HomeMy WebLinkAboutPermit Building 1998-5-27
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Offlce: 726-3759
LOCATION OF PROPOSED WORK' q q s-
ASSESSORS MAP- I 7- 0 ;?- 56 ? 0
LOT'
OWNER' C-eo\c,-f J (CAf-/'A-CN
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ADDR~""" lj q ') So. "1
CITY: ~€'''~ rV) .(:; -( \ j
DESCRIBE WOR\<'
NEW
REMODEL
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ADDITION
CONTRACTOR'S NAME
"S("\~
GENERAl'
PLUMBING'
MECHANICAL:
ELECTRICAL:
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
SPRINGFIELD
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JOB NUMBER J.,'t(){, '2-L
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:6Lj i 00
SUBDIVISION'
PHONF'
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BLOCK:
ST; rJ SoN
STAT~'
de
ZIP: C1"lLliS'
ADDRESS
OeJ/VR..\'L
CaNST.
CONTRACTOR'
EXPIRES ~ PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o FIreplace - Prlor to facing
materials and framing Insp.
fil./~amlng - Prior to cover.
V) !)/Z.'1 t, f
1[2] Wail/Ceiling Insulation - Prior to
~ cover.
eorywafl - Prior to taping,
o Wood Stovo - After Installallon.
O Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected bul prior to
placement of concrete.
o Sidewalk & Orlvew.. - After
excavation Is compicte, forms
and sub-base materIal In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. ,
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
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.
DEMOLISH
OTHER
~!OTICE;
TP.IS PERMIT 81 /ALL EXPIRE II' J nc VVVMI\
AU I MUHILtU UNDER THIS.P<iFW8'EiSll/llEl~
COMMENCED O"l!.Ml36~Q:ONED FOR
ANY 180 DAY PERIOD.
. OF UNITS'
CONSTA. TYPE:
o Temporary Electric
o Site Inspectton - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundatton - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decKing,
o Sanitary Sewer - Prior to fllllng
trench.
o Storm Sewer - Prior to tilling
trench.
o Water Line - Prior to filling
trench.
~U9h Plumbing - Prior to
~cover.
HEAT SOURCE:
RANG~'
61
lnal Plumbing - When all
plumbing W9rk Is complet.e.
-0 Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
e
Final Building - When all
requ)red inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o PlumbIng Connections - When
home has been connected to
water and sewer.
o 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.
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SYSTEMS DEVELOPMENT CHARGE (SDC)
L~I ~yp_; '-.-.
Lot faces
Lot sq, ltg, Interior
Lot coverage Corner
,
Topography Panhandle ,-
Total height Cul-de-sac
BUILDING PERrlhlT "I
';'1} '1
ITEM
SQ, FT,
X $/SQ, FT,
Main
Garage
Carport
OfLl, f2.f ~,,,.
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
-:s,
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
Storm Sewer
FT,
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
HSE GAR Acc'l
I
I
I
I
BUILDING \ih.uYE, PLAN CHECK
AND BUILDING PERMIT
. ~ ,
I P.L.
N
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E
VALUE
"
't ()U 0,;..
. ,..' '.
FEE.-
:3 0,00
'5 (l), () 0
//2; , q 1)_
-p. 'i \)
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'_S THE PROPOSED WORK IN THE.
""HISTOI;1ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, Including the
Development Code, regulating the construction and use of
Ouildings. 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:
Plans Reviewed By
Dale
Systems Development Charge is due on all undeveloped
properties within the city limits which are being improved.
,
ADDITiONAL COMMENTS
. ~.; I:~r~" ...', . .'.. I' J.
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I JO .' .'
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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 certHy
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 perlainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of Ihe Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
prolect.
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
on the site at all times during construction. 0 --"'\.
Slgnatur~!t~~ C Cu-0Y<,"'1 ....(:J...u~. \
Date 0_'7- ;2.7- 'f;:J
VALIDATION:
RECEIPT NUMBER
03()02 ?
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afJ fA} aAdI
DATE PA1P
AMOUNT RECEIVED
RECEIVED BY