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Home My WebLink AboutPermit Building 1995-4-3 (2) RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 .. SPRINGFIELD ~t@ LOCATION OF PROPOSED WORK' 5'";:l92. ~"9Y r~~""T~<AL ASSESSORS MAP: -/J?-z::,<.-A .Y-// y~~~~y /?3s:->/"~ . ~ <...oe-~}lf.J.:> ~LZ>-" , LOT: OWNER' ADDRE~~' CITY' BLOCK' , " STATE: . ~~. DESCRIBE WORK: 0/,:~,/~~-~y...?vq~~......v-- NEW REMODEL ADDITION DEMOLISH '" -OTHER CONTRACTOR'S~~.. . GENERAL'~~~': ;....JO' PLUMBING' MECHANICA' . ELECTRICAl' QUAD AREA' ~ e.-~~ , -- . OF BLDGS: OCCY GROUP:_tYl. t . OF STORIES' . WATER HEATER' I - ADDRESS CON ST. CONTRACTOR' .:. JOB NUMBER "9 Sf //'7t:::> 0.\ " - OFFICE USE - LAND USE: Ij:f,() I VN 225 Flflh Streel Springfield. Oregon 97477 TAX LOT' ~~/=<<:!> SUBDIVISION: PHON~' ?y;>~?~ . OF UNITS: CONSTR. TYPE: - HEAT SOURCE: RANGE: _ ZIP: ~ :?y? ') EXPIRES PHONE FLOOD PLAIN: ZONING CODE: ~D rz.. . OF BDRMS' SECONDARY HEAT: SOUARE FOOTAGE: _~D. To rOQuest an Inspection, you must call 726.3769. This Is a 24 hour recording. AI/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. D Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumblngl Electricall Mechanical - Prior to cover. [$J D Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. J\t1 Foundation - After forms are ~ erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Under(loor Plumblngl Mechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor Insulation or.decklng. . ,'. ... D Floor Insulatlcin ....:- PrIor to decking. _ " D Sanitary Sewer - Prior to filling trench. rX1 Storm Sewer - Prior to filling ~ trench, D Water Line - Prior to filling trench. D Rough Plumbing - PrIor to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. , ., D Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace -, Prior to facing materials and framing Insp. ~ Framlng,- Prior to cover. D Wail/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stove - After Installation. o Insert - After fireplace approval and InstallatIon of unit. D Curbcut & Approach - After . '-. forms are erected but prior to ',: placement of concrete. D Sidewalk & Driveway - After excavation Is complete, forms and sub.base material in place. o Fence - When completed. D Street Troes - When all required trees are planted. D Final Plumbing - When all plumbing w~)rk Is cemplet.c. D Final Electrical - When all electrical work Is complete. D Final Mechanical - When all mechanical work Is complete, rv'l Final Building - When all , required Inspections have been approved and building Is completed. DOthor MOBILE HOME INSPECTIONS D Blocking and Sel.Up - Wilen all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. D Electrical' Connection - When blocking, set-up, and plumbing Inspecllons have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. Lot faces Lot ~yp. Interior Lot sq. ftg. Lot coverage Corner Topography Total height Panhandle -!!:5 Cul-de-sac' '.~ ,..; ;~.:';i~ \~:'\. _S THE PROPOSED WORK IN THE. ".HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. Setbacks I P.L. I HSE . GAR' ACC I I N I I S I Iw I I I I LLLLJ BUILDING PERMIT ITEM SO. FT. X $/SO. FT. = VALUE ~..i5'iClO bb. SQ. l.\,~ b l. Q). SYSTEMS DEVELOPMENT CHARGE (SDC) if> (B) i$IS"1~ Main ~ G~ra8B $__ ~~. /f~/(> /<?/~ Carport Total Value Bullding Permit Fee State Surcharge ~.t>!. + '?, ~ Tolal Fcc (A) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO' Sanitary Sewer FT. Water FT. Storm Sewer FT. So Mobile Home Plumbing Permit State Surcharge Total Charge \.~s ~ 3.""6 (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft ft Curbcut Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) " _'\,~U~: ~e:J jle:> FEE ~.lO ~s.sm ol.~ ~l..cO q5 a5 ~l{B.oI APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express conditIon thai the said construction shall, in all respects, conform to the Ordinance adopted by the Cily .01. 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: -.-36. :::~ ?-~9,>", Date Paid: Receipt Number: /h-::.,.s / Received By: ~.--?_ ~~R <7- Plan,lJ1evlewod By ~ Jc9.l.l! "rS' , Dat~ Systems Development Charge Is due on all undeveloped properties within tho City limits which are being improved. ADDITIONAL COMMENTS - L\"r~";h''> ,,~.~-(..~ W-~'\) ~--MI.~,\l " By signature, I stato 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 tho City of Sprlngfleld, and the laws of the State of Oregon pertaining to the work descrIbed heroin, and that NO OCCUPANCY will be made of any structure without permission of the BuildIng Safety DivisIon. J further certify thai only contractors and employees who are In compliance with ORS 701.055 will be used on this project. I further agree 10 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 ::tj?;C~O Data \. '5>'-,,\.ftS . \ .', VALIDATION: ~7J / RECEIPT NUMBER .\ \0 V.?---'" DATE PAID ~t ~ .<-1,"1 AMOUNT RECEI":EO n d.. ~ '8 .l::)l ) RECEIVED BY ~\ lTh.. / ( - . ATTACHMENT B1 .B NO. 941110 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) " NAME OR COI'lPANY: .Te FFR.E:Y 1)e::""'u,.~ LOCATION: <::'-19'Z~ ?/"I4 fb~';'Y'\l-H;" \"'60'2-04-1\ - no\"Z-o DEVELOPMENT TYPE: ,,^p\2- - C:p..p...l'o(Z..1 At:.-6I"lIOt-..\ C'A!'-?o/L:f PAl{ E. BUILDING SIZE: zt,." H I">" 1 LOT SIZE SQ. Ft. 1. STORM nRA,INAGE (10~?V IMPERVIOUS SO.. FT. /'2-"'1. X $0.209 PER SQ. FT. 2. SAtllIARY SFWFR-CTTY C ~ NO. OF PFU'S X $43.26 PER PFU - (See Reverse) ----- 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X ~ X $436.19 c .............. ) ~ X X X $436.19 X $436.19 $ $ SUBTOTAL (ADD ITEMS 1.2. & 3) $ \C?-z..?~ 4. SAtllIARY SFWFR-MWMC NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ (Use PFU Total From Item 2 Above) SUBTOTAL (ADD ITEMS 1.2.3 & 4) (~ $ I I? 2. ?Co ) MWMC CREDIT IF APPLICABLE (SEE REVERSE) lOlAI ,M\.JMr snr. 5. ADMTNISTATTVF FFFS BASE CHARGE (SUBTOTAL ABOVE) X .05 C7~) ---- --- 1~~Lut ~..."...;,.. PI': SDC.Coordinato~ ' Date: ?oJ,II? /<=>t r; IQIAI snc $ I c:. "I "!!- B2.SDC .