HomeMy WebLinkAboutPermit Building 1993-8-30
...-/
.\
~
RESIDENTIA{< ~
PERMIT ,AP,pLlCATION
Inspections: 726,3769
Office: 726.3759
LOCATION OF PROPOSE~W,.QtlI<' BA. n
ASSESSORS MAP: -t!-' (.1 ~~;r _ /
LOT: BLOCK:
OWNER' ~),.~ '(\c\. )\f\
ADDRESS' '"Q"I \ On 0,
9,1 'Y'o Lf\Q ---- STATE: ( ti.JUf"Iflr\) ZIP: L1. (J4,( x"-'1_
~Q\Y\1Ju l)~1111}rtJ~\ lo \()0Ql;-CL' . Cl\Q l(
REMODEL , ADDITION ~ DEMOLISH .' OTHER vt I , n n _
CITY:
DESCRIBE WOR~
NEW
CONTRACTOR'S NAME
GENERA' 1_ 0 l -mQ~)
PLUMBING: m I{\ _ t' ~
MECHANICAl'
ELECTRICAl'
-
JOB NUMBER g~92-
225 Fifth Street
Springfield, Oregon 97477
D\i tR_--, __
TAX LOT: {)O(Orx--J
SUBDIVISION'
PHONE: Cf\~.q{)3 ~
ADDRESS
CON ST.
CONTRACTOR'
\
REQUIRED INSPECTIONS
O Rough Mechanical - Prior to
cover. ..... ,
- \ \
D 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.
~ramlng - Prior to cover.
Wall/C'elllng Insulation - Prior to
over.
~rYWall - Prior to taping,
o Wood Stove - After I~stallatlon.
[J Insert - After fireplace approval
and Installation of unit,
o Curbcut & Approach - After
forms Bre erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
O Street Trees - When all required
trees -are planted.' '.
.,..'....,
PHONE
'-- \ ~(\Q >
\~~
J~~\ct:t) f\~t'. qD~S\ 4-.\\~.lf\-.~:~
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN'
. OF BLDGS: . OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCF' SECONDARY HEAT:
WATER HEATER' RANGF' SOUARE 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.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbing/Electrical/
. 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 Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng,
o Sanitary Sewer - Prior to filling
trench.
. 0 Storm Sewer - Prior to filling
trench. . .
o Water line - Prior to filling
trench. .
~OU9h Plumbing -' Prior to
/.......,..over.
,rL) Final Plumbing ~ When all
Lp plumbing work Is COrTrplet.e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work is complete,
;4lnal Building - When all
required Inspections have been
approved and building Is
completed.
o Other
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 approvod
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.
Lot faces Lot Type -
Lot sq. ftg. Interior I P.L
IN
Lot coverage Corner
Is
Topography Panh~ndle
, Iw
Total height - Cul.de-sac IE
-,
:_THE PROPOS":'\I~jOeK IN THE
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the .Hlstorlcal
Coordinator prior to permit issuance.
Setb",cks
HSE GAR ACC
BUILDING PERMIT
ITEM SO, FT, X $/SO. FT
VALUE
Main
Garage
Carport
Total Value
c!)J CCx.y.:{J
',~.a)
- J. [03
54-., (-S
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT,
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
IS.CO
. .15
(S . r;,-~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It,
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D. and E Combined)
'il-<\ ?:D
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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 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 Reviewed By
Date
Systems Development Charge is due.on al/ 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 that all
Informatlon 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 the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further cerll fy that only contractors and employees who
are In compliance with CAS 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 front
of the property, and th set of plans will remain
on the site at all tl.m _ ~ cons uction. (no f'1tAA1S)
Slgna~ //~""
7~. h
Date . 80 ~_ 93
~
-
,/
VALIDATION: /,/'\,,-'(
RECEIPT NUM~R r'() /ut )
DATE PAir b ,\Q,C ).V{~CI
. L>
AMOUNT RE~, ~ ~.
RECEIVED ~v 7JliJd )
j --