1PERVIOUS SQ. FT. . X $D.18G rER SQ. Fr. (See Reverse For Runoff Coefficients If Actual Impcrv. Area Is 0- Is UnknO\;n) 2. SANITARY SE>iE!Z-CITv NO. OF rru's IL~ . X $38.55 PER PeV (See Reverse To Detel~inc Total rrU'S) Is ??Cj "~ I J. lil[~L~J2S)3I!~lT+QJ1. r~() Or: UUITS X T!\l';l !,/\TE X COST PER TRIP ;- C'IL~ __ ___u___.~___+ ;: S32S.C! Ie,. 1 '7 - 0'. I . /_#;'-1 ___________.+ _.._____n._ ._.___ x '!. ~:SS.Gl \. -;-. ., ,', X S3S3~Gl To Odcminc Trip Rates) SU[JTOTAL '(ADD ITEI':S 1r.~1:" 1,2,&3)S v'-- (See Attach:nent C 4. AOllllHSTRATIVE FEES, '[lASE CHARGE' (SUBTOTAL fillO\'E) X ;05 I~ "7'OIj. I TOT/:.~-CII'1 St)C 90 .r SeD _ " I 5. SAN ITARY SEWER-H'..!IK __' NO. OF PFU'S' r..f- x S13.25 PER PFU .+ S!O 1-II-IHC ADMIN. FEE s l"l C; ~ ,,_, ,..c.:.. .... }'-:"(Use PFU Total From Ite~2Above) .. ,., -' '~'" -. . - '-,. . . :....~ -'. . ~H'___" ...U Ki p [Jurdi ck SDC Coordinator ~/7--1/1'V ,$ TOTAL-MW~'C SDC b I~'?~ 1 TOTAL SOCS Cf q ~ 't!!.- ~IWI1C CREDIT IF APPLICABLE (SEE REVERSE) + .' ~:: ,,",' . ,',' . --~"-' .:..-.- '.~: ". "+" .' " :. '....,.. . .. r'>::~<:"},,<; .- ~"~'.:' 'i::':(.':: .. ..... .....'..,-.. .'