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Home My WebLink AboutPermit Building 1991-12-16 , RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 . SPRINGFIELD . JOB NUMBER.v07~O 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: ~~ 2 ASSESSORS MAP: 17-t)3 -27<2 y <)/:.,0:7"7';' GLE6/ ~/~.z- TAX LOT: C. LI Lf<t>C> -::?' SUBDIVISION' ~~A'V~ LOT' 5Lf OWNER: -L/">,c.~V~p ADDRESS: //~~ ,IV. E~cA/'- CITY: BLOCi<' PA4'::? T.A;,,-,,.....cS I . i .- ~T-?"-' fr STAT'" ~)".:? PHONE: -.6.P~-~/..?'"=fI ZIP: q~&)2. DESCRIBE WORK:,h1'.I1"~-,F !~~ ~A=r~ - NEW Y REMODEL ADDITION DEMOLISH S~/"""""'..h7-" ~ ~&:'~ WJy;..v.;#/2J!c OTHER h7.H: ~~~,//O? ~ 6. ~ ~ . . ~ 7 - CONST, CONTRACTOR'S NAME ADDRESS CONTRACTOR' GENERAL:/5q,lt;//~.-/ ~~, ~~~4f{4'~/' 4//447 . ','.. -, , ",',' lr,~/ :' H'~S"_'?9, . , PLUMBING: ;1;A;;;~ljH*S'r ,&;>, Jtt;~ 2!:J~~ P6'('. . " I' ~ , ,. MECHANICAl ,..:f./..Tj~., oFf s:;,..-..- 3.55 pv. -::?<i077 ~'" ~":lS-"':./ ELECTRICAL~~ CZcr;,:/; - ~.&'--~~;, ,4a/?'7 /:J'2? QUAD AREA: J~ iV/&/, . OF BLpGS: I OCCY GRoup:.,h?!>'i,JY7-L I E . OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: /I~ . OF UNITS:----.I CONSTR. TYPE: h""7Y' HEAT SOURCE: ?Lf;;' 6 RANGE: EXPIRES PHONE V5?,SI'~SlJS CJi!!9-7'%2 '2 - :;>-92 , -=14~-X-~ FLOOD PLAIN: ZONING CODE: ~ ? . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspection, you must calt 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. D Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. [.El Under.lab Plumbin!lfJ:lectrlca!D Mechanical - Prior to cover. W Footing - After trenches are excavated. D Masonry - Steel locatIon, bond beams, grouting. D Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench, D Underfloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor insulatIon or decking. D Floor Insulation - PrIor to decking, ell Sanitary Sewer - Prior to filling trench. r\71 Storm Sewer - PrIor to filling L....LJ trench. I\7l Water Line - Prior to filling Lp trench. D Rough Plumbing -: Prior't? cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. D Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wall/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping, D Wood Stove - After Installation. D Insert - After fireplace approval and installation of unit. ' D Curbcut & Approach - After forms are erected but prior to placement of concrete. n71 Sidewalk & Driveway - After l.,L.J excavation Is complete, forms and sub.base material In place. D Fence - When completed. rvl Street Trees - When all required lAJ trees are planted. D Final Plumbing - When all plumbing work is complete. D Final Electrical - When all electrical work Is complete. D Final Mechanical - When all mechanical work Is complete. D Final Building - When all required Inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS Ii7l Blocking and Set-Up - When all LAJ blocking Is complete. [K] Plumbing Connections - When home has been connected to water and sewer. IY'1 Electrical Connection - When LAJ blocking, set.up, and plumbing inspections have been approved and the home is connected to the service panel. G.KJ Final - After all required inspections are approved and porches, skirting, decks, and venting have been Installed. 2- Lot TY. Setbacks . Lot faces IS THE PROPOSED WORK IN THE Lot sq, fig, t:.O:>P ~ Interior 1 PL. HSE GAR ACC 1 HISTORICAL DISTRICT, OR ON I THE HISTORICAL REGISTER? Lot coverage Corner N If yes, this application must be signed I I and approved by the Historical ~ S r" Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de.sac M' IE ,5'1 APPROVED: BUILDING PERMIT ITEM SQ, FT, X $/SQ, FT, Main Garage Carport '~l*~~r Total Value Building Permit Fee State Surcharge Total Fee (A) VALUE "Ur p" t,tJ!; _/.-7 ~C> 7~ <~5"" , -:2~.~~ /.c,/~ ..-:::30.~ . - (B) SYSTEMS DEVELOPMENT CHARGE (SDC) 'I2/!?. ?S PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer FT, Water FT. Storm Sewer FT, Moblie Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stoveflnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~' ft Curbcut fI Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) FEE '2< 25' '2.5" 7<":- ?7~ _-?~~ ;:;~ 7~ I~~ "'i':2-G' / e;: ..". /:?"."2~ ~.7b BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, i.n all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the co.nstruction 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. Received By: Plans Reviewed By Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS ~"i&"~"~7/ !&/",&.Je: I~ yzo By signature, I state and agree, that I have carefully examIned the Go.mpleted application and do hereby certify that all Information hereon is true and correct, and I further certify I 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 that NO OCCUPANCY will be made of any structure without permission of 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 s:t~mes during c~nstru~tion, Signalui (.Jv<~f) k~ ---- .- \ Date 1'1 ~ d~- q , VALIDATION: 73<'5 / ~ -y6'-<=7r AMOUNT RECEIVEr 9~b. q/ 4_~.~.., _ ~ . RECEIPT NUMBER DATE PAin RECEIVED BY . .v .. Metropolitan Wastewater Managernent Commission . . (~",": :~<'. ':: ::~:~ ~.:'~ ?~'.'~::-r~.~::! C:'.::":!'~:' ~.:f'.i i:'_"!'-!l;t~f :r~ =.!::!!f'T.f E:::: ::;::': -:-.-~:' ";"f'; ~i. :f:':'~:'T.~ C',':: ~i '!: -,- :;-:~ ;"~-: -:-::': :: .:: -, (::: '.~~:!:.-:-L:'! C~':".~~ ~:] =f:"!!~";:'~ ,:t:"Y ~;;~!-t&.( (,:'~":j C:--.:~ :-p r.~,:;. \,,'u.:E:;;-:,,;; t'.~ t., =.~: 't!i :.~r .! FiFTH A:'JD A SiREEIS - ~~r:.::-:GF::Li) CiTY r-:;'.~L - ~::R;;\GF:ELD, C;:,EGC!J ';;7:.77 TELEr';-;c..:\'~ i":C::) 7.;;..::: j If.'MC CO!\NECTION CHARGE Building Address: ~q,2, cYe.",it;: Ctv.UVI) Refere8umber: 170.3 ;;L7'2<J. Tax Lot Number: d L/c.t()-(j (1'") \), ~J ('" , O.'ner: D\ ~n(tl/l r [\ . i_ /yY1 .AT~l11..f:-,....~ Address: \ \ C\ C\ '\'\ '\~>(\f\ -\. -' ,Phone Number: l 09..<7; - q \23 City: fA ')(160 J1L State: (()i~ .D~BY\ Zip: q f\4n'L.. ~ Residential Fee ($222.00) $r9Q~ ~ Commercial Fee (new non-residential development I remodel) Total fixture unit charge (see reverse of this form) $ SUBTOTAL $ <$ 6)'1,49') > Credit Due (see reverse of this form) TOT~L MVMC CHARGE s \<14 .~ Date Received: /-;;?-/6-?/ Recei pt Number: ::?3 :::z."/' Received By: -/ ~ .,~ - Building Job Number: 9/ n 7 i/O . . .. Fi:nure Unit Caleulatio:l Table: ::u~,hr C! r,E'.' u:-:tures r,ultiplied by \l:lit equivalents. ;,01;::: For r~",od~ls, ealc;Jl~te e.nly the ':;::T aedi tional fi:-:t~:r€s. Fb:ture Type of Unit F xtures ;::Qui~al~nts Fi"ture L'ni ts 3a t h t \I b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drinking fountain... .... ..... ............. Floor drain......................,........ Interceptors for grease/oil/solics/ete.... Inteiceptors for sand/auto vash/e:e....... Laundry tub/clothes "asher............. ... Clothes vasher (3 or more)... ............. Mobile home park trap (1 par ~.3.)........ ~eceptor for rerrig/"ater statio~/etc..... Receptor for Co~~er sink/dish~s~:!etc..... Shover, single stall......... ............. Shover, gang (per head)....... ......... '" Sink, bar, com~ercial...... '" ............ Sink, commercial/industrial/etc........... Urnia1, stall/vall........................ V2sh.basin/lavatory, si~gle............... Vater closet, public installation......... Vater closet, private........ ............. )',iscellaneous: .......... 2 1 2 3 6 .2 6 6 1 3 2 1 2 3 2 1 6- 4 .......... .......... Total Units: Total fixture units h S13.25 each = Total Charge: $ Credit Calculation Table: 3ased o~ total value of property at time of permit application. Year -;'.:ir.e.:':l!:d to t~e Citv Credit per $1,000 assessed value 19ft,l)- 1979 1950 1981 1982 1983 1924 1985 1986 1987 1988 1989 1990 $2.66 $2.64' $2.53 $2.41 $2.19 $2.04 $1.69 $1. 35 $1.15 $0.92 $0.59 $0.23 Credit " S lO}32...0 = s Rate r.SSEssed Val \.:e Total Credit