HomeMy WebLinkAboutPermit Building 1995-7-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Orrice: 726.3759
LOT
OWNER: ~J" 4- ~lAl.;
ADDRESS: __52f5~ LA ),!l,("'
CITY: .<( ^,:- e r'f /J
i.Jl.-l..L1:f-L~/
DESCRIBE WORI(:
,.-l ~. ,~.rtljJ
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:, _~r~_"1....d>Pr
PLUMBING:
MECHANICAl'
ELECTRICAl'
QUAD AREA 4R ~~
. OF BLDGS: \
OCCY GROUP: --b-\
. OF STORIES: \
WATER HEATER:
.
SPRINGFIELD
G -,/7'1
.
JOB NUMBER
-,
~)S' 0 /~ 5'
BLOC~.:
'L
SUBDIVISION:
rL-Y""elL1l...
-L'Vlri1t"..<J
L.t). 6
STATE: -b).,f2..
r'Ar}rY"'- {-
ADDITION
+ 8'-kA~~
DEMOLISH OTHER
PHONE:
~.
r,
ZIP:.32...477
Crr
ADDRESS
q"l:r 4A1' It','"
,.!
CONST.
CONTRACTOR'
PHONE
"'f~'"/-44 n
!lv1({\~~
"
- OFFICE USE -
LAND USE: \ \~"")
. OF UNITS:
CONSTR. TYPE:
VA.)
EXPIRES
6fJ.L" .
C\S\\o.qs
FLOOD PLAIN:
ZONING CODE:
L fiR-
HEAT SOURCE:
RANGE: _
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
ACYJ
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
) .1' .
made the same working day, Inspections requested after 7:00 a.m. will be made the (ollowlng work day.
Ll Tcmpormy Electric
o Slto Inspection - To be mado
after excavation, but prlor to
settJng forms.
o Undersll'lb Plumblng/ElectricalJ
Mechanical - PrIor to cover.
o Footing - After trenches are
excavated.
o Masonry - Sleel location, bond
. beams, groullng.
rp Foundation - After forms arc
erected but prior to concrete
, placement.
o Underground Plumbing - Prior
to fllllnq trench.
o Undeflloor Plumbing/Mechanical
- Prior 10 Insulation or decl<lng,
o Post and Beam: - Prior 10 floor
InsulatIon or decl~lng.
o
Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
CfJ
o
Storm Sewer - Prior to filling
trench,
Water Line - Prior to filling
trench.
o
" "r ;;-,1; ,.
Rough Plumbing'. J ~Prlor lolr
cover.
L
.\
REQUIRED INSPECTl9NS
O Rough Mechanical - Prlo'r. to
cover. '
o Rough Electr~cal - Prior to
cover. ,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facIng
materials and framing Insp.
~ Fram,lng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.' :
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compictc, forms
and sub-base material In place.
o Fence - When completed.
o Street Tress - WheTi~lI:reQujrea
trees are planted.
o Final Plumbing - When all
plumbing worl' Is complet.e.
D Final Electrical - When all
electrIcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
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
waler and sewer.
o
Electrical Connoction - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
"
"
"'CD,Flnal - Alter all required
'Inspections are approved and
porches, skirting, decks, and
venting ha.ve been Installed.
~
Lot faces L~ Setbacks .'; IS THE PROPOSED WORK IN THE
I P.L. I HSE I GAR I ACC .. HISTORICAL DISTRICT, OR ON
Lot sq. Itg. _ erlor IN I I I THE HISTORICAL REGISTER?
Lol coverage Corner If yes, this appllcallon must be signed
Topography Panhandle Is I I I and approved by the Historical
\4/ Iw I I I Coordinator prior to permit issuance.
Total height Cul.de.sac lLLLL
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = VALUE
Main
Garage
Carport r:.1't'J
~~~~ /~I')
"
/n./~
-Ld:",o
1,</"1:
.2 ,-5?....
Total Value
..B?~fio
_~50
S.'ll
~b. 'j1
SYSTEMS DEVELOPMENT CHARGE (SDC)
#9'7 82. if:>
Building Permi t Fee
Slale Surcharge
~.ls.\.~.';),'i
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT. So
Mobile Home
.tl.....c;-~
Plumbing Permit
.!:l" CJO
D,. QQ
&7
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/FlrepJace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
rz
---,
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Stale Surcharge
Total Miscellaneous Permits (E)
<LS
'~()f5..c~~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
llll....
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition lhatlhe said
construct/on shall, In all respects, conform to the Ordinance
adopted by the City 01 Springfield, including the
Development Cocle. mgulallng the cOr)$truclion and use of
buildings, and m"y be suspended or revoked at any time
upon violation of ,my provisions of said ordinances.
Plan Check Fee: .._._.~..fJ..~ __.
Date Pald:.__.?<:>4p..r.
Receipt Number:..._._.L'7.297L--.
Received By: __...._~'-I
p~~~vlewed .8y.----.--1/-sIia~
Systems Development Charge Is due on all undeveloped
properties withIn tl1l! City limits whicl1 are being Improved.
ADDITIONAL COMMENTS
-\"'lfl 1~-(\fiN\f>t.
0DLb~~uro. %Q ~~Oc\f~f1~
(. J\ {) 1.J.kiQj) (\0 "\ . .
--"
-.....
'(-'<..~~.~ ~_ '~'J'\\\'c.'tJ
~~~ C~~\ .
By signature, I stale and agree, that I have carofully examined
the completed application and do horeby certify that all
Information hereon is true and correct, and I further certify
that any and all work porformed shall be done in ac~ordance
with the Ordinances 01 the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
heroin, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certHy ltlal only contractors and employees who
are In compliance wIth ORS 701.055 wilt be used on this
profect.
I further agrae to ensure thai all required lnspoclions are
requested at the proper time, that oach address Is readable
from the street, that the permit card Is located at the fronl
of the perty, ilnd the apprO;PCd s et of Jans will remain
n th Slt~t I II nes during cons uct n.
Slg tur 1&rYJ.
-Y1{/6\ ~
Oat
VALIDATION 1<7 f"\ On
RECEIPT NUMBER \.0 0.' )/
DATE PAID .~ 1\ \. q::::> .
AMOUNT ~ECElt ~ \~b$.).~
RECEIVED BY ~
J
.
.B NO. '3'5t)CjJG8..
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~oe:, J NA-OM I UNt>Se Y
LOCATION: 5<19:J; ULA('_ {--AI. 1~C!Zo?2-?-O~qoo
DEVELOPMENT TYPE: LOR - AOOfTlOIJ
BUILDING SIZE:
LOT SIZE
SQ _ Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ_ FT_
44-(..
$ E ~$a a~<2-ZZ_((",\
X 0_209 P R SQ. FT. (~
2. SANITARY SEWER-CITY
NO_ OF PFU'S
(See Reverse)
X $43.26 PER PFU
(-)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X
X $436_19
X $436.19
X $436.19
G~)
~
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAL-MWMC SDC
$ -
~
--- /"
$ q'.7~
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05 ( 4-"~ )
~~....t.._ Date: t../,., /"1'7 i
Q Kip Burdick 'TOTAL SDC $ "I,~-
SDC Coordinator