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Home My WebLink AboutPermit Building 1991-10-8 RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 LOCATION OF PROPOSED WORK ASSESSORS MAP ~, LOT OWNER R05fAu~._~ ADDRESS 855 W, E-u0E1VF J.., \l") rp 1 'I ST ~ CITY SPRINGFIELD WiL- 5Cf9 (0 I..LLA~c., LN. BLOCK -4 STATE o/?... JOB NUMBER 9 // /S <:::> 225 Fifth Street Springfield, Oregon 97477 TAX LOT 18 - 0 z. - 03 . 23 w 03700 SUBDIVISION G6LJ)t::~_ ~C ~ PHONE 3<Jz - 8/0) ZIP Q74.0?- DESCRIBE WORK NEW ~~ REMODEL 2<t',x28' GA~AGf:.,~HCE - , - 4/'p? 7" 11>'- ....,.~/ OTHER /~~. r . ADDITION CONTRACTOR'S NAME GENERAL GCOJJt:N ~ 14r>,u.\${)fJ N/A MECHANICAL N fA ELECTRICAL N fA PLUMBING QUAD AREA # OF BLDGS OCCY GROUP H'I-I I I . # OF STORIES WATER HEATER DEMOliSH ADDRESS Co,J:;.7. CONST CONTRACTOR # 6th4<17 PHONE h 89-7762. - OFFICE USE - , LAND USE # OF UNITS CONSTR TYPE -S-w EXPIRES S- - 7 -l:J"Z.. FLOOD PLAIN ZONING CODE l:l2..8~#.~ / . ~--'. # OF BDRMS SECONDARY HEAT SQUARE FOOTAG E To request an inSpection, you must call 726-3769 This IS a 24 hour recording All inspections requested before 700 a m will be made the same working day, inspections requested after 700 a m Will be made the follOWing work day D Temporary Electric IXI Site InspectIOn - To be made after excavation, but prior to setting forms ;r:'~/:r .#~ ~~ l'1e4>4IfI-, '""'- p/pG D Underslab Plumbing/Electrical/ Mechanical - Prior to cover [.2!J Footing - After trenches are excavated D Masonry - Steel location, bond beams, grouting D FoundatIon - After forms are erected but prior to concrete placement D Underground Plumbing - Prior to filling trench D Underfloor Plumbing/Mechanical - Prior to insulation or decking D Post and Beam - Prior to floor insulation or decking D Floor InsulatIon - Prior to decking D Sanitary Sewer - Prior to filling trench D Storm Sewer - Prior to filling trench D Water Line - Prior to filling trench D Rough Plumbing - Prior to cover HEAT SOURCE RANGE REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to cover D Rough Electrical - Prior to cover D Electncal Service - Must be approved to obtain permanent el ectrl cal power D Fireplace - Prior to faCing materials and framing Insp I )(.1 Framing - Prior to cover D Wail/Ceiling Insulation - Prior to cover D Drywall - Prior to taping D Wood Stove - After Installation D Insert - After fireplace approval and installatIOn of unit D Curbcut & Approach - After forms are erected but prior to placement of concrete D Sidewalk & Dnveway - After excavation IS complete, forms and sub base material In place eEl Fence - When completed o Street Trees - When all reqUired trees are planted D Fmal Plumbmg - When all plumbing work IS complete D Final Electrical - When all electrical work IS complete I22J Final Mechanical - When all mechanical work IS complete [E] Fmal BUlldmg - When all reqUired Inspections have been approved and building IS completed D Other ; MOBILE HOME INSPECTIONS o Blocking and Set Up - When all blocking IS complete D Plumbmg Connections - When home has been connected to water and sewer D Electncal Connection - When blocking, set up, and plumbing Inspections have been approved and the home IS connected to the service panel D Final - After all reqUired inspectIOns are approved and porches, skirting, decks, and venting have been Installed Lot faces Lot Type Lot sq ftg Interior Lot coverage Corner Topography Total height Panhandle Cui-de sac BUILDING PERMIT ITEM SO FT X $/SO FT Main Garage 6 ',; .L. /'1./P Carport Total Value BUilding Permit Fee State Surcharge Total Fee (A) HSE GAR Accl ~I S'M;~~r /8' ;,(4Uj'. JC)I}M/} . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Setbacks I PL IN Is Iw IE VALUE <<~7S': 2c=> Bt:? S~ ~~3' ~~~3 SYSTEMS DEVELOPMENT CHARGE (SDC) tre (B) '"' I ~, -z. ~ ., PLUMBING PERMIT ITEM Fixtures ReSidential Bath(s) NO Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood StovellnsertlFlreplace Unit Dryer Vent ~,PI!//QP /l7H1. Mechanical Permit Issuance State Su rcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge ~.,,'\; k.~#ce ft 500 Dc) Curbcut Demolition FEE !?-o 1/5'. -e::- /cp. ~ (.?S- 26.?-f;" .;;:er? State Su rcharge ~H- ?J€W~~ .~2."3';;- Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) -:2.~. % ' (A, B, C, 0, and E Combined) rHE 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 APPROVED 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 ---.S2. 3"3 Date Paid Receipt Number Received By &~ 73e.~ "'l ~~s Reviewed 43y ~~ /L>-B'~/ Date Systems Development Charge IS due on all undeveloped properties Within the City limits which are being Improved ADDITIONAL COMMENTS ~/".r1'.o:;..TV~~ ..~~ ~~/>~)~ ~~rt ?'--4~~ ~//~3' 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 descrl bed herein, and that NO OCCUPANCY Will be made of any structure Without permission of the BUlldl ng Safety DIvIsion I further certify that only contractors and employees who are In compliance With ORS 701055 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 Signature ~ ~ If) ~ <is - 9/ Date VALIDATION RECEIPT NUMBER 'Z /5'2 / /0 ",zs-9r AMOUNT RECEIVED -;;;:"77 ~. 3 G .~ DATE PAID RECEIVED BY JOB NO. q \ \ \ So ,CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY' eo "7f:. J;; PP1;"- LOCATION '54'1 C&:> LI LAC. LAtJE DEVELOPMENT TYPE: APP. C:,-p..(2.~ BUILDING SIZE. ?.y -y. 1,.8 LOT SIZE SQ Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. (0/7.- _ X $0.186 PER SQ. FT. $ \"2-S (See Reverse For Runoff Coefflclents If Actual Imperv Area Is Unknown) 2. SANITARY SEWER-CITY NO. OF PFU'S X $38.55 PER PFU (See Reverse To Determlne Total PFU'S) $ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X X $388.61 X $388.61 $ $ x X $388.61 $ (See Attachment C To Determlne Trlp Rates) - SUBTOTAL (ADD ITEMS 1,2, & 3) $ \-ZE?- 4. ADMINISTRATIVE FE~S BASE CHARG~ (SUBTOTAL ABOVE) X .05 $ Co -z.~ TOTAL-CITY SDC $ \~\~s 5. SANITARY SEWER-MWMC NO. OF PFU'S x $13.25 PER PFU - ~:J MWMC AD~IN FEE S (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) k". -' ~cLck.- . Q K1P Burdick SDC Coordinator \c-~-c;) S TOTAL-MWMC SDC $ ~ TOTAL SDC $ I~\ ~