HomeMy WebLinkAboutPermit Building 1991-5-17
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RESIDENTIAL
PERMIT APPLICATION
Inspections:, 726.3769
Office: 726.3759" '
LOCATION OF PROPOSED WORI<'
LOT:
DESCRIBE WORK'
NEW
)(
REMODEL
-
CONTRACTOR'S NAME
G'ENERAl' ~.{."-'-'-
SPRINGFIELD
~ss'''J)/O -..>...L .s+-
BLOCK:
STAT'"
ADDITION
DEMOLISH
.
;Ul. v I-
t] / ()'-/(J).
, JOB NUMBER
225 Fifth Street
Sprlngfleld,Oregon'97477
TAX LOT:
-'S~~~;;ISIONW.,..b~: F"..J.-I--r r
PHONF'
tfJS.117 '"
ZIP'
f7 Vol
OTHER
CONST,
CONTRACTOR' EXPIRES PHONE
.3iQ"'~~ t../ff <lJ S j, 7 '"
ail /' <.( ,,!f/ <{d'S" y '"
~OLVV ~/H_ 7 <f/- 000 ,L
3J8.3<.. 7//, '<fL.-oJ(,7 L
ADDRESS
K H~_.. r oJ ff L M-r. {"f,. r (2~;
,_ )
PLUMBING' ('u~_ PI.. _ I..." K...A...~_r. t:~.
. .~ J
MECHANICAI.?,~I ~r fLI/A'~ ~r70 €..+- Jvtt. ,;:~, "
" ,I ~
ELEcTRICAL' N-~ ~ ~,,_ J E"'--- .,,o 7 ~ 7H 7::J v:>J. I{J 1:;'<.".
. J v.
"- OFFICE USE -
QUAD AREA: , R..\\ lLU LAND USE: \ \ \ \ FLOOD PLAIN'
. OF BLDGS: , . OF UNIT'" ~ ZONING CODE: L 0 {2:...
OCCY GROUP: 'e~--\~ CONSTR. TYPE: VN . OF BORMS: -4
.. OF STORIES: rl HEAT SOURCE: FG SECONDARY HEAT'
WATER HEATER' S RANGF' E... SQUARE FOOTAGE: r9/JJ I ~
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. will be made the following work day.
o Temporary Electric .
o Site Inspection - To be made.
after excavatIon, but prior to
settIng forms,
o
Underslab Plumblngl Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated,
o Masonry - Steel location, bond
beams, grouting,
~Foundation - After forms are
~rected but prior to concrete
placement.
o Underground Plumbing - PrIor
to filling trench,
~ Underfloo~lumblrutl-Mechanici.t>:
P.J - Prior to l'iiscrTaTiOn- or decking.
~ Post and !3eam - p'rlor to floor
ICL..lnsulatfon or decking.
-c7f Floor Insulation - Prior to
~deckjng.
'1Vf Sanitary Sewer - Prior to filling
~rench,
~ Storm Sewer - Prior to filling
~ trench,
~ Water Line - Prior to filling
trench. ~
F;?1' Rough PI.umbing - Prior to
~over.
REQUIRED INSPEC!I,2NS
I':7f Rough Mechanlcal.'- pri?r to
~ cover. '"
~ .;--'... '.--
;g '\
Rough Electrical - Prior to
cover. ,
K7'f Electrical Service - Must be
~ approved to obtain permanent
electrical power,
~ Fireplace - PrIor to. facing
, materials and framing Insp.
g,:raming - Prior to cover.
'T"v'r'Wall/Ceiling Insulation - Prior to
~ cover. '
~DryWall - Prior to taping,
..' . .,
D Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of 'unIt.
K/l" Curbcut & Approach - After
~forms are erected but prior to
placement of concre,te.
. ~Sidewalk'&.Oriveway - After
~excavation Is complete, forms
and.sub-base material in place.
~Fe,nce -'When completed.
~reet Trees...:. When'all":req~lred'
~ees are planted. . ,
~ Final Plumbing - When all
~Iumbing work Is complete,
K'Ji( Final Electrical - When all
~electrlcal work Is complete.
rv1 Final Mechanical - When al/
~mechanlcar work Is' complete.
r'V1' Final Building - When all
~requlred Inspections have been
approved and building Is
completed.
~Other JY(~:JC.f~~tU ,OWe;:;
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.
D Final - After all required
inspections are approved and
. porches: skirting, decks, and
venting have been installed. .
.
.
'-,
. , THE PROPOSED WORK IN THE
Lot faces * Lot Type Setbacks
Lot sq. ltg, /m~ ~terior I PL, HSE '1"0 I HISTORICAL DISTRICT, OR ON
IN /9' . I THE HISTORICAL REGISTER?
Lot coverage ~ Corner If yes, this application must be signed
..::z.~ Panhandle Is sr' I and approved by the Historical
Topography lw 1-1' I Coordinator prior to permit issuance.
Total height u.: Cul.de-sac
IE /2' 12.' I
APPROVED:
BUILDING PERMIT
SQ, FT,
r9A()4
Aloe)
X $/SQ, FT,
VALUE
ITEM
Main
Garage
Carport
/[iJ/Yh.
-1-33/)"0
2/ ~ S'
151. (p~
SYSTEMS DEVELOPMENT CHARGE (SDC)
/5t:Jo .00
Total Val ue
Building PermIt Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
~
/12 ~()
Sanitary Sewer
FT,
Water
FT,
FT,
Storm Sewer
15~
,//)7 5"D
JD Sf>
.217 BS
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
~;n
~(;"D
/z'?O
Fu rnace
Exhaust Hood
Vent Fan
N'
..,.
.
Wood Stove/Insert/Fireplace Unit
Dryer Vent
3 ,t:1U
z.~
77~o
I/)'""
J.9S
~q 3[1.
4~ 1-IAY JC;
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk f34.
It
2.2. ~
/1:0
Curbcut ?~ It
Demolition
StajjSUrCharge
~. f\[' 9-.-- ~
Total Iscellaneous Permits (E)
~.-
4/ . tJo
?'?~2. '7/
, ....~
TOTAL AMOUNT OUE (excluding electrical)
(A. B. C, 0, 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: jf')- r I. uS"
dJ-ttJ11
Receipt Number' /'1 fLi C;
Re~~:
prd-rfs f'[evl "wed By' -
Date Paid:
!5..:.Cj, - r /
Date
.Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
(11 \ W'XtJ 9._
.;.
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
!nformatlon 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 remain
on the site at all times during construction.
Slgnature~-'L ~
</h-.I/Y/
Date
VALlOATION:
RECEIPT NUMBER -:2~&;)9 3
>-/;::> -"7/
AMOUNT RECEIVEr> -:<. ':::1,53' -) /
/26'~--=-,-
OATE PAIr>
RECEIVED BY
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