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HomeMy WebLinkAboutPermit Building 1996-10-1 RESIDENTIAL PERMIT APPLICATION ) .-,~ Inspections: 726-3769 Office: 726-3759 SPRINGFIELD LOCATION OF PROPOSED WORK' L/C:>:<~ ~~4~//'9 r / 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;. rJ (/(j STATE: DESCRIBE WORK: NEW REMODEL (Y;"'~:J ~"".. W,~-tM o ADDITION'~ DEMOLISH , CONTRACTOR'S NAME GENERAL: '/;;J';/ in.-.itL--e.r PLUMBING: MECHANICAL: ELECTRICAL: OTHER ,\",^ ' JOB NUMBER "%/~::?? 225 Fifth Street Springfield, Oregon 97477 ~7 ~; TAX LOT: O/tb ~ SUBDIVISION: PHONF' ? ~ ~ ,-' %12-:5 f) /{, 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"'''') ...... / ...'--.. ',' 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, ......-=. ", .. 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 ... '. ",;: 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 . ..... ~ ~ VALUE " (A) _ ~_-c. /~ 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 ; " .:.:; ~:'.:'~ :: ~ . . 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 I " - ," :# ~PPROVED; ... .. I 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 ~~_._:;. , -'