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Home My WebLink AboutPermit Building 1993-3-30 ~ ~. '~ESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Ollice, 726,3759 . SPtllNGFIELO LOCATION OF PROPOSED WORK: _tf3:6!b.5'~ ASSESSORS MAP: -If3/J?~ 19.~ LOT, ':S BLOCK' OWNER, fj SUBDIVISION: TAX LOT: .2.h (1) o--/- (,,(;.,/ ~~ J4-.:- W~...~^ I ADDRESS, CITY'_~~~~- STATF. ~ DESCRIBE WORK. IJEW u,!-_ REMODEL .__ ADDITION __,'0'__ DEMOLISH ,-,--- OTHER . ~"""-?032.s JOB NUMBER 225 Fifth Street Springfield, OreDon ' 7 177 PHONE: C,8R (7')4 ZIp. 97?O? COIHRACTOR'S NAME ADDRESS . CEHEn/<L: ___7J!~;/ 4:f--~ '.o7::~ ,- PLUMBING, CONST CONTRACTOR' EXPIRES u_" _0 _oo_g.s::)-.ZL-,-o-j(L~lj.2. PHONE G 9"s:;: /7S-'f MECHANICAL: ELECTRICAl. OUAD AREA: _~;q ~) {; . OF BLOCS, _ /-- OCCY GROUP: ,,I! '3 ~- I . OF STORIES: VJATER HEATER: _I=: .--------.---.....-.---.-.--.-- - OFFICE USE - LAND USE ____ll-l-I . OF UNITS: J CONSTR, TYPE: __IIN HEATSOURCE'~ RANGE: _ FLOOD PLAIN: ZONING CODE: Itve. ~ d ?~s9 . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: 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 nHHle the Si1mc working day, Inspections requested after 7:00 a.m. will be made the following work day. o Temporary Electric lC'A Site Inspection - To be m~de ~ Alter 0xcnvntion, but prior to Selling ,Iorrns., (?o' L.. J O Underslab Plumbing/Electrical/ Mechanical - Prior to cover. ~Footing - After trenches are l,..6J excavated. o Masonry - Steel location, bond beams, grouting. ~ Foundation - After forms ~re ~crectetl but prior to concrete placement. REQUIRED INSPECTIONS ~. Rough Mechanical - Prior to ~over. ~7f' Rough Electrical - Prior 10 ~covcr. ~ Electrical Service - Must be J..6II approved \0 obtain pcrlllnnent electrical power. o Fireplace - Prior to facing materii'lls and framing Insp. 1'5~1:"Fr~ming - Prior to cox~r. ~ Wall/Ceilin!) Insulation - Prior to ~covcr. O Underground Plumbing - Prior ft:[ . , Drywall - Prior to taping. to filting trench. 19f UnderlloorGuumbiril!fJ'!l:echanlcaf) ~ _ Prior to 'i'rTsur51TOn or decking. 0 ~ood Stove - After Instnllation. KAPosi and Beam - Prior to floor ~ insulation or decking. 'W(FIOO~ Insulation - Prior to ~ dcck:nu. ~ Sanitary Sewer - Prior 10 filling .k6l trench. f;vrStorm Sewer - r"Jrior to tolling ~trench. ~.watcr Line - PrlQr to fillIng trench. ~ nouCJh Plumbing - PrIor to ., . . cover. o Insert - AUnr flrep:ace ar>provai ane Instnli3Uon 01 unit. rvT CUlbcul & Approach - AUN ~forlTls arc ercc:cd but prior 10 placement of co/i'erell? K:7I' Sidt:walk & Driveway - After ~excn\i.ltiun Is Gomptc~p., forms and sub,case m.itcrihl~in. pi'1ce. D Fence - VJhen coml.I~~t~d. ~ ~(roet Trflp.s -~. WIHm an rcqul,'t;;d V !reCS me P:ii1.tc:l. --.--.-... .-.-.-. - -....- ...--.----.,-.. ~Fln.1 Plumbing - When all ).6.J plumbing work Is complete. ~ Final Electrical - When nil ~ electrical work is complele. 1'7f Fln.1 Mechanical - When all ~eChanica' work Is complete. rV1 Final Building - When all ~reqUlred Inspections have been approved and building Is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set.Up - When .11 blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set-up. and plumbing Inspections have been approved and the home is connected to the service panel. [I Final - After all required -.J !n~pectlons are approved and porches, skirting, decks, and venting have been Installed. Lol laces --tL Lol Type . Sellncks -' ---- -.--- Lot sq. IIg, ~ X"lntcrior PL HSE GAR ACC ----- Lot ~overage ~ Corner N Ie; Topography 52P Panhandle S J7 Total helghl ):7./ Cul.de-sac 1/'/ .------ ~_, ,l~ 1:.( p-' . /" --.- '2'7 ~~- Total Value (. Cfo1Q..)JLi~b.O ~ Building Permit Fee ;?:z~ o/'&~7,) _1!t;.2.~ I'/? ?, 7. ~y II Stale Surcharge - -23. ,. Total Fe'L~ ?~~.:n !/f!;5.~~ SYSTEMS DEVELOPMENT CHARGE (SDC) , ~(B) _~2-~,7 PLUMBING PERMIT ITEM FEE BUILDING PERMIT ITEM " SO, FT, ~~ I >lsr Main ~f5?4'-1 Garage X $/SO. FT. S"'h 2.0 JtP,'2/~ /fFL Carport Fixtures Residential Bath(s) N' ~ Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing permll Stale Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' -;;:--- Wood Slove/lnsertlFlreplace Unit Dryer Vent ~ LM~' I ,F:;q JlAJlr Mechanical Permit Issuance '5~ :)~ . ~:. ~S~O?' State Surcharge Total Permit MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk /00 II Curbcut 3(f.:, ft Demolition Ao,z> JP~ ~ Stattf S-u'rcharge ."oLA-v A/bv. -1iJdHs r = /IJ'zJJ5'l. P? ;L}.uZ,/ -.12033 .,~?~.~ -L60~O 80C) L~8,~ ~f!,q__ 4-.>P -9. i>>O --3,~~- ---5 f'"O -;J 7.':>0 ---", -- ,-- ,/0,".",., _I. /3., 3~-,~~, _2.5.:!!?: ./5,-i~ (/.~~ Z&ctf) --~_. -kl.'tq Total Miscellaneous Permits (E) TOTAL AMOUNT DUE ;eXCIUding eleclrical) '2tft2c>,2~ (A, B, C, D, and E Combined) clZ,l/2.'7' .. THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? II yes, this application must be signed and approved by the Hlslorlcal Coordinator prior to permit issuance. " 1 APPROVED: _ BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permil is wanted on the express condition thall11c said construction shall, in all res~ects, conform to Ihe Ordinance adopted by the City 01 Springlleld. Including Ihe Development Code, regulating the construction and use 01 buildin{js, and may be suspended or revoked at any lime upon violalion of any provisions of said ordinances. Pion Check Fee, ,.. a,.lZfC--L:6<., Dale Paid: /~'" za~ Receipt f'Jumucr:__.__. .1/!J1.-c- -,3,(=?J 6:3- 7---o~~'-;' Systcm~ Development Charge is due 'on all undeveloped properties within the Cily limits which are being il11prQvf!d. ADDITIONAL COMMENTS _,_-p7>t&._~ c5 --R&t7:i-.l- By signature, I stalu and agree, that I have carefully examined the compleled application and do hereby certify \llal all inlormation hereon Is true and correct, and I further cerlify that any and all work f)crformed shall be done in accorddncc wilh the Ordinances of the City of Springfield, and the Law~ of the Stale 01 OrC~lon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permis~ion of the Building Safely Division. I further ccr~ify (hat only contractors and employee5 whO arc in compli.lncu with ORS 701.055 will be used on this projecl. I further agree 10 ensure that all required inspections iH'J reQueslcd ;J1 the proper lime, that each address is readable from the slreet, that the permit card is located at the front of the property, and the approved set of plans will remain t::"~:~"~:'a="~""' ":'''If#''~- Date --,<<3,0/ C? 3 I I aZ"Y/~z> VALIDATION, RECEIPT NUMBER -.-.-U'/ '/ DAT~ PAID____,_3/~/r 3 AMOUNT RECEIVED__ 2~~ "2t(.a RECEIVED [1'1 ,--,_u..4~- t2.~.$. _"l:;l :t3 s{. z."'t -~ ~ ~r .. "NO. 3~o~~~ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI1ARGE -~ U-r ) . WORKSHEET , I ..: '. U{-;tX}t:ea ~......;rr (COMMERCIAL &. RESIDENTIAL) :-"!!.e--. ,-;,UJ4; 11'f~7 . , Ie ,~..1.,," l Jf7" NAME OR COMPANY: 0' 4 P J-/DM6S J:I'-I.c. ~ 8>GS" 4kAxt:/~ LOCATION: " i i 6. r"f"-$ )/1'/-1 fl'\ DEVELOPMENT TYPE: Lol?. - tJeN SfR. BUILDING SIZE: /goz. 53 II tJ-:z~cro '~8"! {YJ '7'" - ~r;{{Jo LOT SIZE SQ. Ft. '. 1. $TORM DRAINAGF. IMPERVIOUS SQ. FT. .j.16~ "1:7'>7(" 0 X, $0.192 PER SQ. FT. ~,";:> 0<f5'-S> 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) 3. TRANSPORTATION I ~ X $39.78 PER PFU c;:, ! ~ oft ) ----------- NO OF UNITS X TRIP RATE X COST PER TRIP I X l.ooS X $401.05 c;~D?OV X X X $401.05 X $401.05 $ ~ $ -- SUBTOTAL (ADD ITEMS 1,2, &. 3) $ 17<-.'; 7;3: ~1 4'. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 , C 9'l? ::,) J,~ TOTAL-CITY SDC $Irtr;']. <l~ 'i2.HI . 5. SANITARY SEWER-MWMC ,,.., , "'" " NO. OF PFU'S ... x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ Z'::>7- (Use PFU Total From Item 2 Above) ~~ :- -() Kip Burdick SOC Coordinator ~/4. ~'-"'X. 1<.-1. 3/.13;5'3 4'~ ?p'I, /'1'? $ t./ q 7:!::- TOTAL-MWMC SDC~~~ "; """"---- " TOTAL SDC $ '20?/ ~ MWMC CR~DIT IF APPLICABLE (SEE REVERSE) . -. . F1XTU R E UNIT CALCU LA TION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) .:....;... .' .~:};;;;. FIXTURE TYPE NUMBER OF NEW. FIXTURES Balhlub...... ................................ ...... .......................... Drinking Founlain......... ........... ................., ......... ...... Floor Drain................................................................ Interceptors For Grease/Oil/Solids/EIC................. Inlerceptors For Sand/Auto Wash/Etc...,.............. Laundry Tub /Clolheswasher............. ............. ......... Clotheswasher . 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrige~ator /Water Slation/Etc........ Receptor For Commer~lal. Sink/Dishwasher /EIC.. Shower, Single Stall...................................,............. Shower, Gang.......................................................... Sink, Bar. Commercia!............,............................,... Urinal, Stall/Wall...................................,................... Wash Basin/lavatory, Single.................................. Waler Closet. Public Installation............................. Waler' Closet, Private.........................................,..... Miscellaneous: I I I .. I 2. 2- TOTAL FIXTURE UNITS ~" ., '~ UNIT FIXTURE EQUIVALENT UNITS 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 '7 . . '2- 7~ "'L ~- ,. = 1'b CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexalion date in table, calculate credits separates. Year Annexed Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1963 1984 $2.63 2.76 2.71 2.60 2.46 2.33 1985 1986 ,1987 1988 1989 1990 1991 Rate' per $1,000 ,. Assessed Value . $2.16 1.90 1.60 0.25 0.87 0.50 0.16 U = Lf1'-=- = = $ 4-17.=, Credn for Parcel or Land Only If Applicable Z . ~ 3> X $ /1. If> 7 (Rate X Assessed Value) Improvement [If after annexation date) X $ (Rate X Assessed Value) CREDIT TOTAL , RUNOFF COEFfiCIENTS FOR STORM DRAINAGE Residential........................................................ 0.4 Commercial...................................................... 0.9 Industrial...,....................................................... 0.45 Governmenlal...................................................O.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT i >." : . "';7J~~;:'.:"r-::-:'" ~\r.#~:I.t:"'~~;.l ." . .08 NO. $0'2-<1"2- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE ei) W .\ , , . WORKSHEET A1n~ ~ c~""'/ ~:"'~J ., , , (COMMERCIAL & RESIDENTIAL) ~ /pUJ4 ;/~YV' . ,(~ NAME OR COMPANY: V 4. D J-kMG"::> ~NC. ~ ~5S- 5f~7/6( LOCATION: ~ 1-......$. rHf:I't DEVELOPMENT TYPE: LOfl.. - NcN SffZ BUILDING SIZE: It!;o'Z. 6'3/1 t);2t',t7'O Il{S1- ~~ -: '"! - ~(''-'QO LOT SIZE SQ. F t. " 1. STORM DRAINAGE IMPERVIOUS SQ. FT. "?'>7(" 0 X $0.192 PER SQ. FT. G<fS1i) -- -- 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) / ~ X $39.78 PER PFU c;; ! (, oi') --- --- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP / X 1.0015 X $401.05 X X X $401.05 X $401.05 c;'fO?o?) ---------- $ $ -- SUBTOTAL (ADD ITEMS 1.2. & 3) $ /7<,.'1 ~ 4~ ADMINISTRATIVE FEES TOTAL-CITY SDC c( Ii\?~) <... --- $/<;/15']. '0 BASE CHARGE (SUBTOTAL ABOVE) X ,05 I' 5. SANITARY SEWER-MWMC NO. OF PFU'S , q, x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ZSS '.2 (Use PFU'Total From Item 2 Above) ~~ , -(] Kip Burdfclc SOC Coordinator ~~ jJtJi<. K,/j. .3/;2j~.3 ~ -:>;pi/, /1"? $ 4Q'3::- TOTAL-MWMC SDC~~ .... ~ TOTAL SDC $ 20?/ ~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) .. ' ,.. , . .... . . FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent ~ Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT EQUIVALENT FIXTURE UNITS Bathtub.... ........... ....................................... ........ ........ Drinking Fountain................ ..... ......... .......... ....., ..... ,. Floor Drain............................................................".. Interceptors For Grease/Oll/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher..,..,..,..,..,............. ....... Clolheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrige~atorjWater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single Stall.................,.....,...,...................., Shower. Gang..........................,.............................., Sink, Bar, CommerciaL..............,..,......................... Urinal, StalljWall.............,.............,..,........,.......,..,.... Wash Basin/Lavatory, Single.......,.....,..,..,.,...."..",. Water Closet, Public Installation............................. Water Closet, Private.............,..,..,.."..,.,.........,...".., Miscellaneous: I I 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 '7 / 7.. / 1, "7_ 2 "L z, ,. TOTAL FIXTURE UNITS = 1<6 CREDIT CALCULATION TABLE: calculate credils separates, I Based on assessed value. If improvements occurred after annexation date In table, 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.46 2.33 1985 1986 ,1987 1988 1989 1990 1991 Rate per $1,000 I Assessed Value $2.16 .1 1:90 '1,60 ! 0.25 I 0.87 0.50 0.16 = Lf"l i!: ~ - = $ 4-17~ Year Annexed Rate per $1,000 Assessed Value Year Annexed Credit for Parcel or Land Only If Applicable Z . ~ 3> X $ 17. 57 (Rate X Assessed Value) Improvement Of after annexation date) X $ . (Rate X Assessed Value) CREDIT TOTAL , RUNOFF COEFfiCIENTS FOR STORM DRAINAGE Residential.................. ...................................... 0.4 Commerclal...................................................... 0.9 I ndustrial........,....m........................................... 0.45 GovernmentaL..............................,...........,..:.., 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT . ,,'0" ,\~- ~~ ~\~'" . -/'" ~. 225 FIFTH STREET \0\\0 r{\'- '" 0 .~ ELECTRICAL PERMIT APPI.ICATION ~'(\a !;le,' ,,"'- ~ SPRINGFIELD, OREGON 97477~0~~~~' ~ INSPECTION REQUEST: 726-3~69;, ""~;/'~' City Job Number~~.2..S OFFICE: 726-3759 1. ~ )'? ' , - I / \,\~0 0",e/ >.,'~' 3. COMPLETE FEE SCIlEDULE BELOII 1. ~T!f!!.c;.F 4~r::z:~,,,\'(\0\,"~J A. Nev Residential-Single or Multi-Family per dvelling unit. LEGAL DESCRIPTION Service Included: J~2&~_./? ~ 'tJ c'2-C,et) Items Cost Sum JOB DESCRIPTION ~ ~~/M ~: ';f:,F/#SJ. Permits are non-transferable and expire if york is not started vi thin 180 days of issuance or if york is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician -i!'-.. I .L J_ Ovners Name ,I~ ~ "I) !7CQ-ui":.... Address_/.../i// r\A~A1JA.lu iOAJ City-12..1i"Phone ~{:;8-/ 75r(; OIINER INSTALLATION The 'installation is being made on property I ovn vhich is'not intended for sale, lease or rent. O\ffier~ Signat, ure: ~^ ~ \ , ) ~~. ,V\'tU W .;>r ________________________~_______~______ DATE: ' ~ - '\ 0 -'i'J RECEIPT 11: ,.,4Af-;J ' \ RECEIVED BY: 'tf!7'\/J/l.-.. _ 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Ci rcuits ...--- $ 40.00 $ 55.00 $ 80.00 volts see "B" ~ above Nev, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or vith Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.90 $ 36.00 ~, 4P)OO '-" a.' t?C? 4..? ~O ,-'.;:; i/ Th. ,cllo',"'r. " "'. '. ."d \cllowing rt4'f1 225 FIITO STREET zonir.'J, and-does nol require speciiic lanc'Et:ECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 epproval, WI(, . . <I /"')o? INSPECTION REQUEST: 726-3769 Zonln" Ci ty')~~ Number 'of"'I) ~.2 '? OFFICE: 726-3759 .' Dale t/,2,O,3-; ; - 3~OMPLETE FEE SCITEDULE BELOV 1. LOCATION OF INST}.LLATI~Nhorizad Signalure ~ "A r~'C:;'C:: 6/At:,/ext A. Nev Residential-Single or Multi-Family per dvelling unit. LEGAL DESCRIPTION Service Included: /fJ:rJ2. D'2, 1/ :2<Pet) Items Cost Sum JOB DESCRIPTION ~ E~r 'T~ SF Ne! . Permits are non-transferable and expire if york is not started vi thin 180 days of issuance or if york is suspended for 180 days. 2. CONTRAcrOR INSTALLATION ONLY Electrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Nallie 7) ~ 'D ~ Address_;;"!:::,/ WMA'Jd<< ~A.J Phone ~;;8-/7G'1 City h-'..Q. . OIINER INSTALLATION The .installation is being made on property I ovn vhich is'not intended for sale, lease or rent. Ovners Signature: .~-----~------------------~-------------- 3 -:, 0 ....."lJ ~?~- DATE: -. RECEIPT II: RECEIVED BY: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd nome or Modular Dvelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ !'O.OO C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 ~ $ 40.00 $ 55.00 $ 80.00 volts see "B" d:Q above D. Branch Ci rcui ts Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 4rJ60 5% State Surcharge . Q. t?O TOTAL .d.. 7 00 I - . '. . h... "__. __... ~_____. ~ .-- -- -- "--. ~!4~ ~ !7tMT ZJer J:- #C ( cJZ<.JA-72J<~ 5/a A/}r;w~- --- - - , I , I -:;.. RESIDENTIAL PERMIT APPLICATION . Inspections: 726,3769 Office: 726,3759 SPRINGFIELD LOCATION OF PROPOSED WORK: ~tfl,C:<::; ASSESSORS MAP' /pvJ7 t") ~ LOT .~ OWNER. ADDRESS: j) + i.) ~~{ fe- '~~ .. ~ W~. ()""--R CITY, DESCRIBE WORK: NEW ~_ REMODEL ADDITION .-II 7 BLOCK' J..-c- I ~ STATF. ~ :5 . r-R. DEMOLISH OTHER . JOB NUMBER ~=? 032:$ 225 Fifth Street Springfield, Oregon 97477 TAX LOT, -?.-?; /'7-F) SUBDIVISION. PHONE: C,8R /7 <>4 ZIP, '9' 7?-O ? CONTRACTOR'S NAME GENERAL:__.~ ~~ PLUMBING. ADDRESS ~~ CONST, CONTRACTOR' D<"3"" 7, '7 EXPIRES Irrsr~ PHONE r.:. ~ /7.rf MECHANICAL' ELECTRICA' ' OUAD AREA' _~):l 3 E; / OCCY GROUP, .I? J' "t- M I . OF BLDGS, . OF STORIES, WATER HEATER' _/=3 - OFFICE USE - LAND USE, I/-J-! I , VAl FLOOD PLAIN: ZONING CODE: 1M ~ . OF UNITS, CONSTR, TYPE: HEAT SOURCE, ~ RANGF. . OF BDRMS, SECONDARY HEAT: ~ SQUARE FOOTAGE, ?~,~ 9_ To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All InspectIons requested before 7:00 a.m. will bo made the same working day, Inspections requested after 7:00 a.m. will be made the followIng work day. o Temporary Electric ~ Sitc Inspection - To be made )DJ after excavation, but prior to selling forms. (~I L.. J O Underslab Plumbing/Electricall Mechanical - Prior to cover. ~Footing - After trenches are l,..6J excavated. o Masonry - Steel location, bond beams, grouting. ~ Foundation - After forms are ~erected but prior to concrete placement. REQUIRED INSPECTIONS ~, Rough Mechanical - Prior to ~over. ~ Rough Electrical - Prior to ~cover. K:Ir Electrical Service - Must be ~ approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. ~Framing - Prior to cover. ~ WalllCeiling Insulation - Prior to ~cover. 0; Underground Plumbing - Prior )2'l Drywall - Prior to tapir'lg. . to filling trench. l-\7f Underfloor~::Hf;~l~eChanlcal) ~ _ Prior to I Ion or clecklng. 0 Wood Stove - After Installation. ~Post and Beam - Prior to floor ~ insulation or decking. ~'Floor Insulation - Prior to ~ decking. ~ Sanitary Sewer - Prior to filling ~ trench. rQ"Storm Sewer - Prior to Elling ~trench. gwatcr Line - Prior to tilling trench. ~ Rough Plumbing - Pdor to cover. o Insert - Aftor fircp:ace,approvai ane insta!i3tlon of unit. . ~ Curbcut & Approach - After ~forf1ls are erected but prior to placement of concrete. I':7l' Sid~walk & Driveway - ^fter ~exc.avation Is complc~c, forms and sub.case material in piace. D Fence - \'Jhen completed. '- ~ Slroet Trees -- WhL:n aH reQuh';~d V trees ~rc plw:tc:.l. ~Flnal Plumbing - When all )-6-J plumbing work Is complet.e. ~ Final Electrical - When all ~ electrical work is complete. 'f':7f Finnl Mechanical - When all ~echanical work is complete. fQf Final Building - When all ~requlred Inspections have been approved and building Is completed. o Other MOBILE HOME INSPECTIONS o Blocking nnd Set.Up - When all blocking is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, and plumbing inspections have been approved and the home is connected to the service panel. [I Final - After all required --' !n.:.;pactions are approved and porches, skirting, decks, and \'cnll_ng have been Installed. BUILDING PERMIT ITEM SQ. FT. X $/SQ, FT. 5e. ~D VALUE Main .;?>v_ 7/J- J02/02J , 10033 Garage Carport J /2 tobJ:? '$~?~ ---2-J>.// #>c, .-g~ SYSTEMS DEVELOPMENT CHARGE (SDC) ,~ZfJ7 Total Val ue Building Permit Fee State Surcharge Total Fee (A) (8) PLUMBING PERMIT ITEM FEE Fixtures, Residential Bath(s) N' '2 Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home 16D~O Plumbing Permit State Surcharge ;300 Lk9S.80 Total Charge (C) MECHANICAL PERMIT c..,~ 4-F.o 9.6.0 Furnace Exhaust Hood Vent Fan N' ~ Wood Stove/Insert! Fireplace Unit Dryer Vent ~.oo Mechanical Permit -;:' /_-?-o /0,00 //3 ~..f3 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk /00 It Curbcut 3(P It Demolition Q&). DO ;c;-/o State Surcharge _"t'LAv A'm/. -1fJrJ#S r 2t9.cJf) -k>.-IO Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) ...,~ '5'.21f, (A, 8, C, 0, and E Combined) - BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said conslruction shalf, in all respects, conform to tile Ordinance adopted by the City 01 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 Chec:, Fce, _8~ Date Paid: .' 1M. ~ ZO~ Receipt Number J~~ Systems Devclopmcnt Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS --rb2:tLL-~ t5 r -E&t7LJ.. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify thai all information hereon is true and correct, and r further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfleld, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further ccr!ify ttlat only contractors and employees who arc in comrJliC'inCO with ORS 701.055 will be used on this project >! I further agree to ensure that all required inspections arc requested at the proper Ii-me, that each address is reada.ble from the street, that the permit card is located at the front of the property, and the approved set of plans will remain ~:~::u:~?J;1 lil~'e5 Urin~f#n~4 . Dalc0;/9'3 / . VALIDATION, RECEIPT NUMBER 7i,(7 ?'/JO/' .J 124....47 2>(D U>f'~/ , . DATE PAID AMOUNT RECEIVED RECEIVED flY