HomeMy WebLinkAboutPermit Building 1991-5-1
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LOCATION OF PROPOSED WORK: ~~(/ p~/S"y.~ #';?~
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. RESIDENTIAL.
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726-3759
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. ASSESSORS MAP:
LOT:
SPRINGFIELD
.
JOB NUMBER ~ /t:::> ~'3':3
225 Fifth Street
. Springfield, Oregon 97477
TAX LOT: ON/<?
BLOCK'
SUBDIVISION:
I
OWNER:
ADDRESS:
CITY:,
.7373 ~At~ ~ C(?f,/'f/Z:>~
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PHONE: -:) C::I/~8~B -tV
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ZIP'
DESCRIBE WORK: l(A/~~~L ~ ~/ZS;&.~ ,~~~ '$/~~C~ ~~.
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NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAL'~~~
CONST.
CONTRACTOR #
ADDRESS
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PLUMBING'.
MECHANICAL:
ELECTRICAL:
, -
QUAD AREA:
.'.
# OF BLDGS:
OCCY GROUP:
# OF STORIES'
WATER HEATER:
EXPIRES
PHONE
?Y?~~~9
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-
l. .
- OFFICE USE -
LAND USE:
FLOOD PLAIN-
# OF UNITS:
ZONING CODE:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE 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. wilrbe"made the following wor,"k.j~y;.,_,,.~,'... _ .._"'" ... ".
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
rvl Footing - After trenches are
lAJ 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.
D Underfloor Plumbing/Mechanical
-:- Prlo.r 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.
o Water Line - Prior to filling
trench. .
o Rough Plumbing - Prior to
cove~ .
'...
o Rough Mechanical ~ Prior to
cover. .
o Final Plumbing - When all
plumbing work is complete.
D Rough Electrical - Prior to.
cover,
o Final Electrical - When all -
elect~ical wo.rk 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,
o Final Building - When all
required inspections have been
approved and building is
completed.
o Framing - Prior to cover.
o Other
o WalliCeiling Insulation - Prior to
cover,
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
0: Wood Stove ~ After installation.
o Insert - After fireplace approval
and installation of unit.
0- Blocking and Set-Up - When all
blocking is complete.
o Curbcut & Approach - After
forms are .erected but prior to
placement of concrete.
[2] Plumbing Connections - When
home has been connected to
water and sewer.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base.material in place.
III Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel. .
D Fence - When completed.
D Street Trees ~ When ali req.uiied
trees are planted. '.',. . . ...
W Final - After all required
inspections are approved and
. . porches, skirting. decks, and
. ;..' venting have been installed.
Lot faces Lot Type' Setbacks
I P.L. I I I ACC I
Lot sq. ftg. Interior HSE GAR
.1 N
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul-de-sac
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BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. = VALUE
.
,
Main .
Garage
Carport
~r~5
Total Value
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SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fee
I State Surcharge
'..
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
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Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
J19~'2~
I"S..:;'s
5'..2~
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
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IS 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.
\APPROVED:
,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permitis granted on the express condition that the said
.
construction shall, in all respects, conform to the Ordinance
adopted by the City of Spring}ield, 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:
Date Paid:
Receipt Number:
:.z;-/'9/
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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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 pertai ni ng to the work descri bed
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.
Signature
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Date
VALIDATION:
RECEIPT NUMBER
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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