HomeMy WebLinkAboutPermit Building 1993-9-14
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DESCRIBE WORK: 4~/;-i~4--/ z;-c-~ ~~
ADDITION Y DEMOLlSH'o
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726'3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: /?-.tt:12~~'-'7"'?
LOT'
OWNER:
ADDRESS:
CITY:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL: ~~~~~
....
PLUMBING:
MECHANICAL:
ELECTRICAL:
SPRINGFIELD
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BLOCK:
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JOB NUMBER ~/~...-b
225 Fifth Str~'e~
Springfield, Oregon 97477
TAX LOT: tt::'-::<76 c::s.
SUBDIVISION:
PHONE:
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~/:f: ZIP: ""5?7"";::>8
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REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cove~ .
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 Framing - Prior to cover.
o Wall/C'eiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub,base material in place.
D Fence - When completed.
o Street Trees - When all required
trees are planted., ,
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STATF'
.OTHER
ADDRESS
.' 'CONST.
CONTRACTOR #
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNITS: ZONING CODE:
OCCY GROUPl CONSTR. TYPE: II OF BDRMS'
,
II OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
[1] 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
decki ng.
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
cover.
D Final Plumbing..:.... When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work is complete.
~ 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 Elect~ical 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.
. .~
,
Topography
Panhandle
Setbacks
I PL. I HSE I GAR I ACC
IN
Is
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'''' THE PROPOSED WORK IN 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.
.1
Lot faces
Lot Type
Lot sq. itg.
Interior
Lot coverage
Corner
Total height
Cul,de-sac
. APPROYED:
'j
-1'. -,
ITEM
SQ. FT.
X $/SQ. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMIT
'.,
'-. ''-
This permit is granted on the express condition that the said
constru2tionshall,'in allh~spects, con'form tothe Ordinance
adopted by the City of Springf~eld, 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: . //~ ~S
.' ......
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Main
Garage
Carport
~
Z?:2 1/1
~..~t?
~2~
Building Permit Fee
962.. ~
17~
.arg
/A".. ;>",.c;:
Date Paid:
Total Value
Receipt Number'
Total Fee
(A)
~Receiv By: '- /
, ...-- ./ ~, '
~~~.,..,' ~~Y-":7
p~eviewed By (' // Date
Systems Development Charge is due 'on all undeveloped
properties within the City limits which are being improved.
State Surcharge
SYSTEMS, DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)'
NO
Sanitary Sewer
FT.
Water
FT. .
Storm Sewer
FT.
Mobile Home
Plumbing Permit
:?tate 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 certi fy'tl1at only contractors and employees who
are in cOrT)pliance 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 p'roperty, and the approved set of plans will remain
on the eat imes duri~ conr/Jtion:J,:
Signatur L ~
Date .OJ I, 1/0 J...., I
, V
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
?~ 71&~IP"'i>
VALIDATION:
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
-:;.?'9..- .?G::
RECEIPT NUMBER -t::J.. ! Od-~
OJ I, L/ It:} J..,
AMOUNT RECEIVED .$ jC;.7 L::,
IX) P;
DATE PAID
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Total Miscellaneous Permits (E)
RECEIVED BY