HomeMy WebLinkAboutPermit Building 1997-3-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
OUice: 726-3759
LOCATION OF PROPOSED WORK:
>(ASSESSORS MAP:
I- LOT:
) 7tJJ
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520 Cf'MTel/\1 cJ
54
BLOCK:
."5"-I:efLA/I t:1/'~1!I'
'/Z 1/3 D..o~PI/",~
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OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
'f2fJ!.j)tLl rI
t
NEW
REMODEL
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STATE:
DR
.J.; .r e
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DEMOLISH
ADDITION
. JOB NUMBEf :7 7o/~ 2-._
225 Fifth Street
Springfield. Oregon 97477
C;ol/& _-
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PHONE: fJr~+ '32 OS-
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ZIP: 'Jg77l1?-1?
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EXP"f[:S
l/Jb 715:::L__ '=1117-
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TAX LOT:
SUBDIVISION:
OTHEFl
GENERAL:
CONTRACTOR'S NAME
/1IJ c..~ ~,P- L ~~v-
ADDRESS
, . CONST,
CONTRACTOR It
?7?!l J11a#1 '!2 '19
PHONE
1
PLUMBING:
MECHANICAL:
ELECTRICAL:
~/..p,"'-#-r,~r.
"K.ose
QUAD AREA:
II OF BLDGS:
OCCY GROUP:
II OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
II OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
7-'-11- S'fB-
FLOOD PLAltJ:
ZONING codlE:
It OF BDRMS:
SECONDARY HEAT: ___..
SQUARl:: FOOTAGE'
I '..---.--
To request an Inspection, you must call 726.3769, Tills Is a 24 hour recording, Alllnspeclions requesled before 7:00 a,m. will be
made the same working day. Inspections requested after 7:00 a,m, will be made the following worl< day!
D Tempornry Electric
D
Site Inspection - To be made
after excavation. but prior to
setting lorms,
D
Underslnb Plumbingl Electrical/
Mechanical...... Prior to cover.
o
FootIng - After trenches are
excavated,
D
Masonry- - Steel-location, bond
beams,grout lng,
o
Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to (II1lng trench.
o Underfloor PlumblnglMechanical'
- Prior to Insulation or decl<lng.
~post and Be. am -. Prior to floor
nsulation._or decking, "
....,.. . -:! -' . - -,)
1><fFI;~~- i~f~l~ti~~ - Prior to -
/ Jecklng. .c-
o Sanitary Sewer - Prior to filling
trench. -
o Storm Sewer - prior to lilllng
trench.
',.. .
., : .',.. '\
D Water LIne - Prior to filling
trench. \. ',,_ .
... . . .
\ . '. r..c ~..).....l. __,..
D' Rou'ghP.lun1~iAg ~. Prior to
cover,
REQUIRED INSPECTIONS
D Rough Mechnnical - Prior to
cover.
w( Rough Electrical - Prior to
~vcr.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o
FireplncQ - Prior to lacing
materials and Iraming Insp.
~mlng - Prior to cover,
. r--".J Wall/C-elling Insulntion _
)LJ'Cover,
Prior to
~rYWall - Prior to taping,
o Wood Stove - Alter Installation.
D Insert - Alter fireplace approval
and Installation of unit.
-'0
Curbcut & Approach.,.... Alter
forms are erected but prior to
placement of concreto.
o
Sidewalk & Driveway - Alter
excavntion is complete, lorms
and sub.base material in place,
o
Fence - Wtlen completed,
o
~,treQI Trees - Wilen nil required
.,
trees are planted, .
o Final Plumbing - When nil
plumbing wo1rl< Is complete,
t><( Final Electrical - When all
/ ~ctrical weil( is complete,
o Final Mechanical - When all
mechanical 00rl< Is complete.
~inal f3ullding - When all
required inspections have been
a roved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
o Blocking and ISet.Up - When all
blocl<in9 is complete,
o
Plumbing Con1nections - When
tlOme has been connected to
water and Se,^ler,
o
Electrical COn[lection - When
bloCI(lng, set.up. and plumbing
Inspections ,,dve been approved
and the tlOlne lis connected to
the service panel.
o
Finnl --- Afler all required
Inspections are approved and
porcllCS, sl<lrting. decl<s, and
venting have b~en Installed,
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Lot faces
LoLsq, fl'g,
Lol Type
"
Interior
Lot coverage
Corner
Topography
Total height
Panl,andl e
Cul.de.sac
BUILDING PERMIT
ITEM SO, FT, X $/SO, F1.
Main
Garage
Carport
""j '\ - .',
~6 ~c ~l:9?.47~
Total Value
\
\
Building Permit Fee
.Stale Syrc},arge. I,gee -f-. 3/ '3
, ,) I" .I.,,~ .,. '7" '. ,. ~' \
'Tot'al Fcc (A) .
Is;j;~#tff PFlOPOSED WORI, 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.
~~~?cl(~_
HSE GAR ACC
I" P,L,
IN
Is
W
E
V A LU E
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'/
-0~ rc:_
_&7~sf.
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
IrEM
Fixtures
Residential Bath(s)
NO
Sanitary S~wer
Water
FT,
F1.
Storm Sewer
F1.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/ Fireplace .Unil'
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
fl
Curbcut
It
Demoll tlon
?tale Surcharge
Tolal Miscellaneous Permils (E)
TOTAL AMOUNT DUE (exclueJing electrical)
(A, B. C, 0, and E Combined)
FEE
,k7r!
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit.is granted on the express condition that the said
construction shall:'in all respects.,cohlorm 10 lhe Ordinance
<,1dopted by the City o.r. ,Spr,ingfield, including lhe
Develop'll:1entCode. regulating lhe construction and useof
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
, .
~, ..:"~
Date Paid:
Receipt Number'
Received By:
.~ ..;~ -:..:'
, -"'-'
,
'" - .' , .' -' ,/ -~ -
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Dale
Plans Reviewed By
Systems Development Charge is due on all undeveloped
properties within tho City limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I stale and agree. lhall have carelully 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 Ordinanc~s of the City of Springfield. and the Laws
of the State of Oregon perlainlng to the, work described
herein, and .lhal NO OCCUPANCY will be made of any
structureewilhout permission of the Building Safety Division,
I further certify tllat only contraclors and employees who
arc in cornpli'illlce 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 tile street, Ihatthe permit card Is located at the front
of lhe properly, and the approved sel of plans will remain
on the sile al all tiTI during 17'/.~ ,"CUloono."
SlgnalureX ~~~~
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Dale
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VALIDATION:
RECEIPT NUMBER 2....:;/ JI~J
DATE PAID V2.f! 7 . /
AMOUNT RECEIVED _/ ~'r~n.:; ,~/ 1/,79
,/A" ,.
FIECEIVED BY //../.2-.
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