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Home My WebLink AboutPermit Building 1997-04-17SPRIilGFIELE, Zfr, a RESIDENTIAL PERMIT APPI,ICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVTSION BUILDING SAFETY I a office: Inspection Line: Page 1 dlob Nrutber: 970385 225 North Fifth Street Springfield, OR 97477 Location of Proposed $Iork: 151 15TH ST Assessors Map #: l-7033631 Lot: Block: 726 -37 59 726 -37 59 Tax Lo Subdivis 03800E# ion SPilNGFTEID, Owner: PAUL KELLY Address: 161 15TH STREET Describe Work: DETACHED GARAGE Phone #: 747-4053 ciry/state/zip: SPRTNGFTELD, oREGON 97477 NEW General Contractor OWNER Conet. Contractor #Expires Phone 7 47 - 4063 QUAD AREA: 2RNW ZONING CODE: LDR VN SQ FOOTAGE: LL20 -- oFFICE USE -- LAND USE: l-111 OCCY GROUP: M # OF BLDGS: 1 CONSTR. TYPE: To reguest, an inspect,ion, caLl the 24 hour recording aL 726-3769. A11 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 fol-Lowing work day. --- REQUIRED TNSPECTIONS --- FOOTING - After trenches are excavated. FOITNDATION - After forms are erected but prior to concrete placement. SHEAR WALL NAILING - Before covering sheat,hing with finish mat,erials. FRAIIING - Prior to cover. STORII SEWER LINE - Prior to filling trench. FrNAr. BUTLDTNG - when all reguired inspections have been approved and t,he building is complete. Lot Faces: W Solar Approved: Y Garage Total Height: L5 Lot Type: IIflIERIOR SetbacksswE 5 140 Setbk From NPL: 7 N 7 Item Main Garage Total Value Building Permit Fee Surcharge/Admin TOTAL FEE --- BUILDING PERMIT --. Sguare Feet x tt20 (A) Value 0.00 L8 ,222 .00 t8 ,222 . OO 134.50 10.77 L45.27 SYSTEMS DEVEIJOPMENT CTIARGE (SDC) (B)4f#. systems Development, Charge is due on all undeveloped properties wit.hin t.he Cit,ylimits and the cit,ys urban Growth Boundry which are being improved. \ueLc $/Square Feet L6.27 SPF!NGFIELC' Job Number: 970385 a SPilNGFTEI,O,a Page 2 Item Storm Sewer Plumbing Permit Surcharge/aamin TOTAL CIIARGE --- PLI'MBING PERMIT --- 50 Fee 25.00 25.00 2.OO (c)27.00 (Excluding Electrical) unleEe otherwise noted --- TOTAL A}TOI'NT DUE --- (A, B, C, D, and E combined)4EAa3? I /2,27 --- BUIIJDING VALUE, PI'A}I CHECK AI{D BUII'DING PER}TIT --- This permit is granted on Ehe express condition that the said construction shal1, in all respects, conform to the Ordinance adopt.ed 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 violat,ion of any provisions of said ordinances. PIan Check Fee:. 87.43 Date Paid: Received By: Plans Reviewed By: DON MOORE Date: Building Site Reviewed By: LISA HOPPER Receipt Number 24877 --- ADDITIONAIJ COITMENTS --- PRIMARY STRUCTT'RE IS 1180 SQUARE FEET. ROOF PITCH OF THIS ACCESSORY STRUC CHGD TO 5:12 FOR HGHT RQMT THE DETACHED STRUCT. SHALL NOT BE LARGER IN FLR. AREA THAN THE PR]I,IARY STRUCT. A SEPARATE ELECTRICAL PERMIT IS REQUIRED FOR ANY ELECTRICAL INSTALLATIONS By aignature, I Btate and agree, that f have carefully examined the compleLed application and do hereby certify that al-I information hereon is true and correct, and I further certify that any and alL work performed shall- be done in accordance with the Ordinances of t.he City of Springfield, and the Laws of the Stat,e of oregon pertaining to the work described herein, and that, NO OCCUPANCY wil-l- be made of any sEructure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.055 wiLl- be used on this project. I further agree to ensure that all reguired inspecEions are requested at theproper Eime, that each address is readable from t.he street, that the permit card is l-ocated at, the front of t,he property, and t,he approved set of plans wiLL remain on the site at all- times dur ing construction. Signature Date 03/14/e7 04/L7 /e7 4-t7-q7 t SPFINGFIELD Job Number: 970385 SPNruGFTEI.O,a Page 3 --- VALIDATION --- Receipt.Number', ?5V re Date Paid:q4>^2> AmounE Received, /22 .Z 2 Received By:ZZ-r-n =,- SPRINGFIELD Page 1 ENGINEERING DIVISTON DEVEI,OP}IENT PLAI{ REVTEW RESIDENTIAII IMPROVED STREET SPruNGFIEIT', Developer: PAUL KELLY Job No Mail Address: 161 15TH STREET SPRTNGFIEIJD, oREGoN 97477 Phone #: Tax Lot #: L703353103800 project Address: 161_ 1GTH ST Subdivision: Lot: BIk: Eng. Rev. No.: . : 970385 7 47 - 4063 Book SLreet GraveL 151 15TH ST Existing Curbcut: Y Comments: EXISTING HOME EXISTTNG IUPROVEMENTS Ac Mat Curb FuI1 Imp Sw Width Curbside Y 5 FEET 12:1 FLA]RS WidLh: Ft Fl-airs :FT Setback ENGINEERING REQUIRE}IENTS Additional Right of Way: N fmprovement Agreement: N Easements: N SAI.IITARY SEWER CAIJIJ THE UTILITIES NOTIFICATION CENTER BEFORE YOU DIc 1-800-332 -2344 Available: Y Stubbed Out To ProperEy Line: y Depth: 4-6 Size of Line: 8 In. Tee: 5 In. Locat,ion From N, S, E, W Properly Line: AS SHoIaIN oN DRAWING oR AS-BUILT MAKC CONNCCTiON: CONNECTION EXISTS. NO CHANGE. FE STORM SEWER Availabl-e: Ypipe Downspouts And Drains To: trEZ/<- ' Pipe Parking Lot Drainage To: N/A Commenls: MAY CONNECT TO EXTST]NG ROOF DRAIN SYSTEM TF IN GooD CoNDITToN New Curbcut Appr.: N Sidewal-k Permit: N Curbcut Permit: N SIDEWALK AT{D DRIVEWAY INFORMATTON STANDARD Comments: SIDEWALKS, DRIVERWAY AND CURBCUT EXIST ENCROACHMENT AI{D ASSESSMENT Encroachment. Permit Required: N Sanitary Sewer In Lieu Of Assessment: N SPECIAL NOTES AI{D REQUIREMENTS Al-l- work within the public right of way shall be in conformance with the Cityof Springfiel-d standard specifications for construction. A11 existing unused curbcuLs or portions thereof shal-I be restored to fuII curb height. as directedby the City. The owner/developer is responsible to reLocaEe any utilities and estabLish private or public easements when the utilities conflict with t,he development, at Eheir expense. Reviewed By: DENNIS ERNST Date:04/lL/97 SEE DRAWINGS ON SPECIAI, REQUIREMENTS FOR FURTHER I}TPORTATiIT INFORMATION SPFIr.GFIELc, a RESIDENTIAI, PERMIT APPLICATION CTTY OF SPRINGFTEIJD COMMT'NITY SERVICES DTVISTON BUIIJDING SAFETY t Page 1 ilob Nrurber: 970385A 225 North Fifth Street Springfield, OR 97477 Location of Proposed Work: 151 15TH ST Assessors Map #: 17033631 Lot: Block: Office: Inspection Line: 726 -37 59 726 -37 69 Tax Lot #: 03800 Subdivision: Owner: PAUL KELLY Address: 161- 15TH STREET Descri-be Work: ADD BATHRII IN cARAcE Phone #: 747-4063 city/state/zip: SpRTNGFIELD, OREGON 97477 NEW QUAD AREA: 2RNW -- OFFICE USE -- LAND USE: 1111 ZONING CODE: LDR To requeat an inspection, call the 24 hour recording aL 72G-3769. A11 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 d.ay. --- REQUIRED INSPECTTONS --- ROUGH ELECTRICAL - Prior to cover. ROUGH PLI,MBING - Prior Lo cover. ROUGH MECHAI{fCAL - Prior to cover. FRiAIIING - Prior to cover. DRYWALL - Prior to taping. FINAL PIJITIIBING - When all plumbing work is complete. FINAL IIECILAIiIICAL - When all mechanical work is complete. FINAL EIJECTRICAL - When all el-ecErical work is complete. FrNAL BUTLDTNG - when all reguired inspections have been approved and the buil-ding is complete. IEem Main Garage BATHROOM IN GARAGE ToEaI Value Building Permit Fee Surcharge/admin TOTAL FEE --- BUII.DING PERIIIT --- Square Feet x $,/sguare Feet Value 19 .00 .00 .00 .00 48.39 0 0 9L9 9L9 (A) 17.50 I .41 18.91 SYSTEMS DEVEI.OPMENT CIIARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits and the Citys Urban Growth Boundry which are being improved. PIJI,ITIBING PERUIT --- ;s#4 Item Fixtures Plumbing Permit Surcharge/admin 2 Fee 20.00 20.00 1.60NOTICE: TTIIS PEBMIT SHALL EXPIRE IF THE WOHK AUTHORIZED UNDER T}IIS PEBMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Job Number: 970385A o t Page 2 TOTAI, CHARGE (c)2L.60 Vent Fan Mechanical Permit Issuance surcharge/edmin TOTAL PERMIT --- MECIIAI'IICAL PERMIT --- 1 (D) 3.00 15.00 10.00 L.20 26.20 --- MISEEIJIJA}IEOUS PERMITS --- surcharge/admin PLAN REVIEW TOTAL MISCETLAI.IEOUS PERMITS (E) 0.00 11.38 11.38 (Excluding Electrical ) unlesg otherwige noted --- TOTAL A}TOI'tillT DUE --- (A, B, C, D, and B coslbined)4LW 3BPe -.. BUILDING VALUE, PLAIV CHECK AI{D BUII,DING PERMIT --- This permit is granLed on the express condition Lhat t,he said consLruction shall, in aI] respects, conform Eo Ehe Ordinance adopted by the City of Springfield, including the DevelopmenL 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. --- ADDITIONAIJ COM}TEIITS --- SEPARATE ELECTRICAL PERMIT IS REQUIRED By signature, I state and agree, that I have carefully examined Ehe completed application and do hereby certify Ehat all information hereon is true and correct, and I furt,her certify that, any and alL work performed shalI be done in accordance with the Ordinances of the City of Springfield, and Ehe Laws of the SEate of oregon pert,aining to the work described herein, and Ehat NO OCCUPANCY will be made of any sLructure without permission of the Community Services Division, Building Safety. f further certify that only contractors and employees who are in compliance with ORS 701.055 wi]1 be used on this project. I further agree to ensure that aff required inspections are reguested at the proper time, Ehat each address is readable from the street, Ehat the permit card is locaEed at the fronE of the property, and the approved set of plans will the site at all times during construction. S fure ? 8PE!tlcFIELEl Date -!rr- 3PE!i.GF!ELD Job Number: 970385A SPilNGFTELI',t o Page 3 --- VAI,IDATION --- Receipt Number Datse Paid Amount Received, :</3,O3 Received By: NOTICE: THIS PEFMIT SHALL EXPIRE IFTHE WORK AUTHOBIZED UNDER THIS PERMIT tS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, zonins (29-L- sPR..,.jFIELE' BLECTRICAL PERHIT APPLICATION225 FIFTE STREET___- +.L{- ,.)-1. SPRTNGFTELD, oREGoN 97477 t fNSPECf,ION REQT EST : 726*37:69.-';,:.:1\ i': OFFICE: 726-3759 Job Nunbe,?72395- Services or FeedersInstallation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -40L amps to 600 amps -601 amps to 1000 amps- over 1000 amps/volts -Reconnect 0n1y s s0.00 s 60.00 $100.00 s130. 00 $300.00s 40.00 suBrorAl oF ABovE /r'b.5Z State Surcharge 3Z Admini.strative Fee TOTAL n\ 1 JOB ON ts a -tr ferable and expireif vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY LEGAI DESCRIPTION77€7*7<*?,2, PVEfa' Oz-alZ-.3 Tr'ST 3. COHPLETE FEE SCEEDTILE BETOIJ Nev Residential-Sing1e or Multi-Family per dvelling unit. Service Included; Items Cost L000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or -Modular Dvelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 ON A Sum B Electrical Contractor Add ress Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name t/L C Temporary Services or Feederslnstallation, Alteration or Relocation 200 amps''or less S 40.00 20L amps to 400 amps - $ 55.00 over 40L to 600 amps - $ 80.00 0ver 600 amps or 1000 vofTs see I'Brr a66tE- D. Branch Circui ts Nev, Alteration or Extension per panel One Circuit S 35.00 Each Addi tionalCircuit or vith Serviceor Feeder Permit g 2.00 Miscell-aneous (Service/feeder not included) -Each installation Pump or irrigation S 40.00 Sign/Out1ine Lighting- $ 40.00Limited Energy/Res - $ 20.00Limited Energy/Comm S 36.00 Add ress Ci ty 1r>Phone OVNER INSTAI,LATION The installation is being made on proper ty I o!',n whi ch is no t in tendedfor sale, lease or t. Si DATE: fu,z E RECEIVED B ture:{.7) Fy 5 *2 RESIDENTIAL PERMIT APPLICATION lnspections: 726.3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT: SP RIFIGFIEL() efi, JOB NUMBER 7 70385 225 Filth Street Sprlngf lelc!, Oregon 97477 TAX LOT SUBDIVISION: --- - /6 r4 BLOCK: PHONE:,7/ STATE:ZlPi L 3 CITY: ADDRESS: OWNER: c.z ADDITION DEMOLISH OTHER DESCRIBE WORK: NEW- REMODEL ADDRESS EXPIRES PHONE NAMP ,{dzzs CONTRACTOR'S MECHANICAL: ELECTRICAL: CONST. CONTRACTOR , GENERAL: PLUMBING - OFFICE USE - / OF UNITS: _ , OF BDRMS: - WATER HEATER OUAD AREA: I OF BLDGS: SECONDAFIY HEAT; SOUABE FOOTAGE:RANGE: OCCY GROUP: E OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thlsmade the same worklnO day, lnspections requestect af Temporary Electric Eleclrlcal Servlce - Must beapproved to obtaln permanent electrlcal power. Flreptace - prlor to faclng materlals and framing lnsp. Framlng - Prlor to cover. Wall/Celllng lnsulallon - prlor to Flnal Plumbing - When altplumblng work is complete. l--l finat Mechantcal - When ail - mechanical work ls complete. Flnal Building - When allrequired lnspectlons have beenapproved and building iscompleted. ls a 24 hour rccordlng. All lnspecilons requested before 7:00 a.m. wlll beter 7:00 a.m. wlll be made lhe followlng work day. REQUIRED INSPECTIONS Rough Mechantcat - prlor to cover. Rough Electrlcal - prlor to Final Electrlcal - When allelectrlcal work is complete. cover. Slte lnspectlon - To be madoafter excavatlon, but prlor tosetting forms. Footlng - After trenches are excavated. Foundatlon - After forms areerected but prlor to concreteplacement. Post and Beam - prior to floorlnsulatlon or decklng. Floor lnsulalion - prlor to decklng. Rough Plumbing - prlor to cover. cover. Wood Stovo - After lnstallatlon Fence - When completed MOBILE HOME INSPECTIONS Plumbing Connectlons - Whenhome lras been connected towater and sewer. Masonry - Steel locailon, boncJbeams, groutlng, f-l Underground plumblnq - prtor Underlloor Plumbing/ Mechanlcal - Prior to lnsulatlon or decklng. lnsert - After llreplace approvaland lnstallatlon of unlt. l-_l Blocking and Set.Up - When all - blocklng ls compleie. A;:l:ary Sewer - Prior to rrrrrns [-l Storm Sewer - pr.ior to fiilingtJ trench. Water Llne - Prlor to filling trench. Curbcut & Alrproach - Afterforms are erected but prior loplacement of concrete. Sidewalk & Drlveway - Afrerexcavation ls completc, formsand sub-base material ln place. Eleclrical Connection - Whenblocking, set-tip, and plumbing inspections have been approvedand the home ls connected tothe servlce panel. Slreel Treos - When all required trees are planted. Final - After all requiredrnspectlons are approved andporches, sklrting, decks, andvenllng have been lnstalled. /O 8.9 7clzy'z 7- [--l Underslab plumbing/ Etectrical / - Mechanlcal - prior to cover. I I ,. -HE PROPOSED WORK TN THE . TORICAL DISTBICT, OR ON iFe ursrontcAL REclsrER? - ll yes, this application must be slgned and approved bY the Historlcal Coordinator prlor to permlt issuancer APPROVED: P,L.HSE GAR ACC N S E Lot faces Lot sq. ftg. Lot coverage TopographY Total helght Lot Type - InterloT- - Corner - Panhandle - Cul-de'sac BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granled on the express condition that the said consiruction shall, in all respects, conform'to the Ordinance adopted by the City of Springfield, including the Development Cocle, regulating the construction and use of bulldings, and may be suspended or revoked at any time upon violation of any provisions ol said ordinances' Plan Check Fee: --- Recei pt Number:--.- Plans Rcviewed BY Date Received BY: BUTLDING PERMIT VALUE (A) SO. FT. X $/SQ. FT.ITEM Main Garagc Carport Total Value Building Permit Fee State Surcharge Total Feo Systems Devetopmcnt Charge is due on all undeveloped properties within the City linrits which are belng improved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS I ITEM Fixtures Besldentlal Bath(s) SanltarY Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE -4- --..-1+ Z+ /'2o N0 FT. FT. /r,*,(c) ,otn. /zO'/ 3LoPlumblng Permlt State Surcharge Total Charge Wood Stove/ lnsert / Flreplace Urril Dryer Vent MISCELLANEOUS PERMITS MECHANICAL PERMIT Total Mlscellaneous Pertnits (D) (E) N0 Mechanical Permlt lssu ance State Surcharge Total Permit Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcul - lt Demolltlon State Surcharge Fu rnaco Exhaust Hood Vent Fan TOTAL AMOUNT DUE (excluding clectrical) (A, B, C, D, and E Combined) 32e By slgnature, I state and agree, that I have caref ully examlned the completed appllcation and do hereby certlfy that all ln{ormatlon hereon is true and correct, and I lurther certlfy that any and all work performed shall be done in accordance with the Ordinanccs of thc City ol Sprlngfield' and the Laws of the State of Oregon pertaining to thc work descrlbed herein, and that NO OCCUPANCY wlll be made of any structUrewithoutpertnissionoftheBulldirrgsafetyDlvislon' I turther certify that only contractors and employees who are ln cornpliance with OFIS 701'055 will be used on thls proiect. I further agree to ensure that all required inspections are requested at the proper tlme, that each address ls readable f rom tlrc street, that the permlt card ls located at the front of tho proPerty, and the aPP roved set of Plans wlll remaln 'o"(/,'/.,-r^on the sitex Slgnature s during constti Date VALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVT-.D aD ? RECEIVED BY 2p Date Paid: RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726.3759 LOCATION OF PBOPOSED WORK; ASSESSOFIS MAP:5 LOT: SPRII\rGFIELt) efi, JoB NUMBER ?,- 7aS 225 Fitth Street Sprlngf leld, Oregon 97477 TAX LOI O7* SUBDIVISION: - 4 BLOCK: PHONE: STATE: OWNER: ADDRESS CITY: (_ ADDITION DEMOLISH OTHER DESCRIBE WORK: NEw Z( REMoDEL ADDRESS EXPIBES PHONE CONTRACTOR'S NAME PLUMBING: GENERAL: MECHANICAL: ELECTRICAL: CONST. CONTRACTOR , _ OFFICE USE _ WATER HEATER FLOOD })LAINLAND USE:QUAD AREA: r OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: , OF BDRMS: -RANGE: OCCY GROUP: , OF STORIES: CONSTR. TYPE: HEAT SOURCE: , OF UNITS: _-ZONING CODE: To request an lnspectlon, you made the same worklno day, musl call 726'3769' Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. will belnspectlons requested after 7:oo a.m. will be made rhe folrowrng work day. REQUIRED INSPECTIONS l--l Temporary Etecrric Rough Mechanlcal - prior to cover. Slte lnspection - To be madeafler excavatlon, but prior tosetting forms. Rough Electrical - prior to cover. l--| Underslab plumbing/ Etectricat / - Mechanlcal - prior to cover,Electrlcal Servlce - Must beapproved to obtaln permanent eleclrlcal power.Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Flreplace - Prlor to faclng materlals and framlng lnsp. Framlng - Prlor to cover. Foundallon - After forms areerecled but prlor to concreteplacement.Wall/Celllng lnsulatlon - prlor tocover. fl l'Jffiffi;"i,liJ;:.brns - Prior [-l Drywail - prror to taprns. Underlloor Plumbing / Mechanlcal - Prlor to lnsulatlon or decklng, MOBILE HOME INSPECTIONS Wood Stovo - After lnstallatlon, Post and Beam - Prior to floorlnsulatlon or decklng.Tl lnsert - After flreplace approvat - and lnstallatlon ol unlt. [-l Blocking and Ser.Up - When ail - blocklne ls cornplete. Floor lnsulatlon - prlor to decklng.Curbcut & Alrprroach - After forms are erected b(rt prior toplacemcnt of concrete. Plumbing Connectlons - Whenhome lras been connected towater and sewer.f-l Sanltary Sewer - prior to fliltng|J trench. [--l Storm Sewer - prtor ro lilting|J trench. E ly;l:1,:rne - Prror ro rir,ns Sldewalk & Drlveway - Afterexcavation ls completc, formsand sub.base material ln place. Fence - When completed. Electrical Connection - Whenblocking, set-up, and plumblng lnspections have been approvedand the home is connected tothe servlce panel. Rough Plumblng - prlor to cover.Streel Treos - When all requlred trees are planted. Flnal - After all requiredlnspectlons are approved andporches, sklrting, cJecks, andventlng have been lnstalled. =-3a=),2 #, zrp, ,a_-/-\ 2z--: - l--l Ftnat ptumbtng - When ail - plumblng worl( ls complete. n Flnal Electrtcal - When ail - electrlcal work is complete. l-l flnat Mechanicat - When ail - mechanlcal work ls complete. [-l Flnal Buitding - When ail - requlred lnspectlons have beenapprovod and building lscompleted. Lot {aces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac i .,- rHe PROPOSED WORK tN THE HISTORICAL DISTRICT, OR ON THE H ISTORICAL REGISTER? - l{ yes, thls applicatlon must be slgned and approved by the Historlcal Coordinator prior to permlt issuance.' APPROVED: P.L.HSE GAR ACC N S E try_ BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the cxpress condltion that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfleld, includlng the Development Code, regulating the construction and use ol bulldings, and may be suspended or revokcd at any tlme upon violation of any provisions of said ordinances. Plans Fleviewecl t3y Date Receipt Numbe Plan Check Fee: Date Paid Beceived By: VALUE (A) X $/SO, FT. Tolal Value Building Permit Fee Slate Surcharge Total Fcc Systems Development Charge is due on all undeveloped properties withln tlre City lintits which are being lmproved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE N0 FT. FI., ,12 FT. 4 (c)*2o PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge Wood Stove/ lnsert/ Fl replace Urli t Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnacc Exhaust Hood By slgnature, I state and agree, that I have carof ully examlned the completed appllcation and do hereby certlfy that all ln(ormation hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance with the Ordinanccs of the City of Springfield, and the Laws ol the State of Oregon pertaining to the work descrlbed herein. and that NO OCCUPANCY wlll be made of any structure without perrnission of the Bulldirrg Safety Dlvislon. I further certily that only contractors and employees who are ln c<rrnpliance with OFIS 701.055 wlll be used on thls proiect. I (urther agree to ensure that all required inspectlons are requested at the proper tlme, that each address ls readable from tlre street, that the permlt card ls located at the front of the property, and the approved set ol plans will remain Slgnatu Date F7 ng constrdu T-D on the si on. il,- fu/, MISCELLANEOUS PERMITS Mobile Home State lssuance Stato Surcharge Sldewalk -- ft Curbcut - ft Demolitlon State Surcharge Total Mlscellaneous Permits (E)2eDATE PAID AMOUNT RECEIVED RECEIVED BY /-F.-2-= VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 77?e BUILDING PERMIT ITEM SO. FT. Main Garagc Carport 2r/ga --