HomeMy WebLinkAboutPermit Building 1991-4-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
OffiCEr 726-3759:
LOT:
OWNER:
ADDRFC::'C::'
CITY:
~') .*.
DESCRIBE WORK:
NEW X REMODEL
'SPRINGFIELD
$TATr=-
\-> 0 ..D' clffl~
ADDITION
OTHER
JOB NUMBER
<1Da4~'
DEMOLISH
TAX LOT: (i) l O?{--..cj .
SUBDI~ISIO~: . 'ei\f}Q.01iQ ~ (j~
'-1 fLlo -b'll Q \
ZIP:
::::::~ 'S'"6JE 'Y)\~S~GCb r9~~~ \~m: 14;;;(flaf
PLUMBING t~~'{'0 f\-mJ~ tD~~ '7bl~
MECHANICAL- O\~S ~f'lj4 0 d.J ~
ELEC-r:~ICAi'. \'to_ ~ (J\"1CO \ f1?) ~"L-
,-., ,'. .. , . ,
QUAD AREA: L\-R:\j~~
# OF BLDGS: _ 'N
OCCY GROUP: ~~"'-\- ~\
\
9../
# OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE: "\\\ \
# OF UNITS: ',\~
CONSTR. TYPE:~.
HEAT SOURCE:'~ ,t.j D..Q&
P--?
RANGF' .
FLOOD PLAIN: ?
ZONING CODE: Ll)\ ,,\
# OF BDRMS: ",~ '
SECONDARY HEAT: .
SQUARE FOOTAGE:d Iq~,'
To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before 7:00a.m, will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I
./
I><I remporary Electric
; ~
D Site .Inspection - To be made.
after excavation, but prior to
setting forms.
o
Underslab Plumbing/l;lectrical/
Mechanical - Prior to cover.
D Footing - After trenches are'
. excavated. ' ,
o
Masonry - Steel,location, bond
beams, grouting. '
r~;"'Foundation ~ After forms are
~ erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
1'><"'( UnderfIOQfPIUmbi~echani~
~'- Prior to lnsuldllun or decKing.,
'.' ~
, - . . .
lXl Post and Beam -:- Prior to floor.
~ insulation or decking.
, ~Floor Insulation - Prior to
decki ng,
r><i Sanitary Sewer -' Prior to filling
~trench.
~ Storm Sewer - Prior to filling
trench.
1></' Water Line - Prior to filling
...trench. i
t><i Rough Plumbing - Prior to
, cover.
. REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~ cover.
I"LI Rough Electrical - Prior to
~ cover.
lVI' Electrical Service - Must be
~approved to obtain permanent
electrical power.
D' Fireplace - Prior tofacing
materials and framing Insp.
~raming - Prior to cover.
.~ Wall/Ceiling Insulation";'" Prior to
,cover. .
1><(Drywall - Prior to taping.
D W009 S'tove --: Afte; i~stallati~~.
D Insert - After fireplace approval
and installation of unit. '
J5<f Curbcut & Approach - After
. ~orms are erected but prior to
placement of concrete.
,~"Sidewalk&'Driveway - After
~xcavation is complete, forms
, andsub,base material in place.
D Fence.- Wheh complElted.
(~::b:ta%e~~ante~hen all ,eo,,' ,eo
1'\:7f Final Plumbing - When all
~ plumbing work is complete.
~Final Electrical'- When all
~electrical work is complete. , '
,
~ Final Mechanical - When all
~ mechanical work is complete.
1><1' Final Building - When all
/ ....required inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D 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.
D Final -After all required
inspections are approved and
., porches, 'ski'rting, decks', and
venti ng', have be,en install.ed.'
f
,,-
Lot faces
.
I P.L.
IN
Is
Iw
IE
Setbacks
HSE GARIACcl
I
I,
I
I
Lot Type
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
Total height
\5'
Panhandle
, ,V Cul-de-sac
.>.,.~..~
BUILDING PERMIT,
Ir;'€~ X3q~'7CI~
1..')/ 0 14.fQ !J J I qj
ITEM
Main
Garage
Carport
Total Val ue
~
/~~O
_~q.6()
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /(J~/I5'P
PLUMBING PERMIT
ITEM
..-. ~ - ,--
FEE
Fixtures
Residential Bath(s)
NO
'2-
/ ~() !!l
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
9J~(;
~tJ!,~ 0
Total Charge
(C)
MECHANICAL PERMIT
Furnace
~,()O
4.50
9. t!)-.a
Exhaust Hood
Vent Fan
NO
?
Wood Stovellnsert/Fireplace Unit
Dryer Vent
~p.o
Mechanical Permit
2~,~':;- 0
/O.~O
j.~3
-31,I?:J
Issuance
'''~~ate Surcharge
T;"ta,..Permit
>--.....~
(D)
MISCELLANEOUS PERMITS
Mobile Home
State~lssuance
State Surcharge
Sidewalk I~O ft
Curbcut 22ft
-37()O
J 3, 3-D
Demolition
State Surcharge
Total Miscellaneous Permits (E)
Zit) .30
/-703.5'3
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, [), an~ E Combined)
IS , PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR~ '
THE HISTORICAL REGISTER?
If yes, this application mus e signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
BUILDING VALUE, 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 provisiohs of said ordinances,
Plan Check Fee: J:J. J) B L nO
Date Paid: " ~ . ~ ()-. q t
::::::;7be' ~g-7
#K'~J?~ 4-.5-9/
Plans Reviewed Bf' Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~ ~.....-..
(\tlJlb?<t('U ~~rlono-aOL
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 a I times d construction.
IlL
DatA
VALIDATION:, ". Cl7t'
RECEIPT NUMBER \q.~,'l?u \
DATE PAID 4 . S .01/ . .
AMOUNT RECE~f),fI . \Cr3 \ .bLO
REC~IVED BY c:-AC~,