HomeMy WebLinkAboutPermit Building 1994-10-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
~71.4,/.#2)5'J:4
JOB NUMBER tl1/13fn
225 Fifth Street
Springfield, Oregon 97477
.
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: --L;? /) 3
LOT' BLOCK:
) /?d1 _ /(J'J_
. TAX LOT: 'ph,
SUBDIVISION'
1/4&n
OWNER: ~'-" '..4 L--.-,,,..)~
ADDRESS: . //""",'/<9 ~) Pvt?
CITY' ~Ff) ,
- , -
A?/J ~
STATE:
~.
DESCRIBE WORK:
~~,;, ,~,e, ~/f//'
NEW ~ REMODEL
,- ~.
CONTRACTOR'S NAME
, '-
GENERAL: ,,'
: /';! VlI' A )~
( ,
"
PLUMBING:
MECHANICA' .
ELECTRICAl'
SRNYtI
/
R~
/
QUAD AREA:
· OF BLDGS'
OCCY GROUP:
· OF STORIES:
WATER HEATER:
15:.
ADDITION
DEMOLISH
OTHER
PHONE:
74%. - 9.,C ~ '"
ZIP: 974'71
ADDRESS'
CONST.
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
LAND USE: Wi FLOOD PLAIN'
. OF UNITS: J ZONING CODE: I~
CONSTR. TYPE: . OF BDRMS: ':J,
HEAT SOURCE: FE. SECONDARY HEAT:
RANGE: 15 SOUARE FOOTAGE: 1/2..1
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All InspecUons requested before 7:00 a.m. will be
made the same working day, fnspectlons requested alter 7:00 a.m. wlfl be made the following work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
O Underolab Plumbing/Electrlcall
'Mechanical - Prior to cover.
o Footing - After trenches are
excavated. :
o Masonry - Steel:locatlon, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
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 - Prior to .
decking. '
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. ',"
o Water LIne - Prior to filling
trench.
.... '
. ,
o Rough Plumbing - Prior to
cove~ .
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
K/(Electrlca' Service - Must be
~~pproved to obtain permanent
electrical power. '.
o Fireplace - Prior to /aclng
materials and framing lnsp.
o Framing - Prior to cover.
I
o Wall/C'elllng InsJlatlon - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installallon.
O Insert - After IIreplace approval
and Installation or unit.
>> "
o Curbcut & Approach'- After
forms are erected but prlor.to
placement of concre'te.. >-, '..
o Sidewalk & Driveway - After
excavation Is complete: forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all' required
trees are planted. .
o Final Plumbing - When all
plumbing W9rk Is complel,e.
o Final Electrical - \^J.hen all
electrical work Is complete. <
o FInal Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
~Blocklng and Set.Up - Whefl all
~Iocklng Is complete.
YC.;;("Plumblng Connoctlons - When
~ home has been 'connected to .
water and sewer. " -l. __
~Electrlcal Connection - When
~ blocking, set.up. and plurQblng
Inspections have been approved
and the home Is connected to
the servIce panel.
h71'"Flnal - After oil required
~ Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
...~. ";'." '.:..: '. .. ~. . '. ~ ..
""'~ .~.f\~:'1(1 . "IS THE PROPOSED WORK,tN THE.
Lot faces Lo( Type Setbacks,
I', Ace'1 "HISTO~ICAL DISTRICT, OR ON '
I P.L. HSE GAR
Lot sq. Itg. Interior IN I "THE HISTORICAL REGISTER?
Corner II yes, this application must be signed
Lot c.9~~rage Is I
and approved by the Historical
Topography Panhandle I'w I Coordinator prior to permit Issuance.
Total ~elght Cul.de.sac IE I
APPROVED'
BUILDING PERMIT BUILDING VALUE, PLAN CHECK
ITEM SO. FT. X $/SO, FT ~ VALUE AND BUILDING PERMIT
.~~C);S\ 2- This permit Is granted on the express condition that the said
Main construction shall, In all respects, conlorm to the Ordinance
, adopled by the City, of Springfield, Including the
Ga(age Development Code, regulating the construction and use 01
Carport buildings, and may be suspended or revoked at any time
upon violation 01 any provisions of said ordinances.
Plan Check Fee:
,~~S~ Date Paid:
Tolal Value
Recel pt Number:
Building Permit Fee Received By:
State Surcharge
Total Fcc (A) Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
d e;;'!)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
Residential Bath(s)
N'
Sanitary Sewer
Water
FT.
FT.
Slorm Sewer
FT.
Mobile Home
/&:;9()
Plumbing Permit
State Surcharge
,7r
...t.t:::
//.,'1..0
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
Slate :Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
/t!)'5.()Q
::zo ,/to
'-J-
.g.':..~,
I. _ I
State Issuance
Stale Surcharge
Sidewalk !
3~ ADA'''''''''_
Curbcul
JIt
"'! It
,---.'.-
-...-..
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
141.~
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
';yn ~~ I"~T A-J-
-;rh S" Ti/:1?I;-,
Un /jt1'<.'~JP~'&'" //""~~i/
/-;)N,7777?J;1J' /C) ~~.l)Cf)
By signature, I state and agree, thai I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further cerllfy
that any and all work performed shall be done In accordance
with the Ordinances of lhe City of Springfield, and the Laws
0/ the Slate 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 certify that only contractors and employees who
are In compliance with ORS 701.D55 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..~es durln~ c.ons~
Xgnature./~~
Datp' //~7/9~ /
VALIDATION:
RECEIPT NUMBER
DATE PAIf'
AMOUNT RECEIVED
RECEIVED BY
/ :)~7 /
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I, .~9}~a
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....-.
..... .
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.
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Job No. 91//3t;;
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: 71,PU "_'JIl\
1-eu.. .,....-:;
PHONE: 7 ~t". - ~ c:::u S-
&. ~.STATE: LJ!t ZIP 'J 7 f 77
ADDRESS:
/k?lq_~
LOCATION OF ~ROPOSED BUILDING SITE:
Street Address if Known: /~ 2 ~ tfrlrJh.J Ll~. #;J
Platt Name:
Tax Lot Number: /703 2.\ 2/ 1'..&//#"P
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back.)
A, Sinple Familv - Detached
Single Family home
Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT _=
$ ~rZJ.. tn)
.
B. Sinple Familv - Attachec!
NOOF 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 $
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet. $
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) $
com1!~~~~
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/0 f <'2-7 fa
Date