HomeMy WebLinkAboutPermit Building 1997-9-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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CITY: r l. ~ {\(L STATE:
OESCRIBE WORK: \\ ') (\\0 (' \ _~ I {\G J
NEW
REMODEL'
CONTRACTOR'S NAME
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ADDITION
DEMOLISH
OTHER
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JOB NUMBER
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PHONE:r.lff\.4~
ZIP: U~\
ADDRESS
CONST,
CONTRACTOR'
PHONE
:~:~::~: ~N\'\'{Q~,,<:) \~Uill\'Nf()7
MECHANICA' ' ' -{\
ELECTRICAl'
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER'
\t)\VJ"bA
-<;
'It
.....:.., Of'l4cE USE -
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EXPIRES
_P>-l'C>'~<i
FLOOD PLAIN'
ZONING CODE:
. OF BORMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
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To requesl an Inspection. you must call 726.3769, This Is a 24 hour record~ng, A!.l!_r\~Ctlons requesled belore 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 a.m. will bC~d~Jw following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
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
placement.
o Underground Plumbing - Prior
to filling trench,
O Underlloor prumblng/Mech~nlcal
- 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 filling
trench.
o Storm Sewer - Prior to fltllng
trench. f
~aler Line - Prior to IlIIlng
trench. .
o
Rough Plumbing - Prior to
cover.
LAND US".
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
",
,,,
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical ServIce - Must be
approved to obtain permanent
alectrlcal power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Orywall - Prior to taping,
0' Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - Afler
excavation Is complete. forms
and sub.base material In place.
o Fence - VVhen completed.
o Street Trees - Whun all required
trees are planted. .
o Final Plumbing - When all
plumbing w9rl< IS complet.c.
D Final Electrical - When all
electrical work Is complete.
o
Final Mechanical' - When all
mechanical work Is complete.
o
Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthor
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 - Aller all required
Inspections are approved and
porch os, skirting, decks, and
venting have been Installed.
lot ;ype . '.' ., 'h .!.;-;.;!:\:l . itl THE PROPOSED WORK iN THE _
Lot faces Setbacks
lol sq. ttg. Interior I PL. HSE GAR Accl HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner II yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul.de-sac
IE I APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopled by the City of Springfield, Including the
Development Code, regUlating the construction and use of
buildings, ~nd may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee:
Date Paid:
Tolal Value
Receipt Number'
Building Permit Fee
State Surcharge
Received By:
Tolal Fee
(A)
Plans Reviewed By
Dale
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmenl Charge Is due on all undeveloped
properties within lhe City limits which are being Improved.
PLUMBING PERMIT
ITEM
FEE
."ADDITIONAL COMMENTS
."
Fixtures
Resldenllal Balh(s). N'
Sanitary S~wer
Water
FT.
!,T~\' \~)
L\Dro
Storm Sewer
FT.
/
Mobile Home
Plumbing Permit
-'1\ .
<; ':t[j.)
, -
:'[6
12: .aD
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Ven't Fan
N'
By slgnalure. I stale and agree, lhall have carefully examined
the compleled 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 Ihe City of Springfield, and the laws
of the State of Oregon pertaining to the work described
herein. and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
'State Surcharge
Tolal Permit
(D)
I further agree to ensuro 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 tim7s fkrlng construction.
Slgnature~~ ./Ja~
JP.'1 - i I
I' rc4, C tfT-
<j -'-F '/7
Date
......
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MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk
It
Curbcul
It
Demolition
TOTAL A1'v!OUNT OUE (excluding electrical)
(A. B, C, D, and E Combined) .
4!h .An
VALIDATION:
RECEIPT NUMB,"-R
OATE PAlO
AMOUNT RECEltf". ~ p.. ~,A{J
RECEIVEO BY ~_~_ ,
c9~3 31
Q-R.q1
~
Slate Surchargll
Tolal Miscellaneous Permits (E)