HomeMy WebLinkAboutPermit Building 1998-6-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK' 4 C; z <)
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ASSESSORS MAP'
LOT:
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~ ~ /'rI till //r,
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BLOCK:
C;>W~ER'
ADDRESS:
CITY:
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STATE:
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DESCRIBE WORK' 12e:M/)iJ .,c~
NEW REMODEL ~ADDITION
~hrH
DEMOLISH
OTHER
. JOB NUMBER
t(gO h~ Lf
225 Filth Street
Springfield, Oregon 97477
TAX LOT: O'i'? r' 0
SUBDIVISION:
PHON~'
ZIP:
M/l/tJ tfi-1/
/J. A~/ /'~I")v rJit'. ~~ur CONST. 1;,t.~8'5S
CONTRACTOR'S NAME f'T1-'f7v ~Uy<-(-- ADDRESSOlJ~O r {f:;,~ CONTRACTOR II
-,- '- -', . J , _I" _. '1
I
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
11 OF BLDGS:
OCCY GROUP'
11 OF STORIES:
WATER HEATER:
0/91(
EXPIRES 0
'4" ~~~S-
PHONE
NOTlce~ '. .
", THIS,PERMIT S/iALL EXPIRE IF THE W()RK
AUl/ iOA/ZCD Ur:DCr. -;-lllt: rEr.;ill-;-l~ "Gf
- OFFICE USE - .
COMMENCED OR IS ABANDONED FOR
AN~~?EjiE~lujj. -~FLOOD PLAIN:
II OF UNITS: ZONING CODE:
CONSTR. TYPE: 11 OF BDRMS:
HEAT SOURCE: SECONDARY HEAT:
RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day; Inspections requested alter 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 UnderslabPlumblng/Electrlcal/
Mechanical - Prlo,r to cover.
o Footing - After trenches are
. 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. ..
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking. ...
~ . \.~, .
" '
D Floor Insulation - Prior to' ",
decking. ,,', ,.'
D Sanitary Sewer - Prior to filling.
trench.
0' Storm Sewer - Prior to tnllng
trench. .
D Water Line - Prior to filling
trench. , -
O Rough Plumbing - Prior to
cover. . \' ' '
REQuiRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough'Electrlcal ....,. Prior to
cover. ,
o Electrical Service - Must be
. approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
{'-" materials and framing Insp.
\ Framing - Prior to cover.
Wail/Ceiling Insulation - Prior to
cover.
rywail - Prior to taping.
. 0 Wood Stovo - After installation.
o Insert - After fireplace approvlll
and Installation or unit. '
DCurbcut & Approach - After
i forms are erected but prior to
, placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material in place.
o Fence - When completed.
OS.treet Trees - When all required
trees are planted. . ,
(""'\
n =Inal Plumbing - When all
V)lumblng w()rk Is complet,e.
o Final Electrical ,.- When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
Ulna' Bulld'ng - Whan al'
required 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 connected to
the service panel.
o Final - After all required
,. , Inspections are approved and
porches, skirting; decks, and
, ventln'g have been Installed.'
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
~.
Panhandle .
Cul-de-sac
BUILDING PERr!lJIT:!l
':~~ '~
ITEM
SO. FT.
X $/SO. FT,
Main
Garage
Carport
IJI2A., ~f t-, tA I l-
I
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) .
PLUMBING PERMIT
ITEM
Fixtures
L
Residential Bath{s)
N'
Sanitary S~wer
Water
FT,
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
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)
.. , : ~..: ~J~f;'if.t~~
Setbacks .
I P.L. HSE GAR ACC
N
S
Iw
IE
VALUE
"
{ 2-0 lJ
--!, 1_ 00
La l. t>
/, &?-
z,./.?5;-
. ,.
,fEE _
20
"2--0
/.~(,
'2-/. ~ 0
IS THE PROPOSED WORK tN THE. .
HISTO~ICAL 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 Vl\UjE,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:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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 the ermlt c s 10 ated at the front
of the propertmya pprov se plans will remain
on the site at a ti s during ns on.
:::alU'f / q r/
VALIDATION:
RECEIPT NUMBER IJ 3 0 I 2- Y
&/2/~'g
I t
AMOUNT RECEIVED If 1. l("2/7
RECEIVED BY eLf IV tv4I
DATE PAID