HomeMy WebLinkAboutPermit Building 1995-05-31a4v
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP;
LOT [o BLOCK:
rlI]tGFIEL1)
Z- Zoo
JOB NUMBER
225 Fif th Street
Sprlngf leld, Oregon 97421
TAX LOT:
SUBDIVISION 1^ra.^,tt 5+t, lil Aa/,
OWNER:PHON E:
STATE:CITY:
V'
ADDRESS:
NEW
-
REMODEL ADDITIoN 1.., DEMoLISH oTHER
-
?DESCFIIBE WORK:
I
CONST.
CONTRACTOB 'AODR EXPIRES PHON E
CONTRACTOR'S NAME
GENERAL:
PLUMBING;
MECHANICAL:
ELECTRICAL:
FLOOD PLAIN
\
E:
\rt \
LDTL
- OFFICE USE -
RANGE:WATER HEATER;
SECONDABY HEAT:
SOUARE FOOTAGE:
ZONING COD
, OF BDNMS:CONSTR. TYPE:
HEAT SOUBCE:
LAND USE:
# OF UNITS
OCCY GROUP:
N OF STORIES:
QUAD ABEA:
I OF BLDGS:
To req
made
uest an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng, All lnspectlons requestecl before 7100 a.m. w,t bethe sarne worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
l-l femporary Etectrlc
Slte lnspectlon - To be madc
af ter excavatlon, but prlor to
settlng forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement,
Underground Plumbing - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to., lnsulatlon or decklng.
Post bnd Beam - Prlor to floor
lnsulatlon or decklng,
Floor lnsulatlon 4 Prlor to
decklng.
Sanltary Sewer - Prlor to fllling
trench.
Slorm Sewer - Prlor to fllling
kench.
Water Llne - Prlor to filling
trench,
Rough Plumbing - Prior to
cover.
Rough Mechanlcal - prlor to
cover.
Rough Electrical - Prlor to
cover.
Electrlcal Servlce - Must be
approvecl to obtaln permanent
electrlcal power.
Flnal Plumbing - When altplumblng work ls complete.
Flnal Electrical - When allelectrical work is complete.
Final Mechanlcal - When ail
mechanlcal work ls complete.
Flnal Buildlng - When ailrequlred lnspectlons have beenapproved and building ls
completed.
Other
MOBILE HOME INSPE TIONS
Blocklng and Set.Up - When ail
blocklng ls complete.
Plumblng Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set.up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspections are approved andporches, sklrting, decks, and
ventlng have been lnstalled.
tr
tr
tr
F
tr
tr
Fm
m
tr
ry
ry
F
ry
ry
ry
l-l rlreplace - prtor to factng
-
materlals and framlng lnsp.
F
tr
tr
Framlng - Prlor to cover.
Wall/Celllng lnsulatlon - Prlor to
cover.
Drywall - Prlor to taping
Wood Stovo - After lnstallatlon.
lnserl - Aftor flreplace apprgval
and lnstallatlon of unlt.
Curbcut & Approaclr - After
forms are erected but prlor toplacement of concrete.
Sldewalk & Drlvewav - After
excavatlon ls complete, forms
and sub.base material ln place.
[-l Fence - When completed.
Stre€l Troes - When all requlred
trees are planted.
o Vo?
zre, ?7)'-
5R\)\,D
ACS
E
E
r;i
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty
!,i.no,
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PBOPOSED WORK IN THE .
HISTORICAL OISTBICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordinator prlor to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
s
E
State surchargu tl.5o + \.51
VALUE
*2R
[g{. €q
r\E
\tg-qTotal Fee
l; ,
2
(A)
X $/SQ. FT.
ft-z
Total Value
Building Permit Fee
BUILDING PERMIT
ITEM SO. FT,
Main
Garage
Caroorth--
Beviewed By sbls,\I D5G
Date Pald
Beceipt Number:
Received By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHA
#''J7Y RGE (SDC) ,;##YP Systems Development Charge is due on all undeveloped
properties withln the City limits which are being lmproved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Slorm Sewer
Moblle Home
FEE
30. qa
39.@
3
19
(c)
N0
FT.
3&.'lp
l,SO+ .tO
PLUMBING PERMIT
FT.
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
't_) r\q\\-s-
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
Mechanlcal Permit
lssuance
State Surcharge .?S+ .{5
Total Permlt (D)
MECHANICAL PERMIT
\S. E
cl5
crr)j
,E9\-;,--89-
+b-
Furnace
Exhaust Hood
Vent Fan Nol
By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and cofrect, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the Clty of Sprlngfield, and the Lawsof the State of Oregon pertalning to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout permlssion of the Bullding Safety Dlvlslon.I further certify that only contractors and employees who
are ln compllance wlth OHS 701.055 will be used on thtsprolect.
I further agree to ensure that all requlred lnspections are
requested at the proper ilme, that each address ls readable
from tho street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the slte at all times durlng constructlon.
Slgnature
Oate _-
MISCELLANEOUS PERMITS
Mobile,Home
State lssuance
Stato Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permls (E) 6
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Comblned)
3Eq1 1 3
BY
VALIDATION:
RECEIPT NUMBER
AMOUNT R
RECEIVED 1
DATE PAID
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMTT
Thls permlt is granted on the expre6s condition that the sald
construction shall, ln all respects, conform to the Ordlnance-- adopted by the City of Sprlngfleld, includlng the
Development Code, regulating the constructlon and use ofbulldlngs, and may be suspended or revoked at any tlme
upon violation of any provisions of said oldlnances.
?)K
er/€a
FT.
€ lz- 7 ;-, r'a-,
\b.9.e
CITY OF SPR'INGFIELD, OREGO'V
The lollowlng proiect ss 5rjh,.nillcr't f. r. ,. ,
zonlng, 8nd do€s ngt rc..!,., .l 3pv...: ,. ;.:ii#
appro/al.
zonins La,D€-- -*
llr7g1vb -zt < '-
225 PIYIH STREET
SPRINGFIELD OREGON 97
INSPECTT0N REQUBST: 7
OFFICE: 726-3759
1.
JOB ON
APPLICATION
SCEEDTILE BELOII
A. Nev Residential-Sing1e or
MuIti-Family per dvelling unit.
Serviee Included:Items Cost
SPIII,llGFIELD
:rii)
1-000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Auhorized N
Ctfui&f-
Sum
$ 8s.00
$ 1s.00
$ 40.00
$ s0.00
$ 60.00
s100.00
$130. 00
$300.00
$ 40.00
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 INSTALI,ATION ONLY B
Electrical Contrac ror rs*uE ol/ E@/Etc
Address ?O , &d,r
Ci ty E
supervisor License Number H73 =S
Expiration Date c
constr contr . ttu ver 5(2O97
Expiration Date
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less L201 amps to 400 amps -
40L amps to 600 amps
-
601 amps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect 0n1Y
Temporary Services or Feeders
Insiallation, Alteration or Relocation
200 amps or less $ 40'00
over 4b1 to 600 amps -l $ 80.00
or"r OoO ;p; or rboo voTts see ngrr ,ffi-
Branch Clrcuits
Nev, Alteration or Extension Per Panel
One circuit $ 35'00
U""f, eaaitional-ci;";it or vith Service,
or Feeder Y"r^it""- ' -/ S 2. oo ,'qOT-
Miscellaneous (Service/feeder not iicltded)
v
Signa
Address
of ising Electrician
D
Ci ty Ph"".7?U-+ffi/
OIINER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
Ovners Signature:
-Each installation
Pump or irrigation
-
Sign/Out1ine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
E
$
$
$
$
40.
20.
40
36
00
00
00
00
5
DATE:
RBCEIVED
,
o0
PhoneS%729
l No. l5oaoo
CITY OF SPRINGFIEI,D SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0HMERCIAL & RESIDENTIAL)
NAME OR COMPANY:
LOCATION:l44a Yol+^toR t?o'>24 bz- o 2400
DEVELOPMENT TYPE:LDR- APEITtoLI
lNcr-uDe
BUILDING SIZE:1{.
1. STORM DRAINAGE
IMPERVIoUS SQ. FT.
2. SANITARY SEt.lER.CITY
NO. OF PFU'S
(Use PFU Total From Item 2 Above)
Mt,ll4c CREDIT IF APPLICABLE (SEE REVERSE)
5 e.^\e9+2*\o SIZ
77o x $0.209 PER SQ. FT.
X $43.26 PER PFU
$
$
x $17.19 PER PFU + $10 MIIMC ADM FEE $
a. Fr.
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x - x $436.19
x _ x $436.19
X x $436.19
4. SANITARY SEWER-MWMC
5 AD1'4INISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
TOTAL-Ml,lMC SDC
suBTorAL (ADD ITEMS 1,2,3 & 4)2o+aL
?+ot
1
Kip Burdick
SDC Coordinator
?-o473
Date: 5 It
TOTAL SDC Zt5 oGZfuL-J.-