HomeMy WebLinkAboutPermit Building 1997-10-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: /'7 /') 1
LOT'
OWNER' 1V\. fr1(..1 IT- K
ADDRESS:' C!? il.S vV
CITY- 'SP(Z...l tJc;..~ l~~
DESCRIBE WORK' K l ic..He".!
NEW REMODEL X ADDITION
CONTRACTOR'S NAME
GENERA" f'v\. '(.. <;',...,.)70S
PLUMBING'
MECHANICAl'
ELECTRICAl'
.
.
JOB NUMBER 97/~S-/,4
225 Filth Street
Sprlnglleld, Oregon 97477
TAX LOT'
SUBDIVISION'
D2..3 (9.0
ra '-5
27
[){L
PHONE:~ ~';;'3Z9
ZIP: 77Lft}
R.e.M {) l::lGL-
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OEMOLlSH
OTHER
BLOCK'
S AN-rD~
H\-I ~ \J I rsvJ
~
AODRESS
R_L.
CONST.
CONTRACTOR'
c..t<....
'EXPIRES ':-:'> PHONE
1.1 AMM..1lAJc:::.
~RoU9h MechanIcal - ~rlor to
~over. .
f'S21'ROU9h Electrical - Prior to
~over.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Fra~ing - Prior to cover.
~all/Celllng Insulatlo'n - .Prlor to
~er.
~ryWall - Prior t~ taping. .
D Wood Stove - Alter Installation,
D Insert - After fireplace approv!ll
and Installation of unit.
D Curbcut & Approach - After
forms arc erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When cOfilpleted.
D Street Trees - When. all required
trees are planted.
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE: _
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONOARY HEAT:
WATER HEATER' RANG~' SQUARE FOOTAGE:
STAT~' .
DR-
<; H-i'<--r ~
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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.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspoctlon - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D 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,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
~
D Water Line - Prior to filling
trench.
'1vl Rough Plumbing - Prior to
r cover.
"f:::7"l' Final Plumbing - When all
~PI.umblng wc;>rk Is complet,e.
rX"l Final ElectrIcal - When all
~Jectrlcal work is complete.
MFlnal Mechanical - When all
~echanlcal work Is complete.
~'nal Building - When all
equlred Inspections have been
a proved and building is
completed.
DOlher
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 Connoctlon - When
blocking, set-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..
Lot faces
'.
Lot Type
. Lot sq. Itg.
InterIor
,
Lot coverage
Corner
Topography
Total height
\
Panhandle "
Cul-de.sac
BUILDING PERMIT "\ ;,'1
ITEM
sa, FT.
X $/so. FT, C
Main
Garage
Carport
_.Ur: U'~
"
Total Val ue
Building Permit Fee
/:11/-1/
,7r-f-,4S
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
l
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
,7rf~F
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
,7 r-f ,f.F
(0)
MISCELLANEOUS PERMITS
Mobile Home
Statr Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Pennlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
,.", '. .: ;. . ;'.: .:l..
'~. , ~,., ~";':'li"'I:}df,:~,d'i.'''L
,__~. I . -~'," .:'.'_:m.','.~
Setbacks '
HSE GAR Acc'l
I P,L,
IN
Is
Iw
IE
VALUE
"
L. !fop ~
FEE
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2.6 . :J..,O
$f"'~
.HE PROPOSED WORK IN T~;:'
.....HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-.....
If yes, this application must be signed
nnd approved by ,the Historical
Coordinator prior to permit Issuance_
I
I
BUILDING 0\UJE, PLAN CHECK
AND BUILDING PERMIT
APPROVED:
,.
This permit is granted on the express conditIon that the said
construction shall, in all respects, conform to the Ordinance
adopled by the City of Springfield, including the
Development Code. regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plan Check Fee:
Onte Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
/5:6rD
j.lfD
/?-,2.tO
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Charge Is due on all undeveloped
properties within the City limits which arc being Improved,
ADDITIONAL COMMENTS
By signature, I state and agree. that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance '\
with the Ordinances of the City of Springfield. and the Laws
of the Stafe of Oregon pertaining to the work described
herein. an? that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all t1me~rlng constructlon~
Slgnature!vJo. ;l,/~~
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Da te <'-'V l)'-(:..X (
VALIDATION:
RECEIPT NUMBER
OATE PAIr>
AMOUNT RECEIVED
'777(;.- ?
/r-"1 A')
-$:"''''
J
RECEIVED BY _