HomeMy WebLinkAboutPermit Building 1996-11-13
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LOCATION OF PROPOSED WORK. '2 57C:; f)~ mtl."S Dr
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAp.
LOT:
OWNER:
CITY:
.
SPRINGFIELD
.1....", .
BLOCK:
Dr
STATF.
Of::(
DESCRIBE WORK:
{)J(,ofJ1'1- ~
REMODEL ADDITION DEMOLISH
NEW
CONTRACTOR'S NAME /l /'
GENERAl. /!HiJl/Un
PLUMBING:
MECHANICAl.
ELECTRICAl.
OUAD AREA:
'1 etJ lit}
. OF BLDGS:
OCCY GROUp.
. OF STORIES:_
WATER HEATER:
OTHER
.
JOB NUMBER Q(015Lf/
,-
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT:
tJV I 0 :<..
SUBDIVISION.
PHONF.
ZIP: t{7177
ADDRESS
CONST.
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framIng Insp.
o Framing - PrIor to cover.
o Wail/Ceiling Insulation - PrIor to
cover.
o
Drywall - PrIor to taping.
- OFFICE USE -
LAND USE: _.______
. OF UNITS: )
CONSTR. TYPE: -2-::'-^-
HEAT SOURCE:
RANGF.
EXPIRES
FLOOD PLAIN:
ZONING CODE: --.L O~
. OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE:
To rOQuest 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 aHer 7:00 a.m. will be made the (ollowlng work day.
D Temporary Electric
o Slto Inspection - To be made
after excavation, but prior to
settlng forms.
o Undcrslab PlumbinglElectric...ll
Mechanical - Prior to cover.
N Footing - After trenches are _J
~xeavate'70 b~ ~OI
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 Plumbing/Mechanical
- Prior to Insulation or decl<lng.
o
Post and Beam - Prior to floor
Insulation or decking.
tJ
Floor Insulation - Prior to
decking.
"
o
Sanitary Sewer - Prior 10 filling
trench.
o
Storm Sower - Prior to filling
trench.
o
Water L1no - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o
Wood Stovo - After Installation.
o Insert - After fireplace approval
" and Installation of unit.
o
Curbcut & ApPI'Jetch - After
forms arc erocted but prior to
placement of concrete.
o Sidewalk & Dri\cway - After
excavation Is complete, forms
and sub-base rraterlal In place.
o Fence - 'Nt1on completed.
o Streol Treos - When all required
trees are planted.
o
Final Plumbing - When all
plumbing w~)(k Is complet.c.
D Final Electrical - When all
electrical worl< is complete.
o FInal Mechanical - When all
mechanical worl< Is complete.
~Final Building - When all
~~eqUlred Inspections have been
approved and building is
completed.
D Othor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
bJockln~J 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 Ille home is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches. sklrllng, decks, and
venting have been Installed.
Lot faces
.
Lol Type
Lol sQ. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac
BUilDING PERMIT
ITEM
so. FT.
X $/SO. FT.
Main
Garage
_1{f;1)
-1(), I U
Carport
Total Value
I P.L.
IN
Is
Iw
IE
VALUE
.,
~~11{
tHE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
HSE rG~; ACC I
I I
I I
j J
Stale~iij'or~'4-u
Total We .7
~'YL-
(A)
_.Q2;!2JJ
---tJi-
---
C)q,5S
SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fcc
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wcr
Water
1'1:
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StoveflnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
CD)
MISCEllANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
, Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
APPROVED:
BUilDING VALUE, PLAN CHECK
AND BUilDING PERMIT
Tllis pemilt is grunted on tlie express condition lhal the said
construction shall, in all respects. conform \0 the Ordinance
adopted by Ihe 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:
Date Paid:
Receipt Number:__.
Received By:
Plans Revic~ed. ciy-'u.------
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
,
~. -Iv be
IlJi{1t1'y1 ?tJ da;/S
By signature, I ::;tale and agree, Ihat I have carefully examined
the completed application and do hereby certify that all
Inrormatlon 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 thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify ltwt only contractors and employees who
arc In compliance with GRS 701.055 will be used on this
project.
I furlher agree to ensure that all required inspections are
requested at the proper time, ttlat each address Is readable
from tile Slreet, that the permit card Is located at the front
ot the property, and t approved set of plans will remain
::"~:~t';" il;;/71"M,/
Dale / - -0 /' y6
\.
VALIDATION:
RECEIPT NUMBER '1 ~7r; f.o
//,,/ ~ -1h
~MOUNT RECEIVED.. .c:;q~~
IJ1 ____ -
DATE PAID
RECEIVED BY