HomeMy WebLinkAboutPermit Building 1994-12-9
SPRINGFIELD
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LOCATI~N OF PROP9A,E~WORK: < ~QBt 0 1)>\ n\rt D \)x1~
ASSESSORhMJt \ 'C:O'd a~cCT) '. \. \ TAX LOT:\llo ('I'fJ..CX')
LOT' ..:. ""'t\ BLOCI", SUBOIVISION\ J::~\"'ll(\s> f'\ G~:
OWNE~' cJ\'C\ Cl.~of\ t 1\.1:0 (\\~Q J) ~~(\~HONE: t \'-\4i . \d-1l()lo
AODRE~: BJY ~?~t) ->\3,() fYi \ '- f)ho 0 ,t-,
CITY:U\\)\ ~ r\ l ~. (j (V - STATE: :~.) 0 rz~f\
DESCRIBE WORK: ~ f\~^ Q, ~() N\lV C, \_~O t\\cl Q~
NEW Y REMODEL ~ADDITION" DEM~ISH
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olllce: 726.3759 .
.
OTHER
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q4/fJ18
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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ZIP:
01" -, <(')
CONTRACT~'~ NAM~ C J' ADORESS '
GENERAI.I..)'l'D J.( \ 01\ C .f\t\., '.
PLUMBIN; ~}[(\ Q rt. \ b ~ ~o 0 \
MECHANIr-!,.fuL.\C'\Of\ rN-l. '
ELECTRICA;\' cA\ \ 0 A Y ~ oM~ (' J
CON ST.
CONTRACTOR *
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QUAD.!,-REA: ~s.,~ /
* OF BLDGS' \
OCCY GROUP', ~ ~ -\ lv\
\
9 -"
. OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE: \ \ \ \
* OF UNITS: \. ,
CONSTR. TYPE:-4L.JV
HEAT SOURCE: \ ~
f_
RANGE:
EXPIRES
1"').\,;\ .
q. \.C\.
tj:\Q..
Q4
FLOOO PLAIN'
ZONING COOE: J.1:)\2....-
. OF BDRMS: ~
SECONOARY HEAT:
SQUARE FOOTAGE: ~
To request en Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requesled belore 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
r'i7'I R~ugh M'echanlcal ~ Prior to
1...0.4. cover.
D Temporary Electric
D Site Inspoctlon - To be made
alter excavation, but prior to
setting forms.
D Undorslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
r<VI Footing - After trenches are
~ excavated.
D Masonry - Steel 'location, bond
.beams. grouting.
~Foundatlon - After forms are
erected. but, prior to'concrete
placement.
D Underground PlumbIng - Prior
to filling trench.
"
~ Underfloor Plumbing/Mechanical
- Prior to Insulation or deckIng.
rD Post and Beam - Prior to floor
~ Insulation or deckIng.
(gJ Floor Insulation - Prior to
decking.
fV1 Sanitary Sewer - Prior 10 filling
L..O.l trench. .
~ Storm Sewer - Prior to filling
trench.
~ Wator Line - Prior to filling
L..Cl..trench.
~ Rough Plumbing - Prior to
CJ cover.
~ Roug'ti 'Electrical - Prior to
~ cover.
C2I. Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
. ~ Wall/C'efllng Insulation - Prior to
cover.
!:ZlDryWall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After fIreplace approval
and Installation of unit.
IL9 Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~ Sidewalk & Orlveway - Arler
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
D Street Trooo - When all required
trees Bre planted.
~Flnal Plumbing - When ell
- plumbing Work Is complet,e.
~ Final Electrical - When all
. electrical work Is complete.
@'Flnal Mechanical - When all
mechanical work Is complete.
r.::t1 Flnsl Building - When all
l..2:"1'"-requlred Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocKing Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, sel.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
Lot sq. Itg.
Lot coverage
Topography
Total height
~
BUILDING PERMIT
l1~T:
~lcO
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
"
'~;,!. \'j,'
". ~".:.I
Lol Type .
X Interior
,.~'
I'P.L.
:' IN
Is
Corner
Panhandle
Cul.de.sac
W
E
X $/SQ~
&.0-./
/4.f0
:~
~?;~
10:41+ ~
(A) ~{)lo.q'J- '
SYSTEMS DEVELOPMENT CHARGE (SDc)
(B) $.1.~f"8, '7/
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath{s)
Sanitary Sewer
Water
Slorm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
FEE
~
flpQ.CD
FT.
FT.
FT.
0/\ /(oo.OO
4.ClU f- P; .CD
(C) /7 Z. 'i?c)
MECHANICAL PERMIT
Furnace
Exhaust Hood, 4.ro
Vent Fan N' ~ ~.CC>
.
Wood Stovellnsert/Flreplace Unit
Oryer Vent 'r':2,.OO
Mechanical Permit / (0 .SU
Issuance /0.00
State Surcharge .50\ .f3~
Total Permit (D) &2S3
MISCELLANEOUS PERMITS
Mobile Home
State issuance
I Stale Surcharge
Sidewalk ~ It ~()$B
Curbcut It 13. '
;':::"~~~ - \':) .0:>
,H\ t\. L\-UqJ.
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlca~':2,C). '8 0
(A, B, C, 0, and E Combined) ,
..!' ":":;:"'~;\~:~I
Setbacks, ....
HSE GAR Acc:1
I
I
I
I
'(.THEPROPOSED WORK,tN THE. '
....HISTOIOlICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVFn. .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
, This permit Is granted on the express condition that the said
construction shail,ln 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: '\~\t'\ J ./
Date Paid: \} ~
Recelpl Numberu Y
Received BY:~'
~s:\\~'~,Lili
f). \~.<#
- ~
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carefully examined
the completed appllcallon 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 Ordlnancus of the City of Springfield, and the Laws
o/the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
struclure without permiSSion of the Building Safety Division.
I further certify thai. only contractors and employees who
are In compliance wllh 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' /r~nt
,
of the property, and the approved set of I ns will remain
Eo"'""", '~1;j '"n.' """
ature J' ~f '
ate
,
.
VALIDATION: i
RECEIPT NUMBER . 15'71 - ,
',1'1 ~
DATE PAlO l-L .q. .
AMOUNT RECEI\lE~d . blp
RECEIVED BY ( @Jl:tl- )
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