HomeMy WebLinkAboutPermit Building 1994-8-29
~-' - -
RESIDENTIAL .
PERMIT APPLICATION
Inspections: '726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: /7t:)~ /"7--"
",
LOT' BLOCK'
OWNER~)..."" \_~J\ ~C'(\l\_m I ~ PHONF'
ADDRE~{'o,'\~ ~\f\ A\ rt I
CITY: \Jl\ tN"'\~ ~.rv STATE: 'ill~~.tJY'
DESCRIBE WORK: p\(i W\1 ~ I \.' 1_ ~ o()iY\ lo\('\l\. \ ~
NEW REMODEL ADDIT~N' . DEMOLISH OTHER
.".,
7 JOB NUMB~R q4 \ \ l dL
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
C jL\\YY )
7"7'7- 8/'/S
ZIP: lflLtrl
---
CONST.
Q)-lr~RACTOR . A . q~RES 14-1 p.:-8fYn
CONTRAc;or.r~~~l.. \ n \ ..t~D~ESS',
GENERAL~ \1\ \\\0 1 ~ \JJ lJL S
PLUMBINf-:'
MECHANICA' .
ELECTRICA~: W I If\ ~
QUAD AREA:
/ ~ AlIi /
· OF BLDGS:
~..;l.,
OCCY GROUP:
. OF STORIES: ~I
WATER HEATER:
,
.1,
- OFFICE USE -
LAND USE:
· OF UNITS'
CONSTR. TYPE:
IIII
-.
FLOOD PLAIN'
ZONING CODE:~JA"
. OF BDRMS'
v
SECONDARY HEAT:
SQUARE FOOTAGE: AjIJ
,
j-"
v ^I.
'.
HEAT SOURCE: _
RAN~E:
, , .
2.')2-
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
made the same working day. Inspections requested af~er 7:00 a.m. ~III be made the fOllowl,ng work day.
REQUIRED INSPECTIONS
o Temporary Electric
O Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
f';:/(Foollng - After trenches are
~ excavated. .
o Masonry - Steel location, bond
. ,beams, grouting.
~Foundatlon':"" After forms are
~~rected'but- prior to 'concrete
placement.
o Underground Plumbing - Prior
to filling trench. .
o Underlloor Plumbing/MechanIcal
-.Prlor to Insulation or decking.
I"'V"1"'"' Post and 8eam - Prior to floor
~ Insuletlon or decking.
~ Floor Insulation - Prior to
.IC>l. decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
o Rough Plumbhig - Prior to
cover.
o Rough MechanIcal"':' Prior to
cover.
~Rough' ElectrIcal - Prior' to
1.6l cover.
,~
o ElectrIcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Fra~lng - Prior to cover.
f'V'1" Wail/Ceiling Insulation - Prior to
L6lcover. '
~ Drywall - prl.or to taping.
'fi71 Wood Stove - Alter Installation.
=.!.. pULer
o Insert - After fireplace approval
. and Installation 01 unit.
. 0 Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & DrIveway - After
excavation Is complete, forms
and"sub.base material In place.
o Fen~e - When completed.
,
O IS,treet Trees - Wh,en,all)req~lred
trees are planted. . ~ . . -"\. .
o Final Plumbing - When all
plumbing work Is complete.
. .
19I' Final Electrical - When all
~electrlcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
"'f\7f Final Building - When all
~requlred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel.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.
Setbacks.
. .
HSE GAR ACC'
"~S THEPROPOSED WO~K 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.
,
I
Lot faces
,
L~t~ype .
:i~.i . .'i",~:,. ';f"':;;"(;"~'~ :~~v.s':~}~tf-'::',
~~1< \ :\:" : ~ ", ,'c' "~:" i:":~:~:,~":'"
-J.L(7, So
6. S'3.
.zi),.~"P. :;j',-;::'
(A) -!i..5:. ~
SYSTEMS DEVELOPMENT CHARGE (SDC)
1C,2. S4
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
CuI-do-sac
BUILDING PERMIT
SQ. FT.
A~
ITEM
X $/SQ. FT. -
. S\o.1lJ'
Main
Garage
Carport
,r-'
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(B)
",;.:.,,:<'
.PP.L.
'-'1 N'
Is
Iw
IE
\4L~tot
"
PLUMBING PERMIT
ITEM FEE
Fixtures ' ,
Residential Bath(s) N'
Sanitary Sewer FT. /\'
Water FT. /
StorlT! Sewer, FT. /
Mobile Home
---.,
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
\ \T~~~ (\, 'JIf)~")
Mechanical Permit
Issuance
State Surcharge
Total Permit
. 1398 M/I?4(/.
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
/ S ""
//)~
,7,J
,1:-
':2/~_?t1J
2<;>$. A1't .
APPROVED"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition 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 ProVlsl~~f said ordinances.
Plan Check Fee: '1 \ . :t:l}1
Date Paid: 'l . ty ---\1-
Receipt Number:r-I \1 \'?1L
R~7~~j
Plans"Revlewed By /' h~
IY
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
~/("!/5-4
Jt~,~
ADDITIONAL COMMENTS
.,4nJ~.' /972.
-, .
A---r /.
-pA17f 1
~~AY~ d.k.7:
.#ti2vd6)'
.61/5of',;?;1 / T ,/!- 5
. .
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 I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, 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 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 property, and the approved set of plans will remain
on the site at all times during construction.
4nat~r/L?~-~{ /~
Date P'if'Cf
VALIDATION:
IL - SQI
R::Jc{~4 _
o r!Jr'P> \lJ
L '\t\...-J -
RECEIPT NUMBER
. DATE PAID
AMOUNT RE
RECEIVED B
r' .
ATTACHMENT B1
. .o~ NO. .tiLlv 0
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: Jf. e.tt J....../I'jA
LOCATION: 13(" oLZi '
DEVELOPMENT TYPE' ~ d.-..wL ,rt... ~ .. ~
; . / ')
BUILDING SIZE: H J'/~
f<J/&AVFS'IS I u'll
1. STORM DRAINAGE .
LOT SIZF'
SQ. Ft.
.' ,
IMPERVIOUS SQ. FT. 2~S- X $0.209 PER SQ. FT. $ sr.s1
2. S8NlIARY SFWF~-r.ITY~
t0l
NO. OF PFU'S X $43.26 PER PFU $ ,
(See Reverse) /1
3. IRANSPORTATTON
NO OF UNITS X TRIP RATE. X COST PER TRIP
X ~36.19
/'
/X
t
X $436.19
$
X $436.19
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $ Sf.S"7
4. S8NlIARY SFWFR-MWtjC ~.
NO. OF PFU'S ~ $17.19 PER PFU + $10 MWMC ADMIN. FEE
(Use PFU Total From(Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
~ ]]!AI -MWMr. snc
SUBTOTAl (ADD ITEMS 1.2',3 & 4)
$?f
I
$
$
$ .Jr. S1
I'
5. AnMINTSTATIVE FEES
Z'2 f~ ABOVE> X .05
'~ ' Date:
/ Mar ornig, E.
SDC oordinator
$ :2.. 'If
?-~-'1.p
]]!AI snr.
$ ~.2, S-'f
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