HomeMy WebLinkAboutPermit Building 1994-5-24
OWNER: 'ThoJ i: ~.D. tQ.. \%V r'iZ.<:"'")(j~e:
ADD~ESS:'27{';~ gueL,~~~:J
CITY: .<:; pit A.koL Red \
1 /
DESCRIBE WORK: .2 L8. "s'Ta\Z.-v €>rJt2cJ2.
,
RESIDENTIAL,
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: ./ 7(') '3
LOT: .
NEW
REMODEL
SPRINGFIELD
...
BLOCK:
STATE:
f"J/L...
r
,
JOB NUMBER
Q4J <:::2.9
( ,-
O~r-AqB
. \
OTHER
ADDITION ----- DEMOLISH
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
/:)~C) ~/'1
SUBDIVISION: . #
PHONE: 747 -- 87/ ()
ZIP'
CONST. 7'1-Ce &-c(,; 3
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHO~E '
GENERAL:' r4pT2"~lL\ 'f?x~t1frfE>i"t~ ?Q&:x(-4<:--r1.k!~~0 97<k-Z 9777~ 1-fCf~-
PLUMBING: "'S-pF('t,L\.L\'-..{ .'. i ,.,3\83 \9,~.qL\.. 01-4. tl, '1
. . . \ . I U.I
;::;:~~~:~~~~ ;~ er~ ~~t O$~if\- 'mtkF
QUAD AREA;ISR~ ") U
# OF BLDGS' \
OCCY GROUP: \=:\'~
f)
It OF STORIES:
WATER HEATER:
'"- OFFICE USE -
\ \ t ,
\ '.
vtJ
LAND USE:
/I OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
"'j
FLOOD PLAIN:
ZONING CODE:
m~
:.
It OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: -A25
To request an inspection, you must call 726-3769. This is a 24 hour recording. AIHnspections 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.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
K7r Footing - After trenches are
~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.
l"'.c-'1' Underfloor-Plumbi!'ll9 / Mechanical
. ......"t - Prior to"tnsulation or decking.
K71" Post and Beam - Prior to floor
~ insulation or decking.
~ Floor Insulation - Prior to
~cking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
l'v1 Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS
!XI Rough Mechanical - Prior to
.cove~ . .
J><l'ROU9h Electrical - Prior to
. cover.
D Electrical Service - Must be
approved to obtain permanent
. electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
gFraming. - Prior to cover.
g,Wall/ceillng Insulation - Prior to
cover.' .
~ Drywall - Prior to taping.
D Wood Stove - After I~stallatlon.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
~acementofconcreta
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
~Iectrlcal work is complete.
I><f Final Mechanical - When all
.mechanical work Is complete.
15<1 Final Building - When all
;' '-.!equired Inspections have been
ilpproved and building is
completed.
D ~ther
MOBILE HOME INSPECTIONS
D 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'~ctlons,areapproved and
porches, skirtln'g, decks, and
venting have been.installed:
','
Lot faces
.Lot Type
Lot sq.. Itg.
. Interior
Lot coverage
Corner
Panhandle
Topography
Total heig~~ /'
. ( ~ ~I )
"-
BUILDING PERMIT .',,"
SQ. FT. X $/SQ.. FT.
_~. ~~c
Cul.de.sac
-
'ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
/3. ~tjr- S."'?
I P.L.
IN
Is
Iw
IE'
Setbacks
'HSE'GAR'ACCI
I
I
I
I
VALUE
'~S3!3
...:2/.....J;1.SD
::zr/~ tJ7
SYSTEMS DEVELOPMENT CHARQEJ,~DC)
(B) lJbb
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO .~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
/,5 ~ ,9tJ
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
/
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total'Permlt
, 7~ ~ ,-fS-
(D)
MISCELLANEOUS PERMITS
I
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, 0, and E Combined)
FEE
~8)~
z:f C)
;~2- fO
/JJ t' II,) i
/ C;,trO
......
/D~O
),40
2fP ,7. 0
34 tj." 7
~
D 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 onthe 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.
/7 s: /8
4j/~/od
Receipt Number: '1'/2.' };4-.
Rece~'ved' y: #~
D~~ ~ 5/:w-h~
Plan Reviewed By ,. Date
Plan Check Fee:
Date Paid:
Systems Development Charge is'due on all undeveloped
prope~ties with.in t~e 9ity,limi.ts whic!'1are being improved.
ADDITIONAL COMMENTS
/JA71I 1.
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 t' es ring str ctlon. .
V natu re , "7t. . tJ LA /
~ . \; - V
Date
VALIDATION:
RECEIPT NUMBER
/L 1)7
.r/Lc/Ad'
( '. f (
34)"", ~ '7
//~
- '(
DATE PAID
AMOUNT RECEIVED
RECEIVED BY