HomeMy WebLinkAboutPermit Building 2000-6-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
ASSESSORS MAP:.
LOCATION OF PROPOSED WORK: I Z 7 J
. 11-0~ ~6 LiI1
LOT'
., .
"
~';. 1.'~'
1'._:'
BLOCK:
OWNER":' ,JQt+u' 4iI- JO~ ~t<Y
~D~'~~isi;~;:'..' I,W{ZI , C~-~)J/~
CITY: ~"'1~Lt-.L6, 'i=i ~ STATE: c.:::iK.
. ~1:" ,\ 1.
DESCRIBE WORK: Ct!).A)f;I&f C~M"2 7D
NEW REMODEL >< ADDITION DEMO~ISH
JOB NUMBERt:7(..TI 1/ 16~ ~' I
225 Fifth Street 00 - OGO~ '(-0 L
Springfield, Oregon 97477
TAX LOT:
\ t;L.1 00
SUBDIVISION:
PHONE:
7f4 -- 2.S"t: ~
v .
ZIP:
~'~e~w R/"n "
.~ /' "
OTHER
CONTRACTqR~S NAME.. ADDRESS
GENERAL:"TCJO ~\\t;'~~ 0?dT9~~
CON ST.
CONTRACTOR #
~ \lo7.Pp.
EXPIRES ,,,,", PHONE
01 %1-5733
.PLUMBING:
MECHANICAL: . - ~~
ELECTRICAl'
QUAD AREA:
# OF BLOGS:
OCCY GROUP:
Ii OF STORi"ES:
WATER HEATER'
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF:
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.
REQUIRED INSPECTIONS
D Temporary. Electric
D Site Inspection ~ To be made
after excavation, but prior to
setting forms.
D Undershlb Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
. excavated: ' ..
D Masonry ~ Steel,lbcatJon, bond'
. beams, grou,~lng.
O Foundatlon'':'- After forms are
. . erected but- prior to 'concrete
placement.
o Underground Plumbing - Prior
to f1~lIng tre.n~h.
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking,
o Floor Ineulallon - Prior to
. deckl ng.
o Sanitary Sewer - Prl(lr to filling
trench. :
o Storm Sewer "- Prior to mllng
trench.
o Water Line - Prior to filling
. trench,
D Rough Plumbing .,.- Prior to
. cover. . :
" "J
.~ .
D Rough Mechanical - Prior to
cover.
D Rough Electrical ....,. Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D.. Insert. - Alter fireplace approval
anQ Installation of unit.
o Curbcut & Approach - After
. forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and'sub.base material In place.
o Fence - When COf.lpleted.
D Street Trees - When all required
trees are planted,
D Final Plumbing - When all
. .plumblng W9rl< Is complete.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work is complete.
o 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
blooklng Is complete.
o Plumbing Connoctlons - When
home has been connected to
water :3nd sewer:
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o J:lnal - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
..,........'
('
'. .
""i f~: :':~!r~:;1r~;!' '
..';:1......
Lot faces
Lot Type
Lot sq. Itg.
Interior
Setbacks .
I P.L. HSE GAR ACe' I
N
E
--j
IS THE PROPOSED WORK l'N 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.
Lot coverage
Corner
Topography
Total height
'1'
Panhandle
S
Cul-de-sac
w
APPROVED:
,
BUILDING PER~IT 'i
!'
"f
ITEM
sa. FT.
X $/sa. FT.
VALUE
BUILDING IALOE,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, includll')g 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.
Main
Garage
"
Carport
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
Receipt Number:
State Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State 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 Ordinanctls 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.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree 10 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.
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Signature
Sidewalk
It
Date
Curbcut
It
Demolition
Total Miscellaneous Permits
(E)
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
State Surcharge
~...<
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
RECEIVED BY