HomeMy WebLinkAboutPermit Building 1994-5-24
OWNER' 'ThJ.. \ 7,' ~.~ ~Q. ~V' r'r&::~( j~e:
ADDRESS:"2?c;..{ gueLI~1~~
CITY: ,<:;P?/~.f;l€td .
1 I
DESCRIBE WORK: ~ ~8 ...'S'TO(2.,v €)ljf2(f2-
,
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT' "
J "71'J "3
NEW
REMODEL
SPRINGFIELD
BLOCK:
STATE:
I') /C.-
JOB NUMBER 9~ c; 2.7
225 Fifth Street
Springfield, Oregon 97477
~ '3 t) 2.-1'i
SUBDIVISION: #
PHONE:747- 87/ ()
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,
o ~ t-A-q t7
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OTHER
ADDITION ~ DEMOLISH
ZIP'
CONST. ?..c;-Cp &-cxc 3
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHO~E ..
G,ENERAL:" r~".fc~1.' ~=J"rl~h..' ?O~I-4L-nkt~~0 97~Z 9777(,., 11t1':J-
PLUMBIN~:5Fr(.o.L~{ ... "'Lo3\(D\9,{iq.q~ AA4.,ll.
;::;:~~:~L~~~~ ;~. er--r-. ~~. Fl- Z~Lf+ 'W..tkF
QUAD AREA$~ )l)
# OF BLDGS: ~ \
OCCY GROUP: ~.~
f) -'
# OF STORIES:
WATER HEATER:
;;... OFFICE USE -
\ I t 1
LAND USE:
it OF UNITS:
\.
vrv
FLOOD PLAIN:
ZONING CODE:
m~
CONSTR, TYPE:
HEAT SOURCF'
RANG~'
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
P)~
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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
D Underslab Plumbingl Electricall
Mechanical - Prior to cover.
'K7r Footing - After trenches are
. V'..\, excavated.
D Masonry - Steel location, bond
beams, grouting,
K7( Foundation"':'" After forms are
~ erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
~' Underlloot'Plumbirml Mechanical
. V"......t _ Prior to'tnsulation or decking.
K71' Post and Beam - Prior tof/oor
~ insulation or decking.
~ Floor Insulation - Prior to
I~cking,
D Sanitary Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench. .
D Water Line - Prior to fillir')g
trench.
1'-./[ Rough Plumbing - Prior to
~cover,
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
. ........ " cover. .. . .
1":><( 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,
~raming. - Prior to cover,
~Wall/Ceiling Insulation - Prior to
~cover,. .
~ Drywall - Prior to taping.
D Wood Stove - After I~stallation, .
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place,
D Fence';';" When completed,.
D Street Trees - When all required .
trees are planted, . ,
. ~ Final Plumbing - When all
. plumbing work Is complete"
.~' Final Electrical -.When all
~Iectrical work is complete,
~Final Mechanical - When 'all
~echanical work is complete,
'l>(1 Final Building - When all
r ",equired inspections have been
approved and building is
completed.
D. ~ther
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, .
D Electrical Connection - When
blocking, set-up, arid plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
insp~ctions .are .approved and
porches, skirting, decks, and
venting .have been. installed:
2~7
SYSTEMS DEVELOPMENT CHARq~J;SDC)
(B) LJbO
\
\
Lot faces
Lot Type
Lot sq, .ftg.
. Interior
Lot coverage
Corner
Panhandle
Topography
Total heig(!ht ~ ~ /'
~~I )
-
BUILDING PERMIT <,"
so, FT, X $/so.. FT,
_~ ~~c
Cul-de-sac
. ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
SUite Surcharge
/3. ~.r- g.e1
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO .:s
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
I P.L
IN
Is
Iw
IE'
Setbacks
HSE GAR
VALUE
.'~S3!3
2/....-?9.$i?
FEE
~8) e...
Plumbing Permit '2..:'10
State Surcharge ;.5 ~ .91)
Total Charge (C) :~2- fO
-
MECHANICAL PERMIT
Furnace
i
,
Exhaust Hood
Vent Fan NO / .IJJ t' Ii,) i
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
, 7~ -r- ,-fS"
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
'(A, B, C, D, and E Combined)
/C;,tTO
...,.
/O~O
).'40
2&.'2.0
341.ft1 7
Accl
I
I
, I
I
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" THE PROPOSED WORK IN 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,
. APPROVED:
BUILDING VALUE, 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 r.evoked at any time
upon violation of any provisions of said ordinances.
/75":/8
4j/~/od
Receipt Number' '1/2.':4
Rece~ved. y ~~
D~~..'-. 5/~~~
Plan Reviewed By , D6te
Plan Check Fee:
Date Paid:
Systems Development Charge is'due on all undeveloped
properties within the City,lImi.~s which are being improved,
~ ,. ~.. .
ADDITIONAL COMMENTS
fiArll 1.
r
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.
I further agree to ensure that all required inspections are
requested at the proper time; that each address Is readable
from the street, that th~per, ;;" rd Is located at the front
of the prop~rty, a he a roved. t of plans will remain
on the site r es ring r-str ction,
V nature '\.#. "/t. tJ LA / .
~ . \, -; C .
Date
VALIDATION:
RECEIPT NUMBER
12 ?~)7
.r/Lc(Ad'
( 34>-:'1 (; 7
/~~
(
DATE PAID
AMOUNT RECEIVED
RECEIVED BY