HomeMy WebLinkAboutPermit Building 1996-8-21
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769 .~,
Office: 726.3759 ~rj
6
LOCATION OF PROPOSED WORK: 2/ -3 -r:-~? L~ ~
ASSESSORS MAP: /.7...~ -~ c/.. /41
OWNER:~fV~~ I',~~~I(-b
ADDRESS" 7/-==3 L71~.:>~- ~'L
. ~., -, ~ /
,::; ~LZ>~-
,,- ./
LOT:
CITY:
DESCRIBE WORK: ~~~
NEW REMODEL
.
SPRINGFIELD
.
JOB NUMBER ~~
..
225 Filth Street
SpringfIeld, Oregon 97477
BLOCK:
TAX LOT:
SUBDIVISION:
~_?~t::>
PHONE: 51'''pb'' /"7<'_7
STATE:
~/?? ,
_ ZIP: 9':::>V./7
_/2-/_~/""/~ ~~ / Z?-J-Y..~~~>
_ , /-. '/ /:-K:..
ADDITION DEMOLISH OTHER
~/
CONST.
CONTRACTOR'S NAME ADDRESS ..~CON~~R # EXPIRES _ PHONE
, ~,3~f~<5~~~~ "'_
GENERAL: r~~~~~~~- 4)~! ~~~ ~~~ ~ /~~"~ ~~ ~~"'2~5
PLUMBING:
MECHANICAL:
ELECTRICAL:
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
# OF SLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. Tt11s 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,
D Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/ Electrical!
MechanIcal - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - Atter forms are
erected but prior to concrete
placemont.
o
Underground Plumbing - Prior
to filling trench.
o
Underfloor Plumblng/ Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. t
o Water Line - Prlono filling
, trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o
Final Plumbing - When all
plumbing worl< Is complet,e.
o Rough Electrical - Prior to
cover.
D
Final Electrical - When all
electrIcal work Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Mechanical - When all
mechanIcal work Is complete.
o Fireplace - Prior to facing
materials and framing Insp.
[Xl Final Building - When all
required Inspections have been
approved and building Is
completed.
rn Framing - Prior to cover.
o Other
o Wall/C'elling Insulation - Prior to
cover.
o Drywall - Prior to taping.
MOBilE HOME INSPECTIONS
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Blocking and Set.Up - When all
blocking Is complete,
o Curbcut & Approach - After
forms are erected bllt prior to
placemont of concrete.
o Plumbing Connections - When
home 11as been connected to
water and sewer.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and t11e home Is connected to
the service panel.
o Fence - WtlOn completed.
o Street Treos - When all required
trees are planted.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
" "
Lot Type. .' '
Lot faces Setbacks
Lot sq. ftg. Interior I P.L. HSE GAR ACC
IN
Lot coverage Corner
Is
Topography Panhandle
Total height Cul.de-sac W
E
. THE 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.
APPf30VED:
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT '
Garage
.
.
This permit is granted of1the express condition that the said
construcllon shall, In all respects, conform to the Ordinance
adopted by the Ci ty 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:
Building Permit Fee
~~._6
'3'7- So
~ /.'t4
-:::j 5: / /
Date Paid:
Total Value
Receipt Number:
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
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)
NO
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
By signature, I state and agree, that I have carofully examined
the completed application and do hereby certHy that all
Information horeon 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.
Exhaust Hood
Wood StovellnsertlFlreplace 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 tho 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 'JJes during c ructlonj
Signature --.xJ.C~
Dale ~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
02( IrJf,6
/ '
Curbcut
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
VALIDATION:
RECEIPT NUMBER "'2 7 ~~~
. '.
DATE PAID 1. ~'2 r %..
AMOUNT RECEIVED '35': /' /
RECEIVED BY ~. ~ <::-
. "/,,--
..
State Surchargj:!
Total Miscellaneous Permits (E)