HomeMy WebLinkAboutPermit Building 1991-2-27
00 RES~NTIA.Loo . .
COMBINATION~LICATION/PEP.MIT, r SPRINGFIELD"""'-:
= 225 North 5th Str,eet ' .' ,'. i
- Springfie'LdJ Ol'e(Jon 97477
BuiZding D~vision
- 726-3.753
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Job wc.ztion: 5~~~ \. X\{~\.A.~_~S _-
Assessors ~p # \ f\ 0 ~ 3 3(YJ \ lTcx' wt H [1) (~C'D
SubdivilJi()n:
()Jner: ~'0AQL 8 \l;,Q\Y\-P \ or
Addres3SA~ C',) ~~Qb
City: ~~9' ~(' \\JJtJ
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Phone: t ?,J 0 ~ ~ \'6 'i<
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Zip:
I I Describe I.'ork:
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I I Addi ticn b'A W\ch.~.~
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Remo':!ril
M 'Mobile .'1om~
.o'.-J)fJ. (:::1.
Dat9 of Application
SuoervisinQ'Eiectrician
'value":f, (\J
~:::~:~t~\~'.,. ~ .,,()tt ~LtC(((l \trk~f'\W Ihw.( ~'44[,)'5
Plumbing ~~ \^'~110 nj) ~xrY:Y;J;zJ .
Electf'ical : Q.ejJ)I)PL / . . ' " '
Neahar.ic..:l
Rcce';pt .~
(qt'-Sl () V
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. Siqr.ed:
Date:
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Expircs
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Phone
It is :he responsibi7.ity of the permit holder to see that all inDpectionsare made at tile proper tim,;. that Iilach .;ddress is rea.::ab!a
from ths 8trset, and that the pcnm: t card is located at the front of the property.
. ASui!.dillfl Dividor. approved Fl4n shall remain on tha Building SUa at all times.
PROCSDU,'1E fOR INSPECTION R~QUEST: Call 726<t71i9 (recorder) state your City designated job nwr.ber, job address. typR of in:;pecticn
raqucsted ar.d w.l:en you 1oIil.l bQ ready for inspQction, Contractors or Q.msre ncme and phonQ number. Requ,;sts received before 7:00 a-:l
lo1iZl. be mads th,; same dey.requests made aft~ 7:00 am will be made the nat ;.)Orkin; daY.n 4
. lOW" City Designated Jeb NumbGl' Is: '-1 \ () \ ry
Reauir~d rnso~ctinnn
- 0: SITS INSPEC':'ION: To be mads after
B:l:cavati.:m, but pJ"ior tc set up of
. . forms. .
'0 . UNDF;RSLAB PWHBING. ELECTRICIIL &
MECHANICAL: To be made before any
LIOrk is .:JO,lJored. .
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fOOTING ,~ FOUNDATION: . To. be rode'
after trenchos are B:l:calJated and
forms are erected, but prior to
pouring concreto.
iJNDrRGROU!!D PWMtJING/ S~R. W.1TE,'I,'
D.'lA IlIA GE: To be l1J2:1.e prior to fil-
lir.g trenches.
UflDlJ,'?FWOR PW~~ING ~ MeCHANICAL:
To be made prier ',te, installation of
fLoor insulation or deoking.
POST AND BEAM: To be made prior to .
illlJtaUation of fLoor inslOla~ion or
decking .
ROUGII PLU.'IBI!IG, er.ECTRICAr. & MeCH~
'ANICAL: ,vo ;.)Ork. is to be cOL'ered
until those inBpec~ions have been
, mada and approvs,:. .
FI.'?EPCACE: . Prior to placir.g facing
materials, aJ!d, b,,;fore. framing in spec-
tiar..' , ',' .
FRAf~ING: MU3t be reque3ted af~er
approvaL of rough plwrbing. alectri-
caL & mechani"aL. AH roofing'
bracing,~ chimncys,et.:J. nr~st be ,
complatod. No. LIOrk is to be con-'
cealed'untiL thia inspection has
. been mads and. approlJed.
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O INSULATION/VAPOR BARRIER I.'ISPECTION:
To. be rode after all insulati.?n crui
raqu~red vapor barriers are in place
but befere any lath, !!!/PSW1l board or
wll. covering is applied, and before
any. insulation is concea1.ed.
O DRYWALL IlISPECT!ON: Tc be made
after all drywall is in placa,
but prior to any taping.
O MASONRY: Stesl location, bond
. . beams, grouting or verticals in
accordance with U.B.C. Section
2415.
D. WOODSTOVE:. After instaLlation is
. ccmpleted... '. .
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CURB & APPROACH AP.'1ON: After ferms
are erected but prior to pouring
.:encrets. .
O. SIDF:WALK & DRIVEWAY: For aLL cen-
crete paving within street right-
ef-way. to be ma::Ie after all. e:J:ca-
vating c""Plete .. form wOrk & sub.
. base material in place.
O .!'ENCE:" Wher. compl;;te -- Provide
gates or movable sections through
P.U.E.
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I DeMOi,ITIO:J OR .'fOt'::' 3UIL;:.'1GS
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,AALL MANHOLES AliD CLEANOUTS ~IUST BE ACCtSSIBLE,
:J Sani~ Sf/lJ8!' cc:r;peC: ::t f~OP{;!'t':i Lir.e
:J Septi.? tank p:;mpo:d ar..; fili-ad :.lUh ;ra:1el .
--, Final - .Ilhen above it:.':'/s are c:;r.rpleted .
~ ar~ when demcZition is c~lste or struc-
ture moved ar.d prc.7ri.:us c;.eane.: up.
Mobile Hcmes
~Cking and Sst-:Ap
~umbing cennectians .- saJer a7ld wa~er
~ ~ricaL Connection - Block~r~, set-up
...J::::t'" and plumbing connections rr.':3t :s apprelJ8ri
before requesting el8~:rica;. ir.spsc~ion
=:J AC~e8GOl"d BuiLdi~
--, F~l - Af~;;r.?:Jrc.r.ee,
~c. are comp~stca.
sk~l't::"f, decks,
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FIliAL PLUMBING'
All. prejeot conditions, such as ths installation ef s:reet trees, co~l~ti.?n of ;~
rsquired landscapi,..g, ~to.. must be satisfiad bQfers tJ-.e BI1ILDI.W; FI:!AL ,;an !:e l'3qllsstJd.
FINAL MECHANICAL
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nii.4L BUILDINC: The Final, Buildi.ng Inspection muet bo requested af~er
Electrioal, and UechonicaL Inspectwno halJO been mads and apprevsd. .
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.FINAL ELECTRICAL
, .
~ile Final ?Lumbin;
ADJUSTIIENT TO BE M.1DE 'AT NO cosr TO CI'!Y I F,;;e !
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Job Nwnbor: q (('J 10 4 Refcl'er.ae Nwnbers:
Zone: 1 X) r t -' - Occupancy Group,~ ~ ' TypeICor:st:
Lot Sq. Ftf]. LOT TYPE I Lot Paces -
I Setbacks
,:; of lot Coverage Interior I P L H ~ ,.
, " OUBe uaI'age
I ' H of Stories Comer 'North
, . Total Height Panhandle lEast
I South
'I Topography Cul-de-sac, IWest
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lITEM
SQ,FTG
x
Value
Main
GaJ'al7e
C_,,~. t
Accessoru
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TOTAL VALUE
Is.D.c.
(vat.ue)
1.5:::
Building permit
State SUI'c1uuoge
Total Charges
ITEM
Futures
I NO. I FBE
CHARGE
Residential. (1 bath)
Sanitary Sewer
Water _
~Jl\.. '*
\S oQ
\ ~ .CJ-J
.U)S
1~.'l5, -
CHARGE' , I
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ptwnbing Permi. t
State Surcr.o.ztge
Total Charaes
,
lITEM
I Res. Sa. fta,
I NewlE:::tend Circuits
I Temporary SeJ"J)ioe
I
NO. FEE
Eleatricat Permit
State Surchar~e
Total. Charges
iITEM
I NO, I FEE
CllARCE
Ful'n:1.ce ETU 'S
E:::haust Hood
I Vent Fan
I Woodstove
I
,
Permit Iasuance
Meahanic:l l Permi t
State SUI'chams
Total Charoeo
-- BNCROACHMENT --
SeC".lr1.tl/ DSTJOsit
Storage
Maintenanae
pcrmit
Total Char17es
Curbcut
sidewa.lk
I Penae
I Etectrical Label.
I'Mo 'l Home
t
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~
PJ-{.fJS
(~ .'15
"-- -<; . cG,<;
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..J W'J )
!::jm;{)
TOTAL AMOUNT DUE:-
L-COC H:
. Bedrooms: ,V) /
r,'nef'Q.!/ Sources r' ~r:;:' J e- TI/De
Heat r- e-...---
~ Aeeess. Watef' Hp.oter
Range
Fireplaoe,
f(oodatove
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..- Fees :.....
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Building Value, &
Permit
This permit is granted on the e:::press oondition that the said constzouotion'
shatt, in all. respects, conform to the Ordinance adopted by the City of
Springfield, incZuding the Zoning Ordinance, regulating the oonstzouoticn
and use of buildings, cind m:lY be suspended or revoked at any time upon vio-
, lauon of any provisions of said Ordi~es.
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Plan Check Fee:
Date Paid:
Receipt H:
, , SigniJd:
'Plumbing' Permit
No person shalt constzouct, instalt, q,tter or change any new 0'1' e:r:isting
ptumbing or drainage system in 'whole 01' in paI't, unless such person is the
tegal possessor of a valid plwnber's Ueense, e:::oept that a person may do
ptumbing work to property which it! olt1rled, teased or operated by the appU-
'cant. ,,'
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Electrical Permi t
Where State Law requires that the etectricat Work be done by an Etectricat
Contractor, the electrical portion of this permit shall not be valid until.
the label has been signed by the Electrical Contractor. '
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,Mechanical Permit
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Plall E:r:aminer
lJate
I HAVE CAREFULLY EXAMINED the completed application for permit, and do
hereby certify that al.t information hereon is tzoue and correct, and I
further certify that any and all work performed shall 'be' done in accor-
dance with the Ordinances of the City of SpringfieZd, and the La:Js of the
.. State of Oregon pertaining to the work described herein, and that NO OCCU-
PANCY will be mde of any structure without permission of the Building Di-
vision. I further certify that only contractors and emptoyees who are in
compl.iance with ORS 701.055 witl be used on this project
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-20~7.4/
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Permit No: Q\O\14 ,
,Address: 6~~ D~\~lV,
. ISSUedbY~ lID.. )oate:{) /OO,/q I
, FOR OFFICE USE ONt Y
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'STATEMENT:
INFORMATION NOTICE TOPROPERTY,OWNERS
'ABOUT, CONSTRUCTION' RESPONSIBILITIES '
Note: Oregon Law, ORS 701.055(4); requires,residential building permit applicants,
, who are not registered with the :Construction Contractors Board to Sign the
following statement before the building permit can be. issued. Licensed Architect
and Engineer',applicants, exempt from registration under ORS 701.010(7), need
_ not submit this,statement..This statement will be filed with the permit.
Fill in the applicable .blanks,and. initial,box 1 and either box2A or2B:
,1\ '
1.W
2.A.~
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I own, reside in,'or will ,reside in the comple~ ~\~:ure.
My genera,lcontractor is\. ~ ~ Y11-l: l n '
Contractor registration' number, l ()q~ ~)
, I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR .
B. , I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and co hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor.
I hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
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'Signature of P~rmlt Applicant
.J-dl'O;;
Date
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CONSTRUCTION CONTRACTORS BOARD
0244J 1/90
rlwV ,,',
Y WJ::lITE COPY TO ISSUING AGENCY PE~MiT 'FILE
~Y TO APPLICANT
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