HomeMy WebLinkAboutPermit Building 1996-10-1
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK' L/C:>:<~ ~~4~//'9
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ASSESSORS MAP: . J 7-LJ:::<~-:?/-Y~
LOT:
BLOCK:
OWNER: ",%.c-/( if' {hah,TIt Jt!)-~Lt':."...
ADDRESS: llO 2J- f AA,,1/LlLL:c<.._ $r
CITY: ~'o.x.~:&/ & 1;.
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STATE:
DESCRIBE WORK:
NEW REMODEL
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ADDITION'~ DEMOLISH
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CONTRACTOR'S NAME
GENERAL: '/;;J';/ in.-.itL--e.r
PLUMBING:
MECHANICAL:
ELECTRICAL:
OTHER
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JOB NUMBER
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225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: O/tb ~
SUBDIVISION:
PHONF'
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ZIP: 9';> C/? X'
CON ST. ",
-CONTRACTOR 1/
D Rough Mechanical -.:. Prior to
cover.
D Rough Electrical - Prior to
cover,
o Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framin'g Insp,
(k] Framing -' Prior to cover.
rn Wall/Celiing Insulation - Prior to
cover, -
I..k1 Drywall - Prior to taping,
D Wood Stove - After installation.
o Insert - After fireplace approv&1
" and Installation of unit.
o '~urbcut & Approach - After
. - -,' fo~ms are erected but prior to
.... placement of concrete,
o Sidewalk & Drivewav - After ,
excavation Is complete, forms
and sub.base material in place.
o Fence - When completed.
"
, D Street Trees - When all required
trees are planted. .
EXPIRES '.~ PHONE
- OFFICE USE -
QUAD AREA- LAND USE:-,- FLOOD PLAIN:
1/ OF BLDGS: 1/ OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: 1/ OF BDRMS:
1/ OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAG E:
ADDRESS
(;iW..l/' &1"'''')
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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.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
, after excavation, but prior to
setting forms.
D Underslab.Plumbing/ Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
IVl Masonry - Steel location, bond
lA-l beams, grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/ Mechanical
- Prior to Insulation or decking,
lEI Post and Beam - Prior to floor
, InsuLaJ.!on Q.W!.eckirig, . .
cecP~~' . ".'
o Floor Insulation':'" Prior'to '
decki ng.
o Sanit~ry Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench.
o Water Line - Pricif~"to fifling
trench. " ..'
D Rough Plumbing -:-' prl!;ir to .' .-
cover,
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o Final Plumbing - When all
plumbing w9rl< Is complete,
o Final. Electrical - When ail
electrical worl< is complete,
o Final Mechanical - When all
mechanical work Is complete,
ill Final Building - When all
required Inspections have been
approved and building is
completed,
D Other
MOBILE HOME INSPECTIONS
D 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.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed,
Lot faces
Lot Type
~ot sq, (tg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
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BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
I P.L.
N
S
Iw
IE
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VALUE
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(A)
_ ~_-c.
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p; '.~
/6. ;2t:?
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary S~wer
Water
FT
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State SurchCl,rge
Total Charge
(C)
MECHANICAL PERMIT
Furnace'
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mectlanical Permi t
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demol i tion
State Surcharge
Total Miscellaneous Permits ,(E)
TOTAL AMOUNT DUE (excluding electrical) .
(A, B, C, D. and E Combined)
(B)
FEE
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IS 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 prio'r to permit issuance.
Setbacks
HSE GAR ACe
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~PPROVED;
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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 Cod~, regulating the construction and use of
buildings, and may be ~uspended 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 certif~ that only contractors and employees who
are In compliance with ORS 70t055 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 ti es dU?::: cft/c~lon.
~Ignature '., #t~d~ ' .
Date
VALIDATION:
RECEIPT NUMBER 731'3 ~
DATE PAID /<::?-;/-:36
AMOUNT RECEIVED ~~ z;;-
RECEIVED BY ~~_._:;.
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