HomeMy WebLinkAboutPermit Building 1991-4-30
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
",SS.~SSORS MAP'
LOT:, HI"';'
.t:JeJ.:J
, SPRINGFIELD
~.~..t':'.
q \03S'i
2N
Dr"''''.., j :sr
BLOCK'
OWNER: "Dol. " ci))l).....~... ~ ...I-~~
ADDRES"" .;)91(3 '1'1<. fDJ,.. s- L)..,.; (
CITY: "E '-'4.-"> cA/L .." a;"""\t!J.,./
IJ ' V .
STAT'"
DESCRIBE WOR"" <:;,A/J I~
NEW )'( REMODEL
n.... c' Kr" J,~-Irj
)
ADDITION DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
~U~DI~I~I~N: 'Kt;,.., b~...:> i? ~ I.~.r
PHONF'
j
4J's 31710
ZIP: <;} I/u/
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
,,- B/~~ ..)~~3 Md,/,,,, ~~ e~), 31o'/f'f
GENERAL' r... f..~, 14 If I <,Id$fO (..,
PLU~BING' G.,$ f-.",,-< Pf~... 6,.....,\ r..:I!-"""../ p "'-1 ;1<3/1'/ /chi y.J- .s;"lloI~_
MECHANICAL:i?oJ~~ Ha6/''''' ( .3570 If: 1'/11:. ~l.c.c: ';;D, 'ft,> '.:J /-,,2- 7 'II -<J<::JO, 2.-
'~<j<<~cf' El~/_~ 79(.73 ov3.l.. rn J '7/~1
ELECTRICAl' elt- Js i 56. fVL ~ 7 ~
.,
\~ !\\\i,J - OFFICE USE -
QUAD AREA: LAND USF' \\\\ FLOOD PLAIN'
. OF BLDGS: \ . OF UNIT"" , ZONING C.ODE: \ -\)~
OCCY GROUP: ?~"'\-- \{\ CONSTR. TYPE: -lJ !;;! . OF BDRMS' ~"
. OF STORIES: \ HEAT SOURCE: ,F"'-:1 SECONDARY HEAT:
WATER HEATER' 6 RANGF' 'T... SQUARE FOOTAGE: 10/1-02-
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 B.m. will be made the following wor~ day. I
~ Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
settlng forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o 'Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
'1\:71. Foundation - 'AHe'r forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
...r-7'I Underlloo(p.lumb~eChanicar:
;x...! - Prior to, Insulation or decking.
-{"'7f Post and Beam - ~rlo'r to, floor
~Insulatlon or decking. '
rvfFloor Insulation - Prior to
~decklng.
REQUIRED INSPECTIONS
f':7! Rough Mechanical - Prior to
~ cover.
tc::'1 Rough, Electrical -, Pdor to~ ._.
~ cover.
r"'V'1' Electrical Service - Must be
~approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
. materials and framing Insp.
0Framin~ - Prior to cover.
~:~~~.C~iling Insulation - pr,i.or to
,~,DryWall - Prior to taping.
" . .., '. .~. .
o Wood S-iove - After Installation.
D Insert'- After fireplace approval
and Installation of unit.
aCurbcut & Approach - After
forms are erected but prior to
placement of concrete. .
f'5<1" Sanitary Sewer - Prior to filling
~ trench. . .
. - ~ Sidewalk.& Driveway - After
....l:::::::S..excavation Is complete, forms
9nd ~ub-base material In place.
lVrStorm Sewer - Prior to filling
~ trench,
~Water Line - Prior to filling
~ trench. '
i\/l Rough Plumbing - Prior to
~ cover.
1><1 Fence - When completed.
~treet'Trees"';' When~li"r~qUlred'
~ees are planted.
" .
~Flnal Plumbing - When all
~~IUmblng work Is complete,
~ Final Electrical - When all
~electrlcal work is complete.
,
M Final Mechanical - When all
mechanical work Is complete.
i"'V1 Final Building, - When ail
~equlred Inspe,ctions have been
approved and building Is
completed.
~Other p.vJ!..P/.a.u'tVft4Cb
MOBILE HOME'INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - 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
. ,or:io"rches, sklrtln'g, decks', and
venting have' been Installed.
"- .
~ Lot Type.
Lot faces Setbacks IS THE PROPOSED WORK IN THE
Lot sq. ftg. 7Z6 x: Interior I PL. HSE GAR ACC HISTORICAL DISTRICT, OR O~
3Z THE HISTORICAL REGISTER?
Lot coverage ~., Corner N If yes, this application must~ signed
<:2.'9" S ~l and approved by the Historical
Topography Panhandle
~ Iw /3 I /3' Coordinator prior to permit issuance.
Total height Cul-de.sac IE
i:l
I I APPROVED.
BUILDING PERMIT
. ITEM, SQ. FT.
Main I LoCfO
Garage151~
X $/SO, FT VALUE
-tf.&. SS -1iSs:z~
~/~ ~,- ~f~~
Carport
Total Val ue
R') (Y'/'),
I
::::?tPP, .0.0
- -/1-10
1/J1frJ
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /~'15~
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
?-
/~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
~f'r;Jrl0
Plumbing Permit J
State Surcharge
\~~
/7~~
. ~75"
} fiZJ 2, .7..5
Total Charge (C)
MECHANICAL PERMIT
;;, ,t:fO
45"0
qoo
Furnace
Exhaust Hood
Vent Fan
N'
-:;;:
Wood Stovellnsert/Fireplace Unit
Dryer Vent
,,<~
Mechanical Permit
22.. 150
1000
/ ~3
34.13
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
'7~
.2/.70
/ ~_ '10
ft
Curbcut
'21~
ft
Demolition
State Surcharge AQ~
, ~ X\J0 0 ~ "Y-
ToUMlscellaneous Permits (E)
n~
4IJ.t:,o
/910&(3
TOTAL AMOUNT DUE (excluding electrical)
(A,.6, ~, D, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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: A ~.r;::.o
Date Paid: 4- -'-\ \ r; .q ,
Receipt Number. \C\',.~
Recelved.JY: M) [)(A )
/~~ - ~~/D2:"J.eh, U-
Plans\ R"eviewed By 7 ~aZ ~
Systems Development Charge Is due on all undeveloped
properties within the City~ limits which are being improved.
~DDITIONAL COMMENTS
\ '11 5\ b~\61_~
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 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.
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 remaln
on the site at all times during construction.
Sign~ rf? ~ ,
Date ('-\lbD/ W
I ,
VALIDATION: I qq
RECEIPT NUMBER . '1 ~
DATE PAID 6)!Y) { J. ( 0.... ) _ ~
AMOUNT RECEIV~n ,<I. 3n H \ J
011 ~_/
RECEIVED BY