HomeMy WebLinkAboutPermit Building 1993-02-15SPFrINGFIELE}
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Oflice: 726'3759 ert,
JOB NUMBER
225 Fifth Street
Spring{ield, Oregon 97477
9 A./<zQ .62-.
LOCATION OF PROPOSED WORK:22
ASSESSORS MAP:TAX LOT:e/ze?
SUBDIVISION:
LOT:BLOCK:
PHONE:
ztPSTATE:
?-7
CITY:
ADDRESS:
OWNER:
DESCRIBE WORK:
- -
NEW
PHONEEXPIRESDCONTRACTOR'S NAME
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
MECHANICAL:
- OFFICE USE _
I OF BDRMS:
FLOOD PLAIN
# OF BLDGS: -
SECONDARY HEAT:
SOUARE FOOTAGE:
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
LAND USE:
# OF UNITS
occY GROUP'.
---, OF STORIES:
rd AI n spect NS req UES ted be to re 7:00 a.m it be
pect mu St c al 7 26-3769 T hi S S a 24 hour rec o ng
To requ CS n ns o you
7:00 be made he fol ow ng work d ay.
d pe ct on S req ues te d aft er a.m.
ma de he S ame wo rki n s ay,NS
R EOUIRED INSPECTION
Rough Mechanical - Prior to
cover.
S
f-l TemPorarY Electriclr
Final Plumbing - When all
plumbing work is comPlete'
Site lnspection - To be made
after excavation, but Prior to
setting {orms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover'
Rough Electrical - Prior to Final Electrical - When all
electrical work is comPlete'cover.
Electrical Service - Must be
approved to obtain Permanent
electrical Power.
Final Mechanical - When all
mechanical work is comPlete'
Footing - Alter trenches are
excavated 'l-----l Fireolace - Prior to facirrgI I materials and framlng insP'
W Final Building - When all
reouired insPections have been
approved and building is
completed.
Masonry - Steel location, bond
beams, grouting'
Foundation - After forms are
erected but Prior to concrete
placement.
Underground Plumbing - Prior
to filling trench'
Underlloor Plumbing/ Mechanical
-'Pii"t to insulation or decking'
Framing - Prior to cover'
Other
Wall/Ceiling lnsulation - Prior to
cover
[-_l OrYwall - Prior to taPing
MOBILE HOME INSPECTIONS
Wood Stove - After installation
Post and Beam - Prior to floor
insulation or decking'lnsert - After flrePlace aPProval
and installation of unit'
Ctrrbcut & APProach - After
'{orms are erected but Prior to
placerllent of concrete'
Sidewalk & Driveway - After
extavation is comPlete, forms
ana s,,O'Oase material ln Place'
il Blocking and Set'UP - When all
L-J 51o61a1ng is comPlete'
Floor lnsulation - Prior to
decking.
Sanitary Sewer - Prior to filling
trench.
Plumbing Connections - When
home his been connected to
water and sewer.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
Electrical Connection - When
oioixing, set'uP, and Plumbing .
inip."tions have been aPProved
in,i tnu home is connected to
the service Panel.
[-_l fence - When comPleteoE
l---l Street Trees - When all 'equiredI I tr,ro. are Planted'
Final - After all required
insoections are aPProved and
oot"no., skirting, oecks, and
venting have been installed'
83.?>
will
E
w
E
E
r
E
n
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR
N
5
E
ACC
_ IS THE PROPOSED WORK IN THE
HISTORICAL DISTHICT, OR ON
THE HISTORICAL BEGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordirrhtor prior to permit issuance.
APPROVED
VALUE
a--,/a-/a 7'.? .-
,/lf>
(A)'?=
X $/SO. FT.
2.?v
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pernrit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springf ield, irrctuding the
Development Code, reqyulating the construct jon and use of
buildings, and may bo suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check ree: 28.€<
atevPlans
Date Palil
Fleccipt Numbor:_
Fleccived
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 4 /?
Systems Development Charge is due on all uncjeveloped
properties within the City linrits which are being improvecl.
ITEM
Fixtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/lnseit/Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
By signature, I state anc, agree, that I have carefully examined
the completed application and do hereby certify that allinformation hereon is true and correct, and I f urther certify
that any and all work pcrformed shall be done in accordance
with the Ordinances of the City of Springfield, anrl the Lawsof the State of Oregon pertaining to the work cJescribed
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Building Safety Division.I further certify that only corftractors and employees who
are in compliance wilh ORS 701.0S5 will be used on thisproject.
I f urther agree to ensure that all required inspections arerequested at the propcr tinre, that each address is readabre
from the street, that the permit card is located at the front
approved set of [:lans will remain
Signature
Date
of the property, and t
ime ring construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut _ ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding etectricat)
(A, B, C, D, and E Combined)
VALI DATION
RECEIPT NUMBER -
DATE FA|D
--kS
-3=ao
AMOUNT RECEIVED
on the site
RECEIVED BY
,.Iftlr-
NAME OR COMPANY:
LOCAT ION :
JOB NO.?=7
,2
ATTACHMENT BI
CITY OF SPRINGFIELD SYSTE}4S DEVELOPHENT CHARGE
ItI0RKSHEET
(coHl,lERcIAL & RESIDENTIAL)
4
DEVELOPHENT TYPE:
OT SIZE SQ
$15.125 PER PFU + $lO }'Il,lMC ADM FEE
2 Above)
s
NO. OF PFU'S
(Use PFU Tota
HltMc CREDIT IF APPLICABLE (SEE REVERSE)
ADHINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABoVE) x 'os
ck
Fr.
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIous sQ. Fr. 7 - x $0'203 PER SQ' FT'$2 a3
2. SANITARY SEWER-CITY
X $42.08 PER PFU $
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x $424.31
x $424.31
x $424.31
4. SANITARY SE}IER-MWMC
s
x
x
x
$
5
I From Item
TOTAL.MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4) s 6= 43
A^rs$
sDc
P
Coordinator
TOTAL SDC $/4,
c
(
q