The URL can be used to link to this page

Home My WebLink AboutPermit Building 1991-8-5 ~tD LOCATION OF, PROPOSED ~~K: 'J D 5/ id.1 V" II I~yr ASSESSOF;lS MA~: '\ '\ l )c) '';',1) ~ \ . , ~ . - ' RESIDE1\.ITIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT: OWNER: A 11 J f-(<; r::..lt?',.., ADDRESS' ) (),)"/ ;::; 11- V I P.ur , I CITy:~')frl' ,.::i ,? /.,.. /1. DESCRIBE WORK' .;i'iK-:s'& NEW // REMODEL ADDITION CONTRACTOR'1f"\ME GENERAL: \~)..i)\\Q2_ PLU~BING: MECHANICAL: "r\ ,,-, '"' ELECTRICA" \ \.)}. ") \\ 0 }L.J QUAD AREA: \ R \\ '} l() \ OCCY GROUP: ~ \ . OF BLDGS- . OF STORIES: WATER HEATER: . . q\fJ<i<l~ SPRINGFIELD Dr- BLOCK' ;::~I 1'\ /)r STATE: !) JOB NUMBER 225 Fifth Streel Springfield, Oregon 97477 TAX LOT: D \ 9.00 SUBDIVISION: PHONE: '7 \Lf.p - \.L3;l.. q 7/0r~5/" ~UI /d~;; 0 DEMOLISH OTHER ZIP: f7'i 7 ADDRESS CONST. CONTRACTOR # . PHONE REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. ~ough Electrical - PrIor to ~ ~over. ~ Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materIals and framing Insp. .~Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. D.Waod Stove - After Installation. o Insert - 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 sub-base {llaterial in place. o Fence - When completed. D Street "frees ~ When 'all required trees are planted. EXPIRES FLOOD PLAIN' ZONING CODE: -.LD\~ . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: Pi 1ft - OFilCE USE - LAND USE: \\ \ \ \ # OF UNITS: vtJ TO reque'st 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. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. rV1 Footing - After trenches are ~ excavated. o Masonry - Steel location, bond . beams, grouting. f'...../f Foundation - After forms are ~ erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/ Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to decking, D Sanitary Sewer - Prior to filling trench. ~torm Sewer - Prior to filling .L23- ~ench. D Water Line - Prior to filling trench. . o Rough Plumbing - Prior to cover. CONSTA. TYPE: HEAT SOURCE: RANGF' o Final Plumbing - When all plumbing work Is complete. 1'x'1 Hnal Electrical - When all ~electrical work is complete. D Final Mechanical - When all mechanical work is complete. ~inal Building - When all ~ _~equired inspections have been approved and building is completed. DOlher MOBILE HOME INSPECTIONS D Blocking and Set.Up -. When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer, D 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 inspectlo'ns are approved and porches, skirting, decks, and venting have been Installed: , Lot faces Lol sq, fIg, Lot coverage Topography Tolal heighl BUILDING PERMIT SA 6!. ITEM Main Garage Carport Total Value Building Per.mit Fee State Surcharge Total Fee Lot Type II Interior Corner Panhandle Cul.de-sac X $/SQ, FT. 14.10 (A) I P,L. ' IN Is Iw IE =\~\~~ 1;<,;8;< ( CJf!.> 0 i.j..'?J /01 .q '3 SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ~ llo1 ~ Ql!8 PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer FT. Waler FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan (C) Dryer Vent Wood Stove/lnsert/Flreplace Unit N' Mechanical Permit Isstance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk fl Curbcut fl Demolition State Surcharge FEE Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding eleclri~ 7 O/i 6 (A, B, C, 0, and E Combined) -- Setb'lcks HSE GAR'ACCI I I I I . THE PROPOSED WORK IK;H HISTORICAL DISTRICT, OR 0 THE HISTORICAL REGISTER? If yes, this application mu 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 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 anYW4iO~~ ordinances, Plan Check Fee: ). b..~I( Date PaId: __ Receipt Num~ .~~ Rec~~IA _L- ~-c;--q/ 4 Reviewed By Date Systems Development Charge is due on all undeveloped properties withIn the City limits which are being improved. ADDITIONAL COMMENTS By sIgnature, I state and agree, that J 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 State of Oregon pertaining to the work described herein, and lhat 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 th p operty, and the approved set of plans will remain ~gnhe ::"lI:1J?~ctlon a Date_~- 5- '7/ VALIDATION: /1 9/0 RECEIPT NUMBER dO DATE PAIr> i .5 ,q \ -, AMOUNT R~~' ~~3.()(LJ RECEIVED ~ == ~J ')( R ) ~ . " . tII' ... ..- , Permit No: q \[) ~(r::6 Address: \ f,)~\ ~i l\~ ') lJ)Lt ) Issued bytJ<t M ./ Date: ryc:;q I FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ' Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1~ 2. ~. c::::J My general contractor is / I own, reside in, or will reside in the completed structure. Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and 00 hire a general contractor, I will contract with a contractor who is registered ,with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above Information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (L~~~ Jf _~]g ~nature of Permit Appiicant l(.-- .:-:: - q/ Date ---~- , CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 ~iJ1J0 . WJ:!!TE COPY TO ISSUING AGENCY PERMIT FILE ~ COPY TO APPLICANT ( 1)~ ~.