HomeMy WebLinkAboutPermit Building 1991-5-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: I:?O'S :2 7
LOT:
SPRINGFIELD
1-
BLOCK'
ADDRI=C::C::'
279<' '?'
P7d4
MN..Jscx") c j;ftc;tc~dK)
Roy~ 'Av-E
OWNER:
CITY:
STATE:
~I
, JOB NUMBER
9/CJ/47
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
E" ~ot)
SUBDIVISION:
PHONI='
0g~ -9'&.s~
ZIP:
9 7~ 2:...
DESCRIBE WORK: :F/'52/~~k77r''}() ./ Q/1/'A )-t:L;///Vt~r ;==On ~;/C?) ~Fi('/JJ(lJfJ('~
NEW
REMODEL
CONTRACTOR'S NAME
ADDITION
DEMOliSH
OTHER
ADDRESS
CONST.
CONTRACTOR #
PHONE
G EN ERAL:
PLUMBING:
()WA)~
~ ~/~--es" ~cX'1<"(::'C,j
MECHANICAL:
\(~~~2~a< EUc--r.-
ELECTRICAL:
EXPIRES
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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
~ excavated.
o Masonry .,.... Steel location, bond
beams, grouting.
~ Foundation - After forms are
.J4l erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
'C8::I Post and Beam - Prior to floor
insulation or decking.
~ Floor Insulation - Prior to
~decking.
,
'M Sanitary Sewer - Prior to filling
r-"'" trench,
'f';Zf Storm Sewer - Prior to filling
~trench,
l"".c(1 Water Line - Prior to filling
~trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~ . '
D Rough Electrical - Prior to
cover.
'TVf Electrical Service - Must be
~approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
-F;;7T Curbcut & Approach - After
.v""'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.
D Street Trees - When all required
trees are planted.
l5<t Final Plumbing - When all
. plumbing work is complete,
, lXT Final Electrical - When all
~e/ectrica/. work is complete,
o
Final Mechanical - When all
mechanical work is complete,
~ Final Building - When all
~required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o 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.
o Final - After all required
, inspections are approved and
. porches, skirting, decks, and
venting have been installed,
-;.,
Lot faces ~ Lot Type Setbacks
Lot sq. ftg. . ~D Interior I P.L, HSE GAR ACC
Lot coverage JAfO Corner IN
v Is IS*'
Topography L2~ Panhandle
Iw
Total height Cul'de-sac
IE 5'
BUILDING PERMIT
ITEM SO, FT. X $/SO. FT.
Mai n j/72. 11'=iuJ ~
Garage 1:4"~ lo.CV\
') I \
Carport
VALUE
2.. S' irO II4J
\OOOc?
2JSOO
J.\,\ 5J~ - }
2,2.3
(A>4wT\.
SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Val ue
Building Permit Fee
State Su rcharge
Total Fee
(B)
PLUMBING PERMIT
ITEM
Fixtures '.
Residential Bath(s) NO
,
Sanitary Sewer FT. .(' -6" L)
FT. N
Water
FT. I,
Storm Sewer
Mobile Home
FEE
--2~ ~
z.E; 4G
2.5'40
Plumbing Permit
7580
:37~
1l!;;?'~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Su rcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ft
Curbcut JS- ft
Izft)
Demolition
State Surcharge
jJLA,J .A'M&1 ,f!eE-
z, S.~:r
Total Miscellaneous Permits (E)
TOTAL AMOUNT ,DUE (excluding electrical)
(A, B,C, D~ ,and E Combined)
IS 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.
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 th,e
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: ~ 2. 5'". ~ ~
Date Paid:
Receipt Number:
Received By:
P~~~~-
~(7/
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
Pl5A?/:N"r /S H/(. l)wE{..,U~
~u~/),v . "360~ ~..dZ
WILL JZ.,E _~~/A'/?~ /!~M€.
--5~L!~Lr ~F! ,,()fhJ J EUvAJ741()
J~,(".FX l4/~"L/c.,tttJ~Al.
Of\nM\~_s\t)b. '~
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. ^f\'/\,Ct- ) II ,', n If)
, IC1\(\WFL-/
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.
'f
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
:~g:::"9;; :: ~";tiA~ .
Date ~....,4/_ 7 - tf/
/7", f' . ,
VALIDATION: q oA
RECEIPT NUMBER I q , 'If', ·
DATE PAID 0 " r; . q I I
AMOUNT A~~Uu.Y3 .:;)1
RECEIVED~ l , ."
. .
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