HomeMy WebLinkAboutPermit Change 1993-05-21SPRI}rGFIELDRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PFIOPOSED WOR
ASSESSORS MAP:
SgS
JOB NUMBER
225 Fif th Street
Springfield, Oregon 97
(9@
TAX
SUBDIVISION
6a=*3so 1PHONE:
(}€-STATE:ZIP:
e
aO
()
t.OWNER:
ADDRESS:
CITY:
\-/
NEW ,.\ REMODEL ADDITION D SH
-
OTHER
DESCBIBE WOFIK:
ADDRESS PIFt t)t-loNE
6633frOAue
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR //
GENEBAL:
PLUMBING
\,\
c U
I
t'-\
RANGE
# OF BDRMS:
WATER HEATEFI
ZONING CODE:
FLOOD PLAIN:
SECONDARY HEAT:
SOUARE FOOTAG
QUAD AREA:
# OF BLDGS
OCCY GROUP:
g OF STORIES;
CONSTB. TYPE
HEAT SOURCE:
LAND USE:
# OF UNITS
To request an inspection, you rnust call 726-3769. This ls a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
[-l Temporary ElectricL---J Rough Mechanical - Prior to
cover.
Final Plumbing - Whe,n all
plurnbing work is comlrlete.
Site lnspection - To be made
af ter excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Eleclrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - Wrren all
me<;hanical work is cornplcte.
Fooling - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
m Final Building - When all
required inspections harve been
approved and building,s
completed.Masonry - Steel location, bond
beams, grouting.
IFI Framing - Prior to cover.
w OtherFoundation - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping.
MOBILE HOME INSPEgflOtlS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Bearh - Prior to floor
insulation or decking.lnsert - After f lreplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.'
Floor lnsulalion - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
honre has been connected to
water and sewer.
Sanilary Sewer - Prior to f illing
trench.Electrical Connection - When
blo<;king, set-up, and piurnbing
inspections have been approved
and the horne is conn€.cted to
the service panel.
Slorm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completcd
Slreet Trees - When all required
trees are planted.
Final - After all required
inspections are approv(,:d and
porches, skirting, decks, and
venting have been inst;rlled.
Rough Plumbing - Prior to
cover.
LOT:
-
BLOCK:
7z4q
Al< ^,' b o,r>e-oe
E
E
fl
tl
E
tf
[]
tl
E
r
E
r
IS THE PROPOSED WORK IN THE
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER? --
lf yes, this application must be signed
and aPProved bY the Historical
Coordinator prior to permit issuance'
APPROVED
ACCHSE
I
I
Lot faces
Lot sq. {lg
Lot covera,qe
TopograPhY
Total heigltt
PL.
E
N
6J
Setbacks
GAR
dBv
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
ccrnsiruction shall, in all respects, conform to the Ordinance
f4*DateD
hencdUnnflfidSsheosodtevpadbyp
a ouSEndhconeruonuansomnegDevep
m erevoorkedanybeUSedndpeay
d rdo n ceanSASany
Date Paid
Recei pt Number:
buildings, and mr
upon violation of
Plan Check Fee:
Received BY: l,-
J{[- .rlij5'-:,#?1BUILDING PERMIT
(A)
/y,
_z--
fb
77_
ITEM
Mairr
G aragc
Caroort
-'\
Tot;rl Valutl
Buildin<1 Pcrnrit Fee
State Surclrarge
Tot;rl Fee
Systems Development Charge is due on
properties within the City limits which are being improved
all undevelopedSYSTEMS DEVELOPMENT CHAR
(B)
GE (SDC) 6
# 6q4
ADDITIONAL COMMENTS
Res;identir,l Rath(s)
Sanitary Sewer
Waler
Storm Sev/er
Mobile Hc.me
PERMIT
FEE
NO
F-r.
FT,
FT.
((- )
Plumbing Permit
State Su rc harge
Tot;rl Charge
PLUMBING
ITEM
Fixtures
Wood Sto've/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
Mechanic;rl Pormit
(D)
NO
lssuance
State Sur( harge
Tolal Pernrit
Furnace
Exhaust Hood
Vent Fan
By signature, I state ancJ agree, that I have caref ully examined
the completed appl c3tion and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with tre 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 rnade of any
structure without permission of the Building Safety Division'
I further certify that only contractors and employees who
are in compliance with OHS 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, ancl the approved set of plans will remain
on the site at all tinles during construction.
Signatu re
Date
.'7 rlc-
MISCELLANEOUS PERMITS
Mol;ile t-lomc
State lssuance
State Ilrlr( har0e
Sid evvalk f t
Curbcut -- ---- f t
Dernolitiorl
State Sur( harge
Total Miscellaneous Permits (E)
.89?9q=
Flt:Ct:IVED BY --
,AT"4OUIJT RECEIVET)
DATE PAID
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding clectrical)
(A, B, C, E', and E Conlbined)
/a/?2
Lot TyL,e
-- - lnterior
-.-
Corner
--- Panhandle
--
Cul-de-sac
Code,
at
JoB No. 1zo z xgCIIY OF SPRINGFIELD sYsTEI,,5
WORKSHi#r.L0pr,tENr CHARGE
(c0fir,ERCIAL & RESrDEtrrrAL)
NAME OR COMPANY:
LOCATION:5 I Loo o - o(tb
DEVELOPMENT TYPE:
BUILDING SIZE:'3 *zt NC ee
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x - x $401.05
SIZE . Ft.
X $39.78 PER PFU
$
s
SUBT0TAL (ADD iTEMS I,2, & 3)$lzE
TAL-CITY $55
x $13.62 PER PFU + $10 Mt,lMC ADMIN. FEE $
I STO DRAI
NO. OF PFU'S
(See Reverse)
E
TMPERVIOUS SQ. FT 217 x $0.192 PER SQ. FT
2. SANITARY SE[^IER-CITY
X
X
x $401.05
x $40i.0s
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X .05
5. SANITARY SEWER-MI,,IMC
NO. OF PFU'S
(Use PFU Total From Item 2 Above)
MhlMC CREDIT IF APPLICABLE (SEE REVERSE)
)AB*I^,L 5 'tqt
SDC Coordinator
TOTAL-MWMC SDC
TOTAL SDC s 6so!
o4
CcZ-