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HomeMy WebLinkAboutPermit Building 1995-2-28 r' RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT: ADDITION CONTRACTOR'S NAME GENERAl' PLUMBING' MECHANICAl' ELECTRICAl' QUAD AREA:~ ~0.j . OF BLDGS' \ OCCY GROUP: ~2)o\-}v\ \ . OF STORIES: . _ _ r WATER HEATER: _Y / t~,.e~~ JOB NUMBER~ 225 FI fth Street Springfield, Oregon 97477 . :PPIA/II)' I PHONE: I ZIP: -11IDK ADDRESS CON ST. CONTRACTOR' PHONE REQUIRED INSPECTIONS ryl Rough Mechanical - Prior to LfirJ cover. ril Rough Electrical .- Prior to '-P'J cOl/er. rvl Electrical Service - Must be ~ approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. [AJ Framing - Prior to cover. m Wail/Ceiling Insulation - Prior to ~ cover. [:;xJ Drywall - Prior to taping. D Wood Slovo - After Installation. D Insert - After fireplace approv41 and tnstallallon of unit. ~ Curbcut & Approach - After L.4-J'- forms are erected but prior to placement of concrete. m Sidewalk & Driveway - After ~ excavation Is complete, forms and sub-base material In place. D Fence - When comPle.te~. r"'\f1 Street Trees - Wh~_n all;requlred ~ trees are planted. _~ (. EXPIRES FLOOD PLAIN' ZONING CODE: ~ "" ~ . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: \~~~ To request an Inspecllon, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be made the same working day. InspectIons requested after 7:00 a,m. wlll be made the followIng work day. BLOCK' .~ STATE:~ DEMOLISH OTHER ~ Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumblng/Electrlca" Mechanical - Prior to cover. D Footing - After trenches are excavated. D Masonry - Steel location, bond beams, groutl ng. ~ Foundation - After forms are ~ erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. !:Xl Underfloor Plumbing/ Mechanical - Prior to Insulation or decking. ~ Post and Beam - Prior to floor Insulation or decking. f\7I Floor Insulation - Prior to L,6J decking. m Sanitary Sewer - Prior to filling ~ trench. i=::7l Storm Sewer - Prior to filling ~ trench. rVl Water Line - Prior to filling LpJ trench. l1SJ Rough Plumbing - Prior to cover. - OFFICE USE - \ \\ \ \ CONSTR. TYPE: \J~ HEAT SOURCE: \= t., ~ ./ LAND USE: . OF UNITS' RANGE: rYl Final Plumbing - When all \ plumbing w9rk Is complet.e. f\Jl Final Eleclrlcal - w.tlen all r electrical work Is complete. C r":'tl Final Mechanical - When all Ll=I mechanical work Is complete. I\Tl Final Building - When all ~ requIred Inspections have been approved and buildIng is completed. DOther MOBILE HOME INSPECTIONS D Blocking and Set.Up - Whep all blocking Is complete. D Plumbing Connections - When home has been connected to . water and sewer. D Electrical Connection - When blocking, set.up, and plurgblng 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 TYP. /Interlor Lot sq. ftg. Lot coverage Corner Topography Total height &D..5 . (Q2.1 Panhandle Cul.de.sac , BUILDING PERMIT \~&1 ~ l " ';';' '",!'J i::~:r~tf~~f Setbacks. _S THE PROPOSED WORK IN THE _ HISTOI;lICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. h~L. HSE GAR ACC I I N I I S I Iw I I E I X $/SQ. FT. - VALUE 5lo. flD 'lS<1~2- l4:. In ,,~,-A() ITEM Main Gatage Carport APPROVED: . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condlllon 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: M \ 0 . ~ R\ \ 0'l.2- Date Paid: Total Val ue ~11,~ Receipt Number Building Permit Fee State Surcharge \~,"t~T '3"t 30~ ~y: d~15 40<\. ~ Total Fee (A) Plan"-Sleviewed By Date (B) SYSTEMS DEVELOPMENT CHARGE (SDC) :l. I" (,., 'ii. PLUMBING PERMIT ITEM Fixtures , ~ Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permll e. r.!2 ~ "!>'"& State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' 3. Wood Stovellnsert/Flreplace Unit ....,,\ - Dryer Vent \P,~\...t'~ ~li..cd-'i\.~i t~~ Mechanical Permit lssuahce I.~:. '" ~ "a State"Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~~ Curbcut ~" It It Demolition ~ulcnarge . \~~~~~ Total Miscellaneous Permlls (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE 'bO Q!2- L Coo ce. \l).~ t1 ~. '@ G?5 ~.~ '\. <;a 05 'Q!:. ~. UL~ ~,~ \ (). taD. ~, .s.'i ~tl-lct, ~tl,~() \ ~,<tQ ~~.~ ._-n'.'3Q .9..BC{ 1. \1. _ _,_oJ Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS ..~ll ~ar 6nrri (IQJ)~ l_Jk+T~ 1.6COt.wt'l ~1\[j[I: \004 "", By signature, I state and agree, that I have carefully examined the completed application and do hereby certify Ihat 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 Clly of Springfield, and the Laws of the State of Oregon pertaining to tho work described herein, and that NO OCCUPANCY will be made of any structure 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 prope y't nd the approve~J of plans will remain on the sIte t all tImes durln~onstr ct~n. Slgnatur ''iJ.//.//~r1?!.~ tr Date, 2- 2/1-'/> VALIDATION: RECEIPT NUMBER DATE PAIP AMOUNT RECEI'19 RECEIVED BY f(-,. . J(;P q39 '2/ 2. ~ /'tr '"3.a,. CJ 7 n (. /J K' /-"'" 10 -f.jS - A ....... if" /[;~ r . . o y!ill!!!!!!~!!~ Job No. Cf4\QHo SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAM"~ I ~I f\ \!~ ()~ ~H) . "<ONE f'A \0. ltAldI: ADDRESS: c::\\o\ b '-\~~ \{d...\. ~ STATE:~IP itl113, lOCATION OF ~ROPOSED BUilDING SITE: u '. kh _ . 1- Street Address if Known: 4\030 ~Dlli~ ~_)llllJ\ . . PI,. N,moI. &i~ ~II. IT~ l~ Nom"", \9.i'l'd.OSI::J. no. ad) 1. DEVElOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back,) A. Sinl!le Familv - Detached , Single Family home NO OF UNITS Manufactured home not in a park $ 4m pO l X $400 PER UNIT _= B. Sinl!le Familv - Attached NO OF UNITS X $370 PER UNIT = '$ C. Multi-Familv Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SDC $ 1-nl) pO $% $ 400 .tJD 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl 'u.to ) \\r ~ CommunitY servic~on r:.......( c........;.........(;I"'lI,..l 2- I :2- <l> / 1')_ Date ATTACHMENT BI - 'I . j,' .. ""B NO. '7 1"1 <0 CITY OF SPRINGFIELD SYSTEMS DEVELOPME~HARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: k8JiH P!:.ouw LOCATION' '-/Ct, so !-IOLl_~ ST. tlAiO~,", >-lEA Dc"; <; dif 2. ~ANTTARY SFWFR-CTTY NO. OF PFU'S : (See Reverse) 3. TRANSPORTATTQtl NO OF UNITS X TRIP RATE X COST PER TRIP X LOI X $436.19 \'\ ' .' X $43.26 PER PFU $ 82.\11 Ii' 55 S .,,\0 - X X X $436.19 $ X $436.19 s SUBTOTAL (ADD ITEMS 1.2. & 3) s 1'7:>5,3 4. SANTTARY SFWFR-MWMC NO. OF PFU'S \'\ x S17.19 PER PFU + $10 HWMC ADMIN.FEE (Use PFU Total From Item 2 Above) HWMC CREDIT IF APPLICABLE (SEE REVERSE) IQIAI -HWMr. SDC SUBTOTAL (ADD ITEMS 1.2.3 & 4) s33lc ~ $ 0 $ ~:;c<o &\ $ 2,0'\ -z!3 if , 5. 6nMTNTSTATTVF FFFS BASE CHARGE (SUBTOTAL ABOVE) X .05 b"Z- S IOY- -1k.o~ M-'f\LLI ST~ Date: rz./z cl'H .. ---++w- ... -+ ... _ ~~: :c,:,,- j~ ;TatSr IQIAI sn( qCo s -:Z-j "q<o - B2 . SDC .