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Home My WebLink AboutPermit Building 1993-11-09:;I'rlIh'GFIELC' RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOT: h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 LOCATION OF PROPOSED WOBK:r..J a a.3:1 sa_ {."..rors MAP: /73 AQ' / 2-' 91 TAX LOT BLOCK:SUBDIVISiONI PHONE ?L{L- 3o71 OWNER: -ts7:ArDe 4 i/r ?,,",8q Lt nJo. ),3ADDRESS: CITY:,'c STATE:C) R. DESCRIBE WORK NEW -- BEMoDEL --- ADDtrtoN --tt- DEMoLISH orHER ZIP:11 ,t') ADDRESS CONST. CONTRACTOR #EXPIFIES PHONECONTRACTOR'E L l_GENERAL:, PLUMBING: MECHANICAL: --_'-==.----- ELECTRICAL SE_ coNSrR t"*' VN WATER HEATER _ OFFICE , OF BDBMS HEAT SOURCE: --RANGE ZONING CODE: FLOOD PLAINLAND USE. '' OF UNITS SECOND.ARY HEAT: SOUARE FOOTAGE: OCCY GROUP: , OF STORIES OUAD AFIEA: # OF BLDGS To request an ins pection, you must call 726-3769. This is a 24 hour recording. All ins pections 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. REQUTRED INSPECTIONS [_-l temporarY Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspeclion - 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 tle approved to obtain Perrnanent electrical power. Final Mechanical - When all mechanical work is complete. lwFooting - After trenches are ,14(excavated.Fireplace - Prior to facing materials and framing lnsP. lVfinat Buildins - When all f\'equired inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting. fittr-,"g - Prior to cover' Other Foundation - After forms are erected but Prior to concrete placement.Wall/Ceiling lnsulation - Prior to CCVCT Underground Plumbing - Prior to filling trench.f_l Orywall - Prior to taoing MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After insl?ll:ltlon Posl and Beam - Prior to floor insulartion or decking.lns,ert - After f ireplace apl)roval and instailation of urit Blocking and Set-UP - When all blockirrg is complete. Floor lnsulation - Prior to decki n g.Curbcut & APProach - Afl{'r f,:rnrs are erected bu. pt'ic-'r to placement of ccncrete Plumbing Connections - When hcme has been connected to water and sewer. Sanitary Sewer - Prior to f illing trencll.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 trencll. Sirlewalk & DrivewaY - A{ter ext)avation is complete, fornts and sub-base material in lllace Water Line - Prior to fi!llng trench. I__.l Fence - When comirleted Final - After all required inspections are aPproved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover. Street Trees - Wlren all required trees are Planted. Q 3/63 7 t\\ tl r tl rl E E tl tf tl tlr fl E tl E E tl i_l fl f] Lot faces Lot sq. ftg. Lot coverage TopographY Total height Lot Type -- lnterior -_ Corner - Panhandle - Cul-de-sac Setback P.L.HSE GAR N S ACC lS r HE PROPOSED WOFIK lN THE HISTORICAL DISTRICI OR 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 pernrit is grantecj 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 Code, regulating the construction and use of buildings, and may be suspended or revoked at any time ewedPlan lrhj-/ 6ale u pon violation of anY Provisi ons of said ordinances63 Date Paid Receipt Number: Received BY Plan Check Fee VALUE (A) _b7c9 BUILDTNG PERMIT Total Value Building Permit Fee State Surcharge Total Fee QZF:?/3 -u_L_ --6-az- SO. FT. X $/SQ. FT.ITEM Main Garage Carport Systems Developrncnt Charge is due'on all undeveloped properties within the City limits which are being improved'sYSrEMs DEVELoP*=*r,":n o T,lril_# ADDITIONAL COMMENTS L ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. FT. F-r. Plumbing Permit State Surcharge Total Charge NO Wood Stove/ lnsert/ Fi replace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Fu rn ace Exhaust Hood Vent Fan 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 Orcjinances of the City of Springfield, and the Laws of thc State of Orcgon 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 pro jec t. I {urther agree to ensure that all required inspections are requestec, at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, ancl the approved set of plans will remain ?3Date on the site at all times U ring construction. 7 \/ fsignature //- MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk --_ ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) -5 E E DATE PAID VALIDATION: RECEIPT NUMBER AMOUNT REC RECEIVED BY TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) t PLUMBING PERMIT ffiPermit No: Address: lssued Date R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. A My general contractor is , 3r 1 2 3 Contractor registration numbe r. I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.B I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above inlormation is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the . reverse side of this form. !-ttt y2 /1 . / 1 r t l- 4,^'-71r."/.eo,-,/tle€/ltl //-i /r Signature of Permit Applie,fnt Date CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT OR F JOB NO.19tc 71 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE }IORKSHEET (col'IMERcIAL & RESIDENTIAL) Leo rt Mo KF H ENNAME OR COMPANY: 814 ,U zbe s-r.1-lo bV btL - ?3o oLOCATION: LDE - Aootrt (cnetd*r) DEVELOPMENT TYPE: BUILDING SIZE: 4o I rz ' 4go 1* LoT SiZ 4go x $0.203 PER SQ. FT 2. SANIT ARY SEI,IER -C ITY NO. OF PFU'S (See Reverse) X $42.08 PER PFU 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP . Ft. x x $424.31 x _- x $424.31 X 4. SANITARY SEt,lER-MWMC 5 ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) X .05 L^-.0- lo p Burdick Coordi nator NO. OF PFU'S (Use PFU Total From Item 2 Above) Mt.lMC CREDIT IF APPLICABLE (SEE REVERSE) x $424 .3 I $ x $15.125 PER PFU + $i0 MhlMC ADM FEE s TOTAL-MWMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4) s K sDc 7.7 qe TOTAL SDC s loz gt I. STORM DRAINAGE IMPERVIOUS SQ. FT.