HomeMy WebLinkAboutPermit Building 1999-4-12
RESIDENTIAL
PERMIT AP,PLlCATION
Inspections: 726.3769
Office: 726~3759
SPRINGFIELD
L.oCATION .oF PR.oP.oSED W.oRK' 2 "4 I CA~-rJ E 'Dt...
ASSESS.oRS MAP' /7 () 3 2-.3 J 1
.oWNER: L-f (tt:>'-( "i J:~e;;2- t.0A ,I... "'.t...
ADDRESS: .2l4:> <..{ t Ctl ~rl E- 1:>..L,-, ~
<:I~";l k l c!-
(1.1Le.- - ~ (bo<\ \ D
L.oT:
CITY:
DESCRIBE W.oRK:
NEW
REM.oDEL
BL.oCK:
STATE:' eL
ADDITI.oN
DEM.oLlSH
J.oB NUMBER
9? /ssy
225 Fi fth Street
Springfield, .oregon 97477
TAX LOT' /.:)5"')00
SUBDIVISI.oN:
PHONF'
7l(b,-I :s II..(
ZIP'
9""1'-t1(
.oTHER
C.oNTRACTOR'S NAME ADDRESS
GENERAL: .S:>A.c-\. ic::. CA-;-As+VLoP In.~
,PLUMBING: (Lo:\b ,e-.oo~ '
C.oNST.
C.oNTRACT.oR #
'J2.4/5{
EXPIRES.,., PH.oNE
7210 ~1 ~o:>
~g~-/l{\
MECHANICAl'
ELECTRICAL:
C l~L\c:-.\S
\ ~
QUAD AREA:
# .oF SLOGS:
.oCCY GR.oUP:
# .oF ST.oRIES:
WATER HEATER'
,. OM.nronon law requires YOUtu:~j~'
'\T I t:I'II n , I ~.-. ~ the ure\:5VII . '(t...
,.. '. ""E'l'tt.:>rlIW ". '_ooth
folloW lUll:;" ",0,.. ~~~~s alo .,.....-
Notification '~~~~1~ through OAR 95~~0~;
in OAR.~~"'IJS~ 'n SGpie.~ of the ru e
0090. 'fou may b~~: (Note: the te\e,~hO~:n
'Ca\hn<a't\i6~~ goO Ut\llWNotIf1cat
,. 'numb@fJ@f~Ef. ~~h.aO 1)~?-9344).,
"'". Center I , I-~U - ,
HEAT S.oURbE':
f'
RANG E:
FL.oOD PLAIN:
Z.oNING C.oDE:
# .oF BDRMS:
SECONDARY HEAT:
SQUARE F.oOTAGE:
To request an Inspectlon,'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 Tempo,"", E'ee'''e G: ~al Plumb'ng - When all
rumblng we'" I, complete.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Unders.lab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated:.
o Electrical Service - Must be
approved to obtain permanent
, electrical power.
Fireplace - Prior to facing
, aterlals and framing Insp.
o F al Building - When all
qui red Inspections have been
approved and building is
completed.
o Masonry ~ Steel location, bond
beams, grouting.
O 0 .other
Foundation - After forms are
erected but- prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
MOBILE HOME INSPECTIONS
o Underfloor Plumbing/Mechanical D Wood Stove" - After Installation.
. -,Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking. ,
o Floor Insulation - Prior to .
decking. , .
I
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
n. Water Line - Prior to filling
~--tre ch. .
D Rou h Plumblr9 - Prior to
c e~ " ,
o Insert - After fireplace approvlSl
.. '\ and Installation or unit.
o Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
o Sidewall< & Driveway - After
excavation Is complete, forms
and sub,base material In place.
D Fence - When COi"'1pleted.
D Street Trees - When all required
trees are planted. ,
o Blocking and Set. Up - When all
blocking Is complete.
D 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. ftg.
I P.L.
Interior
Lot coverage
N
Corner
Panhandle '(.
S
Topography
Total height
Cul-de-sac
w
E
'I
BUILDING PERMIT
'~
ITEM
sa. FT.
VALUE
X $/SO. FT.
Main
Garage
'.
Carport
.' 'I :'". \'J': .;. :"
" . ',~,
("J '
Setbacks
HSE GAR Accl
I
I
.4 THE PROPOSED WORK iN THE.
HISTOBICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
BUILDING VALd'E,PLAN CHECK
AND BUILDING PERMIT
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.
Plan Check Fee:
j.~()OO~ Date Paid:
Total Value
1~'6".5'O Receipt Number:
Building Permit Fee
12. & S Received By:
State Surcharge
Total Fee (A) j 7/,/ ~ Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures '3
Residential Bath(s) NO
Sanitary S~wer FT.
Water FT. 2--<;'
Storm Sewer FT.
Mobile Home
FEE
30
25)<>>
Plumbing Permit
S-C;-O;.J
Lt. '-/0
~'t Llo
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnserttFlreplace Unit
Dryer Vent
Mechanical Permit
jf" {,M-
e,.;
10 .
ir-I 7 s,-
2. b. J... 0
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
J-5(,. 7 r
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS 11 I
Ik..ll U .P I=:-L t:z 1/Zr J tJ~;( ~ 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 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
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 dfring construction.
Signature CJ-A ~
Date
L{r I z.--qq
VALIDATION:
RECEIPT NUMBER I (J. S S f.( 7 ?-
4/r;'/71
AMOUNT RECEIVErD '/7 2-r-b" 7j;
t(J(JM/
DATE PAID
RECEIVED BY