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{\