HomeMy WebLinkAboutPermit Building 1995-2-7
OWNER: ~\\.r<\ ~(\f\
ADDR~S~'... A:\()~~ t~~ \j.YQ.JV
CITY: ~"l.~)\_\_n~00ct. ~ATE: \~
DESCRIBE WORK: ~f) ~
NEW ~ REMODEL' ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
. Office:. 726.3759
LOT:
CONTRACTOR'S NAMEl ~ v\..
GENERAL~J\\~'i..en,\ n.J It,
PLUMBING:
MECHANICAL:
ELECTRICAl'
QUAD AREA:
It OF BLDGS:
OCCY GROUP'
It OF STORIES:
&~~
\
~
\
WATER HEATER:
SPRINGFIELD
BLOCK:
DEMOLISH
OTHER
/
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JOB NUMBER
225 Fifth Street
Sprlnglleld, Oregon 97477
SUBDIVISION:
PHONE:
1 ~jp-~lQ,Cot
ZIP:
al11P)
CONST.
CONTRACTOR It . EXPIRES PHONE
,-- --~
llb-&t-16
, ~ao/?fr\ '~J ld
~~~
ADDRESS
I
)
...:.... OFFICE USE -
LAND USE: \ \ \ \
VtJ
FLOOD PLAIN'
ZONING CODE: ~
II OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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 a.m. will be made the lollowlng work day,
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical!
Mechanical - Prior to cover.
r71 Footing - After trenches are
I....,bJ excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
..' 0 Underfloor Plumbing/Mechanical
. '- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
. decking.
D Sanitary Sewer - Prior to filling
trench.
fVl Storm Sewer - Prior to filling
Lf>-J trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover. .
1/ OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANG E'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ 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 a'pproval
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.
jVI] Final Plumbing - When all
Lf>J plumbing worl< Is complete.
o Final Electrical - When all
electrical work is complete. ,
o Final Mechanical - When all
mechanical work Is complete,
IV1 Final Building - When all
t-.p-J required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D 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 (aces
Lot Typ
Lot sq. ((g.
Interior
Setbacks
I P.L. 'HSE I GAR. ACC '
I N I I
I S I I I I
Iw I I I
I E I I I
IS THE PROPOSED WORK tN 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.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
APPROVED: ,
BUILDING PERMIT
ITEM
SQ. FT.
X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Carport
4Uo
\4. . \[)
vl\~LP
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 01 any provisions of said ordinances.
Plan Check Fee: 4-n.lo~
Main
Garage
"
Date Paid:
Total Value
lo~.c::D Receipt Number'
Building Permit Fee
~o 5.0\ ~ved By
State Surcharge ~ Pia ~vlewed By
vI), ~ \ ~'\S
Total Fee (A) ate
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)~t
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
\
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
NO
\,>-0 ~\t\r(\ .\ O~\i.f'\O\ ~fuL~rt:.
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
05
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
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 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.
Wood Stove/lnserllFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
os
j.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
(rom the street, that the permit card Is located at the (rant
of the property, and the approved set of plans will remain
on the site at all times ~urlng constructlon.4
r-I -AA~J ~ ~
Slgnature\ / 7/"e.h __'/~
Datf' X 2- -7 -./f"
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and' E' Combined)
IDR.(<q-
VALIDATION: ~n
RECEIPT NUMBER \ ~.1
DATE PAID c!). ') . q
AMOUNT RECEI't'E$ \Og, \Lf
RECEIVED BY 0\\ ~
State Surcharge
~o~~~c:~s' ~:,:
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