HomeMy WebLinkAboutPermit Building 1991-8-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPO~ED ~ORK: -Ln~ \
f',SSESSORS)Mp. \ I D~.~ \ 4
LOT:
BLOCK.
JOB NUMBER
Ct\ ()~A4
225 Filth Street
Springfield, Oregon 97477
TAX LOT.
()44-( Y')
SUBDIVISION.
OWNER \. A)(')(\ . ffi~r\r1o~~
ADDRE;S. \j)f1\ t\\ll~ 1)lQUJ nIl,
CITY .,-~ ~ f\~ lJ STATE: (\-.ll'COI)AY\. 7 ZIP: n,1"r]
~ESCRIBEWORK.(i\OJ\\S\M,~ ill ~O\fYK0, ~(}f\(LQ1? /.
NEW REMODEL ADDITION DEMOLISH \.) OTHER (1)'(\ ~ (fY~ (1'\... :
PHON".
\.1\ \ ~ ,0) 1 LffJ
CONTRACT~ NA('fE
GENERAL:~r\ ~ 0
~Q~DDRESS
CONST.
CONTRACTOR #
EXPIRES
yt41}~~( )
. PLlJMBING:
MECHANICA' .
ELECTRICA' .
OUAD AREA.
\ R(\)l0
\
# OF BLDGS:
OCCY GROUP:_tv\
# OF STORIES:
WATER HEATER.
- OFFtCE USE -
\ \ \ \
LAND USE:
# OF UNITS:
\/~
FLOOD PLAIN.
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE:
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 following work day.
o Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical""':' Prior to cover.
~ Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
"K::7r Foundation"':"" After forms are
~erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbingl 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 - Prio~ to filling
trench. " ,~.
~.
. ,
o Rough Plumbing - pr(or to
cove~ .
CONSTR. TYPE:
HEAT SOURCE:
RANGF.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to.
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D F'ireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover. '
~ Drywall - Prior to taping.
D Wood Stove - After"installation.
D Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
o Fence - When completed.
D Street Trees - 'Whe~ all 'req~ire.d
trees are planted,
D
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work is complete.
~ Final Building - When all
~required inspections have been,
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical 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
i_nspections are approved and
, porches, skirting, decks, and
venting have been installed.
Lot faces Lot Type Setbacks , THE PROPOSED WORK IN THE
I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and a p proved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance,
Total height Cul-de.sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/ SO. FT.
VALU E
Main
Garage
:<97
~ S-~:z
Carport
Total Value
~4/.SP
206
1-'<:, Sf>
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /II/A
Building Permit Fee
s"" S-"_ /5
2. s:r - ,7S"
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
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 Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
P~7iS'P/GU ~ 05 ('
~~t,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
~S'~
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 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.
'<'~ 73 - 9 7S"::: ~,<?i3
Plan Check Fee'
Date Paid:
Recei pt Number:
Re/~~~
Plana..fI!\eviewed By.
~/7/9t
(Daj{, .
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
!<.E1IfA.,...y.,r/& CM!///!)('T U)/ ~
,')/ z.,.=. ~Af'" A-z:;"C ,
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 701,055 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 plans will remain
on the site at all times during construction,
Slgnature---fJ~ ~~..- ~
Date
%-7-'f1
VALl DATION:
RECEIPT NUMBER ? /)9 _'<: '7
DATE PAIr> ~//~/~/
AMOUNT RECElv~n ~ ..s-s;;.
c-
RECEIVED BY /l?~h" 0
/'-'f': P - L ' --
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