HomeMy WebLinkAboutPermit Building 1999-1-4
LOCATION OF PROPOSED WORK: 5""60
!g./J J- tf 1.- 2,-2-
" '
, .' l;,'l
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT:
OWNER-
CONTRACTOR'S NAME /) "J!
GENERAL: lie-ie. rR-oCfC11/
PLUMBING:
MECHANICAL:
ELECTRICAL:
ATTENTION:Oregon law requires you to
o~l,QrrAWEA~~st.?pted by the Oregon Utility
~. ItlfiCatlOn Center. Those rules are set forth
In OAR::l!85el:(l{G~01 0 through OAR 952-001-
Of 906X8~ m~~eP.tain copies of the rules by
calling tlie center. (Note: the telephone
Ilumlom mro~r~ lItili~y Notification
WAT~~ru~'A!f~R~OO-332-2344 ).
ADDITION
SPRINGFIELD --
"
JOB NUMBER
~/s16
225 Fifth Street
Springfield, Oregon 97477
tk!( vr
__ TAX LOT: 0& 60 Z-
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
//'D,ylning - Prior to cover.
-----.
~, I ail/Ceiling Insulation - Prior to
~over.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation or unit.
D Curbcut & Approach - After
rorms are erected but prior to
placement of concrete.
D Sidewall< & DrivewtiY - After
excavation Is complete, forms
and sub-base material in place.
D Fence - When cOi'rlpleted.
D Street Trees - When all required
trees are planted.
SUBDIVISION:
PHONE:
-; 2&r "7/3
CA/t/5'fvr;k C~IA!. /}1();J r
,
ADDRESS: .sz:,O Cd r ~ ,oil/I/' e
CITY: 5fJt-/Afi:JHti //
1l.. J\,. .:.
DESCRIBE WORK: ~j~-
NEW REMODEL
BLOCK:
STATE:
O~~
ZIP:
1""1- " 7 ~
~-r
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
,'"
ZONING CODE:
" " : i:'I; " ' . '~H}b~~~!F THE WORK
! ,. ;-;: '),':; ,- ';:~if!6~f(JRt-,E~M.!..lIS NOT
,-' ;)i.,~: '<:ANDQNED J:OR
',; '/ iT :,~,91U~R-E FOOTAGE:
EXPIRES
PHONE
- OFFICE USE -
LAND USE:_
',~ )l'lr-"'....IC
1 ~ t!~, ,I't,;:
FLOOD PLAIN:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested berore 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanlca,1 - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
,
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
covet . _
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE'
\ .
D Final Plumbing - When all
plumbing worl< is complete.
, ,
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete.
~
Fin I Building - When all
D ulred 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, skirting, decks, and
venting have been Installed.
.
.(, c
.t '; ;....,'~,'
'C;'~ ~. ..t' '
~.l ~'4:,
Lot faces
Lot Typ
Setbacks
IS THE PROPOSED WORK ~N THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Topography
Total height
Panhandle ~
I P.L. HSE GAR ACC
IN
Is
Lot sq. ftg.
Interior
Lot coverage
Corner
Cul-de-sac
w
.E
APPROVED:
ITEM
SQ. FT.
X $/SQ. FT.
VALUE
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMITi
('S
'~
Garage
'.
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee:
e Uj O"n> Date Paid:
Total Value
~,$()- Receipt Number:
Building Permit Fee
q,)~ ~<<I fio Received By:
State Surcharge
Total Fee (A) _g3.~ Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Residential Bath(s)
N'
~~
I
~~~
Fixtures
Sanitary S!3wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 propet;t , and the. approved set of plans will remain
on the site II times ~rlng construction.
, (~
)(Slgnature ·
,
~Date ! -4 ,q f
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
,--
3~ l./s L(
DATE PAID 1- y-- q ~ I
AMOUNT RECEtJEp /I a JI q:3. t.f~
RECEIVED BY~~ 4\0-'
I.~
RECEIPT NUMBER
TOTAL AMO,UNT DUE (excluding electrical)
(A, B, C, D, and E Combined)