HomeMy WebLinkAboutPermit Building 1992-1-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769 .~
Office: 726-3759 ~JI
LOCATION OF PROPOSED WORK: S'.:CL~ ~/~~_ #-:2/
ASSESSORS MAP: /7"'O<"~~- e,/y
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e,
SPRINGFIELD
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9/a:>%
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: ~/Y /&:>
SUBDIVISION:.~r V/~
or v
LOT:
. BLOCK:
AlL <.c- ,;A?
;<'YD
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ADDRESS: / .'76>S-
5?:/"'f-p
U.RP6?"-/-
OWNER:
, .
S~
CITY:
DESCRIBE WORK:
. ,
NEW ~ REMODEL
.
ADDITION
OTHER
CONTRACTOR'S NAME
(()(41'.~ ~E;8
GENERAl,
PLUMBING:
MECHANICAl'
"
ELECTRICAL:
STATE:
cP,rf
PHONE:
?~)-B ;:::>//
DEMOLISH
ZIP:
9- ?r~ -/ :;::>
ADDRESS.
CONST.
CONTRACTOR #
PHONE
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 framing Insp.
D' Framing - Prior to cover,
D Wall/Cei~.ing Insulation - Prior to
cover.'
D Drywall - Prior to taping.
" .
D Wood Stove - After installation.
D Insert - After'fireplace approval
and installation of unit,
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
D Sidewalk, & Driveway - After
excavation is complete, forms
and sub-base material in place,
D Fence - When completed.
D S~reet T~ees ....:;.Whenall required'
trees are planted.. '
EXPIRES
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, Insp~ctions requested after 7:00 a,m. will be made the following work day.
REQUIRED INSPECTIONS
, '.
"
D
Final Plumbing - When all
plumbing work is complete,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electricall
, Mechanical - Prior to cover.
D Footing - After trenches are
'excavated,' "
D .~asonry - Steel location, bond
beams, grouting.
1\71, Foundation - After forms are
L4-J erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
-.,. Prior t() insulation or decking.
D Post and .Beam - Prior to floor
insulation or de'cking.
D Floor Insulation - Prior to
decking. .
D Sanitary Sewer - Prior to filling
- trench.
D Storm Sewer - Prior to filling
trench, '
, .
D Water Line - Prior to filling
trench. " .
D Rough Plumbing - Prior to
cover,
, '
D Final Electrical - When all
electrical work Is ~o.mplete.
D Final Mechanical - When all
mechanical work is complete,
IZI Final Building - When all
required inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
. .
D 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
... inspections are 'approved and
,., porches, skirHng, decks, and'
venting have been installed,
Lot faces Lot T~pe _ Setbacks · 4t> THE PROPOSED WORK IN THE
Lot sq, ftg. Interior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I
and approved by the Historical
Topography Panhandle I Coordinator prior to permit issuance.
Total height Cul-de-sac W
I
E' APPROVED:
BUILDING PERMIT
, ITEM SO. FT. X $/SO, FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
-:7 .<Q}O'
/~./6
<<<"2.000.
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.
Plan Check Fee: :<? ~ 7
Main
Date Paid:
Total Val ue
Building Permit Fee ~.!;"e:>
State Surcharge I. <:f?
Total Fee (A) tJ? . ~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Receipt Number'
Received By:
/:2~-
~ PI~~viewed By
/-;/~"'2-,
- - Date
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 Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
By signature, I state and agree, that I have carefullyexamined
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.
Exhaust Hood
Wood Stove/lnsert/Fireplace 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 during construction.
Signature 'X (itA ~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su rcharge
Sidewalk
ft
DatE'
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
t.
~~~~
/-/,p-? z...
AMOUNT RECEIVED 6::;:' '7G::'
RECEIVED BY , ~~ .? - ·
DATE PAID
RECEIPT NUMBER
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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