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Home My WebLink AboutPermit Building 1991-9-16 RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 LOCATION OF PROPOSED WORK ICD() ASSESSORS MAP J'GO~Oz..J 7_ LOT JMlI) V/lS(!O ADDRESS /DD/) (en -1Ya.../ CITY Sf n 11~-R Pi d I '/f.-.. V7nTYY\ <:: I .- REMODEL OWNER DESCRIBE WORK NEW ADDITION CONTRACTOR S NAME olUV\ Q( GENERAL PLUMBING MECHANICAL ELECTRICAL QUAD AREA ~Q~\ln \ Q,~ / # OF BLDGS OCCY GROUP # OF STORIES ) WATER HEATER SPRINGFIELD f 12M-Iv?!} BLOCK JOB NUMBER q tnq 6.3 225 Fifth Street Springfield, Oregon 97477 - /A{;R TAX LOT (Y31100 t) SUBDIVISION BLvd, PHONE 7'i76/3::J (/Ah.{lote C~-k-Avutl:fecl- - 0g7 - 9D2--(j ~ STATE ~P-- ZIP q 7477 REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to cover [Xl Rough Electncal - Prior to cover D Electncal SerVice - Must be approved to obtain permanent electrical power D Fireplace - Prior to faCing materials and framing Insp x DEMOLISH OTHER EXPIRES PHONE ADDRESS CONST CONTRACTOR # FLOOD PLAIN LD?-J /-P2J / -'OFFICE USE - \ \ \ \ \ V,rJ LAND USE # OF UNITS CONSTR TYPE HEAT SOURCE G/=r~. RANGF ZONING CODE # OF BDRMS SECONDARY HEAT SQUARE FOOTAGE .7'L.\/~ ~'. ; \ ~'V)- To request an Inspection, you must call 7263769 This IS a 24 hour recording All Inspections requested before 700 a m Will be made the same working day, InspectIOns requested after 700 a m Will be made the follOWing work day o Temporary Electnc D Site Inspecllon - To be made after excavation, but prior to setting forms D Underslab Plumbing/Electrical/ Mechamcal - Prior to cover ~ Footmg - After trenches are L,L:J excavated D Masonry - Steel location, bond beams, grouting [Z] Foundation - After forms are erected but pnor to concrete placement D Underground Plumbing - Prior to filling trench [:zJ Underfloor Plumbing/Mechanical I - Prior to Insulat[on or decking [ZI Post and Beam - Prior to floor [nsulatlon or decking IY1 Floor Insulation - Prior to l,L::J decking D Samtary Sewer - Prior to filling trench D Storm Sewer - Prior to filling trench o Water line - Prior to f[lI[ng trench I:ZJ Rough Plumbing - Prior to cover W Framing - Prior to cover IiJl Wail/Ceiling Insulation - Prior to ~ cover G21 Drywall - Prior to taping D Wood Stove - After Installat[on D Insert - After fireplace approval and Installation of unit D Curbcut & Approach - After forms are erected but prior to placement of concrete D Sidewalk & Dnveway - After excavation IS complete, forms and sub base material In place o Fence - When completed D Street Trees - When all required trees are planted [JJ Final Plumbing - When all plumbIng work [S complete [Z] Final Electncal - When all electrical work IS complete [2] Final Mechanical - When all mechanical work IS complete Ii7I Final Building - When all L.,Ll.J required inspectIons have been approved and bUilding IS completed DOther MOBILE HOME INSPECTIONS D Blocking and Set Up - When all blocking IS complete D Plumbing Connections - When home has been connected to water and sewer D Electncal Connection - When blocking, set up, and plumbing Inspections have been approved and the home IS connected to the servIce panel D Final - After all required inspections are approved and porches, skirting, decks, and venting have been Installed -'~ Lot faces .IfL.. Lot Type Setbacks I PL IHSE'GAR , ACC I Lot sQ ftg Interior IN , I Lot coverage Corner '5 ""~# Is I Topography Panhandle Iw I Total height Cui de sac IE /0 'Jf7h'V I BUILDING PERMIT ITEM SO FT X $/50 FT Main Garage Carport kU ~ fiDf1 I ::\ (J ~ 70 Tota! Value BUilding Permit Fee State Surcharge Total Fee (A) VALUE ~\ \0 \ 5~ \ 0 \ ) , ~') lr B.;) ~L '6'0 {{l.3~ SYSTEMS DEVELOPMENT CHARGE (SDC) t/.4 13. (B) N ,4. PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood StovellnsertlFlreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS MobIle Home State Issuance State Surcharge Sidewalk ft Curbcut It DemolitIon State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) FEE L_ ~, ---~ -~~2> IS E PROPOSED WORK IN 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 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 Sprlngf!eld, 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 q/ 33 <{-14 -'11 Receipt Number 7/ I DOC) Received By _ ClvvvJ- ~~~.. 'p~evlewed ~.. ~ ~ Plan Check Fee Date Paid 8- '<./ -,9/ Date Systems Development Charge IS due on all undeveloped properties within the City limits which are being Improved , ADDITIONAL COMMENTS , , , , By signature, J state and agree, that J have carefully examIned the completed application and do hereby certJfy 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 701055 Will be used on thiS project I further agree to ensure that all requIred inspections are requested a the proper time, that each address IS readable from the str et, that the permIt card IS located at the front of the prop rty, and the approved set of plans Will remain on the site t all tImes dUring construction ) v\mvt'" .'. 1& ~\"rol- 1/ VALIDATION f 3 RECEIPT NUMBEI(-, Q I I ((( DATE PAID ,'4 - , Lo...t.1 ( AMOUNTRECEI~g ~ ~:\~~ RECEIVED BY ~ / --=-- ~