HomeMy WebLinkAboutPermit Building 1995-5-5
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
JOB NUMBER ~c?'7/g7
Inspections: 726-3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
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ASSESSORS MAP:
LOT:
TAX LOT:
BLOCK:
SUBDIVISION:
OWNER:. ~# M.cc./~,?'
ADDRESS: '-.A/n ~c-~7c~~~C
~;Z>./'L-2:>___ . STATE:
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DESCRIBE WORK: -*?a:/-:r~~ ~':" y ~ .~
'7 ~~...6?::? 'T
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PHONE:
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CITY:
ZIP:
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NEW
REMODEU
ADDITION
DJ:MOLlSH
OTHER
CON ST.
CONTRACTOR #
CONTRACTOR'S NAME
GENERAL: O~~C~
.... -.
ADDRESS
EXPIRES
PHONE
PLUMBING:
MECHANICAL:
ELECTRICAL'
- OFFICE USE -
QUAD AREA: LAND USI=' FLOOD PLAIN:
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE::: SECONDARY HEAT:
WATER HEATER: RANG 1=. SQUARE FOOTAGE:
To request an Inspection, youmust 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 7:00a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
D Rough Mechanical - Prior to
cover. '
D Final Plumbing - When all
plumbing w()rl< Is complete.
o Site Inspection - To be-made
after excavation, but prloY,to
setting forms.
D RoughElectrlc~1 - PrIor to
cover. , :
o Final Electrical - When all
electrical work is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Final Mechanical - When all
mechanical work Is complete,
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
~ Final Building - When all
required Inspections have been
approved and building Is
completed.
D Fireplace - PrIor to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
D Other
o Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - PrIor to
cover.
o Underground Plumbing - Prior
to filling trench.
ITI Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
, - Prior to. Insulation or decking.
'\.
D Wood Stove - After Installation.
o Post and Beam - Prior to floor
Insulation or decking.
D Blocking and Set.Up - When all
blocking Is complete.
D Insert - After fireplace approval
and Installation of unit.
o Floor Insulation.... Prior to
decking.
D PJumblng Connections - When
home has been connected to
water and sewer.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
.j
o Storm Sewer - PrIor to filling
trench.
o Water Line - Prior to filling
trench.
o Fence - When completed.
D Final - After all required
Ins'pectlons are approved and
porches, skirting, decks, and
venting have been Installed,
o Rough P\umblng - Prior to
cover.
D Street Trees - When all required
trees are planted.
>,
Lot faces Lot Tyr
Lot sq. ftg. Interior I P.L.
-
Lot coverage Corner N
Topography Panhandle S
Total height Cul-de-sa<;: W
-
E
!?~ .Pt:::'.
"5:~
/... : 7~
_ 4'-;
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SYSTEMS DEVELOPMENT CHARGE (SDC)
BUILDING PERMIT
ITEM SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
X $/SQ, FT. VALUE
"
/11/#
~
(A)
(B)
FEE
(C)
Dryer Vent
Wood Stove/Insert/Fireplace Unit
NO
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL,~NEOUS PERMITS
Mobile .Home
:. ~.
~ ~
:.:
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
, ',": > ,: ';<iFf
.IS THE PROPOSED WORK tN 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.
Setbacks '
HSEGAR ACe' I
I
I
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT '
This perr(11t is granted on the expr~s condition that the said
construcil'on 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.
., Plan Check Fee: ~ ~ /f! ,
~-;.~ ~'/
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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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 p~rformed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregpn pertaining to the work described
herein, and that N.9.;~.<?CCUPANCY will, be made of any.
structure without permission of the Building Safety Division.
I further certl fy that?nly contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to, en:'sure that all required Inspections are
requested at the pro~er time, that each address Is readable
from the street, that:the permit card Is located at the front
of the property, and Jhe pproved se f plans will remain
on the site at all ~es during co ructlon.
; Slgnaturf' 7 ~ ~ ~L
1 ./ __ .'
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Date
'i
, . '~
VALIDATION:
RECEIPT NUMBER
DATE PAID
/7"2 V~
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AMOUNT RECEIVED
RECEIVED BY