HomeMy WebLinkAboutPermit Building 1998-7-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT'
..
BLOCK:
Al /J. '" "" A \
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ADDRESS' J if'? K IV /). I/J 3 ~ /)
CITY' A il jJ d
, f1j .
OWNER:
DESCRIBE WORK'
NEW REMODEL
CONTRACTOR'S NAME
"'s~L;::'
GENERA' .
PLUMBING'
MECHANICAl'
ELECTRICAL: ~; 1tJ.).1'rJrl
~f-.
STATE: --..,..M__
ADDITION
DEMOLISH
OTHER
.
JOB NUMB~ Cff(o 12-f"
225 Fifth Street
Springfield. Oregon 97477
TAX LO"!:
SUBOIVISION'
1/)" 2...00
PHOI\lE:
7'17- .3~~iR-3
ZIP:
Cf7'17~
~ -I-~NlM~;~
ADDRESS
CONST,
CONTRACTOR K
EXPIRES ',") PHONE
- OFFICE USE -
QUAD AREA: ' LANO USE: '~regon f.IWlAAlllrsal\lDU to
NnT/CE' Allt::I~I'U".v ~nitY
. OF BL.b~:'l' . . OF UNITS: .~, ",I"" Adopted bl!O'AA~eelSJ:\ ,I. 'I
THIS PERMIT SHALL EXPIR N t'f' r n Center Those rules are ." ,u., .
OCCY GROUP: .; IF THE W6fI!(TR, TYPE: ~ Ilca 10 . Hl'.o"'lfjlg~51C;?-001-
AUTHORIZED UNDE in OAH !j:>~-UU ,-0010 t uu~ b
K OF SlORIES: R THIS PERMIT 1~1l'.or SOURCE' 00110. Yml may obtain ~~~l? Wbf&: Y
<';OMMENCED OR IS ABANDONED F~ calling the center. (Note: the tele,p .
WATE~~V'\T8Tn/AY PERIOD NGE: numDertUlI"",Ore.!lcfl\~~~ili1"A"lliGn
" \J~tHClI'.;;J I .....E9 --- -
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 Footing - After trenches are
excavated. 0 Fireplace - Prior to facing
, ~Iars and framing Insp.
o Masonry - Steel location, bond
,beams, grouting. F: mlng _ Prior to cover.
o Foundation - After forms are
erected but prior to concrete 0 Wail/Ceiling Insulation _ Prior to
placement. cover.
o Underground Plumbing - Prior ~O D Drvry). all - Prior to taping,
to filling trench, ~ .
O Underlloor Plumbing/Mechanical '
- Prior to Insulation or decking. 0 Wood Stove - After Installallon.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Elactrlcall
Mechanical - Prior to cover.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to fltllng
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover. ...,
, ,
b
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
~9h Electrical - Prior to
~ver.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Insert - After fireplace approv41
and Installation of unit.
o Curbcut & Approach - After
forms are emcted but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
o Fence - When completed.
D Street Trees - Whan all required
trees are planted.
o Final Plumbing - When all
plumbing worl< Is complete.
, ,
&:
Inal Electrical - When all
electrical work is complete.
o Final Mechanical - When aIr
mechanical work Is complete.
o FI I Building - When all
qulred 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 approved
and the home Is connected to
the service panel.
o Final - After all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot ~yp'e ..
': \.,
"":: ;.r1.' \;;~.\:)
;.. THE PROPOSED WORK IN THE.
"'HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
It yes, this application must be stgned
and approved by the Historical
Coordinator prior to permit Issuance.
Lot s'q, ftg,
Interior
1p.L.
IN
Is
Selbacks
HSE I GAR ACe'!
'-I
Lot coverage
Corner
Panhandle :,.
Topography
Total height
Cul-de.sac
.::!i.__
E
"
APPROVED'
,.,
BUILDING PERMIT;
ITEM
SQ, FT,
X $/SQ, FT,
VALUE
.. '.~,'J H
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
ii ':~
Garage
"
This permit is granted on the express condition thai the said
construction shall, In all respects. conform to the Ordinance
adopted by the City of Springfield, Including the
Oovelopment Code, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee'
_0~J Oate Paid:
Total Value
/$.,oJ Receipt Number'
Building Permit Fee %"/7') Received By:
Stale Surcharge
Total Fee (A) It.' ;0 Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properlies within the City limits which are being Improved,
, ,
PLUMBING PERMIT
ITEM
FEE
ADDITIONAL COMMENTS /I
<:;l:;nRI7/cLe. Et.P.iH (ll dJ
ai,-',J
d22,r ,.. .J
Fixtures
Residential Bath(s) N'
Sanitary Sewer ' FT,
, "
Water
FT,
FT,
Note:
Building Inspector may require
additional plans information,
and/or fees for the completion of
~ this project.
Storm Sewer
Mobile Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have carefully examined
the completed appllcal/on 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 'n compliance with ORS 701,055 will be used on this
project.
Exhaust Hood
Wood Stove/Insert/Fireplace 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 time, that each address Is readable
Irom the street, that the permit card Is located at the tront
of the property. and the approved set of pl'!ns will remain
00 '"' '''~~''O' ""}"""'OO
Signature rl1 ~1A./h1/J )
Oatp '/ - .:L 7 - c; Y -
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
It
Curbcul
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
RECEIPT NUMBER
DATE PAID
630 f'i T
-J!Zl-/9f
1'_ 211 "
~ '/V,J
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D. and E Combined)
AMOUNT RECEIVEO
RECEIVED BY