HomeMy WebLinkAboutPermit Building 1991-8-13
OWNER' l'~:)). ~11\ ~~j' l 0 ~
ADDR:6fS' \" )~. l Y"'\(I(1 Q n ./ ,~ , ~
CITY: ('{ STATE: L>LfQ
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1 h 0 )~( 1..Ltf.t fOUl / Jl )
, AODITION' D~OLlSH , OTHER-
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT:
NEW
DESCRIBE WOR
CONTRACT~rAML
GENERAL' eJt.. {\g
,
PLUMBING'
MECHANICAl 'C\ .
~~.ECTRICAI' } J'A't{. t't'I
-.
SPRINGFIELD
,BLOCK: '
8:
Q/ocr13
JOB NUMBER,
I
225 Fifth Street
Springfield, Oregon 97477
0510
I r X"QO
TAX LOT:
SUBDIVISION'
PHONE:r4-{fJ ._<r(L(SS
ZIP:
/
Lf7179'
\ g~rrt:~S 'l~
CONST
CONTRACTOR'
EXPIRES 4Y1:~~'r(
YO 0 f'L~
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USf'
. OF UNIT'"
CONSTR TYPE:
HEAT SOURCF'
RANGF'
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbingl Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough. Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
rii\walllCeiling Insulation - Prior to
r cover.
pDrywall - Prior t~ taping, "
D Wood Stove - After installation.
o Insert - After, fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erec'ted but prior to
placement of concrete.
, D -Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
'D Fence - When completed,
. D .Street Trees - When all requi'red'
trees are planted. . ,
D Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete,
7f:Jal Building - When all
required Inspecti,ons have been
approved and building Is
completed, "
:::J Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When ali
blocking /s complete.
D
Plumbing Connections -. When
home has been connected to
water and sewer.
D 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.
Lot faces . Setbacks .IS THE PROPOSED WORK IN THE
Lot Type
Lot sq, ftg, Interior I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If 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 Sa. n X $/SQ, n
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
,
\,
'.
Main
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 Spring'field, 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.
\
pian Check Fee'
Garage
Carport
Date Paid:
Total Value
Receipt Number:
Building Permit Fee
Rec~ived By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu mace
Vent Fan
N'
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.
Exhaust Hood
Wood StoveJlnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper tlme; 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 durln~ c/structlon.
Signatu~~""'-- d~__
Date! J;l-~! ~-- /' I
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~
(A, B, C, 0, and E Combined)
RECEIPT NUMBER
~
~oqq4
I.-:::S_ ~ 1 (
d OJCo A"')
DATE PAID
RECEIVED BY _, .
~