HomeMy WebLinkAboutPermit Building 1992-6-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 7?6.3769
Ollice: 726.37',9
-e
SPRINGFIELD
LOCAl ION OF PROPOSED WORK: _9-.1 7
ASSESSOllS MAP: _I.Z~~:?.::2.5'~ 71,2
.-
JOB NUMBER_920?:_~9
225 Fifth Street
Springfield, Oregon 97477
LOT:_.__.. _
BI.OCK:.___ _..____ SUBDIVISION:
TAX LOT
lJ>'-I(JCo
OWNER~ f tc:;_~~j
ADDRESS_ /I b5-~~- 7JJ~.. , .R.
CITy_qn~-J/ ./
DESCRIBE WORK: -/3.~. .' t1 It -L_.
L/
NEW REMODEL ADDITION
CONTRACTOITS NAME
GENERAL: _..t::2.w.-yF~
PLUMBING: _
MECHANICAl."
ELECTRICAL:
OUAD AREA:
II OF BLOCS'
OCCY GI1CiUI':
N OF STORIE::~:
WATER HEATIOI1:_
PHONE: 7Yt.- ..3~-Z c
STATE:~ . ~ /~
(/
.. :JA~is--..-' .,. - t.u... ~ _~~nd
DEMOLISH OTHERe-ifY;Jk:;.!;t~~
CONST. /I.;t
CONTRACTOR N EXPlliES PHO~E
ADDRESS
- OFFICE USE -
LAND USE:_
II OF UNITS: ____"
CONSTR. TYPE::
HEAT SOURCE:
RANGF'
ZIP: 2.7 </'7 J7'
FLOOD PLAIN:
ZONING CODE:
II OF BDr-lMS:
SECONDARY clEAT: ____...
SOUARE FOOTAGE: ___
To request an inspection, you must call 726-3769. This 15 a 24 hour recordi'ng. All Inspections requested before 7:00 ,tm. wilt be
made the saine working day. Inspections requested after 7:00 a.m. will be maele the following work day.
o
Tcmporw'Y Electric
o
Sitc Inspection - To be made
after excavation, l)ut prior to
settino lorms.
o
Undcrsl.ab Plumbing/Electrical/
Mechanical - Prior to cover.
o
Foatinn - Afll}r trenches are
excavall)d.
CI
MasolllV - Stc~t:l location, bond
bearlls, ~]Ioulirln.
IZJ
.
FOlllld;:alion - Altel fOllll~ arc
erected bul plior It) concrete
J]lacellll:nt.
o
Undcrglound PlulIIbing - Prlor
10 fillillU trench.
o
Underfloor Plumbing/Mechanical
_ Priol to insulation or decking.
o
Post and Beam - Prior 10 floor
insulation or decking.
o
Floor Insulation - Prior to
deckinu.
D
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Prior to lilling
Water Line
trench.
o
ROllUh Plumbing - .Prior to
cov(:r.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
.cover.
o Electrical Service - Must be
approved to obtain permanent
erectrlcar power.
o
Fireplace - Prior to facing
malerlals and framing Insp.
o
Framing - Prior to cover.
o
Wall/Ceilinu Insulation - Prior to
cover.
I~
Drywall - Prior to taping.
D Wood Stove - After installation.
o Insert - Alter fireplace approval
and Installation of unit.
I~
Curbcut & Approach - After
forms are erec!Cd but prior to
placement of concrete.
o
Sidewalk & Driveway - After
excavation is complete, forms
and sub.lJase rnaterial in place.
o
Fence - Wilen completed.
D
Street Trees - Wilen ~1I required
trees are planted.
D
Final Plumbing - Wilen all
plumbing work is complete.
D
Final Electrical - Wilen all
electrical worl< is complete.
o
Final Mechanical - Wlwn all
meclwnical work is complete.
IZl
Final BlIildin9 - Wilen all
required inspections have been
approved and building is
COlllptcled.
o
Olher
MOBILE HOME INSPECTIONS
o
Blocking and Set.Up - When nit
blocl<ing is complete.
o
Plumbing Connections - Wilen
tlOmc has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbinu
inspections have been approvl~(J
and tIle home is connected to
the service panel.
'.'
o Final - After all required
inspections are applOved and
porches, skirting, decks, and
venting have been installed.
rL .
Lot facos Lot Type Setbacks
I P.L. , GAR I ACC I
Lol SQ. flg. Interior HSE
IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height CuI-dc-sac
IE
., THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ONt _ _
THE HISTORICAL REGISTER1 7Z<S"'
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
"
APPROVED'
ITEM
SO, FT.
X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMIT
Main
This permit is granted on the express condition that the said
construction shall, In all respects, conform to ttle Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction anel use of
buildings. and may be suspended or revoked al any time
upon violation of any provisions of said ordinances.
Garage
Cj!fJ'~lH
rlJc)M:7~T/6J..J
Plan Check Fee:
Total Value
,
~..:k')n. D 0
&l{ttJ.5'''
/.tt/3
2/. 5=3'
Date Paid:
Total Fee
(A)
Receipt Number:
ReceIved By:
Pfa;:jI,fw~;~'r3v'
6~22..
Date
,
Building Permit Fee
State Surcharge
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I stale 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 witl be made of any
structure without permission of the Building"5afely Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper time, that each address Is readable
from the slreet, that tho permit card is located at IIle fronl
of the property. and the approved sel of plans will lefl1<lin
on the site at all times dUrln"nstr~ction.
Slgnaluro~4 ~
DaI9.a1/f /7'7.J-
./ '
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surchargo
VALIDATION:
RECEIPT NUMBER
sl / /
Ly~--7--:.:2
:< /. ,::;-"'5
Total Miscellaneous Permits (E)
DATE PAin
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
-:4 /. s:s
AMOUNT RECEIVEP
RECEIVED BY ~..q-"'~...c-.. ~
,r /-- - .
,