HomeMy WebLinkAboutPermit Building 1992-5-26
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LOCAl ION 01- PROPO',ED WORK 2q9~ C:::~#,,;rdF~fY./~
A"SESSORS MAP _L?-o:5~2S--'7.~
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DESCRISI: IMlRK __ &?L&-,;L<-='
RESIDENTIAL
PERMIT APPLICATION
InSp(;ctlOns /2637GU
Office 72637,,9
LOT
ADOrlESS
CIlY ___
NEW
REMODEL
CONl RACIOF, S NAME
CENCRA.L ''- :f'Jw~~
...
PLUMBING _
MECHANICAL
ELECTRICAL
QUAD Am A
It OF BLOC1S
OCCY ennuI
II OF ~TOllfL j
WAr lOR HEAII'R ,___
/-
SPRINGFIE:.LO ...01....,..._
/ .-, <!:J
JOB NUMBER ___L";:___L;;>_::5
225 Fifth Slreet
Springfield. Oregon 97477
TAX LOT
0e6/P3
BLOCK
,4,
Mo<S?"Q,6""
SUBDIVISION
PHONE _~~ -"9~.50_
ZIP
_9?zc22____
STAl E __~~.
~
C-<<~~,; _"'1>
ADDITION
DEMOLiSH
OTHER
~7",,-,,/' ~7"--
'-
ADDRESS
,:,"CONST
CONTRACTOR #
, \
PIION[
REQUIRED INSPECTIONS
I~
Rough MechanIcal - Prior to
cover
,)
,
\.:;'\
EXPI RES
FLOOD PLAIN
ZONING CODE
1/ OF BonM'::;
SECONDARY IIEAT
SQUARE F001AGE _
To rcqucc-! an InspeLIHlIl, you must call 72G 3769 J IllS Is a 211lour recordmg AIIIIl..:>pcctlon::. requested before 700 i1 m Will IJe
rnd(Jc tlw dUll] worl\IIHj day. IW pcctlons [('quested aftol 700 d fll Will be made the follOWing work clay
[]
TempOI dry Ele(.llll~
o
SIte In',pectloll - ro be made
dfler I'.. (avdtlOI1 lJUI prlOI 10
scttlflt) 10'1ll~
[]
Undel sl db Pllllllblllgl Electrical /
Mechdlllcal - Pllor to (.(IVU
D
Footlllg - After IrencheJ are
cxcavatf d
D
Mnsonry - Sle<.l location bond
beafllJ ~Jroullng
IKI
FOUllddllOn - After fOrlll::. .Ire
crcctccl bIll pllOI to conclClc
pluCeflll..-flt
[=1
UndCI{JIOllnd Plumbing - Prior
to flllll") trcncll
[]
Und{ ,floor Pllllllblllg/McchdlllCdl
_ J'IIOI Ie) lrlsuldtlon or cfL,cklllq
o Post dlld Be<lJlI - Prlo, IU flonr
Insulallun or lIc( hlflg
-, ,
o Floor In~ulatlOn - Prior to:-
dc( klnu .
o
Sdnll.1IY Sewer - Prior to fdllng
trendl
D
Storm Sewer - Pllor to {llllng
Irenctl
o
\
,
Wdtl..r Line - Prior to filling
trendl ....::. .... --
D
Rough Plumblllg - Pnor to
cover
....'";. '..
OFFICE USE -
LAND USE
It OF UNITS
CON 'rR lYI'I,
IIEAT SOUI1CE
11ANG E
o
Rough ElectriC II - P,lor 10
cover
D
Elpclncdl ServIce - Must be
approved 10 obtain permdnent
electrlcdl pOWU
D
Fireplace - PIlar to facHlg
mn.terlal~ and framing lnsp
IX!
Flaming - Pilar to cover
o
Wdll/Celllllg In~ulatlOn - Prior to
cover
[X]
Dlywall - I rlor to taprno
l~ Wood Stov. - After rll ,lall..1l1on
o IIl~ert - Aller frrepldce dpproval
. Lind InstdllalrCJIl of unit
D
Curbcut & Applodch - After
fOI inS are ( It'{ led but prror to
pldcemcnt of ( oneretc
D
Sidewalk & Dflveway - After
e)/( avatlofl I~ complete forms
and sub l)d~c llldtenal In place
o
Fence - When completed
D
Street Trees - When,a!l/equlred
tH..C::' are pl,mtud ~. ...:._ ~
o
FlIlal Plumblllg - Wilen all
plumvrno wor!, IS C'orrlph te
D
FlIldl Electllcdl - WI\,~n .-lrl
clc( trledl wOr], I::' CO!llfJII Ie
o
rlllal Meclldlllcal - WI1Ln 1111
,noc tlclnlCdl warl, I", (olllplottJ
LV
FlIlal Building - WtH 11 all
requIred In~pcctlon~ have b( (~Il'---"
approved and burldrnU rJ
completed
.....
o
Other
MOBILE HOME INSPECTIONS
o
Blocking and Set Up - WIl. Il ill
blot.klng IS C'olllplek
D
Plumbing COnl1ectloll~ - Wllt...n
tlOme has been conn0ctuJ to
water and ~cwer
D Electrical Connection - WtH n
blocking, set up, and plulllbln~
Inspectron~ h<.lVe been Llpprovu(l
and the Ilomc IS connected to
the servIce panel
D
Fmal - Arter dll required
Inspections are aPPlOved anej
porches, SI\lrtlflg, decks, amJ
venting have t)een In....tdllcd
Lol Ilc OS
Lot Type",
Lol 3q fig
Interior
I ot <- over 1ge
Corner
fopoCjlapllY
P mllancJle
Tot,ll hClqlll
Cui desac
BUILDING PERMIT
11 [M SO FT X $/50 FT
~
MUll
C"'U'l\JC
'-
Carport
e;-I'/.::;L~ C:;--;, -;/~; r/
Intdl Value
Building Pernllt Fcc
SIdle Surctl~Hgc
fuldl Fee
(Al
Setbae..k<;
~ HSE .9^R Ace
'5 I"HE I'HOPor,ED WORI< IN THE
HISTOfllCAL DISTRICT Oil ON
lllE HI,";IORIC^L REGIS1U,?
li- _ ----
~~-- -----
If yr~s 1111.., appllC"1lron rnu I IJ( srgned
'Jrlll dpprovcd by ttle HI,lorlc"11
Conrum dr)! prrp/ In PUlll11 r' c u,nr(
\-,
.......~-~-
^PI'ROVED
"
E
l~_____
VALU E
-~
''2~~--
3.B.~
_133
rO.$'5
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
IrEM
rlxtU1CS
H(~~ 1<.If'ntr,1 Oalh(s)
N"
v llll\ uy ~ ewe I
FT
W,lIf'1
FT
Slor III Sewel
FT
MolJlle Horne
Plumbing Permrt
Slilte SUJChdrgc
Tolil CI1;:],r~Jc
(C)
MECHANICAL PERMIT
f-UIlllee
Exll lusl Ilood
Vent Fan
N'
Wood Stovr/lnsert/Flreplace Unll
I)IY!,! Venl
ML( IldnH "I Ilt'rfnlt
1 ,unnce
StalL Sur( h~lIqc
Tolal Permrl
(D)
MISCELLANEOUS PERMITS
Mobile Horne
Slate Issuance
SI,II(' GurdwrQo
Sidewalk
II
CurlJrut
II
Demol r tlOn
Slale.. SUlclliJrgc
fold Mrscellnneous Pornllts (E)
TOT^L AMOUNT DUE (cxcludlng clcctrlcal)
(^ n C f) ,net E Combined)
'.
FEE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
(
,~nllS perini I rs <1r 11ltccl on lhe cxpreC'~ ~oncJrll()ll \111\ tile Jld
t.onstrUt Iron Slldll, III alllCSDccts, cotlform to tllc' Qrcltnance
adopted by tho Crty of Sprlnollcld, In( luclrng the
Development Gmle ICClulatlrlg the constructron dncl USf' of
bUIldIngs and nlay be su~pendecJ '..>! Icvokctl 11 dny trrne
upon vloliltlon of any provr~lons of sard Ordlll,l!H es
Plan Check Fee
z -2_ 0"'3"
D'1te PaId
necelpt Number
R/ZY - ~
"P~~~d's~~ ./
"S -;?~-L2
Date
Systems Developmenl C~l,UCJC IS due on dll undC'vclopcd
propertIes within the CIty lrmrts whrch drc berng rmproved
ADDITIONAL COMMENTS
Oy signature I st"1te Inti agr8G IIlal I helve carcflJ1ly examrned
the completed dpplr('(1tlon 1I1d do hCleby cr I lily 1I1at drl
rnformatlon hereon IS Irue dllcJ corrcct, and I [III Iller ccrllly
tllat any dnd all work IJC'rfOlflH,(j shall be done rll dl.cord,ncc
wllh the OrdrndrH es olllle Crty of Sprrnqrtcld r!ld thL l dWS
uf the 01 tic of 01( <lOll lH rl rrlllnCJ tu Ihe \rJ(qh. d(~ ('Irtll d
helOln drld tlhll NO QC ('\ IPANel wrll IJL rll rrlr 01 my
,
IlucturL wrthout pcrrnr< SHirl of the Ilurlrlrnl] S If, I, Drvl"ron
I further (ertlfy Illtll only r onlraclor rnd CI1l)ll(l/L(~v who
clIP in complranr c Will) OHS 701 O~5 wrll be II ,I'd on tllrs
plolect
I further agree to ew:;urc \h 1t all rcqurred rn-::-IJLctrons are
requested at the proper lime, that e.lch lldumsd I~ reacJablc
from the street, lhal the pClml1 calc/Is located ']\ the front
or the plOperty ,md the approved set of pldn.::. will remarn
on the slle at tl/lles dunng conslructlOn
&iJ~
Dale ----<..--1)" -,2 L - '1;;2.
r.lynatulo
V^L1DA110N
tt'7 /2-_
-~-~~-
b~~.G AMOUNT RECEIVED t652 ~6-__
. rlECEIVED BY ---- 4~"'- ~
- ------- ---''''? ----'
rlECEIPl NUMBER
DArE P^ID