HomeMy WebLinkAboutPermit Building 1997-5-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
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SPRINGFIELD
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LOCATION OF PROPOSED WORK:
I~ 7",?
/7,-9;~ 2-?
;\( ASSESSORS MAP'
X LOT'
BLOCK'
OWNER' (;. Fo iR- Sf P ,_ ~ " +- iR. I+Jtfl
ADDRESS" /0 70 ;!)AR/,o/v e ~
CITY: S J.? t<< ; f\/ Q -r: p I d!
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STATE: . C) (f2
DESCRIBE WORK'
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ADDITION
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' . S (? J F
i
PLUMBING'
MECHANICAl'
ELECTRICAl'
DEMOLISH
..
9 76~/.>
JOB NUMBER
225 Fiflll Street
Sprlnglleld, Oregon 97477
M5
TAX LOT:
SUBDIVISION:
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PHONE:
?Y6-3S7!J
ZIP' 97VJt;:;?>
.-
OTHER
ADDRESS
CONST.
CONTRACTOR'
EXPIRES '.: PHONE
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.
~ramJng - Prior to cover.
~WaIl/C'elllng Insulation - Prior to
~cover.
o Drywall - Prior to taping.
o Wood Stovo - After I~statlatlon.
o Insert - After fireplace approv41
and Installation of unit.
o Curbcut & Approach - After
forms are erected b~lt prIor to
placement of concreto.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When comp.l~ted.
o Street Treos - Whon all requIred
trees are planted. ,.
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN:
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TVPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: _ SQUARE FOOTAGE:
To request an Inspection, you mus1 call 726.3769. Tills Is a 24 Ilour recording. Alllnspecllons roquesled belore 7:00 a.m. will bo
made the same. working day, Inspections requested after 7:00 a.m. will be made the following work day.
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'fV'( Final Plumbing - When all
~ plu.mblng w()rl< Is complet,o.
.. ,
o Final Eloctrlcal - When all
electrIcal worl< Is complete.
o Final Mechanical - When all
mechanical work Is complete.
'Jvo( Final Building - Wilen all
~eqUlred Inspections have been
approvod and building 15
complotod.
DOtllor
MOBILE t-IOME INSPECTIONS
o Blocking and Sel.Up - Wilen all
blocking Is complete.
o Plumbing Connections - When
home Ila5 been connected to
water and sewer.
o Eleclrlcal 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
porchos, skirting, decks, and
venting have been InstallOd.
o Temporary EloClrlc
o Site Inspection - To be made
after excavation, but prtor to
setting forms.
o Underslab Plumblng/Elactrlcal/
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
placemont.
o Underground Plumbing - Prior
to filling trencll.
o Underlloor Plumblng/Mochanlcal
- 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 flIilng
trench. .
o Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench. ..
D Rough Plumbing - Prior to
cover. .:.
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Selbacks
~IGARIACcl
I N I II I
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~~.--l I APPROVED: _
. . 'j
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
. , c~.
Lot faces LOI Typo
Lot sQ. ftg. Interior
Lot Coverage Corner
Topography - Panhandle Y
Total height Cul-de-sac
-
"':. kl.
BUILDING PERMIT ., " 1
ITEM SO. FT. X S/SO. FT.
Main
Garage .
Carport
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- ,
Total Value
Building Permi t Fee
Stale SUrCharge 1.'1:3 '" /,!fp
TOlal Fcc (A)
VALUE
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.s.P-., ~-o
'.S . t:J ~
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
FEE
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
c.qa..'i/) Vh'TJ
/ .t;) (TO
Plumbing Permit
State Surcharge
,7r+,1-,j'
Total Charge
(C)
/ c.,. 20
'-
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
,.,
Wood Stovellnsert/Flreplace Unit
N'
Dryer Vent
Mechanical Permit
Issuance
Stato Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
Slate Surcharge
./J bbJ A7 2J.,I/E? J )
,
Tolal Miscellaneous Permits (El
OUNT DUE (excluding electrical)
TOTAL AM
(A, B, C, 0, and E Combined)
25P3
~2.~.2..
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i. IS THE PROPOSED WORK iN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yes, Ihls application must be signed
and approved by lhe Hlslorlcal
Coordinator prior to permit Issuance.
This permit Is granted on the express condillon thallhe said
construct/on shall, In all respects, conform 10 the Ordinance
adopted by lhe Clly of Springfield, InClUding lhe
Development COde, regulallng the constrUCllon and use of
buildings, and may be sUspended or revoked at any lime
upon vIolation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans RcVICWQ(JEiy--'-
I
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Dale
Systems Oe~elopmcnt Charge Is duo on all undeveloped
properties within the City IImlls Which are being Improved.
ADDITIONAL COMMENTS
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By signature, I olato and agres, that I hava carOfully oxamlned
the completed eppllcatlon and do heraby cerllfy thai all
Information hereon Ie true end oorreot, and I lurther oortlfy
that any and all work porformed ehall be done In accordance
with the Ordlnanc~s of the City of Springfield, and the Laws
of the SlaloiDf Oregon perlalnlng to lho work described
heroin and th~l NO OCCUPANCY will bo made of any
slruct~re wllho~t permission of Ihe Building Safely Olvl.lon,
I further certHy that only contractors and employees who
are In cO~Pllanco with OAS 701.055 will be used on thIs
project.
I further agreo to ensure that all required Inspections are
requeSled at 'he proper time, that oach address Is roadable
f the .treat that the permit card I. localed at Ih. Ironl
rom, d I f plans will remain
of the properly, and Ihe approve .e 0
on the site at all times during construction.
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Signature - t/." ~
Dale 0/2.J)1 f~
VALIDATION:
7.c;" 5' 2-2.-
RECEIPT NUMBER ,S ,;-;
DATE PAir }:f/..2-~ !: 2...
~2....
AMOUNT RECEIVED )f'~
RECEIVED BV ~. _ _
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