HomeMy WebLinkAboutPermit Building 1995-12-15
SPRINGFIELD
. . ,
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number
225 North F1fth Street
Spr1ngf1eld, OR 97477
Off1ce
Inspectlon Llne
Locat1on of Proposed Work 2546 CENTENNIAL BLVD
Assessors Map # 17032544
Lot Block
Tax Lot #
Subdlvlslon
00204
Owner HOUSING AUTHORITY Phone # 687-4090
Address 300 WEST FAIRVIEW DRIVEC1ty/State/Z1p SPRINGFIELD, OREGON 97477
Descr1be Work REMODEL/REPAIR RESIDENCE
REMODEL
QUAD AREA 2RNW
OFFICE USE
LAND USE llll
To request an 1nspect1on, call the 24 hour recordlng at 726-3769
Page 1
951628
726-3759
726-3769
All lnspectlons requested before 7 00 a m wlII be made the same worklng day,
lDspectlons requested after 7 00 a m wll1 be made the followlng work day
REQUIRED INSPECTIONS ---
DRYWALL - Pr10r to tap1ng
FINAL ELECTRICAL - When all electr1cal work 1S complete
FINAL MECHANICAL - When all mechan1cal work 1S complete
FINAL BUILDING - When all requ1red 1nspect1ons have been approved and
the bU1ld1ng 1S complete
Item
Maln
Garage
REPAIRS
Total Value
BUILDING PERMIT ---
Square Feet x $/Square Feet
BUlldlng Permlt Fee
Surcharge/Adm1n
TOTAL FEE
(Al
MECHANICAL PERMIT - --
Exhaust Hood
Vent Fan
3
Mechanlcal Permlt
Issuance
Surcharge/Adm1n
TOTAL PERMIT
(D)
--- MISCELLANEOUS PERMITS ---
Surcharge/Admln
PLAN REVIEW FEE
TOTAL MISCELLANEOUS PERMITS
(E)
(Exc1ud1ng E1ectr1cal)
unless otherw1se noted
TOTAL AMOUNT DUE
(A, B, C, D, and E comb1ned)
Value
o 00
o 00
2,350 00
2,350 00
38 50
3 09
41 59
4 50
3 00
15 00
10 00
1 20
26 20
0 00
25 03
25 03
92 82
Job Number 951628
Page 2
--- BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ---
Th~s permlt 18 granted on the express condltlon that the sald constructlon
shall, 1n all respects, conform to the Ord1nance adopted by the C1ty of
Spr1ngf1eld, 1nclud1ng the Development Code, regulat1ng the construct1on and
use of bUlldlngs, and may be suspended or revoked at any tlme upon vlolatlon
of any provlslons of sald ordlnances
Rece1ved By
Plans Rev1ewed By DON MOORE Date 12/12/95
BU1ld1ng S1te Rev1ewed By LISA HOPPER
--- ADDITIONAL COMMENTS ---
SEPARATE ELECTRICAL PERMIT IS REQUIRED
MINIMUM COMPONENT PATH
By s1gnature, I state and agree, that I have carefully examlued
the completed app11cat1on and do hereby cert1fy that all 1nformat1on hereon
15 true and correct, and I further certlfy that any and all work performed
shall be done 1n accordance w1th the Ord1nances of the C1ty of Spr1ngf1eld,
and the Laws of the State of Oregon perta1n1ng to the work descr1bed here1n,
and that NO OCCUPANCY w1ll be made of any structure w1thout perm1ss1on of the
Cornmunlty SerVlces Dlvlslon, BUlldlng Safety I further certlfy that only
contractors and employees who are In compllance wlth ORS 701 055 wl11 be
used on th1S proJect
I further agree to ensure that all requlred lnspectlons are requested at the
proper tlme, that each address 15 readable from the street, that the perm1t
c:~~~ocated at the front of the property, and the approved set of plans
"~;2;; 7~.n ,,=, 'on., oo'''roo,,= 12- /6' <15
/~U. - ~
n _ VALIDATION
Date Pa1d
?37/62~
/ ;; ./'5' "7..s-
Q2.g:;z
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Rece1pt Number
Amount Rece1ved
Rece1ved By