HomeMy WebLinkAboutPermit Building 1993-7-6
RESIDENTIAL
PERMIT APPLICATION
Inspeclions; 726.3769
Office; 726.3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP:
LOT'
OWNER'
ADDRESS:
CITY:
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DESCRi"BE WORK:
NEW
REMODEL
. ADDITION
.
SPRINGFIELD
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JOB NUMBER
q ?C/'JII
BLOCK'
STATE: n4.
DEMOLISH )C
OTHER
225 Fifth Street
Springfield. Oregon 97477
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TAX LOT' 7/-1;tJ(:")
SUBDIVISION'
PHONE:
71/6 -~Y'// ('~~~,t;f..';t)
ZIP; 977"7 "7
GENERAl'
G- Afi.r
CON ST.
ADDRESS CONTRACTOR'
Bk!~#.Lrr tiA;e~/o/"i//"t/~ r;;>.4!
EXPIRES
JI/Y'/'/9 ~
PHONE
CONTRACTOR'S NAME
PLUMBING:
MECHANICAL'
ELECTRICAl'
,
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE; . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' SOUARE FOOTAGE:
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.
o Temporary Electric
.0
Site Inspection - To be made
after excavation, but prior to
set! ing forms.
o Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing' - After trenches are
I excavated. .
o
Masonry - Steel locatlon, bond
beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underfloor Plumbing/Mechanical
_ Prior to Insulation Or decking.
o
Post and Beam - Prior to floor
insulation or decking. .
o Floor Insulation .- Prior to
decking. .
o
Sanitary Sewer - Prl"or to filling
trench.
o
Storm Sewer - Prior to filling'
trench.
o
Water Line .:..- Prior to fil/lng
trench.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o
Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prlor'to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complE:te, forms
ar.d sub-base materia! in place.
o Fence - Wh~n completed.
o St.re,at Trees - V./hen all required
tm~s are planted. ,
o
Final Plumbing - When all
plumbing work Is complet,e.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work is complete.
IC7f Final Building - When all
~ required Inspections have been
approved and building is
completed.
g] Other. ~.l~ ~
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.
D
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
venting have been installed.
Lot faces
.
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
"
, (--
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT.
FT.
Storm Sewer
Mobile Home
c:;?j.// ~ c:'.I'h?
;
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stoveflnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
~S THE PROPOSED WORK IN THE
H";TORICAL DISTRICT, OR ON t<J 0
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I PL. 'HSE I GAR' ACC I
S
N
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.'Ii-_ _ _ _~ .
i
E
VALUE
.~
FEE
/5'tPeJ
,7.r
)C;: 7 J
19,_~O
,90
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APPROVED.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
.-;.'
ThiS permit is granted on the express condition that the said
construction shall, ill all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, reO\Jlating 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 uncJeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the .completed application and do hereby certify that all
lnformation hereon is true and correct, and I further certHy
that any anll 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 permissio~ of the Building Safety Division.
I further certify that only cornractors and employees who
are in compliance with ORS 701,055 will be used on this
project.
I further agree to ensure that ~II required inspectio,ns are
requested at the proper time, that each address is readable
from the street, that tile permit card is: located at the front
of the property, and the afJproved set of plans will remain
on the site c?'t" time~ d~ng &structi~/ /J
)Csignaturr> ~ f' ~
Date 1/ (pI'?:?
VALIDATION: d ~
RECE:PT NUMBER Q'2JU:::>
DATE PAID 'l. ~ q S,
AMOUNC RECElVsP < =.~. \ oS
RECEIVED CY ~\ 1')0:-; -
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