HomeMy WebLinkAboutPermit Building 1995-7-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726.3759
.e
SPRINGFIELD
,....ASSESSORS MAP'
-~OT:
/7ns
LOCATION OF PROPOSED WORK: -'--%~ ./ -:? ~/)./J LJ
/2
2.5
BLOCK:
OWNER: '/.J,ru) "Y-: //./ --<l A/r.././ ~/",~~/..,()'"."" ~
ADDRESS: L.9:...r:e.,2__.w..cr.Q a.L>
CITY: 0- ff') €'~...LJ
,
STATE:
eJ'.-e
.
95/eeo-
q?/"2'29',
JOB NUMBER -7 ~ ~~ r
225 FilII' Street
Sprlnglleld, Oregon 97477
~/JH /l
,-
Q'7-??7
TAX LOT:
/S /80-:n
.
SUBDiVISION'
PHONE: ?~?-r.?t!)q/
ZIP:
97~9' '7
---
..a fi /) ;Cd ".e
DESCRIBE WORI~:
./
r".?A1""..42.~
DEMOLISH
flEMODEL .._,._ ADDITION
NEW
/=/ ./ 7Z/ .e,€' G-.&' R..-{Je:?€" '"
,
OTHER
EXPIRES
1
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAL: ~..LJ...iL'~ Af ;'~~,r"'<~
2'67-(5, A!vy-+-C A.vc, 'be,. '
PLUMBING' , . '.
PHONE
~q.8 -'7//(),/
.
MECHANICAL:
ELECTRICA"
. -..- ~,',
A
~
QUAD AREA:
. OF BLDGS:
. ,
OCCY GROUP:
. OF STORIES:
WATER HEATER:_..
- OFFICE USE -
LANO USE:
N OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF.: _
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:__
To roquest an Inspection, you must call 726.3769. This Is a 24 hour recordIng. All Inspections requested before 7:00 a.m. wI/I be
made the same working day, Inspoctions requested after 7:00 a,m. will be ma~e the following work day,
o Tompornry Eloctrlc
o Site Inspection - To be mado
after excavation, but prior to
selling forms.
o
tJ
Underslflb Plumbing! Electrlcall
Mechanical - Prior to cover.
Fooling - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting,
~UndatlOn - After forms are
~~~ecled but prior to concrele
placemont.
o
o
Underground Pllwlblng _ Prior
to IIll1nQ trench.
Underlloor Plumbing! Mechanical
- Prior 10 Insulation or decking.
o Post and Bea~ - Prior to floor
Insulation or docldng.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to fillIng
trench.
~ Storm Sewor - Prior 10 filling
~ trench.
o Water Llno - Prior to filling
trench.
o Rough Plumbino ....:. Prior 10
cover.
REQUIRED INSPECTIONS
o Rough Mechanlcal.._ Prior to
cover,
o Rough Electr~cal - Prlor'to
cover, .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materlala and framing Insp.
o Fram.lng - Prior to Cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Slovo - After Installation.
o Insert -' After fireplace approval
and !nstallallon 01 unit. .'
o Curbcut & Approach - Alter
forms are erected bllt prior to
placemont of concrete.
o Sidewalk & Driveway - Alter
excavation Is compictc, forms
and sub.base material In place.
o Fence - When comPI~te~d. . .
o Street Troes - When all required
trees are planted, '.'
... .-".
o .Flnal Plumbing - When all
plumbing' w9rl~' Is complet.e.
D FInal Electrical - When all
electrical work Is complete.
o Final MeChanical - When all
mechanical work Is complete.
o Final Building - When all
requIred Inspections have been
approved and bUilding Is
completed.
DOlhor
MOBILE HOME INSPECTIONS
o Blocking and Sel,Up - When all
blockIng Is complete.
o Plumbing Connections - When
home has been connected to
waler and sewer.
o Electrical Connection - When
blocking, set,up, and plumbing
Inspections have been approved
and the home Is connected to
Ihe servIce panel.
.., '..
o Final - Alter alf required
Inspections are approved and
porches, sklrllng, decks, and
venting have been Installed,
Lol faces
Lot TYPO.
Interior
I.:ot sq. ltg,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de,sac
'..
Ie'
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes. this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbocks
I P.L. HSE GAR I ACC I
IN
Is
Iw.,
LL
BUILDING PERMIT
ITEM SO, FT: X $/SO, FT, = VALUE
Main
Garage
.7~__
I
-----,
Carport
,l!t.w/ mV~
Tolal Value
S''Sr
4,6-0
Building Permit Fee
State Surcharge ;. 93 + /,/p
Total Fee (A)
'.
-:2./2*-
_~f~
~,6-1
4/_~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 17.2~S"
PLUMBING PERMIT
ITEM
Flxlures
Residential Bath(s)
Sanitary Sewer
Water
N'
FT.
Slorm Sewer
FT.
FT. <:'5"D"
Mobile Home
Plumbing Permit
State Surcharge I :J.I'" -+- . 7.J"
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical PermIt
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
,1)/ A",J /~/Ck)
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
2. S' .!IO
2~
2;7,4?'0
.2. 5D 1
._2~7
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This p.crmlt Is granted on iho express conditiO'; thai tho said
construction shall, in all respects, conform to the Ordinance
adopled by the Cily of Springrtel,d, incluc)lng the
Developmenl Code, regulaltng 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:
2..S0:r
Date Paid:
Receipt Numbcr:__. _._.
Recelv~: .._..,
Plan1Rev~-------'
Date
Systems Development Charge Is due on all undeveloped
properties within thn City limits which arc being improved.
ADDITIONAL COMMENTS
~ ' , , 5 J\~
-~ ~~~..Li-_dZ~&!!!2_,!:BA#/
I'J-"M/~
I
By slgnalure.I 5tatc and agree, that I have carofully examined
the completed appllcalion and do ,hereby cerliry that all
Information hereon Is true and correct, and I further cerlHy
that any and all work performed shall be done In accordance
with the Ordlnonces or the City or Sprlngrield, and Ihe Laws
of the Stote 01 Oregon perlalnlng to tho work described
heroin, end thai NO OCCUPANCY will be made 01 any
structure without permIssIon of the Building Safety Division.
I further certify thai only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agreo 10 ensuro thai all required Inspecllons are
requested at the proper lime, thai each address Is readable
from the street, that the permit card Is located al the front
of the property. and tho approved set of plans will remain
on the site at a,1I tlmos during construction.
'xlgnalure! ~ J / /..fI: /;'.-0
Date
VALIDATION:
RECEiPT NUMBER /(f)., 1'72-
DATE PAID ~~---;
AMOUNT RECEIVED ____~
___ ~ECEIVED.._B~ _ -:t3 ,____.. ,_,..____ .!.___
.
. JOB Nor'T0u l!5 n
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY:
DON
,
1: tJAt-I( ~l
I
uJ I LU AM.!,
LOCATION:
I <Ho Z
Lo/'\ O/-l 0
A-u~
DEVELOPMENT TYPE:
ADomoNAL-
c"AfZ..AG(;.
17 03 Z~ 12. #=/Goa
BUILDING SIZE:
I OT SI7~
,SQ. Ft.
1. STORM ORATN~
IMPERVIOUS SQ. FT.
763 d'-
X $0.21 'PER SQ. FT.
((" I~" ~'"")
'- ----
2. SANTTARY S~FR-r.TTY
NO. OF PFU'S
(See Reverse)
X $43.43 PER PFU
((-)
- -"
3. IBANSPORTMlQN
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $437,93 ~- ')
---- --
X X $437.93 $
X X $437.93 $
4. SANTTARY S~W~R-MWMr,
NO, OF PFU'S x $18.75 PER PFU + $10 MWMC ADMIN.FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $
TOTAL -MWMr. Sf2C. If - "'.
~
SUBTOTAL (ADD ITEMS 1. 2.3 & 4) $ I tn'i ~
5. AOMTNTSTATTV~ FFF~
BASE CHARGE (SUBTOTAL ABOVE) X ,05
G Sz:=-)
----- .,/
.-11fD~ M -{.IW5 r€/Z...
Troy McAllister
SDC Coordinator
Date:
7/Z-!;/tS-
, ,
TOTAl snr,
$ /72 G>~