HomeMy WebLinkAboutPermit Building 1993-12-8
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ADDRESS: '1, )( (J I..&~"'A Lb
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P-JAA' YrL
RESID'ENTIAl
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORt<.
ASSESSORS MAP:
LOT:
OWNER:
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
.
SPRINGFIELD
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Jln~:::> Lu::l
BLOCK'
STAT'"
CJR
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1i-.x.':lI'l
DEMOLISH
OTHER
.
JOB NUMBER
0~IJ~S>
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
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SUBDIVISION:
PHONE:
~R
J ';).i,. 4i::JL-.
7'lf'1'- ~~
ZIP:-9/l/11
CONTRACTOR'S NAME ADDRESS
GENERAL: fHL ~eJ-LA./I P~p() Pv,1. 70't k. s..;,h , (JI)..
CONST.
CONTRACTOR'
q,J.J,x 1;:l:Ii'Of'l.~'iI
PHONE
gf.,/-/(..,g'1l
PLUMBING:
MECHANICA' .
ELECTRICAl'
QUAD AREA: c4 Q..~
\' I'>>
Q\..
l ".'
"OF BI.:DGS'
OCCY GROUP:
" .
. OF STORIES:
WATER HEATER:
- OFFICE USE -
1\ \ \
LAND USF.'
.} I
. OF UNITS:-
CON~"'lR T;~E: _::J.l\/
HEAT SOURCE:..
RANGf'
EXPIRES
'3 Ie-I q "/
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
~~fl
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectioos 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.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, groutlng.
lXl Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulatioo or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
t~nch. .
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
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.
(Xl Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted: .'
o Final Plumbing - Wheo all
plumbing work Is complete.
D Final Electrical - When all
electrIcal work is complete.
o Final Mechanical - Wheo all
mechanical work Is complete.
I\7l Final Building - When all
I,d..J required Inspections have been
approved and building Is
completed.
o Other
MOBilE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocklog Is complete. .
o Plumbing Connections - When
home has been connected to
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 are approved and
porches, skirting. decks, and
venting have been Installed.
:L Lot Type . Setbacks ~ THE PROPOSED WORK IN THE
Lot faces
X I P.L. HSE GAR ACC I ... HISTORICAL DISTRICT, OR ON
Lot sq. Itg. Interior :2'e>'~ THE HISTORICAL REGISTER?
Lot coverage Corner N If yes, this application must be signed
S ~ and approved by the Historical
Topography Paohandle lw ,$"1 Coordinator prior to permIt Issuance.
Total height Cul-de-sac IE I&'~
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
A,/\.I)p
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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 suspeoded or revoked at any time
upon violation of any provisions of said ordinances.
Main
Total Fee
Plan Check Fee: 3,:) . 5<''3
/I - Il -0,3
1000-,S
Receive "By: /DB
-~F< ~""7
evh~wed s.;!--I'{... "
Date Paid:
Total Value
State Surcharge
~~.s~
~-53
(A) -!?"?. t:/ ~
SYSTEMS DEVELOPMENT CHARGE (SDC4 it
(B) 113?~
Receipt Number;
Building Permit Fee
/2-~-93'"
Date
Systems Development Charge Is due on all uodeveloped
properties within the City limits which are belog Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Residential Bath(s)
Sanitary Sewer
N'
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Fixtures
Water
FT.
FT.
Storm Sewer
FT.
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.A~'~--P'<- F~t!:iIfL /~v.t.i'
~. AU'~"'.v:r,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
,I
Fu mace
Vent Fan
N'
By signature, I state and agree, that I have carefully examined
the completed appllcatloo 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 Bulldlog Safety Dlvlsloo.
I further certIfy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 slte})a.1I times during c.~oJstruction.
,Klgnatur/,;f"~,, - if ./J",~.-/--.J
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Date
/2 -g-?.5
Curbcut
Demolition
State Surcharge
VALIDATION:
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
/~~ ~2.
RECEIPT NUMBER
DATE PAiP
AMOUNT RECEIVEi"'
RECEIVED BY
//C)"} 0
/2 -~ ~'73
/d&> .e-2.
~
Total Miscellaoeous Permits (E)
- ,
.... -
.
.JOB NO. C)?n 'J!;
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: A/o'-I>"IA AI !JAiJSEN
LOCATION: q 7J? QUlfJALT
/7032&-'-1'2. ~ ()(p'100
DEVELOPMENT TYPE: i.....P;!.. - SHoP ADD; -nON..
BUILDING SIZE: '~,I. 2'Z-(,;'/CJ.-vP~S 0+1(6) LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. t.ftfo X $0.203 PER SQ. FT. ~S<j?~)
"-..... ..-/
2. SANITARY SEWER-CITY
NO. OF PFU'S .~ X $42.08 PER PFU ~
(See Reverse) '- ...-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $424.31 ~ .- "\
I
'- ..-/
X X $424.31 $ ~
X X $424.31 $
4. SANITARY SEWER-MWMC
NO. OF PFU'S -- x $15.125 PER PFU + $10 MWMC ADM FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $
TOTAL-MWMC SDC C .- ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ ~~.~~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~? 4----, i;' d i I /2- " II ~
U Kip Burdick. 'I
SDC Coordinator
~ '-1-4/2)
.......... ..-/
,'1
TOTAL SDC $ cy!:;_