HomeMy WebLinkAboutPermit Building 1999-4-14
SPRINGFIELD
RESIDENTIAL
PERMIT APPllCATIO~
Ins pecti onSQ26'3769)
Office: 726~37::>~
LOCATION OF P'ROPOSED WORK: 3t,lfo6
ASSE$SORS MAP:, I frD 2. l()()()
LOT"
I2J
BLOCK:
OWNER: 1/81/-;II UJt.J/.A II "" ~
ADDRESS' ~tl./ Di) ., /Sfl.w,J
CITY: S,I)~ I-/~
DESCRIBE WORK: to /7~" .> 8"~(S~
, "'r ' " J
NEW REMODEL "ADDITION DEMOLISH .
~.
CONTRACTOR'S NAME' ',,'
GENERAL:
,PLUMBING:
MECHANICAl'
ELECTRICAL:
'Ow A/I /L.-"
s I2J
STATE: 6~
\' kef!
JOB NUMBER
99ol{/Z
225 Fifth Street
Springfield, Oregon 97477
. TAX LOT:~/3()O
~ -
SUBDIVISION:
PHONE:
7'1(, -fd f"t
ZIP:
47L17 ~
OTHER
ADDRESS'
"CONST.
CONTRACTOR 1/
EXPIRES :'~ PHONE
, ,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
~lIghElectrical -,. Prior to
( LJY;er,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp,
~amlng .- P"o, to cov",.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to'taplng.
o ~ood Stove - After Installation.
o Insert - After fireplace approval
and Installation or unit.
DCurbcllt & Approach - After
, forms are erected but prior to
placement of concrete.
o Sidewall< & Driveway - After
excavation Is complete, forms
and sub.base material In place.
, 0 Fence - Wher) corrlpleted.
D Street Trees - When all required
trees are planted. '
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
1/ OF BLDGS' 1/ OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: II OF BDRMS'
1/ OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE 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,lnspections requested after '1:00 a,m. will be made the following work day.
o Final Plumbing - When all
. ,plumbing worl< is complete.
@;tV',', , '
D Fi I Electrical.,.... When all
ctrlcal work Is complete.
o Final Mechanlcal- When all
mechanical work Is complete,
11'9 al Building - When all
~ulred Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking 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 conne,cted to
the service panel.
o Final - After all required
, Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
r.-.
r
I
,
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms. '
o Underslab Plumbing/Electrical/
~echanlcal - Prior to cover.
t Dioottng - After trenches are
V excavated;' ,
o Masonry - Steel location, bond
, ~ams. grouting.
r DF,bundatlon ~ After forms are
. L-I4rected but prior to concrete
~ placement.
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
-,Prior to Insulation 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. ,
D Storm Sewer - Prior to filling
trench.
:'~'D Water Line - 'Prlor to filling
,trench. ,
O Rough Plumbing ..:-. Prior to
cover. ' ' -
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
';'
Panhandle '
Cul-de-sac
'i '~
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/FJreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8. C. 0, And E Combined)
I P.L.
N
S
w
E
VALUE
"
il. )2-'<
(
9ZJ---P
7. Yu
-3j. q ()
FEE
-M-tj/)
.: '1 ~ . \ ~ ' ~
Setbacks
'HSE'GAR'ACCI
I
I
EPROPOSED WORK i'NTHE .
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:
'; ,^, R) '~~,
BUILDING "ALtlE, 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: ~(), I?,
Date P~id: _~~)1 Ii'
Receipt Number' D ~ '5 ~ 0 I,;) /f
Received By,' ~ t..J~
JIJJ
Plans Reviewed By
I~
~ Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
t1 ~
~
~u/J
I
~it4
/ha..,.. .h,
./
By signature, I state and agree, that I have carefully examined
the completed application and db 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 Ordinanc~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 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 all times during construction.
Signature (]I~ e~d~
Date .t--/ II 1-/ / ~ q
I ( I( / /
VALIDATION:
RECEIPT NUMBER 0 .3 34 q J-
DATE PAID Lj -jq -- 09
AMOUNT RE~EIVED Cjq ~ Cj I
R!;C!;IVt;D eyl1..,fYJf~~~{,/A cYi CJ
--- - ----------~--- --. ,---.-.-..-.- ~:'i;;-"---- - =-..=;.------
-=w..-.....~,..- --- - - ---. .---.--.----.---.--