HomeMy WebLinkAboutPermit Building 1991-3-29
ASSESSORS. MAP:
, ~LOT: \Q
RESIDENTIAL
PERMIT APPliCATION
Inspections: 726-3769
Office: 726-3759
SPRI,NGFIELD
BLOCK'
OWNER: ....'~~, \&~'C(L-",
ADDRES~'. ',~~C\ ~C\ '1) r\. ~r 11.. Y\ l_k'
CITY: ,Lt), \ctj. 0 STATE: \J
DESCRIBE WORK: :..~..~, ~ QD \C\ Q{\C'~
JOB NUMBER
Ct\D\C\<b
225' Fifth Street
Springfield, Oregon 97477
TAX ~qT ()\.s/2rx~
SUBDIVISION: Wbmri,Q ,,~
PHONE: l'L~n -~C?Q.9J
~J\()~
NEW
)(
ADDITION
, DEMOLISH
OTHER
REMODEL
, .
ZIP:
C\\L\ffi
CONTRACTO~NAME
GENERAL: ~~
PLUMBING: \ ~ -l ,ill~.fJ
MECHANICAI.\\'\l1 )\~ OJ) f)
ELECTRICAL: \.~\ \ \ ~
CONST.
CONTRACTOR # EXPIRES PHONE .
I 'L'I 0 rz qlO jq.z. 0'21o-3gCJ>f
3 'dOt"] lo ltJ/lnJq \ (ogK-A3I-
'. & E)'7!iD\''2!Q.3~4'7-~'
cO I Z\:=\ J 4/A:4 }Cil (p<6'").- J gs J
-- .. I
ADD.RESS
QUAD AREA:
# OF BLDGS:
4~R~S '
- \
'K.~~ \\'\ \
\
r___
.....;; OFFICE USE -
OCCY GROUP:
\ \\ '\
\ ~_ fit\. ,
CONSTR. TYPE: V t \J
HEAT SOURCE: t'L
r...
.-.... -'
LAND USE:
# OF UNITS'
# OF STORIES:
WATER HEATER:
RANGE:
FLOOD PLAIN: -
ZONING CODE: L\J \2-
# OF BDRMS: \..~
SECONDARY HEAT: F 0 0
SQUARE FOOTAGE: ~ OQ~n
.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.
REQUIRED INSPECTIONS
D' Temporary Elec'tric
.,
'M Rough Mechanical - Prior to
~cover.
'"
", l'X1~Site.Jnspection - To be,made
'~v '\. after excavation, but prior to
setting forms. '7t!)(I.-S'l
.
~ Rough Electrical - Prior to,
~cover.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
"15<1' Electrical Service - Must be
; "p,pproved to obtain permanent
electrical power.
1';7(, ' I Footing - After trenches are
~excavated.
o Fireplace - Prior to facing
, materials and framing Insp.
o Mason,ry ,- Steel location, bond
, beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement. "
,.
~' Framing - Prior to cover.
. '"
· fX.1 Wall/Ceiling Insulation - Prior to
~over.
o Underground Plumbing - Prior i:/1 Drywall - Prior to taping.
to filling trench. ~ '
''['....)(1.1' Underfloor~umbin~hanig.aY.....c-71' " . '. ' ,
~_ Prior to insul.atlon or decking. r;x...,J Wood Stove - After InstallatIOn.
, . . z:e;eO ~. F"t,tJ.
tJ Post and Beam - Prior to floor '
~sulation or decking." D Insert - After fireplace approval
and installation of unit.
, ~Floor Insulation - Prior to
~ Ctecking,
- I'
N-..f:urbcut & Approach - After
?--' R:>rms are erected but prior to
placement of concrete,
"
'1><1. Sanitary Sewer - Prior to filling
I' -..t[ench,
. /'
~idewalk & Driveway - After
~ EThcavation is complete, forms
and ,su,b,base material in place.
.. "
I><L Storm Sewer - Prior to filling
)L--J'trench.
~Water Line -Prior to filling
~rench. '
D 'Fence - Whe'n completed.
1><f Rough, Plumbing - Prior to,
" ,cover.
@treet Trees - When all required
rees are planted. '.
l'x"fFinal Plumbing - When all
~Iumbing work is complete.
"F>21' Final Electrical - When all
~Iectrical work is complete.
1;><[ Final Mechanical - When all
,. ,mechanical work is complete.
l><l Final Building - When all
t'.equire9inspections'have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When aU
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 -15- Lot Ty Setbacks k dE PROPOSED WORK IN THE
I PL. I I I ACC I HISTORICAL DISTRICT; OR ON W
Lot sq. ftg. ~ Interior HSE GAR
~.~% IN .20.1 I THE HISTORICAL REGISTERC
Lot coverage X Corner If yes, this application must be signed
~) Is /S/ I and approved by the Historical
Topography Panhandle
Iw 2tJf I Coordinator prior to permit issuance.
Total height leo.51 L Cul-de-sac
IE 11' It' I APPROVED:
BUILDING PERMIT
\;~lo x~'.ryh= \~~M
4?-A \~ .\0 - ~~
ITEM
Main
Garage
Carport
Total Value
l 01 i.~rD
,~~'7.~
/ (P. cgS
3q3,~S"
Building Permit Fee
State Su rcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) L/)/7: tJS
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO z..
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
I~o~
Plumbing Permit
State Surcharge
f3;D-O
--L0.flJ ();!
Total Charge
(C)
MECHANICAL PERMIT
~~
f .t;)o
<t.Cro
/5~
~'1 era -
Furnace
Exhaust Hood
NO
/'~
Vent Fan
Wood Stove/lnser~rePlac~ '
Dryer Vent
Mechanical Permit
37.~O
I/) (H)
23~
4~, S()
Issuance'
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
/FP3 ft
~ft
.31 ,4S"
/3, "0
Cu rbcut
Demolition
State Surcharge
yLA,v Ctfa::/L rE:ife
,
2/9, t:)S
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
,(A, B, C, D, and E Combined)
/~5tJ. 6~
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 provisions of said ordinances. X R/ l
Plan Check Fee: ~ If' (;) S' ~I 'fjli
Date Paid: -:::~~
~
Receipt Number'
Receiv:~:
Pla~~ij~
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
,- l'_Ll5\.i)~_\r\ QJ &~crQ ~
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
<;>1 the State of Oregon pertai ni ng to the work descri bed
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 loc~ted at the front
. , \
of the property, d the approved set of plans will remain
\
on the site at times du~onstftiOn\:
Signatur 0t, _\.~ h "-k.
Date~q/ 9/
I,
VALIDATION:
/ q $" 99
-:? --.2 ~.9/
AMOUNT RECEIVED '2 <.e:? ~6
RECEIVED BY 4~~----
, ,/ ... =-----~
RECEIPT NUMBER
DATE PAID