HomeMy WebLinkAboutPermit Building 1998-12-22
SPRINGFIELD --
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LOCATION OF PROPOSED WORK: 5" ,,() CA ~ c ~
1162 02 ~ 2-
RESIDENTIAL
PERMIT A~,PLlCATION
CJ~/~ I~
JOB NUMBER
Inspections: 726-3769
Office: 726,3759
225 Fi.fth Street
Springfield. Oregon 97477
f)L/vE
06'00
ASSESSORS MAP:
TAX LOT:
" ,~; BLOCK:
LOT:
SUBDIVISION:
OWNER: C;',t./~7Q"A/:'-;w.. CJ:;,L /HOAl,
ADDRESS: '5 "'1 ,j" c C~ -1L wr
CITY' ,~/~I A/~ f.t~~ STATE: t?/L
7Zlr ~ 71' J
PHONE:
ZIP: 176(7~
DESCRIBE WQRK: 'C~.v V~"".,.
tb fi;. #I. ~ .4..-t4
I
DEMOLISH OTHER
~~~
'REMODEL
NEW
ADDITION
: '....:"
CONST.
CONTRACTOR II
CONTRACTOR'S NAME
~ J/f.1t
OJ
/
/
ADDRESS
EXPIRES
PHONE
.~
GENERAL:
,PLUMBING:
MECHANICAL:
i.'/-!'l!'.........
n\VII\"t;..
--, .\"" --")1 11T "I IALL C:YOII:U: II: TI-If: WORK
1M;:' r-cn v, I v' _..r .. ,-
_ OFFICE urs.eTI:lORIZED UNDEK I Hltl t"t:nIVIIIIJ I~U:-
COMMENCED OR IS ABANDONED FOR
FLOOD PLAIN:
ANY 180 DAY PERIOD.
ZONING CODE:
ELECTRICAl .'
QUAD AREA:.:...-_ XTtT"'J C ~:'Ie-I3.W requi~It!J~:
AI I t:1'\I'I~" lu~" , Oreaon Utility
# OF BLDG~()\\G1A' r~I'C\~ adooted by the .p ~'SM"1b1ifh
" ..',.. Center. Those rules a , .,' .
OCCY GR~lflcatlo~ ' - I_0010tflrOUghOA;B9Q~FP.~1rPE:
inOAR9o~"'':JV . ,-" . of the rules by
# OF STOR~Q.-.Vollmay obtain COPI~S ~fe't.,ho~SJRCE:
: II' ,the center. (Note. the . '.
WATER HEAT~ 109 'I ~aonUtility~~.~~lon
numoer TVI l It:: on::;~~' . .. \
, . · 1', I.""~ t)1)?_?'l44,_ '
ltt:llllt::. ,0:> ,,--
To request' an Inspection. you must call 726-3769..Thls 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.
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
~~~ :~~h~~C~,PE::~?t~ S
I ver.
---""
,ff/-j R~ghElectrical - Prior to
t::::/~"-over.
D Temporary Electric
o Final Plumbing - When all
'plumbing worl< is complete.
1?al Electrical - When all
~;~t'JcaJ wO'k " compleJe
,/,"~
I 0 Fin~1 Mechanical - When all
~chanical work Is complete.
D Site Inspection - To be made
after excavation. but prior to
setting forms.
o Underslilb Plumblng/ElectricalJ
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrIcal power.
o Footing - After trenches are
,excavated. '.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - SteeJlocatlon. bond
beams, grouting.
amlng - Prior to cover.
U Other
o Foundation - After forms are
erected but- prior to concrete
placement.
o W II/Ceiling Insulation - Prior to
over.
~all - P"O' to taping.
D Wood Stove - After Installation.
D Underground Plumbing - Prior
to filling trench.
MOBILE HOME INSPECTIONS
D Underfloor Plumbing/Mechanical
-,Prior to Insulation or deckln'g.
~' st and Beam - Prior to floor
nsulatlon or decking.
loor Insulation - Prior to
decking.
D Blocking and Set-Up - When all
blocking is complete.
o Insert - After fIreplace approvllI
and installation of unit.
D Plumbing Connections - When
home Ilas been connected to
water and sewer,
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections Ilave been approved
and the home Is connected to
the service panel.
D Sidewalk & Driveway ..:...- After
excavation Is complete, forms'
and'sub-base material in place.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filiing
trench. .
o Fence - When ccrllPle~ed.
o Final - After all required
Inspections are approved and
porches. skirting. decks, and
venting have been Installed.
D Rough Plumbing :,- Prior to
cover. ,
D Street Trees - When all required
trees are planted.
" , 'i.
Setbacks
p.L. HSE GAR Accl
N I
S I
w -j
----.-.
, E
Lot faces
Lot Type.
Lot sQ. ftg.
, Interior
Lot coverage
Corner
Topography
Total height
Panhandle "
Cul-de'sac
ill,
BUILDING PERMIT
ITEM SQ. FT.
.'i.:.:
'i~
f~
X $/SQ, FT.
VALUE
Main
Garage
"
Carport
fi ,ft, I... 0",/&
I
Total Value
tift' II. ~()"- W
,
17i
Building Permit Fee
'2.~
7.'fD
97. flJ
-,
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(~)
N"
Sanitary S~wer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust HoorJ
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer, Vent
IIv Ifv p", &;'7 '" (I~ (&
Mechanical Permit
/5. Oil
I d. () v
'1~l7J
2..' 2A'
Issuance
State Surcharge
Total permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolitiol)
State, Surcharge r I
El. t2.T~~ /JIA,....
1;9.9"
,-/'-, , , ""V:-;
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
" 2'.11
.S THE PROPOSED WORK ~N THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
I f yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
\. ('l\., Jt~ -;-n
BUILDING VALlJE, PlAN CHECK
AND BUILDING PERMlj
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.
(,(), I J
Plan Check Fee:
Date Paid:
Receipt Number:
Recei;JY:tJJ
12-/' o/'l.f
, Date
Plans Reviewed By
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
u'_o: ,~__:~ _ _
Note:
Building Inspector may require
addi ti onal p l2,'1s~ info rmati () n,
and/or fees for the completion of
this proj ect. ~. \
I
I
_I
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 donein accordance
with the Ordinanctls 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 ~ade 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
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 times during construction.
Signature ~
Date QlI_ /;);)\
(!PCLUJ ~ ~ -I-
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VALIDATION:
RECEIPT NUMBER () 5:l st 7
DATE PAID /'J.-j:;.;.-!rr
AMOUNT RECEIVED ?, ,2y J..~ )
RECEIVED BY (;;( Wl1~