Loading...
HomeMy WebLinkAboutBuilding Building 1996-05-30SPRIl\IGFIELI) RESID ENTIAL PERMIT APPLICATION lnspections: 726.3769 Office: 726-3759 LOCATION OF PBO ASSESSOHS MAP: LOT F 3 BLOCK: JOB NUMBER 4 soq ao 225 Fifth Street Springtleld, Oregon 97 477 TAX LOT; SUBDIVISION: PHONE:1'11 - O3A'L STATE:C\fL ZIP:9tl7BCITY: ADDRESS: OWNER: r^oJo-L ADDITION DEMOLISH OTHER DESCRIBE WOFIK: NEW- REMODEL X MECHANICAL: - FI trCjTRICAL EXPIRES PHONE CONST. CONTRACTOR #CONTRACTOR'S NAME O trrnr-'r- ADDRESS GENERAL: PLUMBING - OFFICE USE - C OF BDRMS: RANGF.: ZONING CODE: FLOOD PLAIN: WATER HEATER: # OFdNITS: LAND USE: SECONDARY HEAT: SOUARE FOOTAGE: QUAD AREA: r OF BLDGS: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT.SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour rccordlng. All lnspections requested before 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS [--l Temporary Eleclrlc Rough Mechanlcal - Prior to cover. Final Plumbing - When all plumblng worl( ls complete. Site lnspection - To be made after excavatlon, but prior to settlng forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover, Underslab Plumblng I Electrical, Mechanlcal - Prlor to cover. Electrical Service - Must be approved to obtaln Permanent electrlcal power. Final Mechanical - When all mechanical worl< ls cornplete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng materlals and lraming lnsP. Final Building - When all required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng.Framlng - Prlor to cover. Other Foundatlon - After forms are erected but prlor to concrete placement.WalllCelting lnsulatlon - Prlor to cover. Underground Plumblng - Prior to filllng trench.[-l Drywall - Prlor to taoing MOBILE HOME INSPE TIONS Underlloor Plumblng/ Mechanlcal - Prlor to lnsulatlon or decklng,[-l Wood Stovo - After lnstallatlon Post and Beam - Prior to floor lnsulatlon or decklng.lnsert - After flrePlace aPProval and lnstallatlon ol unlt. Blocking and Set-Up - When all blocking ls complete. Floor lnsulation - Prlor to decking.Curbcut & AlrProach - After forms are erected but Prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.Electrical Connection - When blocking, set-up, and plumbing lnspections have been aPProved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation ls complete, forms and sub-base materlal in Place. Water Llne - Prior to filling trench. Fence - When comPleted. Slreel Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and ventlng have been installed.[flnoug]t Plumbing - Prior to - cover. I tl tl E E tl tl E tl tl n E E E E E Etl P.L.HSE GAR ACC N S E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Tyl _. - lnterior -- Corner - Panhandle - Cul-de-sac IS THE PROPOSED WORK iN THE HISTOHICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: VALUE (A) x $/so. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FI. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on lhe express condition that the said construction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including the Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plans Reviewed By Date Fleceipt Numbe Date Paid Received By Plan Check Fee SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City linrits which are being improved. ITEM Fixtures Besidential Bath(s) Sanitary Sewer Water Storm Sewer FEE (c) cxf 2(- No e PLUMBING PERMIT Mobile FT. FT. Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fl replace Unit Dryer Vent MECHANICAL PERMIT (D) Mechanical Permit lssuance State Surcharge Total Permit Fu rn ace Exhaust Hood Vent Fan s By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all lnformation hereon is true anct correct, and I f urther cerilfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, and the Lawsof the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCy will be made of any structure without permission of the Buildirrg Safety Divislon.I further certify that only contractors and employees who are ln compliance with OBS 7Oi.O55 wlll be used on thlsproiect. I further agree to ensure that all required inspections are requested at the proper time, that each address ls readable from the street, that the permlt card ls located at the frontof the property, and the approved set of plans will remaln on the site at all times during construction. Date o/s 6 tu re MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut .- ft Demolition State Surchargp Total Miscellaneous Perrnils (E) -7TOTAL AMOUNT DUE (exctuding electricat) (A, B, C, D, and E Combined) IV t\ RECEIVED BY VALIDATION: RECEIPT NUM DATE PAID AMOUNT R . FT. N0 s/s \ CITY OF OFEGO'U SPRINGFIEID, oREGoN 97411 - -)-Eaf INSPECTION REQT EST: 7264%* approval. 225 FTTTE STRXET OFPICE: 726-3759 Auihorizad 1. LOCATION OF INSTALT^ATION LEGAL JOB DESCRTPTION /r*t,*-.e Fs*rnzp./ To A. Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION OT.ILY Electrical Contractor Address city- Phone Supervisor License Number Expiration Drte Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name Address ELECTRICAL PERHIT APPLICATION Ci ty Job Number o 3. COHPI,ETE FEE SCMDULE BELOV A Nev Residential-Single or Multi-Family per dvelling unit. Service f ncl-uded:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Sertice or Feeder s 8s.00 s 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: The following proiect es euhmitJed hap the foliowing ioning, anO?begnot require spacilic larld use SPftI 'IELT) 200 amps or less ? 201 amps to 400 amps -401 amps to 600 amps _601 amps to 1000 amps_ 0ver 1000 amps/vo1ts Reconnect OnIy SUBTOTAL OF ABOVE 5% State Surcharge 37" Administrative Fee TOTAL Sum &s s0.00 s 60.00 $100.00 s130.00 P, s300.00 s 40.00 c. D E Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"or less $ 40.00 201 amps to 400 amps - S 55.00 over 401 to 600 amps - S 80.00 0ver 600 amps or 1000 voTIs see uB* a66E Branch Circuits ;/*- <.. c:,ty Wd Ynone 7/7- O3Z,z OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Omers Signature: DATE: Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Addi tionalCircuit or vith Serviceor Feeder Permit I S 2.00 /4. Miscellaneous { Service/feeder -Each ins tall-at ion Pump or irrigation SSign/0utline Lighting- SLimited Energy/Res - $Limited Energy/Comm S )*/ not included) 40.o0 40.00 20.00 RBCEIVED 5 a? <775 D4ruet: ,<TT CITY OF OBEGO'V S"FTINGFIELD D EVELAP M ENT S ER Vl C ES DE pA R r !\r E fiT December 6,1996 225 FIFTH STBEET SPRINGFIELD, OR 97477 (s41 ) 726-s7s3 ;AX (5d1)726-36,c!) Terry Bollenbaugh 3735 Oregon Street Springfield, OR 97478 Dear Mr. Bollenbaugh, Your request for an extension ofyour permit to convert your garage in to a bedroom at your residence, located at3735 Oregon Street, Springfield, Oregon, City Job number 950980 has been reviewed and approved. This extension may only be granted one time and will expire 180 days from the granting of the extension (June 6, 1997). If you have any questions or if I may be of further assistance, please call me at 126-3664 . I I 'l*[^t, i1- Communify Secretary cc: Dave Puent, Community Services Manager/Building Official hk ,!r/, t /ri u Re6rr.r-t* {". B,.lJ,^6 (fet^,'l E*lenr,r,.- Rn,,.'t * qS cqgo T an^ rs ?a<.s .,-'r. s ', r) T wil\ ##,c- ;/zt I 1u , 2) tr^4-5 n ^b o\,^r\ CtL{ernS..'tf {--^7 b,*^d'^6 Pc--r' it. D.^o- to lr"^lt6 neorls A \a^.,u ,'ro* hr..l t r..r-tc fr.. ,3 [ F. nds ra-y\ s"h.cr+ U=--rea&5--fa--*t Ga-cl- t o,sp+a-*ic,,-'-h?. /-^ t &{!"^C/%A 3l3s O.1A^ St 1p.'5{ulL4r< a7!79 7.17-o 3BZ 3'{Z- lgZ( LrlgrL pl^'cn^r -ADDRESS-3735 OREGON ST -INFO- REPAIR RESTDENTIAL l-l-Ll- OO1-06]._RES PLAN CHECK OO2-OO2-BUILDING PERMIT OO3-OO4-BLECTRICAL 004-070-sDc/sroRM 0 05-07 3 -SDC/ADMTN OO6-OO5-PLUMBING BUILDTNG DIVISION JOB# 9 )80 _LEGAL- LOT BLOCK ACTIVE -VALUE- 5533 DESCR:REMODEL GARAGE TO BEDROOM L702314300311 _OWNER- TERRY/MARGARET BOLLE 747-0382 3735 OREGON STREET sPRrNcFr ELDIOREGON / 97 47 B 950622 / 960531 -ENERGY- -STATS-HEATI- 2_ 1 BLDG ZONE LDRH2O- ]- STORIES FLOODPLAINRANGE- BEDRM OCC GRP R3INSULATION UNITSPATH- SQ FEET 232 CONST TYPE -CONTRACTORS- GENL-OWNER CONTRACTOR PHONE- PLMB-OWNER ELECT-OWNER MECH- DESGN- QUAD AREA 3RSC sEQ-REQUIRED PERMITS- -------FEE--SURCHARGE--DATE--RECPT--CAT-------VALUE 40.63 62 .50 66.00 4.39 0.22 15.00 0.00 3 .13 3.30 0.00 0.00 0.75 950616 9507 25 950725 9507 25 950725 96053 0 oL7 87 2 L8454 L8454 L 8454 L8454 2L7L6 601 500 510 0 6r 533 0 0 0 0 SEQ-MINIMUM INSPECTIONS + REQUIREMENTS-- --EXP DATE---ACT DATE- FLOOR SEQ--TNSPECTIONS -COMMENTS------- -----DATE---RSLT--rNSP 001--007-MASoNRY OO2_OOs-POST & BEAM OO3-OO9-INSULATION OO4_OA2-ROUGH ELECTRIC OO5-044-ELECTRIC SERVICE OO6-OO6-FRAMING O O7-O O 9_INSULATION OOB-011-DRYWALL O O 9-04g-FINAL ELECTRICAL O1 O-O 3 g-FINAL MECHANICAL O1 ]._O ]. g_FINAL BUILDING 012_02 3_ROUGH PLUMBING 013-02g-FINAL PLUMBING 001--002-FooTrNG OO2-OO7-MASONRY OO3-OOs_POST & BEAM 004-00g-TNSULATTON U/F OO5-044_ELECTRIC SERVICE OO6-044_ELECTRIC SERVICE SUB-CALLED OK TO CONNECT SERVICE. 007-042-ROUGH ELECTRTC C/N FOR FrNAL O O B-O O 9-INSULATION OO9-OO6-FRAMING O1O-o11-DRYWALL LEFT CARD 011-011-DRYWALL 2ND TRIP OL2_023-ROUGH PLUMBING 9s 0 818 950818 950818 9s0 82 8 9602L2 96 0 213 960509 960524 960524 9605 2 I 9605 2 I 96053 1 950818 95 0818 960524 960509 960 21- 3 960524 950828 960528 WIR 38oK 38OK 38oK 38IRC 6LoK 61oK 51oK 59oK 59UGE 59oK 59oK 28 Permit #: Address Issued by:Date: 7-2 5;4f Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appti- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3,A'. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and thatl have read and do understand thelnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. applicant) (White copy to issuing agency perrnitfile, pink copy to applicant) t OR (Signature (Date) ?SeZO B tr '{ o * BoQ!r^0---..(A t/zs lqs Information' Notice to Property Owners About Constructism Hesponsibilities Nrste : This l*f*rwtcttion Notice to Prtspert;r- *wners sfs*ut {*nstrur:tion Respottsibilities w.*s rlevef*p*l by the Consiruction"Confr*ttors &oartl in arc*rd*rcce with OkS 7A] "055{5i. If you are acting *s _vour fiwn c*fitractnr tr: eonstruct fr fiew htme *r rnak* a substantiai impr*vement. to an existing str*cture, you can prevent many probiems by being aware of the following responsibilities and areas of concern. EMPLOYEH RESFON$IBILITIES: If you hire persons not registered with the Construction Contractors Boardto do labor in constnlcting.or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the ernployer, you must comply with the following: Oregon's withhotding tax law: As an employer, you must withhold income taxes frorn employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax frorn your employees. For more information, call the Oregon Dept. of Revenue at 945-8091. Unemployment insurance taxl As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees, Far more information, call the Oregon Employment Division at the Department of Huma! Resourees at378-3524. Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obrain workers' compensation insurance, you may besubjecttopenaltiesandwillbeliableforallclaimcostsifoneafyouremployeesisinjuredonthejob. Formoreinformation, call the Workers'Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Reyenue Service: As an employer, you must withhold federal income tax frcm employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more infcrrmation, call the Internal Revenue Service at l-800'829-1040. OTHER HESPONSIBILITIES AND AHEAS OF CONCEHN: Code compliance: As the permit holder for this project, you are responsihle for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liahility and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage [r:r accidents and omissions such as falling tools, paint oyerspray, water damage ftnm pipe punctures, fire, or work that musl be re-done. Time ta supervise ernployees: Make sure you have sufflcient time ttt supcrvise ynur employees. Expertise: Make sure you have the expertise to act as your own general c*ntractor, to c*ordinate the work of rough-in and finish trades, and t* noti$r huilding nfficials at the appropriate tirnes so they can pedorm the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 973CI9-5052, 5A31378-4521). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-awn.pm4 U94 IoB No .15o18o CITY OF SPRINGFIELD SYSTEMS DEVEI,OPMENT CHARGE WORKSHEET (CoMMERCTAL & RESIDENTIAL) NAME OR COMPANY TF-B-<v I illnpoop,.zr Bo u LL^/bA U G 11 LOCATION:z1b6 Dt<E Sr l-7o 2?i, 4Z - db zil DEVELOPMENT TYPE: BUILDING SIZE: 1. STORM DRAINAGE TMPERVIoUS SQ. FT. 2. SANITARY SEI,IER-CITY NO. OF PFU'S (See Reverse) SIZ x $0.209 PER SQ. FT. X $43.26 PER PFU . Ft. ZI 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x _ x $436.19 x x x $436. 19 x $436.19 $ $ 4. SANITARY SEWER-Mt,lMC N0.0F PFU'S x $17.19 PER PFU + $10 Ml.lMC ADM FEE (Use PFU Total From Item 2 Above) Mr.rMc CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MltlMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4) 5 ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) X .0s $ s+7.1 Ki p Burdick 2Z SDC Coordinator Date:a /zz/qE -17 TOTAL SDC s+(rlI FIXTURE UNIT CALCULATION TABLE: Number of New Fixture (NOTE: For remodcls, calculate onty tt ET additional fixturesl NUMBER OF FIXTURE TYPE NEW FIXTURES '' Unit Equivalent :' Fixturc Units UNIT FIXTURE ,. EOUIVALENT UNITS Bathtub..-..2 1 2 6 2 6 6 ,l .) 2 1 2 2 1 6 Drinking Fountain... Floor Drain- lnterceptors For Grease/Oil/Sotids/Etc. --. - - -. -.. -- -. -. lnterceptors For Sand/Auto Wash/Etc. : - - - - - - -. - : - - - - -- Laundry Tub/Clotheswasher..-...-...-- Clotheswasher - 3 Or More.--.- Mobite Home Park Trap (1 Per Trailer) Receptor For Refrigerator/Vvater Station/Etc Receptor For Commercial Sink/Dishwasher/Etc-- Shower. Single Stall.........- Shower, Gan9......... ...--..-..:..---- Sink: Bar, Commercial. Residential Kitchen Urinal. Stall/Walt... Toilet, Public lnstallation. Toilet , Private Miscellaneous: /Head 4 TOTAL FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value calculate credits separates. lf improvements occurred after annexation date in table, Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) xs (Rate X Assessed Value)x $-- (Rate X Assessed Value) CREDIT TOTAL = $ Year Annexed Rate per $ 1,OOO Assessed Value Rate per $ 1,OOO Assessed Value 1979 or before 1 9BO 1 981 1 982 1 983 1 984 1 985 $3.46 3.38 3-32 3.21 3.O6 2-92 2.73 1 985 1 986 1 987 .I9BB 1 989 1 990 1 991 1 993 s2.46 2.14 1.77 1.37 o.97 o.61 o.44 o-15 Year Annexed RESIDENTIAL PERMIT APPL ICATIO N lnspections:726.9769 Office: 726.3759 LOCATION OF PROPOS WO ASSESSOBS MAP: LOT; SPRIhl GFIELc) BLOCK: JOB NUMBER 225 Fif th Street Sprlngfleld, Oregon 97 477 TAX LOT: SU BDIVISION:C o),*, d",l {._ At PHON E?3 ZIP: e2_) STATE:r}n '17*o OWNEB; ADDRESS: CITY: ADDITION DEMOLISH OTHER DESCRIBE WORK: NEW - FIEMODEL ADDRESS EXPI BES PHON E COco {O trSn 5c. CONTBACTOR'S NAME ELECTFICAL: MECHANICALI NSI. NTRACTOB ,f G EN ERAL: PLUMBING sRS \\\\ - OFFICE USE - WATER HEATEH: LAND USE:QUAD AFIEA: * OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: # OF BDBMS: --- OCCY GROUP; # OF STOBIES: CONSTR, TYPE: HEAT SOURCE: RANGE: # OF UNITS: -- [--l Streel Troos - When ail requlred - troes are planted. To request an lnspecilon made the sante worklng ' you must call 726'3769. Thls ls a24 hour recordlng, All lnspectlons requested be[ore 7:00 a.mday, lnspectlons requested after 7:00 a.m, will be made the followrng work day. vrlll be REOUIRED INSPECTIONS [*l Temporary Etectrlc Rough Mechanlcal - prlor tocover.Flnal Plumblng - When atlplumblng worl( ls complete. ii,:;r ff{ffili;, oJio?,:,i:'" F :r"',: E,ecrr,ca, - pr,or to settlng forms, UnderslabPlumblng/Electrlcal/ rptMechanlcal - prlor to cover. FJ Electrlcal Servlce - Must beapproved to obtaln permanent olectrlcal power.Footlng - After trenches are excavated. ffi rvtasonry - Steel locailon, bond.4 beams, grouting. [-l Flreplace - prlor to factnglJ materlals and framlng lns{ [X Framlng - prlor to cover, Foundatlon - After forms are erected but prlor to concreteplacemont.ry Wall/Celllng lnsulatlon - prlor to cover. tl l'Jflilfl;"1'!:J;:-tins - Prior ffiorvwau - prror to raprns Underlloor Plumblng/ Mechanlcal - Prlor to Insulatlon or decklng. MOBILE HOME INSPE TIONS Wood Stovo - Atter lnstallatlon ffi Post and Beam - prlor to floorLe lnsulatlon or deck!ng. [E ftoor lnsulatlon - prlor to "-+J decklno. !nsert - ,4.f ter flreplace app,-ovai and lnstallatlon of unlt. [-_-l Blocking and Ser.Up - Wnen a,t 'i ht.^^t?t^^ t- ^^_-r_.-rv rr uvrrrPrcle. Curbcut & Approach - Afterforms are erected but prior toplacomcnt ol concrete, Plumbing Connectlons - Whenhome has been connected towater and sewer.Sanltary Sewer - Prior to f llling trench. Storm Sew€r - Prlor to fllilng tren ch. Sldewalk & Drlveway - Af terexcavatlon ls COmpleto, formsand sub-base materlal ln place. Electrlcal Connection - Whenblocklng, set.up, and plumbing lnspectlons have been approvedand the home ls connected tothe servlce panel. Waler Llne - Prlor to filling trench.' Fenco - When completed. Bough Plumblng - Prlor to cover. Final - After all required lnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled. C,I -7 LiTn FLOOD PLAIN: zoNlNG "oo.,ln [Q ntnat Etectrtcat - When ail f electtlcal work Is comptete. TFFrtnat Mechanlcal - When atr f mechanical work ls complete, E(DFtnat Buitding - When ailf requlred lnspections have been/ approved and bullding is completed, tl tl fi:. t :' Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Typr - l' lor\/ - Corner - Panhandle - Cul-de-sac Setback PL.HSE GAR ACC N S E IS THE PROPOSED WORK IN THE . HISTOBICAL DISTRICT, OR ON THE HISTORICAL REGISTEB? - lf yes, thls appllcailon must be slgnedand approvecj by the Hlstorlcal Coordinator prlor to permlt lssuance, APPROVED: Total Value Building Permit Fee State Surcharge 3.t3 Total Fee iBUILDING PERMIT VATUE 4rffi* Chth 232,t 5. ql /o*??_ sl(A) SO. FT, X $/SO. FT, L1 -ts t.88 ITEM Main G arage Carport GS_3365.* BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT This permlt ls granted on the express condiilon that the saidconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprln gulatlng the construcilon and use of ewed ByPI r/nr /:s / DatA -(r, a3 By: gfield, includlng theDevelopment Code, re ay be suspended or revoked at any tlme any provislons ol sald ordlnan ces. tFlec 4-l12 bulldlngs, and m upon violation of Plan Check Fee; Date Paldt Becelpt Number:, SYSTEMS DEVELOPMENT cHARqE (SDC) (B) {4L&Systems Development Charge ls due on all undeveloped propertles wlthln the City llmits whlch are belng lmproved, Besldential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE (c) N0 FT. FT, FT. Plumbing Permlt State Surcharge Tolal Charge PLUMBING PERMIT ITEM Fix tu res ADDITIONAL COMMENTS By slgnature, r state and agree, that r have caref uily examrnedthe completed appllcailon and do hereby cerilfy that alllnformatlon hereon is true ancl correct, and I f urther cerilfythat any and all work performed shall be done in accordancewlth the Ordlnances of the Clty of Springfield, and the Lawsof the state of oregon pertarnrng to tho work descrrbedhoroln, and that NO OCCUPANCy wlll be made of anystructure wlthout permisslon of the Bulldlrlg Safety Divislon.I further certlty that only contractors and employees whoare ln compllance wlth OFS 7O1.OSS wlll be used on thlsprolect. I further agree to ensure that all required lnspecilons arerequested at the proper ilme, that each address ls readabrefrom the street, that the permlt card ls located at the frontof the property, and the approved set of plans wilr remarnon the slte at all ilmes durlng construcilon. Date l^/,^ir-. Slgnature MISCELLAN EOUS PERMITS Moblle Home State lssuance State Surcharge Sidewalk -_..-- ft Curbcut .-._- ft Demolitlon State Surcharge Total Mlscellaneous permlts (E) l\,lECHANICAL PERMIT Fu rn ace Exhaust Hood Vent Fan No Wood Stove/ lnsert/Fireplace Unit Dryer Vent Mechanlcal Permlt lssuance State Surcharge Total Permlt (D) VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVEDToTAL AMOUNI DUE (excludlng etectrtcat) 7&. t&(A, B, C, D, and E'Comblned)RECEIVED BY ?--2 9-9 I tA-