HomeMy WebLinkAboutPermit Building 1992-8-6
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED. WORK:
ASSESSORS MAP: -I..!;!:(73
LOT:
.
SPRINGFIELD
AS+-
.5 rl';'---
A130
.3~ 4.2
BLOCi<'
OWNER f? {lH e r-Id5:~lfAC;'
ADDRESS' '3'3 tf:7 G arwtE ~)1lt-( ;~ d
CITY 4~~.~~~.JcL-.--__--- STATE:
DESCRIBE WORK TiYl<-f;- (I F6rilYld<')....J{if'j!/f"
NEW REMODEL X ADDITION DEMOLISH
oJ<
OTHER
.
JOB NUMBER
92-/07<1-
,;:
225 Fifth Street
Springfield. Oregon 97477
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TAX LOT:
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SUBDIVISION'
PHONF'
74(-'117.6
ZIP '37t./Y'7'
CONTRACTOR'S NAME ADDRESS
GENERAL:5+ij/A.}ey L.yf/17,,::fh__ A'ICcJ
PLUMBING:
CONST,
CONTRACTOR #
Gfi~4(. S.75J#
PHONE
7f {:..6''/ S(
MECHANICA' .
ELECTRICAl'
QUAD AREA:
g OF BLDGS: __._____._
OCCY GnOup: _ _._._____~__._.
g OF STORIES:__
WATER HEATER:
- OFFICE USE -
LAND USE:
# OF UNITS:
. ,
CONSTR. TYPE: _______
HEAT SOURCE:
RANGE:
EXPIRES
1'/1/93
FLOOD PLAIN:
ZONING CODE:_
# OF BDRMS:
SECONDARY HEAT:
SQUARE 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.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumblngl Electrical!
Mechanical - Prior to cover.
~ Fooling - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement.
[J
Underground Plumbing - Prior
to filling trench.
D
Undcrfloor Plumbing/Mechanical
_ Prior to insulation or <lecklng.
o
Post and Beam - Prior to floor
insulation or decl<ing.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing -. Prl,or to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior "to
cover.
o Electrical Service - Must be
approved to oblain permanent
electrical power.
D Fireplace - Prior 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 Installnllon.
o Insert - Atter fireplace approval
and Installation of unit.
o
Curbeut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trc.cs - W~len all required .'
trees are planted. .
D Final Plumbing - When all
plumbing worl< Is complete.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
~ 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.
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o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
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,
.~ ~
,
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o
Final - After all 'req'uired
Inspections are approved and
porches, sklrtln'g, decks, and
venting have been installed.
,',
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Lot faces
Lot Type.
Lot sQ. fig.
Interior
Lot coverage
Corner
Topography
Total height
Pantlandlo
Cui-dc-sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Value
Buildi.ng Permit Foe
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sower
FT.
Water
FT.
Storm Sower
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (eXCluding electrical)
(A, B. C, D, and E Combined)
.S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
nnd approved by the Historical
Coordinator prior to permit issuance.
Setbacks
~ HSE GAR ACC
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W
_~__J_J_~
VALUE
_2Lt3().Qo
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J.9.3
-fO.-li
FEE
4/J ,";.3
, .
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition tl1at Ole said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, rC~Julating the construction and use of
bulldin{lS, and may be suspended or revoked at any lilne
upon violation of any provisions of said ordinances.
Plan Check Fcc: ____~_
Date Paid:
Receipt Number:
Received By:
Plans Revleweej By
Date
Systems Development Charge is due on all umJevelopcd
properties within the City"lilllitS Wllich are being irnproved.
ADDITIONAL COMMENTS
_'AtJC-.~JWf~4:7~WLC./' ~
_~~ax. -~.&/~-/&'-/"7-...
By signature, I state and agree, that 1 have carefully cx?mincd
tile completed application and do hereby certify that all
information hereon is true and correct, an(J I furlllcr certify
thai any and all work performc(1 shall be done in accordance
win, the Ordinances of the CHy of Springfield, nnd thc Laws
or tllC Stale of Orenon pertalnin{J to the worl< described
herein, and thaI NO OCCUPANCY wiJI '/)1) maue of any
structure without permission of the Building Safety Division.
I furttlCr cerlify that only contractors and employees who
are In compliance with ORS 70'1.055 will be used on this
project.
I further agree \0 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 tile front
of the property, and tile approved set of plans will remain
on the site at all times durinu construction.
>,l1alure.gk/~~~~
Date ,d}/}7?-......
VAll DATION:
RECEIPT NUMBEH .__ 5$-L(
DATE PAID gl"~/92... _.___
AMOUNT RECEIVED __~,?f':J
RECEIVED BY _..__.__~~_