HomeMy WebLinkAboutPermit Building 1993-8-2
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LOT'
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BLOCI"
JOB NUMBER
225 Fifth Street
Spr:ngfleld, Oregon 97477
TAX LOT:
SUBDIVISION'
CYf~{)( )
PHONE:
~S-tc0V\lo
OWNER: ~ f\~ \. ~~Q-;\\ D - -
ADORES" rQ lo Po ~()y"(.' Q sro Y l-L~ A-J )
CITY: r 1 ')00 02.c./. STATE: W~ ~fY(\ ZIP: C\f,4C')\
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DESCRIBE ~ORK:W't'11 ~\.JL_ \. ~ f\ \ ,_ \ ,<t\(){'{\O .*' l\~~ ~~
NEW REMODEL ADDITION DEMOL~ OTHER ~
,
CONTRACTOR'S NAME. ADDRESS
'GENERAL:.&~jlf\ ~ '\\~ \~~
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CONST.
i~ \W .~C~8'aiVl~ln44.~XPIRES loKC1~lk
o 5l'I/C14,
PLUMBING'
MECHANICAL:('1 (I {\ V\
ELECTRICA~ J"f\.~\ ~()).DI\
8SS'{l)~ ~I r ~ (03\ ~0 ll{vfB ,~/j1
QUAD,AREA: \~J\l~ ") - OFFICE USE -
LAND USE: \ \ <(SC) FLOOD PLAIN'
. OF BLDGS: \ . OF UNITS: I J ZONING CODE: WI~
OCCY GROUP: R?J~N\ . OF BDRMS' &
CONSTR, TYPE: ~ '
. OF STORIES: I HEAT SOURCE: U SECONDARY HEAT'
WATER HEATER:_ r./' RANG"' V SQUARE FOOTAGE: (f~
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will bo
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Silo Inspoction .:.... To be made
alter excavation, but prior t
setting forms.
fflUnderslab Plurribi JEleclricalJ
~ Mechanical - Prio 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 .filling trench.
o
Underlloor PlumbingJ Mech~mical
_ Prior to Ins':ll~tion or de~king.
D' Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
. r:fJsaniliJrY Sewer - Prior to filling
. ~ tre.nch. .
o Storm Sewer - Prior t9 filling
trench. '
'r::Tbw3.tcr Line' - Prior to filling
, ~rench. "
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical. - Prior to
cove~ -
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to oblain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior 10
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Inserl - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
fc.rms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base materia: in place.
o Fence - When completed.
r 1 St!'cel Trees - WhEm all required
tll~CS arc planted.
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
'--.!2. Final Building _ When all
~ required Inspections have been
approved and Au~di~g ~~
completed. ~\>> T I
DOlher
MOBILE HOME INSPECTIONS
( r-i)locklng and Set.Up - When all
f:bloCklng Is complete,
1 Plumbing Connections - When
home has been connected to
water and sewer.
f Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
fFlnat - After all required
inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed. ..
. . . - .-
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Lot. faces Lot Type Setbacks , IS THE PROPOSED WORK IN TH'c
,
Lot SQ, ltg, Interior I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner Is I If yes, this application must be signed
and approved by the Historical
Topography Panhandle Iw I Coordinator prior 10 permit issuance,
Total height Cul.de.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
Main
Garage
Carport
\ ~3\..Q
Total Value
ri( () .3.)
I ,~~
~~0
SYSTEMS DE~ELOPMENT(~HARm[)
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT,
d5,CO
C1S~
Water
Storm Sewer
FT,
Mobile Home
\~.ou
\rSP)
,-IJ,.~S
i~~S
Plumbing Permit
State Surcharge
Total Charge
(Cl
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertJ Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
c>
\TDP~
r!JO OJ
0. ~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
H
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on tho express condiUon that the said
construction shall, in all respects, conform, to tho Ordinance
adopted by the City of Springfield, including tht:
Development Code, renulating the construction and use of
buildings, and may be suspended or revoked at any time'
upon violation of any provisions of sa~d o'rdinances.
Plan Check Fe'"
Date Paid:
Receipt Numb~r'
Received By:
Plans Reviewed By
Date
Systems Development C~arge "is d~e'on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL C.oMMENTS
{\~)\~ ~l~I\,tnr-.-
By signature, I state aml agree. that I have carefully examined
the completed application and do hereby certHy that all
~nformation 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 ~f Springfield, and the Laws
of the State of Oregon per'~aining to the work described
herein, and tl:at NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
arc In corrypliance wilh ORS.701.055 will be used on this
project.
I further agree to ensure that all required inspectio[ls are
requested ilt the proper time, that each address is readablo
from the street, thai the permit card Is located at the fronl
of the property. and the approved set of plans will rcmai n
on the site at all tImes dUn,ng~nstruction
SignatureQ~ d:M./-I.?il.
Date_;! i:-7--q3
v
VALIDATION: . Q;'n,A' ~. .
::~:I::I:UM~B ~ ,~ ,q~J: - \ ,
AMOUNT REC E .0\D ~ '(G\~I () 4{) ') ,
RECEIVED E3Y {/(C( ~ -
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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 shown by my signature on this form, that vith
t~jEjr~e a:bached &E1rm},~ fpr a home to be located at
ILl/ 11_/'''# njL) / ,Springfield, Oregon, Ci ty Job Number
'( I viii 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 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
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
sft~
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't .- Z - 93
Date
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CITY OF WInGFIELD SYSTU1S OEVELOPI~T
WORKSHEET .
(COll11mc1AL t, RESIDENTIAL)
(il,ilIGE .dt0"H81
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N'M-IEOl{ COIWArI\': J':~to.~T.;.._.~Q_0t>. t'AO&\L.t"-. ~oW\1::. .p,.".~
LOCATlOU: c,1j( i;;r~ e..\J.JL\0J!:lv~ 101,01'.'11.-12- Lkrv\S I":>
DEVELOPI-IEllT TYPE:
Mo\J tG~ .\ k.\ .
::tf ::J 0 1
[JUILDING SIZE:
LOT SIzE
SQ. Ft.
1. STOR/.l DRAIIIAGE
U1PERVIOUS SQ. n. - . X SO.lBG rER SQ. Fr.
(See Reverse For Runoff Coefficients If Actual I~perv. Area
Is 0-
Is UnknO'o;n)
2. SMl ITARY SE;i[!Z-C IT]'
ria. a:: rrv's I Lj. X S38.55 PER rev
(See Reverse To O,~tennine Total rEU'S)
Is ??q I~ I
:. . 1;~f~..T~.!.:tl?T(, TJ.Q;:.
r:rJ c;: UUriS X TE~-:' !~:\TE X CCST PEr. TR1\)
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~: ~2:::.CI
b 7.:2. ";,0'::" i
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v X S:S3.Gl
(See ^t::lc!:~c~~-C1'o U:2l'2r::inc Trip R~~e::)
SUBTOTAL '(ADD ITEl:S 1,2, & 3) S
-.t"'-::'
fru:" -
4. A0l1!llISTRATIVE FEES
'[Jf,SE CHf,RGE' (SUBTOTAL fillOVE) X ;05
h "?'OIj. I
TCT!':.~_-C II':'
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r C. ......,... 90
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5. SANITARY SEWER-H'..!I'\C
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.- ':",110. OF PFU'S
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X S13.25 PER PFU .+ S!~ 1-\WHC ADKIN. FEE S "J c; '--"
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~lWHC CREDIT IF APPLICABLE (SEE REVERSE)
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TOTAL-MlmCSDC Is I'7S~ I
JOT AL sacs CJ q (" <I:!:..
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. G . Ki p Burdick
SDC Coordinator
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