HomeMy WebLinkAboutPermit Building 1997-3-24
OWNER: r \\C-. \ I "fU\\\et'"
ADDRESS' '~f4tf{) \ '\ 0 ~ \\-r\\1 e ./
CITY:. ~\'('\(\~ ~(''d, ~, STATE: ()r~W1'{\
DESCRIBEWO~V 0 no II ) l+\.lQ.... b'unn ~~
NEW REMODE~ - \ ADDITION \ \ DEMOLISH - \ OTHER
. CON ST.
CONTRACTO~S NA E ~DDRE*_ <\..., ~\ "I CONTRACTOR'
GENERAL: " , ~ :-=.,~\ dl\{).\I.tl.}.., t;:1o()91,....
PLUMBIN(.:' 1, f:~~ \) ~'M. ~i\(\ . - 0 -
MECHANIC! ' . \ N\ ,', )
ELECTRICAl' ~E'J~f,.i\0 oS ~ol't
"
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT'
QUAD AREA-
· OF BLDGS:
OCCY GROUP'
· OF STORIES:
WATER HEATER'
..
SPRINGFIELD
.
(\1D~ l S
BLOCK'
- OFFICE USE -
LAND USF'
. OF UNIT'"
CONSTR. TYPE:
HEAT SOURCE:
RAN"'~'
JOB NUMBER
_ TAX LOT:
SUBDIVISION'
o~
PHONF'
ZIP: Q,'l til
EXPIRES ..... PHON~I\_
e<i-nQlJ2b. tt:1Lb
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To requesl 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.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Unde,slab Plumbing/Electrical/
Mechanical - Prior to cover.
o Fooling - 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 Underfloo, Plumbing/Mechanical
- 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 filling
trench. ".
o Waler Line - Prior to filling
trench.
r-7i' Rough Plumbing - Prior to
L.J.LJ cover.
~\
rlVRough Mechanical -' Prior to
~~ c ver.
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.
~ Fra~lng - Prior to cover.
~,^!all/Celllng Insulation - Prior to
cover.
~rywal1 - Prior 10 taping.
o Wood Stove - After Installation.
o Insert - After fireplace approvl!l
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base malerlal In place.
o Fence - \tVhen completed.
o Street Trees - When all required
trees are planted.
n .FInal Plumbing - When all
~p'umblng w9rk Is complet.e.
~nal ElectrIcal - When all
electrical work Is complete.
~nal Mechanical - When all
mechanical work Is complete.
.--/Flna' Building - When all
LLJ required Inspections have been
approved and building Is
completed.
OOlher
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, se'-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
porches, skirting, decks, and
venting have been Installed.
J
....,..
Lot faces Lol ~ype .
Lot sq. flg. Interior I P.L.
IN
Lot coverage Corner
Topography Panhandle .... Is
Iw
TOlal height Cui-de-sac IE
.'., ~::;}J~'\;;,.~i"
'.HE PROPOSED WORK iN THE.
HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR Accl
I
I
BUILDING PERMIT ", ';) .~
ITEM SO. FT. X $/SO. FT. - VALUE
Main
Garage
'.
Carport
APPRqVFn.
'. '.,. '... ~I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition Ihatlhe said
construction shall, In all respecls, conform 10 the Ordinance
adopted by the City 01 Springfleld, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
~ <fl ['f{) fJ) Date Paid:
TOlal Value
- -~
\~ . Receipt Number'
Building Permit Fee
, ~:S Received By:
State Surcharge ":ft)
Tolal Fee (A) \~f:.lz... Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
FEE
Fixtures
Residential Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge -\- ~O
Tolal Charge (C)
l5~
\.m
\ Lo ,?J)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slove/lnsert/Flreplace Unit
Mechanical Permit
Issuance
State Surcharge -TWo
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
fl
Curbcul
fl
Demolition
Slate Surcharge
Total Miscellaneous Pennlts (E)
TOTAL AMOUNT DUE (eXCluding electrical)
(A, B, C. 0, and E Combined)
&\~
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature. I stale and agree, that I have carefUlly examined
the completed application and do hereby certify Ihal 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 Slate of Oregon pertaining to tho work described
herein, and thai NO OCCUPANCY will be made of any
struclure wllhout permission 01 Ihe Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on Ihls
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address is readable
from the streel, Ihal the permit cerd Is locatad at the front
of the property, and the approved sel of plans will remain
X\~ the slle al all times ~Urlng construction,
'~nature &-0 It bA:-
"Oat.,.
VALIDATION: c-' r-.rv1
RECEIPT NUMWR c1.0A-Tf
DATE PAID ~ "')-/J~ "
AMOUNT RECEI~ ,^ ~/Jf...\ .\'1 /'
RECEIVED BY U\(fyt~~)
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