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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)