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Home My WebLink AboutPermit Mechanical 1999-7-21 t~/I-/(d ~ j)?IMJE , 10 oct ~owl1:-N <<'f7r< (" ;/(;.F/'cS-(d tlll.\ T, RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WOrK' ASSESSORS MAP' /76"3 'f 2- 'J LOT' OWNER: AODRcee. CITY' DESCRIBE WORK" NEW REMODEL CONTRACTOR'S NAME GENERAl' PLUMBING' . BLOCK: 01'!-U1 G5 STAT~' f1 EA--f- . JOB NUMBER 190 1 ff 225 Filth Street Sprlnglleld, Oregon 97477 TAX LOT' SU8DIVISION: 01105 PHON~' 70..(9-6f96 o;(?. ZIP: '77 r::77 ;VJ-'l/f.tf) :. v S' (S h-.=rvt OTHER ADDITION DEMOLISH ADDRESS CON ST. CONTRACTOR # EXPIRES '::'> PHONE MECHANICAl' ELECTRICAl' /171/<'.)64 ~ fJ~,oCb ce. I (j..cJ /!-. f..L(/,!:!-f/ t:;7 W/"tro1. FJ6- We; / /?/f. q7 fo3 77 to- 3(~OO ?<f.6-f6J.1 - OFFICE USE - squires you to TICE' . ATTENTION:UlbHUI""wr UtTly QUAD ARI)!J? ' ""\f'!RE IFTHftWO~E: I \'0'" rilles ef10pted blf~B'0gr~R~: .,1(1" THISPERMII ::it1I-\LL.<J' u.'..., C I r Those rules are 5'" U"" # OF BLDGS'--- U:43En~ISPERM~~lTS: Notlftcatlon en eO'10ttttel\Uli~~S!3e:fl01- AU I t1Ut1ll..CU , . .. "CI"IQ in OAR 952-UU1-0 u~ r les by OCCY GRo.UP.M: "Et'''~~~P'C ~DONE'C01'ISTR. TYPE: 66S0 Yell mayoblainqie%BY.t:\~: u L;ur IIV' .V~- p- . . r (Note: the iillepnolltl # OF STOIJ\AA' 189 Q~Y ,,~QI()D. HEAT SOURCE: calling Ihe cenle. &R%l~Bt<<isa\liJ;,rl numbertorllleOreg" \ WATER HEATER' RANGE: _ C'9P!eris 1'80!3Q"'t;IAR"E1t~OTAGE: To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested belore 7:00 a.m. will be made the same working day. Inspections requested after 7:00 8.m. will be made the following work day. D Temporary Electric D Site Inspection - To be made alter excavation, but prior to setting forms. D Underslab Plumblng/Electrlcal/ Mechanlca! - Prior to cover. D Footing - After trenches are excavated. D Masonry - Steel.locatlon, bond beams. grouting. D Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underlloor Plumbing/Mechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to deckl ng. D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. D Waler Line - Prior to filling trench. . D Rough Plumbing ~ Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. o 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. D Framing - Prior to cover. D Wail/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. D Wood Stovo - After Installation. D Insert - After fireplace approvl!ll and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement ot concreto. D Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. D Fence - When COiYlpleted. D Street Trees - When all required trees are planted. D Final Plumbing - When all plumbing work Is complete. , , ~nal Electrical - When all ~iectrical work Is complete. @ Final Mechanical - When all o 'echanical work Is complete. D Final BUilding - When all required Inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS D Blocking and Set.Up - When 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 Inspeclions 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 L~t ~ype. Lot sq. ftg. . Interior Lot coverage Corner Topography Total height ,. Panhandle Cul~de.sac BUILDING PERMIT 'I 't ITEM .' SO. FT. X $/SO. FT. Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fcc (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary S~wer Water FT. FT. FT. Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent f-kJ /...~ Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut It Demolition Slate Surcharge Total Miscellaneous Permlls (E) TOTAL AMOUNT DUE (excluding electrical) (A. B, C, 0, and E Combined) ., I P.L. N S W ----- E VALUE " FEE I f:uo //, f/;) /, \'" 7..t.>b . .:, ;'. -. \ ~ .. "'I::':}}:!:;:~l ,'~ . .".'-1;11:,\ I .S THE,PROPOSED WORK'tN THE. '-'.HISTORICAL DISTRICT, OR ON THE HISlORICAL REGISTER? II yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. Setbacks. HSE GAR ACC. APPROVED: . BUILDING VhL~E, 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: Dale 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 COiylMENTS . ;::Z~TIt( ~ tt1fit-,...J / ~'lA/n/ 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 wllh Ihe Ordinances of Ihe 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 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 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 adZ I tI es during constr~c 10:, ?"- 0 rp r: (71 Signature _ ......;" / # 7-()-(~'1.{ Date VALIDATION: RECEIPT NUMBER O~/'-I1?Lf DATE PAID 7/;../ 7'<7 AMOUNT RECEIVED ,r.J ~ RECEIVED BY ~ tJ,;.,.,j/ JOB NO. q;J..c?:.+8 t CITY OF SeINGFIELD SYSTEMS DEVELOPM. CHARGE WORKSHEET I . (COMMERCIAL & RESIDENTIAL) NANE OR CONPANY: HoIAJP,l'p i 7)1I/NE JiM1E.S> LOCATION: &:.0"/ f('DwnIJ Av€. 170~~of']."3 -/(05 DEVELOPMENT TYPE: NE:W Au-IE. ~~D~Y E.....pt, BUILDING SIZE: 1'6 X /1.- (/"'CC.()P6~ €Ave) LOT SIZE 1. STORM DRAINAGE SQ. Ft. Iff IMPERVIOUS SQ.. FT. '2-1 fo X SO.186 PER SQ. FT. ~ '10 - (See Reverse for Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER-CITY NO. OF PFU'S - X S38.55 PER PFU (See Reverse To Determine Total PFU'S) 3. TRANSPORTATION s NO OF UNITS X TRIP RATE X COST PER TRIP X X S388.61 S. ..-:---. .r X X S388.61. l' ~ . .," . -._.-_. ..'."'-..........x..-"....=- XS388.61 ,"" .' s' -'. (.~~e, Attachment; C To Determine Trip Rates) '.cf.o II . ..' . ..' SUBTOTAl(AOD ITEM.S 1.2. & 3)' s.. ~ 4. ADMINISTRATIVE FEES 'BAsE CHARGE. (SUBTOTAl ABOVE) X .05 S :2 Of _ .' . ., TOTAL-CITY SDC S L.h.. ~ 5. SANITARY SEWER-MWMC NO. OF PFU/S. x S13.25 PER PFU ~ S10 MWMC A-OKIN. fEE S (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) /0 ~L"'( 3/,7/12.- U Kip Burdick sac Coordinator s TOTAL-MWMC SDC S ./ ,., TOTAL SDC S --r2. -