HomeMy WebLinkAboutPermit Building 1993-11-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: S- 9.. 8' q
ASSESSORS MAP: I? (l.f. ; ~ J t.(
LOT:
OWNER, r II J;. 0 A
ADDRESS: oJ 1? '!
CITY: S' P R , AI;"
rT
J.j 1tS:.J.l13 A N}.(. CO
BLOCK:
R tJ:r.i;'
WI /.-1::LS-AN '<5
F J E. Lj'>
Ill'
STATE: .LL/l;:
DESCRIBE WORK'
.Ji"J'\P
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
(') lAI'ALV"
GENERAl'
PLUMBING'
MECHANICA' .
ELECTRICAl'
OUAD AREA:
2..RNc...
\
M
\
. OF BLDGS:
OCCY GROUP:
. OF STORIES,
WATER HEATER:
VJ
.
0/3/ t,.,s-:.'")
(\
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
'7/1<1
SUBDIVISION'
PHONE: -U.f.' - ,,),1' / /
ZIP: _9 :> l./ ~ rf'
DEMOLISH
OTHERfIq"PP'.t1 Fn"P1 oTIf{:." 1,(>(41711, I
,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. .
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical ,power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior ;0 cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After l~sta"at.I~{n.....
o tnsert - After, fireplace approval
and Installation of unit. '
.. ..
:' 'It. ~'. . It . . :'. .'
o Curbcut & Approach,-:Afte,:'
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 - ~Jhen completed.
ADDRESS
CONST.
CONTRACTOR ·
PHONE
EXPIRES
"
- OFFICE USE - "
LAND USE: \ \ \ I FLOOD PLAIN'
. OF UNITS: ZONING CODE:_ I DC)
CONSTR, TYPE: VA) . OF BDRMS:
HEAT SOURCE: SECONDARY HEAT:
RANGf' SQUARE'FOOTAGE: \? l\-1
To request an Inspection, you must call 726.3769. This Is a 24 hour recording, All Inspection;' requested before 7:00 a,m, will be
made the same working day, Inspections requested after 7:00 a.m. will be made the follovJlngwork day:
.
o Final Plumbln9 - When all
plumblng.work Is complete,'
- .' .........
" '. : \ ~ t' '
D Flnai'Electrical - When all
electrical work Is complete.
o Flnat Mechanical - When all
mechanical work Is complete.
'i7f Final 'Building - When all
~requ~~.~i::t. ~'1spectlonS'have been
'. approved. and building Is
completed:
DOther
,,'
MdBILE HOME INSPECTIONS
,,:'1'.',
. '
:::5.,~'~ ;,?'.;}d',,/'~:~':,:'.'-: ".~ t.,:.,.,.....
'0 Blo~klng.and.Set.Up ...,. When all
, <.blocklng.ls' ,complete::,' ,
. ...:.\~-~ (~';;~::,~;;-,:~!~~ .:,.:...' . . ':.: ,
'''~;Plumbli1g:,Co~~nec.tlons - When
.~..... I home has beenlconnected to
~ ,.(....,\water;:and, 'sewer~, .' "-: . '.
. . _ (:"_:-' ~. ' : . t ",;, I' ..
.' "; '1. .;.",:.; . 1, 1 " 'II _,.,,',f.
.. .'-'/, ,\l--,"j' ,... "I
D.E,ectrlcal'Connectlon - When'
blocking, set.up, and plumbln9 '
Inspections have been approved
and the home Is connected to
~, . 't,he, service panel. ' ,
.
o Tcmporl!ry Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
~ Footing - Atter trenches are
~ excavated.
o Masonry - Steol location, bond
beams, grouting, ,
lQ( Foundation - AHer forms are
~orected but prior to concreto
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
_ Prior to Insulation or deckIng,
o Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation - Prlor to
decking, . '
o Sanitary Sewer - Prior to filling
trench. ~
o Storm Sewer - Prior to filling
trench. .
O Water Llno - Prior 10 filling
. trench.
I~ Rough Plumbing - Prior to
cover.
, , .:-4:Fl~'a'l:i""A;{ei'~I(reqUI";d--<
.~ '. bt, Inspectlons)are 'approved and
o Straot Troes - When all required ." " . porches, skirtlQ'g, de'cks', and
trees are' planted. ,,' venting have'tieen.lnstalled~
,
!3tf.50
tP.73
(A) /1-1.2~
,SYSTEM~ .DEVELOPMI;NT CHARGE (S~~ ~
, (B) 112-8(, - 1
Lot faces
"
.-.,
La! s'~. ftg. - .'
Lot -coverage
Topography 17.L1'
Total helghl ~
C\""A'""I
BUILDING PERMIT
ITEM sa, FT,
Main
. '
Garage
Carport
.5/foP
1$ 4'1
Total Value
Building Permit Foe
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
ME9HANICAL PER!VIIT
Furnace
I
Exhaust Hood
Vent Fan
Wood Stove/lnsert/Flr~plac~'Unl,t
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Tota( Permit'
LOI Type .
$I~~~rl;"f" '
.
: C'Orne r
, .. I
Panhandle
Cul.de.sac
X $/SO. FT, ~
~/Cl
(C)
N'
(D) ,_
"
MISc'ELLANEOUS PERMITS
Mobile Home~
. .
State Issuance
State Surcharge
,",f
Sidewalk 'It
Curbcut
It
Demolition
State Surcharge 1
Total' Miscellaneous' Permits '
(E) ".
Setbacks
,:: .;1, P:L. .HSE ,GAR. ,ACC I
'I' .."..-..... I
:N __
Is ,-
Iw
LL-__--.J
VALUE
1905D
FEE
I
/
/
/
/
/
I
/
/
/
/
/
/
','
TOTAL. 'AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
1-'?-7' '10
leTHE PROPOSED WORK IN THE
-"HISTORICAL DIS!RICT, OR ON
THE HISTORICAL REGISTER?
If yes. this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
l'
,
~..
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 10 the Ordinance
adopted by the Clly of Springfield, including lhe
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 ordinanccs.
'V, 4~
1/ [;'1 Iq'3' f
Recelpl Numbe" \()\.1c~
Recelved~~~. lOB
:-?Z~~~?!~
Plans1'levlewed By
Plan Check Fc""
Date Paid:
_j./ ;/z?;J-l
(~afe
Systems Development Charge Is due on all undeveloped
properlles within tile City limits which are being Improved,
AQDITIONAL COMMENTS /- (/J;
LrA0 r- ~f7n, .\. ')1]11 LC' --" H 5lQ--,
(If) /JJ;:\0l) \ _
(' ~J) ~ (\ t\X> nz..: ~ 'XV'O .q ---^ ) "-
ltl?o 1\(d.Q)lA~)
~?-F1) '5~P-J~D4,
~ ('~JUJ-~,P%1/,- ;?/). M~
.J:LJ) A-';'s.an~ l 7/) fi,/; --1?~(~-
fl,iLJ) 4:-Z7t7,( A.W,~ ~
JJ1G/~j~p~, /~tV
~P,y ~__w~y Nl JCJ-9/
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 tllat NO OCCUPANCY will be made 01 any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
are In compliance with GRS 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.
Signature" "1i2",d. /l &~
,. )1'2
Date ~.:t. - <7-:..'?
VALIDATION:
/ [) q 58
/e; ND;) q3
AMOUNT RECEIVED '$ L/-~) 1, 70
IlL/Ph /lA.u....
RECEIPT NUMBER
DATE PAIr>
RECEIVED BY
.
.OB NO. Cf? 1&.5 Z-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: tl-fE-t:>A :I. Ross I
LOCATION: 6'1-39 Llr&.-H8At-./1<-S /(D.
DEVELOPMENT TYPE: LDfl-. .' 4t>OJ -rICN
/747.-'2..-83'-1- 700
BUILDING SIZE: :;n~'H LOT SIZF SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. t ".; '-f '1- X $0.203 PER SQ. FT. ~ 1- TZ- 8i:)
'-- .-./
2. SANITARY SEWER-CITY
NO. OF PFU'S X $42.08 PER PFU C~~
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X
X $424.31
X $424.31
X $424.31
~-)
---- ...........--
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE $
(Use PFU Total From Item 2 Above)
SUBTOTAL
$
TOTAL-MWMC SDC ~
~ _/f
(ADD ITEMS 1,2,3 & 4) $ 217.- l>~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEE~
BASE CHARGE (SUBTOTAL ABOVE) X .05
,VJ'.~LvL /1/&;/"3
Kip Burdick. "
SDC Coordinator
~
'--- ...-/ .
'17
TOTAL SDC $ Z 2> (p -