HomeMy WebLinkAboutPermit Building 1999-2-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: 17 (; ~ 7_ 7_,
LOT'
OWNER: ,11u-(f6<:'
ADDRESS: <;..., ,..,.,p,
CITY: <rr;(j +,,,1)
DESCRIBE WORK: /nslc;//
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SPRINGFIELD
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BLOCK:
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAL: _1Jor+J...<<Je.sf
STATE: [JR
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and
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ADDITION
DEMOLISH
.
Q1(}/(,/
JOB NUMBER
225 Fi Ith Street
Springfield, Oregon 97477
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IJ L/2.. 0 ()
__ TAX LOT:
SUBDIVISION:
PHONE:_ 7l.Jt, -409;/
ZIP: 97C177
OTHER
CONST,
CONTRACTOR'
ADDRESS
~JJP"5 CV_9~-,-~PuJ_'1
9q f Jnif n co"""'/ I <:'(;G '7
PLUMBING:
MECHANICA' '
ELECTRICAL'
ATTENTION:Oregon iaw reqUires you to _ OFFICE USE _
follow rules adopted by the Oregon Utility,
QUAD ~r"tinn r...mt"r Thnsarules are~Mo~E:
i;S~~R 952-001-0010 through OAR 952-001-
. OF B: . ' . ITS:
b . YOU may OOlall' c.;ujJ'''s of the nf?[s~
OCCY GR011i1llPg th" c"nt", ~NntA' the tele~flSTR. TYPE:
JUjmherforthe Oregon Utility Notification
. OF STORIES' HEAT SOURCE:
L.ennn r:, ,-ouu-""",-2344).
WATER HEATER: RANGE:_
EXPIRES
':Co PHONE
e~" ..'20::0 ~::)..t 53'3
FLOOD PLAIN'
"'''''-1''' I!!' ZONING CODE:_
!\Ivl \#j;;.
THIS r>EAlvlIT :lHALL E~BDill~WORK
"TIIOnIZC~ UNDER m6cB'~BM~1(I~~2-!
1\U 'Fon F'OR
CJ:.}:.le!C,:n OR 18 A!Y'0"t!1AQ~ FOOiAG E
_ . 'H~"li""'~
ANY 1~H tJH! ...t::: 11.......'....'
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 same working day, Inspections requested after 7:00 a.m. will be made the (ollowing work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
settIng forms.
D Under.lab Plumbing/Electrical I
Mechanical - Prior to cover,
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or deckIng.
D Post and Beam - Prior to floor
insulation or deckIng.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
. trench.
D
Storm Sewer - Prior to filling
trench,
D
Water Line - Prior to filling
trench.
o Rough PI!-'mbir'!g - Prior to
cover. "
REQUIRED INSPECTIONS
D Rough Mechanical ~ Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - PrIor to facIng
materials and (raming Insp.
Framing - Prior to cove'r.
Wood Stovo - After InstallatIon.
o Insert - Atter fireplace approvlll
and Installation of unit. .
o
Curbcllt & Approach - After
forms are erected but prior to
placement ot concrete.
o Sidewall~ & Driveway - Afler
excavation Is complete, forms
and sub.base ma!erlal in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing worl~ is complete.
, ,
o Final Electrical - When all
electrical work.ls complete.
o Final Mechanical - When all
mechanical work Is complete.
@
, I;lna' Building - When all
o equlred 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 .'3.nd 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.
'",'
.' '; ;:. \' '-I'~ ....,.;; ": ,; i
.
IS THE PROPOSED WORK iN THE,
....HiSTORiCAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit issuance.
Lot faces L~t ~yp.
Lot sq. ltg. Interior
Lot coverage Corner
Topography Panhandle t:
Total height CuI-dc-sac
p.L.
Setbacks
, , , I
HSE GAR ACC'
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APPROVED:
'if
BUILDING PERMIT
.'i'; ''{
ITEM
SO, FT,
X $/SO, FT.
VALUE
BUILDING VAuk PLAN CHECK
AND BUILDING PERMIT
Garage
'.
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 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,
Main
Carport
Plan Check Fee:
/ rOO ~ Date Paid:
Total Value
2-'7.9 Receipt Number'
Building Permit Fee
, Received By:
State Surcharge 2.3(,
Total Fee (A) ~/.yJ Plans Reviewed By Dat~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) N~
Sanitary S~wer
Water
FT.
Note:
Building Inspector may require
additional plans infohllation,
and/or fees for the completion of
this project.
FT.
Storm Sewer
FT,
,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have ca'refully examined
the completed application and do hereby certHy 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 perlainlng 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 701.055 will be used on thIs
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 plans will remain
on the sIte at all times ~n~nstructl
Signature J,A4r/"W. ~
? _Z--/_ /' ;:;
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
Total Miscellaneou~ Permits (E)
DATE PAir>
O~z..7f'Y
2-/I.f/r1
Y'{J~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
AMOUNT RECEIVED
RECEIVED BY