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Home My WebLink AboutPermit Building 1995-7-10 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 . SPRINGFIELD ASSESSORS MAP: LOCATION OF PROPOSED WORK' / <<> 05 1?~~~~::<7- ~<. ;<'~/N P, ou/ OWNER:_IV/Ilt1.,J( /tv I~ cNc"t'I- r ~A""""'''A ADDRESS' )(. 05 l'\A IN llo w Dv. S,?rl"" _?41~ f ( I LOT: CITY: BLOCK' Y..~ N4/1 STATE: () v, DESCRIBE WORK: 1 I A-on .t-/ "1J- 0..... f,",;i., 11'00141..,. / OTHER Do""tNt....... ABo"(... R.~"""... ADO '0,6 \. NEW REMOD~L...1S-.- ADDITION CONTRACTOR'S NAME GENERAl' r-H/.... F-A/5n=./H NONe. N ol'-l e-. Hul"o~ O(.VV\e.~ PLUMBING: MECHANICAl' ELECTRICA' ' OUAD AREA: I AN tV . OF BLDGS: OCCY GROUP' . OF STORIES: WATER HEATER: DEMOLISH . 9S't:::?~~ JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 Dy. TAX LOT: L:' /~ eD 2.... SUBDIVISION' PHONF' ') 'i I -:3 1-1- ':L ZIP: 9')'!?? ADDRESS C....,', 6~ 1./ KaDt''''/( CONST. CONTRACTOR' 9.5 8-"1 .r;;;- EXPIRES )-5-9') PHONE "8'(-'(-3'9 REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. ~Rough Electrical - Prior to ~ovor. ' o Electrical Servlco - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. S"Framlng - Prior to cover. ~Wall/Celllng Insulation - Prior to ~ cover. ~rYWall - Prior to taping, o Wood Stovo - Atter Installation. o Insert - After fireplace approvlIl and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placemont 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. , FLOOD PLAIN: ZONING CODE: ---.:W il.. . OF BDRMS' SECONDARY HEAT: SOUARE FOOTAGE: 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. Inspections requested after 7:00 a.m. will be made the following work day. - OFFICE USE - LAND USE: I \ II o Temporary Electric O Site Inspection - To be made after excavatton, but prior to setting forms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. J9( Footing - Alter trenches are ~excavated. o Masonry - Steel location, bond beams, grouting. ~Foundatlon - After forms are ~erected but prior to concrete placement. o Underground Plumbing - Prior to filllnQ trench. o Underfloor Plumbing/Mechanical - Prior to Insulation or decking. ~ Post and Beal'11t - Prior to floor ~ Insulation or decking. i::A' Floor Insulation - Prior to J6..! deckl ng, o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. . OF UNITS: CONSTR, TYPE: HEAT SOURCE: RANGF' o Final Plumbing - When a/l plumbing work Is complete. 'K:;:r Final Electrical - When all ~ electrical work Is complete. o Final Mechanical - When all mechanical work Is complete. I'Y"(Flnal Building - When all ~requlred Inspections have been approved and building Is completed, o Other MOBILE HOME INSPECTIONS o Blockfn9 and Sel.Up - When all blocking Is complete. o Plumbing Connections - When homo 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 porchos, skirting, decks, and venting have been Installed. ... Lot faces Lot Type. Setbacks _ THE PROPOSED WORK IN THE, Lot sq, ltg, ..; I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON _ Interior IN I THE HISTORtCAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height .1!t Cul,de,sac (,~' ) IE I APPROVED: BUILDING PERMIT BUILDING VALUE, PLAN CHECK ITEM sa. FT. x $/SO. FT. VALUE AND BUILDING PERMIT Main Garage '. Carport M~/f7W 5n 5t'o,].O l//~Pf1~ ~~()d Zf1:,JD .- 7J~OO 1// ??9IJ , , ,~s:a tOP !i3f~ Total Value Building Parmi I Fee -/,:J3~., "', 0 Slate Surcharge r -, G- Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) .q, OS ~ -If:> PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' / /' / Sanitary Sewer FT. FT. FT. Water 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 / Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition Slate Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) C]:l; ,/0 , This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City 01 Sprlngfleid, including the Development Code, regulating the cOr)strucllon and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances, Plan Check Fee: 5'"~.<' '3 _6-/ ..q-;;- 17~o Date Paid: Receipt Number' .... , n~~ Systems Development Charge is due on all undeveloped properties within the Ci,ty limits which are being Improved. ADDITIONAL COMMENTS :'5b"~p.--~/-,(,~ /7Nnur /,f A'b:;U~~ /~t 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 Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wlil 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 arc 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 ~":..~~".. Date V;~~:: lS VALIDATION: RECEIPT NUMBER jg<. c; /" 7-/o~'7 5 9~ --'::>c:::> ~ / DATE PAIr> AMOUNT RECEIVED RECEIVED BY . .B NO. 9f>oSQ5 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: MA-fLI'. J../UIS~IJ('A" /AIY1At'tA Y4JZ./JAU- LOCATION:--Lt.o5" 1?AIN'130W---12f!.. '-70~Zi4"L - ~'?()2- DEVELOPMENT TYPE: LDL ~ J'4.D,."nON. BUILDING SIZE: LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 7--4- X $0.209 PER SQ. FT. ~ 2. SANITARY SEWER-CITY NO, OF PFU'S (See Reverse) X $43.26 PER PFU G ----- ) ----- 3, TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X $436. 19 C ) ----- ----- X X $436.19 $ X X $436. 19 $ 4. SANITARY SEWER-MWMC NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE $ (Use PFU Total From Item 2 Above) .. ---- ---- SUBTOTAL (ADD ITEMS 1,2,3 & 4) $. 5 0; JOTAL-MWMC SDC $ ~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 ~.~. L~ '-0 Kip Burdick SDC Coordinator Date: ,,!tz /'iC; , I. TOTAL SDC C lJ22.) '- ~ $ 5 7-..!