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HomeMy WebLinkAboutPermit Building 1995-6-14 RESIDENTIAL PERMIT APPLICATION Inspections: 726,3769 Office: 726,3759 . SPRINGFIELD ~SSESSORS MAP' ~\OT' T'J" I 2./ S-\-vee./T SO('jt<e.\d. 01<. TAX LOT: t9 g; ~ <5 0 BLOCt<' OWNER'l'o.......\ ~ c.';"''if ~ ('_D"''''-O\-c.. ADDRE'"'' 'L\ 1-11.. \ :\:,,'-, 'S.-\v t'~ + CITY' 0:;0(; "'l: e..U IA ,..;;-'hPt"A \e...A DESCRIBE WORK: NEW./ .REMODEL , ... " I' . STATE: _DI< 1"00"",", (<,\.A\I\v""O........ '1 ~"" ADDITION DEMOLISH OTHER . 9~C)7fj.3 JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 SUBDIVISION: PHONE: -, '"" \ - ?"3,~ \ ZIP: '1, \oj.., ~ CONTRACTOR'S NAME ADDRESS GENERAl' /D-hi\je., Co"S1v\^c:\"\",^. 'r~c... 5'-\\ CONST. ,CONTRACTO~ EXPIRES PHONE S~W....\:.. ~O\'\" TLlOlo\'; C\'l\.Q! l<;l(..al~~'a' eEl..(... '1io-07Otf PLUMBING' MECHANICAl. ELECTRICA" QUAD AREA: ~R~--", . ClF BLDGS: OCCY GROUP' . OF STORIES: , WATER HEATER. - OFFICE USE - LAND USE:--+W . OF UNIT~' CONSTR. TYPO". HEAT SOURCE: - RANGE: FLOOD PLAIN: ZONING CODE: ..LQ/2- '. . OF BDRMS' SECONDARY HEAT: 'SQUARE FOOTAGE: rQ/tp To request an Ins pee lion, you musl call 726.3769. Tl,ls Is a 24 hour recording. All Ins pee lions requested belore 7:00 a.m, will be .,,. made the same working day, Inspectlons requested afler 7:00 a.m. will be made the following work day. o Temporary EI~Clrlc o Site Inspection - To be made after excavation, but prior to seltlng forms. o Underslob Plumblng/Electrlca" Mechanical - Prior to cover. ~ Footing - After trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After (orms are erected but prIor to concrete placement. o Underground Plumbing - Prior to f1l1lnQ trench. o Underfloor 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 tilling trench. ("Q'( Storm Sewor - PrIor to filling ~rench. . o Water Line - Prior to filling trench. '. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical "- Prior to cover. D Rough Electr!cal - Prior to cover. ' o Electrical Service - Must be approved to obtain permanent electrical power, o Fireplace -'Prlor to facing materials and (ramlng Insp. ~ Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o Drywell - Prior to taping, o Wood Slovo - After Installation. o Insert - After fireplace approvel and Installation of unit. o 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 Fence - When completed. o Street Trees - When all.,requlred trees are planted. . \. '. .. 0 ,Fln~1 Plumbing - When all plumbing w9rk Is complet.c. D Final EIOClrlcal - When all electrical work Is complete. o Final Mechanical - When all mechanical work Is complete. K/l' Final Building - When all ~requlred Inspections have been approved and building Is completed. OOth.r MOBilE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. o Plumbing Connoctlons - When home has been connected to waler and 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 Inspectlons are approved and porches, sklrllng, decks, and ventlng have been Installed. ('~ Lot faces Lot ~ype . l/' _ Interior Lot sq. Itg. Lot coverage Corner Topography Total height Panhandle ff Cul,de,sac BUILDING PERMIT ITEM SO. FT., X $/50. FT. Main Garage Carport ~~ Total Value Building Permit Fee Slate Surcharge 4,6 1-f' '3.79> Tolal Fcc (A) I P.L. IN Is Iw IE Setbacks HSE GAR 10' VALUE " .L/~ 92 ;5",0 '92.. ro --.J.fl 99.'7/ SYSTEMS DEVELOPMENT CHARGE (SDC)-$ (B) if 4-1~ PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT, Storm Sewer FT., .In/V Mobile Home Plumbing Permit ~ State Surcharge Tolal Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Ven t Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (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, D, and E Combined) ~ FEE 2c;~ Z7:0 D I ,~S-. .?S" '2 7, _D a~,'31 .... -,;~,:~?"'~;".;::~: ~i -. , ;. THE PROPOSED WORK IN THE, HISTORICAL DISTRICT, OR ON .THE HISTORICAL REGISTER? If yes, Ihls application must be signed and approved by the Historical Coordinator prior to permit Issuance. ACC I I I I I' APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condllion that the said construction shall, in all respects. conform to the Ordinance adopted by the City .01 Springfield, including the Development Code. regulating the cOr),struction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. ~a/3 ~m~J Receipl Number. /7C:;-o '7 ReceIV~_~~~ 4viewed ~ Plan Check Fee: Date Paid: h/f.:/~\ ID~ Systems Development Charge is due on all undeveloped properties within tho City limits which are being Improved. ADDITIONAL COMMENTS #y P:I H'~l"'d J'IO(t:.. llll/I #lflIJ!!D ..d. .<r'fYJ~"'/T /./A ~A p:;p ~Ace - t) " By signature, I stale and agree, that I have carefully examined the completed application and do hereby cerllfy 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 01 the City of Sprlnglield, and the Laws of the State of Oregon pertaining to the work described herein, and thai 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 streel, that Ihe p rmit card is located at the front of the property, an the proved set of plans will remain ~u:= at all mt ring construction. Date (p, I 'i: "'7 I I VALIDATION: RECEIPT NUMBER /7777 ~,/y..~7 1?C/.5/' r2'~ / DATE PAID AMOUNT RECEIVED RECEIVED BY . .OB NO: cr'5D~-'.;;'3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: Y'AU L ~ G-lI'.\.(,,~f2... C.Ot-lt-J oLE:. LOCATION: 44-2.1 LVY -7>,1'. '<:&0"2-00::,....1 - o~o~o DEVELOPMENT TYPE: Ll>12-- - A.t>o I""{ ION BUILDING SIZE: 12.". \ 4. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 2.. \ '= X $0.209 PER SQ, FT. LOT SIZE SQ. Ft. ~4s'0 2. SANITARY SEWFR-(ITY NO, OF PFU'S -- X $43,26 PER PFU (See Reverse) (-~ 3, TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X $436.19 G ) ...... .....- X X $436.19 $ X X $436.19 $ 4. SANITARY SEWER-MWMC NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE (Use PFU Total From Item 2 Above) $ TOTAL-MWMC SDC $ r=-; ..... ----- $ 4S14 MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 \~, ,,~_~.LvL. Date: S )"K>/"lC; UKlp Burdick ' 'TOTAL SDC SDC Coordinator G ?7.("~ " ...-/ $ 47~ SI.IIINUI:I~l.U ~"f ""J'hp. rOllO"""l1g' : . ~.. 225 FIFTH STREET :'~~inil, Md~~J~t:7. .~. 8d1l,j~~CAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 'h-'eva!. .r~UIr8 1lecI!ic/AAduee 1ovrl"i7 INSPECTION REQUEST: 726-376? Z~B3'n Ci ty Job Number '92cg.?9 OFFICE: 726-3759 Dnt~ \".I! JlLJU COMP!:ETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATIo~utherQUd Sjgn~lIre ~;.. &. ~rrUob . i/vz.I /W-- LEGAL DESCRIPTION ~ 7' ......a--?~ ."$-z. c.?"'-1b~ /8~.~:;~tr;oitt~ Il ){ 'IV J (\ i f\..J <!..o1I\!i. 1 t t M'\ 0 fl.-J !' Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical ContractorQ,~8 p DOl\i~ I ~. I I Address P,C, ~ ,4gJ,.... CitY~~.. ~hone"l41-~').5fo Supervisor License Number I !:, ~ (" S 10 -I-q')..... 0384Q Expiration Date Constr Contr.. Number Expiration Date q-I-Q1-> ."~S";;:)L;;;~~) Owners Name p~ (1~~ Address r:r.f1~ f.Y ~ City~~. Phone '14/- 33:3/ OIlNER INSTALLATION The .installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: ~/~--;?2.. RECEIPT t1: <'/"=?2 RECEIVED 8Y: ...-..:?.-....-=- ~ . ''?' - sidential-Single or Multi-Faml y er dwelling Service Included: Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling 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 uni to Cost Sum $ 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 volts D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 see "'B" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One ,Ci.rcu it Each Additional Circuit or with Service or Feeder Permit E. 5, SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 ~O $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 .15'.00 1,'15 3h, rj 5'