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Home My WebLink AboutPermit Building 1992-08-035P't ELD RESIDENTIAL PERMIT APPLICATION I ns pec tions: 726'3769 Olhce:728.J/li$ LO()AIION Ot: I)ROPOSED WOR -o3 -zb- y*L 225 Fifth Street Sprlngfield, Aru\on 97 477 Qrnpr TAX LOT:odo ASSESSOR UOt: -7 S I.,4AP BLOCK: --... Z SUBDIVISION JaZa-Z" ?rt,ne-PHONE:?26'O by' OWNER: , ADDRESS:3a ?q2 q t(S /3 ",rr, =?_nhr0,izl4 STATE:()p ZIP:77 y7t *.Ir e.e DESCFIIBE WORK NEW '=_-., REMODEL --- ADDITION DEMOLISH OTHER ADDFIESS CONST. CONTRACTOR #EXPI RES PIlONECONTRACTON'S GENERAL: -. -o uche NAMEB MECHANICAT-: - PLUMBING: ELECTRICN L f lRl)LO SE_ OFFICE RANG tr:WATER HEATI-R OUN D AREA: f OF BLDCS # ot'UNITS: ()ON:]IR, TYI'I:: LAND USE: --T L HEAT SOURCE: ----- SECONDARY HEAT SOUARE FOOTAGE: FLOOD PLAIN: ZONING CODE r OF RDF]MS: To request a^ inspection, you rnust call 126-316g. Thls ls a24hour recorcllng. All inspections requested before 7:oo a'm will be made the sanre working day, inspections requested after 7:00 a.m. will be made the following work day' REQUTRED INSPECTIONS ,XremPorarY Electric Rough Mechanical - Prior to cover.,K Final Plumbing - When all plunrbing work is comPlete. Site lnspectlon - To be tnade af ter excavation, but Prior to setting forms. Rough Electrical - Prior to 'lVf rinal Electrical - when all ,J^\.qtu"ttical work is cornplcte.cover. Unclerslab Plumbing/ Electrical / Mecharrical - Prior to cover. lV electrical Service - Must be[A\rplrroved to obtain Pertnanent electrical Power. Final Mechanical - When all mechanical work is cornPlete. ,K Footing - Aftr.:r trenches are excava tc'd.Fireplace - Prior to facing materlals and lramlng lnsP. lV final Building - Wltert :tll Aequired inspections havc bt;crl approved and building is completecl. Framing - Prior to cover Other -- --..- -.- NZf Foundation - Af tor forms arcA("r""t"tl trtrt ptior to corlcrt.l le Placcrletlt. Wall/Ceiling lrrsulation - Prior to cover. Underground Plumbing - Prior to filling trenct).Drywall - Prior to taping MOBILE HOME INSPECTIONS )<J,i:ll,chanical Wood Stove - After installation.or deckirrg. Post and Beam - Prior to floor insrrlation or decking.lnsert - After firePlace aPProval an(l Installation of unit. Blocking and Sel'UP - When all blocking is cotnPlete. Floor lnsulation - Prior to deckingl.Curbcut & ApProach - After forrns are erected but Prior to placement of concrete. Plumbing Connections - Wlterl home has been connected to water and sewer. E X Sanitary Sewer - Prior to f illing trench.Electrical Connection - Wherl blocking, set-up, ancl Plumbing inspections lrave been aPProved and the home is connected to the service panel. Storm Sewer - Prior to f illing trench. Sidewalk & DrivewaY - After excavation is conlPlete, forms ancl sub-base malerial in Place. IVI wutor Line - Prior to fillingAtglrencn. Ferrce - When completed' Rough Plumbing - Prior to Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. lurnbi cover ,uB NUMBER -/azzo OC()Y Cill()tJl' r OF STOFIE:]: r Masonry - Stt:cl location, bond bearrts, {Jroutirl(J. tl t_l t_l fl fl tl tl Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type .\\-Setback PL.HSE GAR ACC N S E lnterior *Corner Panhandle Cul-de-sacA{ THE PROPOSED WORK IN THE -I-fISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? --lf yes, this application must be signed and approved by tl're l-listorical Coordinalor prior to pernrit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is g;ranted on the express conditiorr that the said construotion sh;rll, in all respects, conform to tl)c Ordin;rnce a<lopted by tlre City of Springfielcl, irrcluding the Development Cocie, reglulating the construction and use of buildings, and nlay be suspencled or revol<e<l at any time upon violation of any provisions of said orditr;ttrr:cs' Plan Check Fce:- Zt -l:- /ry#- -_2_!_ BRecei Flcviewed Date Paid Receipt Number:-. BUILDING PERMIT VALUE ?rD=Fotl-- 5A (A) SO. FT. X $/SO. FT. ? ITEM Main Garage Carport Total Value Building Permlt Fee State Surcharge Total Fee Systems Development Charge is due on all undeveloped properties within the City limits which are beirrg irnproved'SYSTEMS DEVELOPMENT CHARGE (SDC) F (B)-{ ADDITIONAL COMMENTS t5__ PLUMBING PERMIT FEE N0 o a 1OOFT. @ 7s(c) O Statc rcharge oo it FT. < Bath(s) Sewer Total Charge Plumbing ITEM Fix t u res Water Storm Sewer Mobile Home Residen Sanitary %3. Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT (D) No Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined the complete<J application and do hereby certily that all information hereon is true and correct, and I f urther certif y that any and all work performed shall be done in accordance with the Ordinances of tl.re City of Springfield, and the Laws of the State of Oregon pertaining to the work described lrerein, and that NO OCCUPANCY will be trratle of any structure without perrnission of the Building Sa(cty Division' I f urther certify that orrly contractors and etnlrloyees who are ln compliance witlr ORS 701.O55 will be trsed on lhis proiect. I f urther agree to ensure that all required insl)e(;tions are requested at the proper tinle, that each addre:;s is readable from the stteet, that ttre pcrrnit card ls localt-'rl at the front of the property, and ttre ;rllproved set of plarrr'; will retttain gnaturc. Date - on lhe sitc at I titrrr.':; <lt rring construclion MISCELLANEOUS PERMITS Mol;ile Home State lssuance State Surcharge Sidewalk - ---- ft Curbcut -- lt Demolition State Surcharge Total Miscellaneous Permits (E) 57 65 ',DATE PAID AMOUNT FIECEIVED FIECEIVED BY, VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined)3 7- P/itrgai 2 t ,- s @ SPFINGFIELE) RESIDENTIAL PERMIT APPLICATION lnspections:726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: 4zCq?-D 2fr, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 t44L N U't^ ASSESSORS MAP:il ob'z b 4L TAX LOT loo o LOI - BLOCK:SUBDIVISION AwP-PHON E: D?-ZIP:STATE: -0OWNER: ADDRESS: CITY: NEW - REMODEL ADDITION DEMOLISH OTHER r- .d-,.q*sf 4o^5DESCRIBE WORK: ADDRESS EXPIRES PHONE d CONTRACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTFIACTOR # GENERAL: PLUMBING RANGE: * OF BDRMS: - OFFICE USE _ LAND USE: ZONING CODE: FLOOD PLAIN: WATER HEATER: * OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: QUAD AREA: * OF BLDGS: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This ls a 24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Eleclric Rough Mechanical - Prior to Final Plumbing plumbing work - When all is complete. Site lnspection - To be made after 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. Electrical Service - Must be approved to obtain permanent electrical power. ffi'finat Mechanical - When all ,ftmechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to faclng materials and framing lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. OtherFoundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.[--l Drywall - Prior to taping. MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Slove - After installatlon. Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and lnstallation of unit. Blocking and Set.Up - When all blocking is complete. Floor lnsulation - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.Electrical Conneclion - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Storm 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 completed Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Rough Plumbing - Prior to cover. {i"b4 4/rn/o4 24/-119,6/ E E E E E E tl tl tl r Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type v - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E -HE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the H istorical Coordinator prior to permit issuance. 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 provisions of said ordinances. Receipt Number:- Plans Reviewed By Date Plan Check Fee: Date Paid Received By: (A) X $/SO. FT. : VALUE Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtu res Resldential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent .hl,r,tD. /5 00 /c.e" (D) No ?- ,7f Vent Fan Mechanical Permit lssuance State Surcharge Total Permit z;,75 MECHANICAL PERMIT Fu rnace Exhaust Hood 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 f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, 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 ln compliance with ORS 701.055 wlll 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. Date )Gnature MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) :3DATE PAID -,.7 f / 2-. AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) "-'- -t'/'J,1a t '< \. /ca sr SP,lI}.GFTELO fro?zRESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office; 726-3759 LOCATION OF PROPOSED WORK: Zfr, JOB NUN/BER 225 Fifth Street Springfield, Oregon 97 477 lsq z l/, 6fl{ ASSESSORS MAP:l) ozau q 2-TAX LOT:OICOO LOT BLOCK: PHONE: \5q ztPSTATE: N lJL- o uG4 CITY: ADDRESS: OWNER..- DEMOLISH OTHER DESCRIBE WOFIK NEW -- REMODEL ADDITION ELECTRICAL: - PHONE l/ ff{5 -etGENERAL: EXP FIES t(7 'S NAME fuorHa 1t tIIr MECHANICAL: CONTRACTOR PLUMBING ADDRESS CONST. CONTRACTOR # .r45 N 2R /,/ ^/ WATER HEATER:RANGE: FLOOD PLAIN: - ZONING CODE _ OFFICE USE _ # OF BDRMS: - OCCY GROUP: A OF STORIES: QUAD AREA: , OF BLDGS CONSTR. TYPEr HEAT SOUFICE: LAND USE: # OF UNITS SECONDARY HEAT: SQUARE FOOTAGET To request an inspection, you must call 726-3769. Thls is 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 Electric ll Rough Mechanicat - Prior to cover.w Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after 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. Electrical Service - Must be approved to obtain permanent electrlcal power. Final Mechanical - When all mechanical work is complete. Footlng - After trenches are excavated.Fireplace - Prior to faclng materials and framing lnsp. Flnal Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover, Underground Plumblng - Prior to filling trench.Drywall - Prior to taping. MOBILE HOME INSPECTIONS Underlloor Plumblng/ Mechanical - Prior to insulation or decking.Wood Stove - After installation. Posl and Beam - Prior to floor insulation or decking.lnsert - After fireplace apProval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decki ng.Curbcut & Approach - 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 f illing trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filllng trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench. Fence - When completed Streel Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.W Rough Plumbing - Prior to cover. E SUBDIVISION: fl E tl tl Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type - lnterior _-- Corner - Panhandle - Cul-de-sac backs P.L.HSE GAR N S lS : PROPOSED WORK lN THE HISiORICAL DISTRICT, OFI ON THE HISTORICAL REGISTER? -_-- lf yes, this application must be signed and aPProved bY the Historical Coordinator prior to permit issuance' APPROVED:E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said consiruction shall, in all respects, conform to the Ordinance aOopteO by the City of Springlield' including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances' Receipt Number:-- DatePians Reviewed BY Received BY: Plan Check Fee Date Paid: BUILDING PERMIT VALUE (A) SQ. FT. X $/SO. FT.ITEM Main Garage Carport Total Value Bullding Permit Fee State Surcharge Total Fee Systems De'reloprnent Charge is due on all undeveloped properties within the City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (S (B) DC) ADDITIONAL COMMENTS ITEM Flxtures Resldential Bath(s) SanitarY Ser,lver Water Storm Sewer Mobile Home PLUMBING PERMIT zs;2_C I4o'@ FEE4o No FT. +oFT. FT. (c) I 7 -odPlumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent MECHANICAL PERMIT (D) No Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all informationhereonistrueandcorrect,andlfurthercertify 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 proiect. 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 ls located at the front of the property, and the approved set of plans will remain on the site at all times during construction' Signature Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -_---- ft Curbcut =.-- ft Demolition State Surcharge Total Miscellaneous Permits (E) q0z o G- J.oo VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY -_-_ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) l4z,p ,b I I 2.25 IJII."TII l;TRI.:IiT sPtuNGFIIiLl), oltl':Gol{ 97 47'l INSPIfGI'I0N REQUIISI': 7?.6-3'169 Otrl'ICIi: 7).6-\751) ILBCTRICAL PTNTHIT APPLICATION Ci ty Job Number COHPLU'TII P E SCIII1DULII DIILOU Nev Residentlal-Single or MuI t l-Family per dr.relling uni t. Servlce Incltrded:Items Cost 1.000 sq.ft. or less Each addltlonal 500 sq. ft or portlon thcreof Each Manuf 'd tlome or Modular Dwelling Scrvice or Feeder $ Bs.oo $ 1s.00 $ 40.00 Scrvlces or Feeders Installatlon, Alteratlons or Relocatlon: n 200 amps or less 1 201 anrps to 400 amps - 401 amps to 600 amps - 601 amps to 1000 amps- Over 1000 amps/voIts - Reconnect onIY Al 200 amps or less 201 amps to /r00 amPs - over /r01 to 600 amps _ 0ver 600 amps or 1000 volt 0 ALLA t|,f s ltl q7 LV? I c D Pcrnrits arc non-transferable ancl explre 1f vork is not started vlthin 180 days of issuance or it vork ls suspentled for 180 days. 2. CO}N.RACTOR INSTALIJTTION ONLY lilcc t rical Con t rac tor o lt) Add r:ess Z ttrone 3W*53?{ Sum 40.00 5s.00 80.00 s see trDx a[ove .00 .00 .00 .00 .00 .00 $s0 $60 $100 $130 $300 ]N Ci ty Supervi.sor License Ntinrtrcr 36 {Lt "5 Iixpi ra t i ott Da te Temporary Services or Feeders InsiaIIatlon, Alteration or Relocation /r0$ s $ $ Con:;tr Cotltr. Number llr qL/ Iixpi ra t ion Da te {-zs 3 Signa rc of Supcrvising [Icctrician Ounc rs Arld r cs s ci t Plronc ALLATION Tlre ittstallation is being nrade on property I ovn vl'rich is not intended for sa1e, Iease or rent. Ovncrs Slgnaturc: Dranch Clrcul ts Nev, Alteratlon or Extenslon Per Panel one clrcuit $ 35'oo Eaclr Addi t ional Circui t or vi tlr Servicg. .r or lreeder Permit '--\2O S 2.00 l'liscellaneous (Servlce/feeder not incltrded) -Eaclt installation Plrmp or irrigation $ 40'00 E suroTAL 0t, ADoVB 5f State Surclrarge TOTAI, DATE: RNCNII'T tili(:r.:Ivl:t) ItY 5 oo ai,; i ,t t. lo-r RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 O{fice: 726-3759 LOCATION OF PROPOSED WOFK: SPFrIhl IELD \ Ea.ar2_ l..Jo q ?dLo h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT:A\ooO \.\a# LOr:_ BLOCK SUBDIVISION PHONE: ZIP:STATE:aee lDCIF I e-l.r) \5 CITY: OWNER ADDRESS:\coZ DESCRIBE WORK: NEW--REMoDELADDITIoNDEMoLISHoTHER 4+L 1 -b EXPI RESADDRESSCONTRACTOR'S NAME MECHANICAL: ELECTRICAL PHONE 7- CONST. CONTRACTOR # C EN ERAL: PLUMBING Bo.rctr'<, Corltt _ OFFICE USE - LAND USE: # OF BDRMS QUAD AREA: A OF UNITS: FLOOD PLAIN WATER HEATER SECONDARY HEAT: SOUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: RANGE: ZONING CODE: OCCY, GROUP: e OF STORIES: To request an inspection, you must call 726-3769. This is 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' REOUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. 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 1 Mechanical - Prior to cover. Electrical Service - Must be approved to obtai n Permanent electrical power. Final Mechanical - When all mechanical work is comPlete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and f raming lnsP. Final Buildlng - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but Prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trcnch.I-l Orywall - Prior to taoing MOBILE HOME INSPECTIONS Underlloor Plumbing / Mechanical - Prior to insulation or deckinq.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After f ireplace aPProval and rnstallation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulalion - Prior to decki ng.Curbcut & Approach - After forms are erected ilut Prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prror to filling trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is cornplete, forms and sub-base material in Place. Water Line - Prior to filling trench. Fence - When completed Strecl Trees - '.Virer. ail required trrcs aie Fllanted. Final - After all required inspections are approved and pcrches, skirting, decks, and venting have been installed. x Rough Plumbing - Prior to cover. l---.-.rli ASSESSOHS MAP:t-?6a 2-(- \PzL LrE- L},44 E t-_l E I r tl E tl tl tl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type Seti:acks rHE PROPOSED WORK IN THE ITfSTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? --_- lf yes, this application must be signed and approved by the H istorical Coordinator prior to permit issuance. API]ROVED: ln terior Corner Panhandle Cul-de-sac I PL N 5 E ACC I BUILDING PERMIT ITEM SQ. FT. Main Garage VALU E (Ai X $/SQ, FT. Carport Total Value Building Permit Fee State Surcharge Total Fee BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT 'this pernrit is granted on the express condition that the said construction sh;rll, in all respects, conform to the Ordinance adopted by thc City of Springfield, including the Devclopmerrt Code, regulating the construction and use of buildings, anrj nray be suspended or revoked at any time upon violation of any provisions of said ordinances. Pl;rrrs Rcvir:wcrl 8y Date PIan Clreck Fee Date Paid Reccipt Nurnber: Received By SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developrnent Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Flesidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE N0 FT. 160 -4o,oQ Fi. (c) PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsertl Fireplace Unit Dryer Vent N0 (D) MECHANICAL PERMIT Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hoidt Vent Fan By signature, I state and agree, that I have caref ully examined the completed application 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 the Ordinances of the City of Springfield, and the Laws of the State o[ 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 witlr ORS 701.055 will be used on this proiect. I f urther 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. Y.rN,Sig natu re 23Date4__/? /2a MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E)fqf (p-q- AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER DATE PAID _ b TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 4L,ab FT. 4c)'@ 2,o o 4z,ab 4.a.-