HomeMy WebLinkAboutPermit Building 1995-04-07II\lGFIELE,RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JOB NUMBER
225 Fif th Street
Spri ng f leld, Oregon 97 477
llao A)J Trvl .*-
ASSESSORS MAP:11 b Lbo bd TAX LOT:44 ?ot
LOT:o\-BLOCK:3o :,{Ct {,@t*or 'ta Ql,ir-JSUBDIVISION
REMODEL ADDITION DEMOLISH OTHER
STATE:7
5
ZIP:q7
(. oo €r/
N2
DESCRIBE WORK:
NEW
CITY:
ADDRESS:
OWNER:
ADDRESS EXPIRES
iln. B
PLUMBING:
MECHANICAL:
ELECTRICAL:
PHON E
wt,'111- 1116
CONTRACTOR'S NAME
GENERAL:
CONST.
CONTRACTOR #
llt tc
I
u
^1
SOUARE FOOTAGE tLfi0
- oFFrcE usE -
WATER HEATER
# OF BDRMS
LAND USE:
ZONING CODE:
FLOOD PLAIN
SECONDARY HEAT:
r OF UNITS:
RANGE:
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
I OF STORIES:
OUAD AREA:
r OF BLDGST
To request an Inspectlon, you must call 726-3769. Thls ls a 24 hour recording. All inspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REOUIRED INSPECTIONS
l--l Temporary Electrlc Rough Mechanlcal - Prior to
cover.
Final Plumbing - When allplumbing work ls complete.
Slte lnspectlon - To be made
after excavatlon, but prior to
settlng forms.
Rough Electrical - Prior to Final Electrical - When ail
electrical work is complete.cover.
Underslab Plumblng / Electrical /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal pcwer.
Final Mechanical - When all
mechanical work is complete.
ffifootlng - After trenches are
flexcavated.[l Flreplace - Prlor to faclng
-
materlals and framlng lnsp.
l!'] Framlng - Prlor to cover.,,H.
Final Building - When alt
requlred lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
lV/Founaalton - After forms are
Af erectecl but prlor to concrete
placement.Wall/Celllng lnsulatlon - Prior to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Stove - After lnstallatlon
Posl and Beam - Prlor to floor
lnsulatlon or decking.lnsert - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulallon * Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor lo
placement of concrete.
PJumbing Connections - When
home lras been connected to
water and sewer.
Sanltary Sewer - Prlor to fllling
trench,Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Storm Sewer - Prlor to filling
trench.
Sldewalk & Drlveway - After
excavation ls complete, forms
and sub-base materlal in place.
Water Llne - Prlor to filllng
trench.
Fence - When completed
Street Trees - When all requlred
trees are planted.
Final - After all required
inspeclions are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.Rough Plumblng - Prlor to
cover.
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PHoNE: -'?7 oo6r-
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Tyl
- In terio r
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
to
IS THE PROPOSED WORK TN THE ,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
VALUE
5u/3/s ? /,es
(A)
41c
k
/.'/.5 /
/@i
776
/^ 7e
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FI.
Main
Garage
Carport
BUTLDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the expre6s condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, includlng the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances,
dBvan
gReceipt Num
Date Paid
Received
Plan Check Fee:G3
sYSr EMS D EV E Lo
Hr/r \Y*'#HARGE (sDc)Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
FEE
(c)
FT.
FT.
FT.
Residential Bath(s)
Plumbing Permit
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
N0
Sanitary Sewer
Water
Storm Sewer
Ivl0bile Home
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flrepla.ce Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carofully examlned
the completed application and do hereby cerilfy that all
lnformatlon hereon is true and correct, and I f urther cerflfy
that any and a.ll wor.k perfcri-neC shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertaining to the work descrlbed
herein, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Buildlng Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 7O1.O5S wlll be used on thls
project,
I lurther agree to ensure that all requlred inspections are
requested at the proper ilme, that each address is readable
from the street, that the permit card ls located at the front
d the approved set of plans wlll rernain
natu re
Date
X dri
of the property,
on the site const ruction
MISCELLANEOUS PERMITS
Mobile,Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding etectricat)
(A, B, C, D, and E Combined)
EC
BY
VALIDATION:
BECEIPT NUMB
DATE PAID
AMOUNT R
RECEIVED I
CITY OF OFEGO'V,
frv2"
225 FIFTE STREET
SPRTNGFIEI.,D, OREGON 97 477
INSPECTION REQUESTz 726-3769
OFFICE: 726-3759
SPrlt' EIELO
as submltled hes
requiro specific land use
Loe
PERHIT APPLICATION
Ci ty Job Number 1To4? t
3. COHPIJTE FEE SCEEDTILE BELOIJ
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service IncLuded:Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Sertice or Feeder
$ 8s.00
$ 1s.00
s 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less '/
201 amps to 400 amps
-40L amps to 600 amps _601 amps to 1000 amps_
Over L000 amps/voIts
Reconnect 0n1y
C.
D. Branch Circuits
The lollowing project
zoning, and does not
approval.
oa. 5--cl )
Authorizeci Sig
1. LOCATION OF INSTALI,ATION\l bo N. Tzrt v
I,EGA.L DESCRTPTION
11o?-7 a?*o+bol Sum
JOB DESCRIPTION
tn9*xvu tecaasf SePv&
2. COMRACTOR INSTALI,ATION ONLY
Electrical contrac 6, 9{ilV,'ETPFI AEU
Address UtP Vo* 9f
Ci ty COCterJe phone +8+-?z1B
Supervisor License Number y'O-L$)-u
Exp iration Date to /a I qg
t-,l-l
Permits are non-trans era bIe and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
1.80 days.
Constr Contr. Number +t71 |
Expiration Date 7 lqu
si ture of cl:rn
0vners Nane l'loNtE baPg?-
Address llbo AI. 3>tJ?
Ci ty S?n'o Phone 1+1-noto{
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for saIe, lease or rent.
0vners Signature:
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less $ 40.00
over 401 to 600 amps $ 80.00
0ver 600 amps or ibOO voTTs see uBu a56E
s s0.00
s 60.00
$100.00
s130. 00
$300.00s 40.00
ry &
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permi t ? S 2.00 Z.on
E. Miscel-laneous (Service/feeder not included)
-Each install-ation
Pump or irrigation _Sign/0ut1ine Lighting_
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
$ 40.00
s 40.00
$ 20.00
$ 36.00
5
DATE:
RECEIVED
?c
I No. q5D4> I
CITY OF SPRINGFIEIJD SYSTEMS DEVEI,OPMENT CHARGE
WORKSHEET
(cot'IMERcIAL & RESIDENTIAL)
NAME OR COMPANY:Mo*t r L C-oo ? ER o4 6oa
LOCAT ION://bo L/ 2rzN2 C;T /-7oz 2?0 v4-
DEVELoPMENT TYPE: LD? - App OhLa'e , P*Ve DE\IL
G4AAC,E t2A r(EN&I
OT SIZ FtBUILDTNG SIZE:
I. STORM DRAINAGE
TMPERVIoUS SQ. FT.
no
x $0.209 PER SQ. FT
2. SANiTARY SEt,lER-CITY
NO. OF PFU'S
(See Reverse)
X $43.26 PER PFU
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 SEl^lER-MI,IMC
NO. OF PFU'S Y $17.19 PER PFU + $10 MWMC ADM FEE $ T
(Use PFU Total From Item 2 Above)
Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL -M I,JMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
t6s*
lest
5 ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .os
Kip Burdick
SDC Coordinator
s r4!/1b #
.(o
.{4
g
-o-
Date:
TOTAL SDC
tlohe