HomeMy WebLinkAboutPermit Building 1994-7-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
,
I
9~~Q
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED Jll(~i<' ' / ~hq
XASSESSORS MAP' \. IU-5d. s'00-.
iJI, I ern If' \ c9-G-Z ~
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CJJ('rD
OWNER:~~ p sL~ -..{ ? \ 17u1\)€-~,,~ ~f\jE?\.r
ADDRESS: ) ~ ~q I: Q t t h~ v< d,\.-R- .. .
CITY' ~J;)-fl' \ '^-c,~ \ P d I STATE: EY
_ , .\ X\
~ 'u
(\X~ \, Ilr. I< ~h
. A~DlTlb~ ../ DEMOLISH
LOT:
DESCRIBE WORK:
NEW
REMODEL
BLOCK'
TAX LOT:
SUBDIVISION'
PHONE: 2-~ (;, -~ '""R[Xy
ZIP:
9'7'f~ _
YJ{
\CL~~ ,'+ \'c",^- )
OTHER
GENERA' '
CONTRACTOR'S NAME ADDRESS' .
. C0'\_t~ Q A- ')
CONST,
CONTRACTOR .
PHONE
,PLUMBING'
MECHANICA' '
1 ELECTRICAl'
QUAD AREA~ QJuu.)
. OF BLDGS:-----,=
OCCY GROUP: rl.~
. OF STORIES'
WATER HEATER'
, ,
- OFFICE USE -
L~N~ USE:--l11..1
\
CONSTR. TYPE: V AJ
. OF UNITS'
HEAT SOURCE:
RAN"''''
EXPIRES
FLOOD PLAIN'
ZONING CODE: illfL-
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
.-,e::,.
'.
-
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 req'uested after 7:00 8.m. ~III be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Sfte Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
~ Footing - After trenches are
~~xcavated. .
o Masonry - Steel location, bond
,beams, grouting.
~Foundatlon - After forms are
~ erected.but prIor to 'concrete
plecement.
. .' ,.
o Rough Mechanical - Prior to
cover.
f':7f Rough'Electrlcal - Prior to
~over. '
o Electrfcal Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
~ Fr8~lng - Prior: to cove<'
'F::7I' Wail/Ceiling Ins~latlon - Prior to
)oO.J cover.
o Underground Plumbing - Prior 1V'1 Drywall _ Prior to taping,
to IIIl1ng trench, ~ '
)c;;( Underlloor Plumbl""~ech~' "
~ -,Prior to Insulation or aecklng, 0 Wood Stove,.... After Installation,
~ Post and Beam - Prior to floor
~ Insulation or decking.
'l<;;;:>1" Floor Insul~'tlo~ ....: Prior to
~ decking, ,
o Sanitary Sewer - Prior to IIIl1ng
trench,
o Storm Sewer - Prior to filling
trench. '
o Water line "'7 Prior to IIIUng
trench:
.. . ~ ~
o Rough Plumblng:- Prior to
cover.
o Insert - After fireplace approval
end Installation of unit,
o Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
!
o Sidewalk & Driveway - After
excavation Is complete, forms
and 'sub-base material In place.
o Fence, - When ~ompleted.
o ,Street Trees - When all required
trees are planted.. '
o Final Plumbing - When all
plumbing work Is complete,
. ,
1':71'" Final Electrical - When all
~ electrical work Is complete.
T"i7f Final Mechanical - When all
~ mechanical work Is complete.
~ Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthar
MOBILE HOME INSPECTIONS
o Blocking and Sat.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 and
porches, skirting, decks, and
venting have been Installed.
Lot faces
" ~ '\
Lot sq, ,!tg" ....,--
Lot coverage _
Topography
Total height ~
BUILDING PERMIT
ITEM SQ, FT,
Main
'7\
Garage
Carport
Total Val ue
Building Permll Fee
State Surcharge
Total Fee
Lot'~ype'I'
Interior
Corner
_ Panhandle
~ Cul.de.sac
X $/SQ, FT, =
-.S" .~o
3P4 A!)oor~.
(A)
;(;') '. '.'r".;;'" 'l";-'.:\,'.,..j :~;,;-,,~.,!.'i; ..~..,~.,.:
",:, ,I '\ ''I '. '. I. , ..,c- ~ '~;'lIi'. ,1("
.~ ~;;... ',l ',' '. > .'. :', ;;: .,'7<(. '.
",,'l' " Setbacks,
',h~L, HSE GAR ACe' I
I N I
:1
" tTHEPROPOSED WORKtN THE _ '
-"HISTOI;IICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
S
W
IE
VALUE
A7/ <)
{
"
SD,b''-;;
2:';3,
, .....
( , -
t::;'4.Sr
SYSTEMS DEVELOPMENT CHARGE (SDe)
~.2.I. ~o
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT, '
Water FT,
I" Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan N'
FEE
/
/
/'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
-P-7E1.Ja 7Jt.(cr
Mechanical Permit
Issuance
,
State Surcharge
,
Total Permit
3~ Mp?o'.u
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk It
Curbcul It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
MIN.
/5. &-a
/0.''''
.7.r
,TJ
2~ .Z.O
/~(S
.
APPROVED' '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on 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 time
upon violation of any provisions of said ordinances,
Plan Check Fee: -:<.? ~ 3
7/1)/7 r
Receipt Number: Is 14' /'
Received Yl:'. .r:-~
ff/~~ -
Plans lAevlewed By
Date Paid:
M-~
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
-SqOM~f H.ErjX'/~ ,~/Wb1<<
/<. ..o~ 'A "
c.. _ .orr" ~ :.;
,LJApl1
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 Springfield, and the Laws
of 'the' State of Oregon pertaining to the work described
herein, and ,that NO OCCUPANCY will, be made of any
stru~ture 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,
X. ,. ~r.,
" Signature -!!6,'3 f/}:N t.. \!) '~A " )'
Date1A{j~~/97 '
VAUDATION:
RECEIPT NUMBER
DATE PAin
AMOUNT RECEIVED
RECEIVED BY
14.,r) ~L.
'7/2'5" /9~
'~( '//'
;. . '
~
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e
ATTACHMENT Bl
I
JOB NO. 9 </ ,t;, ,9~Q.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT 'CHARGE 1?ldF~
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: "L~ J rd....:J4 A...L<I M
v ., /'
LOCATION: /4-.?9 2~;_
. ..
DEVELOPMENT TYPE: j)//y/NG- Roc", App/ T..".</
BUILDING SIZE: r...S-K IS" .(""1" A.eCA
LOT SIZF
SQ. Ft.
1. c;TORM DRAINAGE
I
I' IMPERVIOUS SQ. FT, '11,5- X $0,209 PER SQ. FT. $ ';'0.38'
!
2. ~ARY SFWFR-CTTY
NO. OF PFU'S -d .4"" L- X $43.26 PER PFU $ ~
(See Reverse) i I
3. IBANSPORTATfON
NO OF UNITS X TRIP RATE X COST PER TRIP
X ./ X $436,19
~ X $436.19
/X
$~
/
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $ .2.().]0"
-'
4. ~ARY SFWFR-MWMr"
NO. OF PFU'S ~ x $17.19 PER PFU + $10 MWMC ADMIN.FEE $
(Use PFU Total Frcmr Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-KWMr. sor.
SUBTOTAl (ADD ITEMS 1.2.3 & 4)
$
$
,
/VA
$ :;,.o.]'i!
5. AnMTNlSIATTVF FFFc;
BAf CHARGE / ~UBTOT AI.. ABOVE) X .05
~{ AJl)~ Date: ,-,/8'- '1~
/ Ha~IHor'nig. P. .
SDC'toordinat
$ /,0.2.
IQIA! SOG
$ ;1../.-90
B2.SDC .