The URL can be used to link to this page

Home My WebLink AboutPermit Building 1995-4-10 RESIDENTIAL PERMIT APPLICATION InspectiOns 7263769 Office 7263759 SPRINGFIELD / Q5D::AIS . JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK 2A\~ ASSESSORS ~~ \ 50~ao'rl-. '\ ~ ~ BWCK OWNE~l_\rVi\ f'f\tDY-O\~ J~0, ADDRESS 9)q'5={ [In ~~? r\r\ ,i}J\illD. CITY '" ~J\ \s\C\ ~ 0 ~ N. STATE I \)~ Q.f\ ~ ~\ f\(")\ 0 , K<'\ fn I ~ 11 '--~-h\~Cl.0C~ ~ADDITION DE~IS~ DESCRIBE WORK NEW ......- REMODEL OTHER ~ TAX LOT Qg40U SUBDIVISIA"Qh~ G,f\J\r\Qm , PHONE 1\44 lnq\o.lr ZIP qfl4(]91 CONST CONTRACT~ME ADDRESS CONTRACTOR # EXPIRES PHONE GENERA'\ ~ On f 0t-, q10D~ 1\ 2.C\ C\lo Q?3la\d'i2... PLUMBING Y ~ rt \.'n.ll~ l \ S\l?,\ 0... \0\0,\0 to~?l S\\ tn MECHANICAl \ Q\() :.t D n f 1Il+, q t:W8 1 2q qto Q230WOZ- ELECTRICAL' AU . C; \ 0 .r:b.~) Inhl4-S C\ '\ qS <\-lS ?I~q - OFFICE USE - QUAD AREA ,,31< ",r _ LAND USE --111 I FLOOD PLAIN . OF BLDGS I . OF UNITS I ZONING CODE ~ OCCY GROUP Q ?-'+fJ\ CONSTR TYPE U;U . OF BDRMS .'1 . OF STORIES I HEAT SOURCE fJ) 1-1 SECONDARY HEAT (1 WATER HEATER S RANGE r-, SQUARE FOOTAGE JJ.i19,,~ To request an Inspection, you must carl 7263769 This Is a 24 hour recording AlllnspectJOns 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 d Temporary Electnc D Site Inspection - To be made after excavation, but prior to settIng forms o Underslab Plumblng/Electncall Mechanical - Prior to cover ~ootlng - After trenches are excavated o Masonry - Steel location, bond beams, groutlng ~undatlOn - After forms are erected but prior to concrete placement .'<,j o Underground Plumbmg - Prior to fIlling trench [9-Underfloor Plumbing/Mechanical - Prior to Insulatlon or decking ~ost and Beam - Prior to floor InsulatIon or deckIng ~Ioor Insulation - Prior to deckln9 ~nltary Sewer - Prior to fj)JJng trench ~torm Sewer - Prior to filling trench ~ater line - Prior to filling trench ~OU9h Plumbmg' --; Prl~r1to cover " ~ REQUIRED INSPECTIONS ~Ough Mechanical - PrIor to cover ~ough Electrical - Prior to cover cg.::lectncal Service - Must be approved to obtain permanent electrical power o Fireplace - Prior to facing materials and framing Insp Q-P-rammg - PrIor to cover ~all/Celllng Insulation - Prior to cover c:rorywall - Prior to tapIng D Wood Stove - After installation D Insert - After fireplace approval and Installation of unit ~urbcut & Approach - After forms are erected but prior to placement of concrete @Sldewalk & Dnveway - After excavation Is complete, forms and sub base material In place D Fence - When completed o Street Trees - When all required trees are planted ~mal Plumbmg - When aU plumbing work Is complete ~Inal Electrical - When all electrical work IS complete Q-:lnal Mechanical - When all mechanical work Is complete cg--Flnal 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 D Plumbing Connections - When home has been connected to water and sewer D Electncal Connection - When blocking, set up, and pfumbrng 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 ventlng have been Installed Lot faces Lot Typl ,/ Interior Lot sq ftg Lot coverage Corner Topography Total hel(\Q~~ BUILDING PERMIT ITEM SO FT \ \ ?J3 ~\.JD Panhandle Cui de sac X $/SO FT 5\.0(1) \'\. \[) Main Garage Carport Total Value Building Permit Fee State Surcharge -t- ~ DID Total Fee (A) I PL IN Is Iw IE Setbacks I I I HSE GAR ACC I I I I VALUE lo'2>Ldft 'l~C\lo 1j\~1jD ,,~ 00 Af)a.~ ~f}\O q~ (B) SYSTEMS DEVELOPMENT CHARGE (SDC) i/s:nr.t74 PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N" 6{ Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge + 3.'1'0 Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N" Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~ It Curbcut 1:)\ 0 It Demolition State Surcharge \~. ~\~f\ \l~\:lOD0 FEE \1 of) cO I.."-DDCO \ :4. ro II~&J .::\ S[) q,~ ?,cD ~ \I n SQ II) CO \ ?.l?J df) 63 r01) ,~ J ~ q() 4\)cD Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrlcal~~L\ C19 (A, B, C, 0, and E Combined) IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER~ t\ n 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 Clty 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 Date Paid \~r1~ Receipt Number ..0 ,~ Received By ~ ~~v~~, \1.l;J, Date Systems Development Charge Is due on all undeveloped properties within the City limits whIch are being Improved ADDITIONAL COMMENTS ,,\0 \-:''0(\ r- Y , "" ~A 0 u 'Yl ~ Y' .tv J.+--r. ~\\\\~}./ fl sPO \ C\loO ''-..\If\}h \ 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 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 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 pia will remain on the site at all times durlp,Q C~UCtl ~__ Signature ~ ~ ~ DatE" VALIDATION ~Ii\,.,d RECEIPT NUMJ\ER -, - () r DATE PAID '-to (U _ AMOUNT RE~EI~E[ 0l3lo4. i Cj RECEIVED By\J\{ iYA )