HomeMy WebLinkAboutPermit Building 1995-7-12
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
~
., f.
JOB NUMBER
12?//j2-
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: -L2....a. CF/i?/CA;?.A///PC 6>c V/::>
LOT:
ASSESSORS MAP: /_7..::!>"?--~:" 7''7""
BLOCK:
, TAX LOT: // -<'::;""-G,ooo
SUBDIVISION:
OWNER: P&/fC#~ 5~~,~
ADDRESS: '-_/2 /?~~..f'.~.~~~~--:~
~?~u:>.
CITY'
~~~.
,pi? A
STATE:
, PHON.E:
? ~/-~So
_ ZIP:
~? 0/;::> >
DESCRIBE WORI( )&A/EU/ /~""~/7 /{p~ /:?f"'~t' r _)i?~ ~~~
NEW F1EMODE:L ~ ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME ADDRESS
GENERAL: ~~~__,._..
PLUMBING: ~/~
MECHANICAL: .
ELECTRICAL: /~ ~~~
r, 'e ". - f
CON ST.
CONTRACTOR /I
PHONE
EXPIRES
:2-1< x1w
/
/I OF BLDGS: ____ ,
OCCY GROUP: ----if :s
/I OF STORIES: -.-'-.l._L
QUAD AREA:
WATER HEATER _u_'___.,_______.,__
- OFFICE USE -
LAND USE:
,/Jif--
FLOOD PLAIN:
ZONING CODE: L ~
/I OF BDRMS:
SECONDARY HEAT:
SPUARE FOOTAGE:_
/I OF UNITS:
CONSTR. TYPE:
lL.M
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 sanle working deW, Inspections requested after 7:00 a,m. will be made the following Work day,
o Tcrnpornry Electric
o Site Inspection "- To be made
after excavatlon,'but prior to
setting forms,
o Underslab Plumbing I Electrical!
Mechanical - P~ior to cover,
o Footing - After trenches are
, excavated,
o Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior :to concrete
placement.
o
Underground Plumbing - Prior
to filling, trench,
o
Underfloor Plumblngl Mechanical
- Prior to insulat/on or decl<lng,
r\t/(post and Bea~ -" Prior to floor
~ Insulation or decl<lng,
~ Floor Insulation - 'Prior to
~dec.king, ,
o
Sanitary Sewer - Prior to filiing
trench,
~Storm Sewer - Prior to fIIi1ng
~ trench,
D Water Line - Prior to filling
, trench,
.
I'xl.Rough Plumbing - Prior to
r--'cover.
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover,
~ Rough Electrical - Prior to
cove~, '
o Electrical Service - Must be
approved to obtain permanent
electrical. power.
o Fireplace - Prior to facing
materials and framing Insp,
~ Framing - PrIor to cover.
I";tJ Wall/Celling Insulation - Pr'lor to
~over.
I)<J Drywall - Prior to taping.
, .
o Wood Stovo - After Installation.
o Insert - After fireplace apprOVlll
, and Instal/atlon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub.base material In place,
o Fence - When completed.
0' Street Trees - When al/ required
trees are planted.
IS?1 Final Plumbing - When all
~Iumblng W~)rl< Is complete,
rc;( Final Electrical - When ail
~ electrical work Is complete.
15?1 Final Mechanical - When all
. ~mechanical work Is Complete,
l::5<r Final Building - When al/
"equired 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,
Lot Type Setbacks j THE PROPOSED WORK IN THE
I P,L. I I ACC I .. HISTORICAL DISTRICT, OR ON
Interi'or HSE GAR
IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Is I and approved by the Historical
- Panhandle Iw I Coordinator prior to permit issuance,
Cul-de-sac
IE' I APP.ROVED:
Lot faces
Lot sq, ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT.
VALUE
Main
Garage
"
Carport
Total Value j/$. 6t~~).,:iL ~~C
B '/d' P 't F ~~.~o
UI lrig erml ee
State Surcharge z..(tP +I.~O
'J 4-J
~~, -
3,4~
4t;;, ,'7/
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
---cJ>
(B)
PLUMBING PERMIT
ITEM
FEE
/ rz:; .800
Fixtures
AhtJ.
Residential Bath(s)
NO
Sanitary Sewer
FT,
FT,
Water
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
I 7~ 7-'tc~~
/,20
/ ~ .';LO
Total Charge
(C)
MECHANICAL PERMIT
5iir
Furnace
Exhaust Hood
Vent Fan '
NO
Wood Stove/Insert/Fireplace Unit
Dryer, Vent
~ I',v .J
Mechanical Permit
~c-o
/~CJ~~
/,2,0
2t; 2.10
Issuance
State Surcharge
.7S'+."iS
Total Permit
(D)
MISCELl-ANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcul
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D, and E Combined)
~<f.//
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grante9 on the express condition that the said
construction shall. in all respects, conform to tile Ordinance
adopte_d by t~c ,City of Springfield, including the
Development Code. regulating the cOr)itruction and use of
buildings, and may be suspended o'r revol<ed at any time
upon violation of any provisions of said ordinances,
.Plan Check, Fe~: "
Date Paid:
Rec el p t N u m be r: .__" _'_______'______'___
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within tho City limits ~hicll,pre b.eing improved.
ADDITIONAL COMMENTS
/.J2 L?,~_
. ,
5?~~4_~~~;r ~;
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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
herein, and that .NO OCCUPANCY will be made of any
struclure without permission of the Building Safety Division,
I further certify that only contractors and employees who
are In compli~rGe with ORS 701,055 will be used on this
prolect.
I further agre? 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 approve s t of plans will remain
on the site a~" limes during tr~cli\\,
~~--~QWV ~\
~--\ L-q \
Date
VALIDATION:
RECEIPT NUMBER I ~ Z90
_"L:) Z -13___.
AMOUNT RECEIVED ( ( 9 - 771
..,1~__
DATE PAID
RECEIVED BY