HomeMy WebLinkAboutPermit Building 1995-10-26
RESIDENTIAL
PERMIT APPLICATION
. .
Inspections: 726-3769'
Office: 726-3759
~....,
SPRINGFIELD
LOCATION OF PROPOSED WORK: /-:2 /2
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ASSESSORS MAP: /?~-26-~
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.OWNER: ,/~l!!S~L., ~P'
ADDRESS: !~n. C~/e:~~~
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DESCRIBE WORK: ~~_>/;7roe::..r ~"'r'/&> ~~:e> ~yr: ~.,.3'
ADDITION K
LOT: --
CITY:
NEW
REMOpEL
CONTRACTOR'S NAME
GENERAL: ~".,~~ 7f
PLUMBIN(::'
MECHANICAL'
ELECTRICAL:
BLOCK:
STATE:
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I
JOB NUMBER ~~ ~2
225Fi fth Street
Springfield, Oregon 97477
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TAX LOT: //~
SUBDIVISION:
PHONi=.
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DEMOLISH
OTHER
ZIP'
9?9? -::::>
ADDRESS
CONST.'
CONTRACTOR #
PHONE
EXPIRES
-OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR: TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAG E:
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 excavatiqn, but prior to
setting forms, .
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
o Footing - After trenches are .
excavated, ' '
o Masonry - Steel location, bOr:ld
beams, grouting.
D Foundation......, After forms are
erected but p~lor to concrete
placement.
\
D Undergr~und 'Plumbing - Prior
to filling trench, ,
o
Underfloor Plumbing/ Mechanical
- Prior to insulation or decking,
D
Post and Beam - Prior to floor
l(lsulation or decking,
o Floor Insulation "7" Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench. '
o Water Line - Prior to filling
trench.
D Rough Plumbing......, Prior to
co'{er. ' "
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~, '
o Rough Electrical -:- Prior to
cove~
o Electrical Service"':'" Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp,
,
I
rn Framing ~ Prior to cover,
o Wall/Ceiling Insulation - Prior to
cover,
D Drywall - Prior to taping.
o Wood Stovo - After 'nstallation,
D Insert - After fireplace approval
and installation of unit.
D
Curbcut & Approach ~ After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation Is compl!3te, forms
and sub.base material In place,
D Fence - When cOlT,lpleted.
D Street Trees - When all required
trees are planted, ,
D' Final Plumbing - When all
plumbing work is complete,
D Final Electrical - When all
. electrical work Is complete,
"
D Final Mechanical - When all
mechanical work Is complete,
Gr] Final Building - When all ,
required Inspections have been
approved and building Is
completed,
D Other
MOBILE HOME INSPECTIONS
D 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, ski rtlng, decks, and
venting have been Installed,
Lot faces
Lot Typt.,
\ ~ :'
Lot sq.' ftg,
Interior
Setbacks
I P.l. I HSE GAR I ACC i
Lot coverage
Corner
I N I
I S I
Iw I
I E I
Topography
Panhandle
Total height
Cul-de-sac
....
BUILDING PERMit
ITEM
SQ, FT,
X $/SQ, FT,
VA LU E
Main
Garage
"
Carport '
~ ~~ :::7~ /~.;'2?
;2!:;4:P. c.ses
Total Value
~ 5"'t:?
~ I,q,
"
,707/,/6-
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Building Permit Fee
State Surcharge
Total Fee
(A)
S1S~S DEVI;LOPMENT CHARGE (SDC)
#vIf.,pA~ 4:.<:~~y
. ~? :;Vc<.~ ' (B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
FT,
Water
. Storm Sewer
FT,
Mobile Home
,I
Plumbing Permit
State Surcharge
Total Cnarge
(C) ,
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
'(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
rt
Curbcut
ft
Demoli tion
State Surcharge
Total Miscellaneous Permits (E)
TOTALAMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined) ,
't./~S?
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I
I
(~- IS THE PROPOSED WORK iN THE,
'uHISTORICAL DISTRICT, QR 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 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:
7~0"3
//?-<d'~r...,
r _
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r
Date Paid:
Receipt Number:
/~'~~
Date I
Systems Development Charge is due on all undeveloped'
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
r
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certl fy 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.
I further agree io 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 Siteata,"5Fmes. during construction..
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VALiDATION: /..
RECE;PT NUMB~t .,' ;~
DATE PAID \ ) ~(Q "'L)
AMOUNT REC"e~ \ ~. ( "\\ .C?1~
RECEIVED BY lj l.. _J
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