HomeMy WebLinkAboutPermit Building 1994-6-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 72603759
LOT:
CITY'
.
- . "" '"
BLOCK'
.
q4()1~
JOB NUMBER
.11
STATE: ( 1)). 0 ~; ZIP' Q(j<101
REQUIRED INSPECTIONS
l'5C-, Rough Mechanical - Prior to
~ cover.
~ RoU~h 'Electrical - Prior to
~ cover.
'>-i. Electrical Service _ Must be
P approved to obtain permanent
electrical power.
o Fireplace - Prior to taclng
materials and framing Insp.
~ Fra~lng - Prior to cover.
~ Wall/C'alllng Insulation - Prior to
r cover.
~ Drywall - Prior to taping.
o Wood Stove - After Installallon.
O Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
exc~vatlon Is completc, forms
and sub.base materIal In place.
o Fen~e - When completed.
o Street Trees - When all required
trees are planted.
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES PHONE
,~3'~?
\ Q. rolJ - OFFIC~
QUAD AREA: LAND USE: \ \ __ FLOOD PLAIN:
. OF BLDGS: . OF UNITS: 0) ZONING CODE:.M1)IZ)
OCCY GROUP: k3tM CONSTR. TYPE: tiY VA) . OF BDRMS: ( 0
. OF STORIES: .!l HEAT SOURCE: WH SECONDARY HEAT: f)
WATER HEATER' -f RANGF' 7.... SQUARE FOOTAGE: ~18
DEMOLISH
OTHER
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, Inspectlons requested after 7:00 a.m. will be made the following work day.
~emporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
MechanIcal - Prior to cover.
n Footing - After trenches are
~xcavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement.
D Underground Plumbing - Prior
to tilling trench.
i\--J. Underfloor Plumbing/Mechanical
\.2:Q - PrIor to Insulation or decking.
K-7( Post and Beam - PrIor to floor
J6,.J Insulatlon or decking.
~ Floor Insulation - P;lor to
decking. , '.
"'r\:7"1 Sanitary Sewer - Prior to filling
...DJ trench.
~ Slorm Sewer - PrIor to filling
trench. ..' .
vi Water Line - Prior to filling
~rench.
Rough Plumbing - Prior to
cover.
~ Final Plumbing - When all
(:l plumbing Work Is complat,e.
~ Final Electrical - When all
I electrical work Is complete.
Final Mechanical - When all
mechanical work Is complete.
Final Building - When all
required Inspections have been
approved and building I.
completed.
-{
DOther Nvr'JF:. A\ll -to So
Si&t~fl.,.~..\..1 ( ~" s:cl.ti-
~~ \iYv'\ v-..'lf
M\ 1-t 'M" ^ 'I"""" (..Q..... ~~M.. .
MOBILE HOME INSPECTIONS ()
o Blocking and Sat.Up - Whan all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, sel-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
".> ". , '. t \ I .,', e ;J~"
'-~. ,\ '~.i'. ':"!"'I'.:"'l \:'," ~:~&.~.~.
Setb-cks .
I :L. I HSE GAR1 ACC I
I S I
Iw I
I E I
Lot faces
L~Pe .
Interior
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
~
Cul.de.sac
BUILDING PERMIT
::I~ SQ. FT. \s~ill = J!J.9,LdlL
Garage ~ \'-\.\D ..~
Carport
Total Value
\td~Cft(o
(+i'\~q5J ~9\a.~
. ~L\q\
,-~?1~. \ \
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~ ?3S'!.. '9
PLUMBING PERMIT
ITEM
FEE
Fixtures
N'~~
,,~n
Residential Bath(s)
Sanitary Sewer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
qU)~.~
< ~\.!Y7'"""
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
q,co
/J) .6)
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
(o rn
Mechanical Permit
~1.OU
10.00-
'.35
~~.::6
Issuance
(+.8\)
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk -5LL It
Curbcut ~ It
-
1'7 ..su
~f5 4f)
Demolition
t\)S\U5h'f'(\~ ~~
"'" M'~."."~". ~~ ",
TOTAL AMOUNT DUE (excluding electrical) ~..!.f\G\ ~~
(A, B, C, 0, and E Combined)
'. THE PROPOSEO WORK IN THE.
"HISTORICAL OISTRICT. OR ON
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
. APPROVEf"
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 City 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'
Date Paid:
Receipt Number'
~:
Plans Revlew~
..~.01'Cf1
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
fJ l)\1)Dlru , ~o\ Q iihOr )
\. <A+-l'o \ \, rltxJ
~ I Y11o~: \L\l<5
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 Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon 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
project.
I further agree to ensuro 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.
~ature L -1.?/
, /;
Dato t: ~ 2 0 - cr <(
VALIDATION:
RECEIPT NUMBER
DATE PAID
I~ 5/7
1"-/2l)/ '7~
::; ~4-j;) ,lalO
~~
,
AMOUNT RECEIVED
RECEIVED BY
:..,
~
. .., . '. " '1107?Z
:" ;:'~' ",. :- "i.", '.ro, _ " .' ,:" '. '::.:::. _ .._~-,. .::;:.~
,":, CITY, 0(; SPRI NGFI ElOJSYSTEMS- DEVELOPMENT CIli\RGE!:.~,':-: ~"~
.'. . ;'<:'. \}:':~~W.:. ~:. 0 :" , . 't}:.. 'wURkS'Hi:ET')';':"''-!';::'' .' ::.' . .c..:..
,': .:' ,-'-":,"',,:,--'---(COHHERCIAL'& RESIDENTIAL),...., ':'H: ,r"~~;.~..:.: .-'
'" ':i ..:.:..:.';......:...,:. '.:"._ ..~~: ". -:' . ..i:',....... ..__..........
'NANE O~:c"6~~~~i.>.: ~. 2),fiJ)>'~:' ,0 '.. .... '. .0:
LOCATlOrj:.r.,.i.o~.zSd;:i.~....&.J:' _. . <:'~-:':'--:';- -_..:.::-:~>,~::. :, I '
~E~~L~~~~Nt TfpE:::-//~~-~:1V..!:'.. .,..',.::-... :;..~;..:-...~."J
.. I ' .
. ", . ". ..- - '_~~~'."""-';''' ':.~. .
BuiLDING'SIZE: - :.S-:~;.-7,::';'.."+-'~';';':c..:c7LOTShE '-:': - -~.. '. - -' ,~\~ -~fS'Q': . fi<
. . ~ .
- . ~ .......... .
: ~- ~... .. - . ~. ".." -.
1". . STORM DRAINAG[l.;:~.,-;' ' ". ~;,j_<:1.3~!) Y":.. .
. ,~.. -.... " . .
..-....
-.. ~ ~ . ~ .. ...... ...
IMPERVIOUS SQ. FT. 2tP].0
r-S''JJ_~
~
, 0:. " I'
. , .
.. -i1~dJ~
"~
;;'.., "I ':: ",
~ .:_ '". . t
- - I
.('" '6 Sr. 7;;)
'-- .-/
5
X $0.203 PER SQ. FT.
..
2. SANITARY SEWER-CITY
,. 110.- OF PFU'S', .','n"32..
(See R.everse) . .- .
'..
X S42.08 PER PFU
~ ":-.-. .-" '. ~~-~~::'..- .
,"..'
. -:--..... ----- -_:- ~.~....
. .".. -...
. '.' ~ "".
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3. TRANSPORTATIOII
NO OF UNITS X TRIP RATE X COST PER TRIP
x. 1_01
X
X
4. SAN IT ARY SEWER -NWI1C
2
X 5424.31
X $424.31
X $424.31
5
NO. OF PFU'S "5:2. x SIS.12S PER PFU + S10 MWMC ADM FEE S -f'1~,OCJ
. (Use PFU Total From Item 2 Above) .
, .
537,sG
TOTAL-MWMC S~C ~
, '- ../
SUBTOTAL (ADD ITEMS 1,2.3 & 4) S 3/ f ~ , 'I l'
MWMC CREOITIF APPLICABLE (SEE REVERSE)
. .
.'
S. ADMINISTRATIVE FEES
. . Jt:TA
K P B~. J:~...
S Coordinat
TOTAL SDC 5 3 s~- 3. ({, P
: ,:.0?-?V
. . ....." .
'" ..., . ~ -.
, .
. . ~ ~ "'.' ;
"., ,
.'
o !L'!i!Ii!,m~!~!!!;
.
Job NO..94rf9'~
SYSTEMS DEVELOPMENT CHARGE
. WORKSHEET
NAME: lrf\ e::{l.PlJ 0 .... PHONE: ~tJA~ .~!)..J
lO~:O:~::~~~~~~~lU~~r)~1o~~ ~ ~_____
Platt Name: G\'O..nO~ Tax Lot Number:
1. DEVElOPMENT TYPE, (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back'>
A, Sinl!le Familv - Detached
Single Family home
NO OF UNITS
B. Sinl!le Familv - Attached d
NO OF UNITS
C. Multi-Familv Aoartment
NO OF UNITS
D. Manufactured Home Park
NO OF UNITS
WPRD SDC
Manufactured home not in a park
X $400 PER UNIT _=
$
X $370 PER UNIT =
, $ '740~
X $277 PER UNIT =
$
X $280 PER UNIT =
$
$ .2ll2.E?
$/2f
()A ("\ 00
$'m.).
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit>
f)
~A.
Community Services D
City of Springfield
/
I
Date