HomeMy WebLinkAboutPermit Building 1997-4-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769 ~.dy
Office: 726.3759 ~_J,1
LOCATION OF PROPOSED WORK: 1)355 ThI2j -it N 2.-
ASSESSORS MAP: I? ~:< - 3? 3 - 7 Y
!LOCK:
OWNER: ~f.w~ -I- ~a~ W~8i0
CITY:..:.- .NVL5(tl Utt;
. ~'Jjr ~{< 11.
DESCRIBE WORK: ftW
I
.
LOl:
NEW
REMODEL
ADDITION
CONTRACIOR'S NAMf ~~ '\
GENERAl. \. \ ~
PLUMBING:
MECHANICAL:
ELECTRICAL:
SPRINGFIELD
STATF'
fJR~
.
JOB NUMBER "7..A:?b'::<~
225 Fifth Street
Springfield, Oregon 97477
2fPWj-fi ej rIv
TAX LOT: c::J 7'6'""2 Y
SUBDIVISION'
.,
DEMOLISH
OTHER
PHONE:
~L//.~ 43 qf.o
ZIP: q 1978
ADDRESS
CONST,
CONTRACTOR #
~'.
EXPIRES
PHONE
- OFFICE USE -
aUAD AREA: LAND USE: FLOOD PLAIN'
'. # OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# qF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' saUARE 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 Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench. ,
o Underfloor Plumbing/ 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. .
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior t'o filling
trench. '.
o Rough Plumbing -' Prior to
cover. ,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to tapln'g.
o Wood Stovo - After Installation.
o Insert - After fireplace approvlll
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.
o Street Trees -When all required
, trees are planted. . .
o Final Plumbing - When all
plumbing w9rl< Is complet.e,
o Final Electrical - When all
electrical worl< Is complete.
o Final Mechanical - When all
mechanical worl< Is complete:
o Final Building - When all
required 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 Connoctlo~s - When
home has been connected to
water and 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.
, ,
. ~~.... y.. :.~"
.....t'
. .
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Lot faces Lot Type Setbacks
Lot sq, fig. Interior I p.L. HSE GAR ACC
IN
Lot coverage Corner
Is
Topography Panhandle
\W
Total height Cul.de.sac
IE
, t.HE PROPOSED WORK tN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTE~?
If yes, this application must be signed
and approved by the Historical
Coordinator ,prior to permit issuance:'
APPROVED:
BUILDING PERMIT
ITEM sa, FT,
X $/Sa, FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT .
Garagc
Carport
&7$?, ~~ r:-
/~-~
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
,
"
Plan Check Fee:
/b, ~?
Date Paid:
Total Value
(A)
A -5: .--~
1-2.~
.7'5-
?-?~
Receipt Number'
Building Permi t Fee
Received By:
State Surcharge
Total Fee
- --.... -_.~...-
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
Storm Sewer
FT.
FT.
FT,
Sanitary S!'lwer
Water
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 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 or tho City of Springfield, and the Laws
of the State of Oregon p.erlalnlng to the work .descrlbed
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/lnsertlFlreplace 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 str et, that the permit card Is located at the front
of the prope ty, and the approved set of plans will remain
on the site at II time ~;.../ lJ,lA.At
Signature J/ I :7' ) J
Date 1~/q7(J
-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
It
Demolition
State Surcharge
VALIDATION:
TOTAL AMOUNT DUE (excluding clectrlcal)
(A, B, C, 0, and E Combined)
S0: '2p-
RECEIPT NUMBER 75':;?c..> c.:;::/
S/-2g ~5?
L77'~ -.:2.;;;:-
/2~~
,)-
/'
DATE PAID
Total Miscellaneous Permits (E)
AMOUNT RECEIVED
RECEIVED BY