HomeMy WebLinkAboutPermit Building 1994-11-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
)(
ASSESSORS MAP'
LOT:
.
.."'":~-~
BLOCK'
.
~/!715
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX .LOT:
SUBDIVISION:
08 SOW'.
If'LL. - 76-f<.5'-
. PHONE:
OWNER' ~~. /Jn~~
ADDRESS: ~2 ~:-s- ~ '1~ <-, "~
CITY: ~-"'"'?rft'/-~
~/7'~
/
,~
~
STArE:
((..,.
ZIP: ~'/(L,>?
, ,
DESCRIBE WORK'
NEW L-- REMODEL
ADDITION ~
DEMOLISH
OTHER
CONTRACTOR'S NAME ADDRESS
GENERA' ~ r 200'-<- ~7<-/~
PLUMBING:
CON ST.
CONTRACTOR'
~<t...? Ss-
EXPIRES PHONE
fl-~o-JJ-.. ?.!9L-~o/ I'
1
MECHA~~ICAI .
ELECTRICAl'
"
QUAD AREA: ...~e.~
· OF B'_DGS: ~
OCCY GROUP:
. OF S~ORIES:_\
WATEf' HEATER:
- OFFICE USE -
III \
LAND USE:
· OF UNITS:
CONSTR. TYPE: --'1/ AJ
HEAT SOURCE:
RANGE: _
FLOOD PLAIN'
ZONING CODE:
( fie.-.
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:-.a~
To request an Inspection, you must call 726-3769. This Is 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. will be made the following work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
C Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
]V( Footing - After trenches are
~ excavated.
CJ Masonry - Steel location, bond
beams, grouting.
CJ Foundation - After forms are
erected but prior to concrete
placement.
CJ Underground Plumbing - Prior
to filling trench.
O UnderllDor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to fllllng
trench.
o Water Line - Prior to filling
trench.
~
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Framlng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior 10 taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement o' concrete.
o Sidewalk & Driveway - After
excavation is complete, 'orms
and sub-base material in place.
o Fence - When completed_
o Streel Trees - When all required
trees are planted.
o Final Plumbing - When rill
plumbing work Is complet,c.
D Final Electrical - Whon ail
electrical work is complete.
o Final Mechanical - Whon all
mechanical work Is completo.
'1'V'f Final Building - When all
~requlred Inspections have becn
approved and building is
completed.
OOthor
MOBILE HOME INSPECTIONS
....
'. .
o Blocking and Sel-Up ~ Wh,en all
blocking Is complete. "
" .
o Plumbing Connectlons;_ "Yhcn
homo has been connccted'lo
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections arc approved and
porches, skirting, decks, and'
venting have been Installed.
...;' ,
Lot ~yp. ,
Lot faces
Lot sq. Itg. ~ Interior I P.L.
IN
Lot. coverage Corner
Is
Topography Panhandle
W- \W
Total height Cul.de.sac IE
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. ~ VALUE
Main
Garage
"
/QZ. ~
~~,,~~
-2-':54-
~/D
Carport
Total Val ue
Building Permi I Fee
2.Jdo
3.~.$
'7, 3ft>
State Surcharge
)JJr,13
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
$ 5'" o~
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
/
/
/
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
/1
/
/
/
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT OUE (excluding electrical)
(A, B, C. D, and E Combined)
9t1,5f
';'."
".i., ~::~'1h;\f:~;
'IS THE PROPOSED WORK IN THE _
"-HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Setbacks
HSE GAR ACC'
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 Clly.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.
Plan Check Fee: ~ . / s
---LY~/)'~
Receipt Number: /'7:3 '72>
Received By: A/~
/f/~'
Plansof1e~ewed By
Date Paid:
J/h)0-~
/' ~.7e f
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~~;~.~~~M=~~~
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 further 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 of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission 01 the Building Safety Division.
J 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 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.
~nature~""- - ." 7......0 ~
/
Date J/ ~.:2 :\ ....9C/
VALIDATION: (t:(Ctl
RECEIPT NUMBrr r' u....; /5
DATE PAID II' Z:::)!-ft ~
AMOUNT R~,ko , . YU.5{-
RECEIVED BY~. )(j)[.l/
J
,
,
ATTACHMENT B1 0
. IliB NO. / ~/7/s-
CITY OF SPRINGFIELD SYSTEMS DEVELOPME~CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: D,J., Jtt.. iJ--P
LOCATION: -125"5" ~JI~ .<'../.
DEVELOPMENT TYPF' .~ ~
I. .
BUILDING SIZE: F.4l/c ~p~.eM..c= /3 ;(~O 1.0T SIZF
.. ,
,
. I
I
SQ. Ft.
1. STORM nRATN~
IMPERVIOUS SQ. FT. 2CoO
2. SANTTARY SFWFR-rTTY
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
X $0.209 PER SQ. FT.
~1,~~ )
\.. ----
X $43.26 PER PFU
$ ~
./
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X
X $436.19
X $436.19
X $436.19
$ ~
/
$
$
SUBTOTAL (ADD ITEMS 1.2, & 3) $ 5"~'3~
4. SANTTARY SFWFR-MWMr
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ ~
(Use PFU Total 'From Item 2 Above) /
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
. IQIAI -MWMr. snc
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
$
$
$ S"~Ji'
5. AnMTNlSIATTVF FFF~
~.7.z~
BASt-CHARGE (SUBTOTAC'ABOVE) X .05
~/!~
/Mat\v Hibrnig. P.V
SDC'Ed'ordinator
Date:, //-/5'- "t~
IQIAI sor
$ 51, (J~
B2.SDC
.'