HomeMy WebLinkAboutPermit Building 1994-5-2
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RESIDENTIAL
PERMIT APPLICATION
LOT'
)-rA(<)~
ADDRESS: '300
~(-d'
OWNER'
vJ t-t{i'vll; e.w
CITY'
DESCRIBE WORt<. ~'t"'-Vl-oY
NEW REMODEL 1/ ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
M--fo h d
MECHANICAl'
ELECTRICAl' trIA+- -h ~ d
QUAD AREA: \ R\\Jl0
. OF BLDGS:
OCCY GROUP:
, , .
fc\~
,
. OF STORIES:
WATER HEATER'
~.
SPRINGFIELD
'~
.-
JOB NUMBER q L{ O,::s;:; '7
- ,-
225 Fifth Street
Springfield, Oregon 97477
r-ttiY v1' -( fA j
-
(cJv..t "td~ ~
00 I 0 I
REQUIRED INSPECTIONS
J<;:7f Rough Mechanical - Prior to
~ove~ .
K7l 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.
~Framlng - Prior to c~ver.
J<V1' Wall/Celllng Insulation':'" Prior to
~cover.
aDryWall - Prior to taping.
o Underlloor Plumblng/Mechanlcal 0' Wood Stove - After I~stallatlon.
- Prior to Insulation or decking.
BLOCK'
STAT~'
i1fL
DEMOLISH
OTHER
TAX LOT'
SUBDIVISION'
PHONE:
&//1- L{o1o
ZIP: t{7,-/71
ADDRESS
CONST,
CONTRACTOR'
PHONE
;>.
'- OFFIC?-:P,!JF -
LAND USE: -11 Vi
o
. OF'UNITS:
CONSTR. TYPE: JL0
H'EAT SOURC~'
RANGE:
EXPIRES
FLOOD PLAIN'
ZONING CODE:
\JIJ)
. OF BDRMS'
SECONDARY HEAT:
SQUARE 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 8.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to .
settIng' forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutl ng. . ,
D Foundation - After forms are
. - erected but- prior to concrete
placeme~t.
o Underground Plumbing - Prior
to filling trench.
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 filling
trench. .
o Water Line - Prior to filling
trench. '...
'K?rRough Plumbing -:- Prior to
~cover.
...... .......
o tnsert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete. .
o Sidewalk & Driveway - After
excavation Is complete, forms
and s:ub.base material In place.
o Fence - When completed.
o Street Trees - When 'all required
trees are planted.
15?1 Final Plumbing - When all
~ plumbing work Is complet,e.
'f\:?'T Final Electrical - When all
~electrlcal work Is complete.
1":71' Final Mechanical - When all
~mechanlcal work Is complete.
'l')(f Final 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
Inspections are approved and
porches, skirting, decks, and
venting have been.inst.alled.
Lot faces
Lot Type .
Lot sq. fig,
"Interior
Lot coverage
Corner
Topography
Total hel ght
Panhandle
Cul.de,sac
,\ .......
l~ 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
I P.L. HSE GAR ACC
IN
Is
Iw
IE
BUILDING PERMIT:
ITEM SQ. FT. X s/sa. FT. = VALUE
l\ 1.., OOD
?+7~
/2.3S"
259 .;,r
SYSTEMS DEVELOPMENT CHARGE (SOCk
(B) -4-' f+-'"
Main
Garagl;l
'Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures, .c,
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exh"ust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace UnIt
Dryer Vent
Mechanical Permit
/MI'IV,
Issuance
State Surcharge
Tota,l Permit
(D)
MISCEllANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
T01,AL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
6e. c-o
~oo
;;, ~.a-o
d,S-O
/5.00
I C),()O
.7)'
26'.7;
2,4-~.ID
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: --1Jo () ,Fit;
Date Paid: oS ~. f:}~ .~
Receipt Number: J1,!;::J..t) .
Received 'By: 0 ~
... ,
q'~
Plans P\evlewed By
d25/<J"4
/ opte (
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
)jJIJIJ. frlblatJT //tflI
'5t7~ eth:,( ,I&r/H~r /.1~.
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon 15 true and correct, and I further certtfy
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 In compliance with ORS 701.055 Will be used on this
project.
. ,
I further agree to ensure that all required Inspectlons 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 81.1 ~ during constructton.
X;-gnatu~ L-
/'"
Date~'l"?-
VALIDATION:
RECEIPT NUMBER /"7 C;-~
DATE PAIl' ,_0 <, '7 Y
AMOUNT RECEIVEI' ? Y8. /C>
RECEIVED BY L - ~ ~ ---
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