HomeMy WebLinkAboutPermit Building 1993-5-13
.
~ JOB NUMBER
"Q 225 Fifth Street
~" Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' 1?,l~~q f 1 r\ ~'(D Q..,Y\
ASSESSORS.t:AP: 1'70 Q3 ~'73 4 TAX LOl' (2 SQ/X.l
LOT:""\ BLOCK: SUBDIVISION: ~ )N ./
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
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OWNER\ r 1\ \. "l\ ~ \ _ ()r ffi ffiL[' ) PHONE: ( f\ R'i-., - tCJd nS_
;S~\ ') \ - ~~ -\:\.' - - . -
:~~RESq-l'"bi f\Q_ STATE: \J\'O ~B\\ ZIP: qr\4CV)
DES\RJ1E WORKl~ ~~ \:{'},-] ,~~ l ~ ~.~ \y D f\:i1 Q I\0 0 _
NEW';'./ REMODEL ~DITION DEMOLl~ OTHER
CONTRACTOR\r'l('M~ _ _
GENERAL:\.;. ~U2D
CK> 7'lJYc.7
AAL:X\Q f' )
PLUMBING:
MECHANICA' t
ELECTRICAl'
ADDRESS
CONST.
CONTRACTOR'
PHONE
EXPIRES
OUAD AREA: 8~~~ - OFFICE utE -
LAND USE: ~ \ \ FLOOD PLAIN:
. OF BLDGS' . OF UNITS: \ ZONING CODE: UXU
OCCY GROUP: Q,,:\*Y\ CONSTR. TYPE: VtJ . OF BDRMS: < q
. OF STORIES: ~ HEAT SOURCE: FE:--- SECONDARY HEAT'
WATER HEATER: f'--' RANGE: _ p) SOUARE FOOTAGE&J6 /
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 reQllest~d after 7:00 a.m. witt be made the following work day.
cpTemporary Electric
O Site Inspection - To bp. lTl<:!dc
after excavntion, but prior 10
setting forms.
o
Underslab Plumbing/Elcctrical/
Mechanical - PriO,. to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, gmuting.
D
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.
[RJ
Post and Beam - Prior to (Ioor
insulation or decking.
IA I Floor Insulation - Prior to
decking.
(2] Sanitary Sewer - Prior to Oiling
trench.
l-:vl Storm Sewer - Prior to filling
trench.
[K] Water Line - prior to filling
trench.
[RJ Rough Plumbing - Prior te
cover. . ~
REQUIRED INSPECTIONS
rv1 Rough Mechanical - Prior to
LA,.J cover.
[bJ Rough Electrical - Prior to
Cf)vcr.
I..{l Electrical Service - Must be
3pproved to obtain f,':;rrnancnt
electrical power.
o Fireplace - Prior to facIng
materials and framing Insp.
[g] Framing - Prior to cover.
[Zl Wall/Ceiling Insu'lation - Prior to
cover.
[K]
Drywall - Prior to ~nI?Jng.
D
Wood Stove - After installation.
D Insert - After flrejJi.Jc/1 approval
arl<1 installa:ion of unit.
f4J
Curbcut & Approach - After
forms are erected bl:I' prior to
plaCl):llcnl of concrcte.
Iyl Sidewalk & Driveway - After
excavation is com~letc, forms
and sut..ba::;c material in place.
o Fence - When ccmr'eted.
[KJ S.treul Trees - Whei1 211 required
!rc~s ;lre planted.
!2'J
Final Plumbing - \^/hen all
plumbing work Is complet.c.
!XJ
Final Electrical - When all
electrical work Is complete.
[X]
Final Mechnnlcal - Wilen all
mechanical work Is comp:ete.
IX]
Final Building - When alt
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - Wilen
home has been connected to
water and sewer.
o Electrical Ccnnection - When
blocking, set-up, and plumbing
inspections have b~en approved
and the home is connected to
the service panel.
o Final - After all requIred
inspections are approved and
porch~s, skll'ting, decks, and
\.'~Ill!ng have been installed.
Setbacks
I P.L. HSE I GAR ACC I
~~~-
1;1
1-
~~~
Lot faces ~
Lot sq. flg. 6S!f~
Lot coverage ~
Topography ~
Total height, AS /
.
Lot Type
Interior
Corner
Panhandle
~ Cul.de.sac
S
liN
IE
BUILDING PERMIT
I !~If' ~;~b = q~LqlQ
41\~ \L\ ,\() _(Q ;~M'/,
ITEM
Main
Garage
Carport
( ()()W"6
_'12~ 2S"
;?/. 7~
'f.g.O~
SYSTEMS DEVELOPMENT CHARGE (SDC)
~
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' -?
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
1<92_9P
Plumbing Permit
~~~
~. ~.,.
-:::7~2./3
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
~csO
~ ~9::>
/2.--
Furnace
Exhaust Hood
Vent Fan
N'
4
Wood Stovellnsert/Fireplace Unit
Dryer Vent
-::?:,-
Mechanical Permit
-::?5~ Si:>
h?_"~
/.2!i5
"? 6. ;;e,.
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
~&;
"':Zt:.
/57 'tftC'
a~
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
-:::?'9. 2:>
?7C "Z'2..
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
'I
I~E 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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition U1allhc said
construction shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon Vi~latiOn of a~prov~o"tff,said ordinances.
Plan Check Fee: 0 c:J\. _
Date Paid: . ?J) . ~
Receipt Number:
Received By:
. ~'-/ ' ~ -r::-"73
tP~~nev,ewed By .-. Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify thaI all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the OrdinancE;:s 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 wittlOut permission of the Building Safety Division.
I further ecrU fy 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 c ap roved set of plans will remain
on the site at all r url g constructio
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Date
VALIDATION:
RECEIPT NUMBER
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DATE PAIf'l
AMOUNT RECEIVED
RECEIVED BY