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Home My WebLink AboutPermit Building 1991-10-1 or- 0m\\\~X~~(lt. c. - .. Inspections: 726.3769 Office: 726.3759 ASSESSORS MAP: LOT: SPRINGFIELD , ,r- . BLOCK: OWNER' ADDRESS: C'TY' o\'~'N~ ~ tA~ rJ _ ~ / 7 3, 'I \/1/ P/ d;:f,:. . "'J . "'- (f.:l.<> DESCRIBE WORK' NEW REMODEL CONTRACTOR'S NAME ~~ GENERAl' PLUMBING: MECHANICAl' ELECTRICA' ' / ~ . JOB NUMBER 9/1 /...::, ~7 225 Fifth Street 47 Springfield, Oregon 97477 '7610 ;./, ~I TAX LOT: ( ) ( e),U) SUBDIVISION' PHONE: 2 D ! &"<;"4 - ~ ..., ,,- '- STATF' ~-A ADDiTION X DEMOLISH OTHER ZIP: 9, "'.,.... ....... voLu....,,~..:.... , CONST, CONTRACTOR # ADDRESS tf,;( v-.rd..-<:'" ~. ~ ' EXPIRES PHONE "~ -t:;22/) rf-.'vV~,.~ , 7.('3331' -\ c:C:>~~2.. - OFFICE USE ...:. QUAD AREA' LAND USf' FLOOD PLAIN: # OF BLDGS: # OF UNIT'" ZONING CODE: OCCY GROUP: CONSTR, TYPE: # OF BDRMS: # OF STORIES: HEAT SOURCF' SECONDARY HEAT: WATER HEATER: RANGF' 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 Plumbing/Electrical! Mechanical - Prior to cover. D Footing - After trenches are excavated. o Masonry - Steer location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underlloor 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 - Prior to filling trench. o Storm Sewer - Prior to filling trench. O Water Line - Prior to filling trench. D Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. D Rough Electrical - Prior to cover. _.~' D Electrical Service - Must be approved to obtain permanent electrical power. o 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. D 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. D Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. o Fence - When completed. D Street Trees - When all required trees are planted. . D Final Plumbing - When all plumbing work is complete. -0 Final Electrical - When all electrical work is complete. o Final Mechanical - When all mechanical work is complete. o Final Building - When all required inspections have been approved and building is completed. ~ Other p~P/J....g" 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. o Electrical Connection - Wh'en 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 Type. ------ . Lot faces Setb'lcks --r's THE PROPOSED WORK IN THE Lot sq, ftg, Interior I f'L. 'HSE GAR' ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de.sac IE I APPROVED' BUILDING PERMIT ITEM sa, FT. x $/sa. FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Main 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 Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Garage Carport Plan Check Fee: J 2 Ol:m Date Paid: Total Value ~~,S;.., Receipt Number: Building Permit Fee Received By: +-7'3 State Surcharge . "---- Total Fee (A) /tJ'?,43 Plans Reviewed By Date 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 NO 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 certify that only contractors and employees who are in compliance with GRS 701.055 will be used on this project. Exhaust Hood Wood Stove/lnsertl Fireplace 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 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 tim~s duri1\,: coo",nnssttrrjUccttiiOOh. / XSignatureg~{ O~ "- Date MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge VALIDATION: Total Miscellaneous Permits (E) RECEIPT NUMBER DATE PAIr> ~1/<<I?5 1;<')-/-7'/ /~J_ ~:J g/~ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) I/J S 43 AMOUNT RECEIVEr> RECEIVED BY I ..<:::0 _. '~ . . ,.~ 3857 --- ~-'.- -.'----~,--- ----.----- Permit No: 7///5Co Address: 7L/'7 )(1, A' C;T Issued by: //4 Date: /0-/-71 STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued, Licensed Architect and Engineer applicants, exempt from registration under ORS 701,010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1, L....J I own, reside in, or will reside in the completed structure, is ~"'l:'./('1>" .I?>Y,p,n/ : h)h~..e~"" 2, A~ My general contractor Contractor registration number /4~ 3 ?, I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board, OR B, L....J I will be my own general contractor, If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board, If I change my mind and ao hire a Qeneral contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor, I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~.-0" (PlJ i-I}) ,x Signafure of Permit' Applicifn't - /1>/1('1/ Da:ie ' CONSTRUCTION CONTRACTORS BOARD 0244J 10/24/89 \J\~t-<..- _ A,\.k..... WI:IJIE COPY TO ISSUING AGENCY PERMIT FILE P!NK COPY TO APPLICANT ~,