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HomeMy WebLinkAboutPermit Building 1994-4-25 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726,37S9 LOT: .. BLOCK' p, OWNER: _k E tI /lJ ~ 1l.L&/tJ1i k/1J.,/;,.F' " ~ ADDRf"'" '{J7j 0 JJ' SS Si/, CITY: :if ei 1./ 5J ,..pJj) DESCRIBE WORK' IJ i;/,/,) NEW v.... REMODEL STAT~' (?);e . 5('2.70 J./..IJ J7l -e. ADDITION DEMOLISH OTHER JOB NUMBER ?4~ ?,22. 225 Fifth Street Springfield, Oregon 97477 TAX LOT: ~ SUBDIVISION: C!.Mt'A-/J1E /JF:/ c')fJ; 5 ;<;; I" A/. PHO,NE: _1'??& -.~ :210 '7y/ ZIP: 97~7,f' CONST, CONTRACTOR'S NAME ' ' ADDRESS CONTRACTOR # EXPIRES GENERAL: c.()f.El:8AJD I11mes 6r;.:z9;nFJ/tJlr/;2l/ (('19/'1 YI.@jjr PLUMBING: EiJ}iJ/0 p./..i)t7I~tA:)C /J IT.../ 4f'Jffi~ \a.]N14' MEC~ANICAL:jJ:PR.Ve<( 'f f'iCla .J(jdt;tJ()(:Pa€..~'aJt', E/X;; OrptJ lO 3\~ ELECTRICAL: C-ofJEUlIJ fI, ~.I.ECir"'-,~ ('jc.eSu;~U, ' ~'7.aS - .Q.~iu>('(J ) QUAD AREA: L\-Q bF, # OF BLDGS: \ OCCY GROUP: Y<'?;-t- !v\ \ '~ # OF STORIES' WATER HEATER: ''"- OFFICE USE - \ \ \ \ LAND USE: . OF UNITS" \ CONSTR, TYPE: \ J N HEAT SOURCE: . ~'~ 6, RANGF' PHONE 1,;lt -&/Iff q~5'-3.:<t3 1~" -lIP ;2../ . g-'75-~>>t FLOOD PLAIN' ZONING CODE: Ij)i~ Q, # OF BDRMS: SECONDARY HEAT: FV SQUARE FOOTAGE/;) ~ ~2... To request an inapection, you must call 726,3769. Thia Is a 24 hour recording, All inspections requested before 7:00 a,m, will be mada the same working day. Inspections requested, after 7:00 a.m, will be made the following work day, qtJ, Te'mpOrary Electric ~ ' \,'" Site Inspection - To be made fter excavatlon,..9t.~.t pJ.I'or to setting forms, '=>0 Il...$ o Underslab Plumblng/Electrlcel1 Mechanical - Prior to cover. rc;:( Footing - After trenches are ~xcavated. o Masonry - Steel location, bond beams, grouting. !Of Foundation - After forms are ~ erected but prior to concrete placeme~t. o Underground Plumbing - Prior to filling trench, K/rUnderllo~echanl,Slll LA.l - Prior ~r oecKlng. 'lv'rPost and Beam - Prior to floor ~Insulatlon or decking. ~ Floor Insulation - Prior to ~ecking, ../ , rv1 Sanitary Sewar - Prior to filling ~trench. ~Storm Sewer -, Prior to filling ~ trench. ' ~Water Line - Prior to filiing ~ trench. ' , , " &"i Rough Plumbing - Prior to ~over. REQUIRED INSPECTIONS 'C7(Rough Mechanical - Prior to ~ cover, ~A,' ~,"'. ' '.~ Rough Electrical - Prior to f~~cover. ,}I" A"V'f' Electrical Service - Must be ~approved to obtain permanent electrical power. o Fireplace - Prior to facing. materials and framing Insp. ~ Framing - Prior to ~o,~er. p<:f Wall/C'alllng I~sulallon - Prior to ..over. ~ryWall - Prior to taping, o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prIor to placement of concrete. o Sfdewalk & Driveway - After . excavation Is complete, forms and sub-base material In place. o Fence - When cOlTlpleted. ~treet Trees - When 'all required ~ees are planted. "fV""i'" Final Plumbing - When all ~plumblng work Is complete. ~Flnal Electrical - When all ~etectrlcal work Is complete. I5C::"'T Final Mechanical - When all ~mechanlcal work Is complete. k71 Final Building - When ail ~requlred Inspections have been approved and building Is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set.Up - Whan ~II blocking Is complete. . o Plumbing Connections - When home has been connected to water tilnd sewer. . o Electrical Connection - When blocking, set,up, and plumbing 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. '\'i~ , . . Lot Type Setbacks 'C,IS THE PROPOSED WORK IN THE ~ I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON _ Interior IN I THE HISTORICAL REGISTER? Corner 2-':r If yes, this application must be signed Is IS, /& I ,and approved by the Historical Panhandle Iw ,\--, , . CoordInator prior to permit Issuance. Cul,de,sac IE 5 I . APPR9VED' I ,L.o.qa~es,,>--\,--*- , ...... ,,' ..~-, ' lC;tsq, Itg,-/'..i2f<!-'-' Lot coverage JL.Z Topography ~ , Total height J2.." p\<:)/ \'( ,.QR'\ '~ . BUILDING PERMIT: . . , ~ \. . - ... . ITEM SQ, FT, Main /2>23 5"34 Garage Carport Total Value Buliding Permit Fee State Surcharge Total Fee X $/SQ, FT, = ,)~.2.0 ..L4/0 (A) VAWE /02~.'() 752/iftJ /&n~9- 4,<;:s~ --. "2'2.. 7 46 47~ 'l..f3 SYSTEMS DEVELOPMENT CHAR~E (SD~~ c$' , (B) fI '2-' 1'Z.. - PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary Sewer Water FT, FT, Storm Sewer FT, Moblie Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnser Mechanical Permit Issuance State Surcharge Total Permit -;/ (C) 2. (D) MISCELLANEOUS PERMITS Mobile Home . State .Issuance \ State Surcharge Sidewalk (.;, '7 It Curbcut - '34 It Demolition State Surcharge Total Miscelianeous Permits (E) FEE / ~ c--D %,,00. .jC~91,O-O G~ 4S"O 6. 'fV> 3,6-0 !=;,trO ~4.S () /~ (JO -i. 73 .f(o ,2. ~ 20.,r -.l s/o TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D. and E Combined) . 2960 ,"2" 7 'BuiLDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shali, 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: _2/;(O.oe Date Paid: 7/ :!CJ/5-",t I ' ' Receipt Number' 12/2'7 Re7~~~ Plans'-Revlewed By - ~~~t' Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, ADDITIONAL COMMENTS ,~ , ' \ ~~U')\ 'f\\::')\'r\Q ) l'\\t\CJI i~\)~O \~~1_~~J~rb . ~-t\\\~'{\\. ~ ~ \L.\f}~ ~An-I / I ~NJf:i'5 .?~ ,;~r /.J'~4 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 J further certify that any and all work performed shall be done in accordance with the Ordinances of the'Clty of Springfield, and the Laws of the State o! 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 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 proRerty, and the approved set of plans will rem In on the~ all times ~onstru tlon. XsignC ;YlC()ae . t (j I I Datp VALIDATION: RECEIPT NUMBER /2.:/.1 ~ DATE PAID 4/275'./- 7~O.27 AMOUNT RECE1VED~::~ .~'':':!~:~fi -,- RECEIVED BY' --rJ~ . , . -, o l!.!!i!I!!.!!!!~!!!! Job No. Q4ffi2.-t- SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME:~Of\~~n() Fffi~ PHONE: ,\,QIt'J -,,~Lili' ADDRESS: ~ \:' ,f\ ' ~*"'~~ 001-, S STATE: G\2..zIP qrtlb ~ LOCATION OF IiROPOSED BUIL91~9 ~ITE: Street Address if Known: \ n ~D LO ~\n ~.lQ~e) Platt Name: C'h(l)\f.) r\O ~ ~.~Tax Lot Number: \ 1:I"fd(')AR. t\ ~ I~ \J 1. DEVELOPMENT TVPE (Check appropriate dwelling(s), SDC Calculations and dwelling type definitions are on the back.) A. Simile Familv - Detached \ Single Family home NO OF UNITS { B, Sinl:Jle Familv - Attached NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS _ Manufactured home not in a park Cf) $ 4{f). , X $400 PER UNIT _= . X $370 PER UNIT = , $ X $277 PER UNIT = $ X $280 PER UNIT = $ WPRD SDC $ !rD00J $;:1 $~~ 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 Credit) ~~d,~)~;~~t'-/ City of Springfield D~ /L5,C{\