HomeMy WebLinkAboutPermit Building 1995-5-18
RESIDENTIAL
PERMIT APPLICATION
~.
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' /7 n 2-
LOT
OWNER'
ADDRESS:
/(~fJ" lee>'\..
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CITY:
DeSCRIBe WORK' /Y1" v'..
New
REMODEL ^
ADDITION
SPRINGFIELD
BLOCK'
So<=,-
51
STATE:
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
,.0~r c:J,?
DEMOLISH
OTHER
SUBDIVISION'
PHONF' 72'
ngj
ZIP:
97&f7Ef
",w- (50,-<--1'1)
.<.. 'i "
CONTRACTOR'S NAME
tJ L. ?tJo!~
CONST.
ADDRESS 7 rr // CONTRACTOR'
CTM.%t ~ '7;Z /lnd.."./rr.., t.,.... 785/9
PHONE
? ,N 29 'i'O
GENERAl'
PLUMBING'
MECHANICAl'
ELECTRICAL:
FoJv.ic.. k: Y- >IT""-...
QUAD AREA: f/ ;.;,c
. OF BLDGS'
OCCY GROUP:
. OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND USE:
11//
/
I,L}"I
EXPIRES
10>
FLOOD PLAIN:
ZONING CODE: -.b.~~
. OF BDRMS:
~
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
SECONDARY HEAT:
,.--
SQUARE FOOTAGE:
,.--
To request an Inspection, you must carl 726-3769. Ttlls Is a 24 hour recording. Alllnspecllons 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
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblngl Electricall
Mechanical - Prior to cover.
o Fo'ollng - After trenches are
excavated. ~ '
o Masonry - Steel location, bond
beams. grouting.
o Foundation - After forms are
erected but p.rlor to concrete
placement.
o
Underground Plumbing - Prior
to fIIllng trench.
o
Underfloor Plumblngl Mechanical
- Prior to Insulation or decking.
~ Post and Beam' - Prior to floor
~Insulatlon or decking.
~Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to (1lllng
trench.
o Storm Sewer - Prior to filling
trench.
o Water Une - Prior to filling.
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - ~rlor to facing
materIals and framing Insp.
~raming - Prior to cover,
1"V'I' Wail/Ceiling Insulation - Prior to
~cover,
~OrYWall - Prior to taping.
o Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
(orms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete. (orms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing wc;:>rk Is complet,e.
~ 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 aod 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.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventlng have been Installed,
Lot facos
Lot sq. ltg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SO. FT.
Main
Garage
Carport
F~A_ J/;f}.l'f'hf.
Total Value
~-
Lot TYPO.
Interior
,:'-; .
_S THE PROPOSEO WORK IN THE,
. HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I PL.
IN
Is
Iw
IE
Setbacks'
I , , I
HSE GAR ACC
I
I
\
I
Corner
Panhandle
Cul-de-sac
X $/50. FT.
VALUE
"
/~o-o
Building Permi t Fee
State Surcharge /',0'+ ,4>2-
Total Fcc (A)
;2.E) . 5"'0
/." 5'
2..2..' S'
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PlumbIng Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FEE
FT,
/
/
/
FT.
FT.
(C)
N'
Dryer Vent
Wood StovellnsertlFlreplace Unit
/
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(0)
State Issuance
State Surcharge
Sidewalk
lt
Curbcut
ft
Demolition
Slate Surcharge
lUA-AJ ~ M/1lXJ. ]
/>-, .3J
Total Miscellaneous Permits (E)
<<:" "'~
TOTAL AMOUNT OUE (excluding electrical)
(A, B, C, D, and E Combined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction sharr, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the cOl')structlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions 01 said ordinances,
Plan Check Fee: ~ 3 ,33
Date Paid:
Receipt Number'
Re:?~h4
Plans 'Reviewed By
f';?Y9.r
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
'pA7H 1.
By signature, t state and agree, that I have carc(utly examined
the completed application and do hereby certify that all
In(ormation hereon Is true and correct, and I further certtfy
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 ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
rOQuested at the proper time, that oach 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 ~t all tl[neS......durlng ;!;9s~lon.
~turp;V~ CC/~~
Date ~/ty?>
VAliDATION:
RECEIPT NUMBER
1'7~U
,S::-//!1;1'r
(
7' -:a.. ..2.,,,,,
.a-jTK:L.~
DATE PAIr>
AMOUNT RECEiVED
RECEIVED BY