HomeMy WebLinkAboutPermit Building 1999-11-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/7n?.
ASSESSORS MAP'
LOT'
OWNER: Fre.t!]) 150 '1.kin
ADDRESS' ..q I ~ ~ /-;n /q /
CITY-. ~/ !)rf2..
DESCRIBE WORK'
L,s fer//
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICA' .
ELECTRICAl'
.
SPRINGFIELD
1.11.." ,
.
'10'/ ~5' <l-
I
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
])r/1Ie 5./){j ,tJf<.
TAX LOT: ~/ !OeD
BLOCK'
- .
SUBDIVISION:
J;onl13 !. .&Y/o1 PHONE:
Or
STATE: . Ok(
Wall -fttrnac.e
ADDITION
DEMOLISH
OTHER
7Lf'i-1LlTq.::;-
ZIP: 97l..f7?
1tJa. nWtl / c" 5
ADDRESS
CONST.
CONTRACTOR'
,~
REQUIRED INSPECTIONS
~OU9h MechanIcal - Prior to
~(g,over.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover. -'
o Drywall - Prior to tapl~g.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
aod Installation of unit.
o Curbcut & Al,proach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation. Is completc, forms
and "sub-base material In place.
o Fence. - When completed.
o Street Trees - When all required
trees are planted. . '
EXPIRES
PHONE
- 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:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspecllons requested belore 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 mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
- excavated. .
o Maaonry - Steel location, bond
. beams, grou\lng,
o Foundation - After forms are
. erected but prior to concrete
placemont.
o Underground Plumbing - Prior
to ~lIl1ng trench.
O Undarfloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
D. Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sower - Prior to filling
trench.
,
o Weter Line -- Prior to filling
trench.
o Rough Plumbln~ - Prior to
cover. ...
,
.,
o Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
rc;;( Final Mechanical - When all
~ mechanical work Is complete.
o Final Building - When all
required Inspections have been
epproved and building Is
com pie led.
~ Other..ui.ff L.1&.e
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. aod plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspectlons are approved and
porches, sklrtlng, decks, and
venting have been Installed.
['
"
,.
,
I Lot faces ..,..
Lol Type
Lot sq. Itg. Interior
Lot coverage Corner
,.
Topography Panhandle.
Total height Cul.de'sac
"
BUILDING PERMIT ','1 " .t
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
(A)
"~'
" ",. 1~
"",, '" -1' '\:. ,i, .:':.._~., .
t .c,,:, ~"l':"~" '11: .;l~.~,dll.,i..
., I. ." .,'.Il'":!'
. .;,.,';,1..';
Setbacks .
.
i IS THE PROPOSED WORK. IN THE.
.... 1
HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
1'p.L. HSE GAR
IN
Is
~~--
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
/,04 +,4')
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricai)
(A, B, C, 0, and E Combined)
FEE
>>Mt.J ,
/<:)~
( - .
../4? tK)
),S"O
~.!>"
20. $7l)
ACe' I
I
I
If yes, this application must be signed
nod approved by the Historical
. Coordinator prior to permit Issuance.
"
APPROVED:
"
BUILDH(jh VALlJE, P'LAN 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 Sprlnglleld, 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'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
_L2A5 5?x#CC 7'l-(/~f' fA)
2LDI..(~ j//'lvT ~ ,h-dA>>C:5
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 donG in accordance
with the Ordinances of the City of Sprlnglleld, and the Laws
of the State of Oregon pertaining to tho 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 Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is loc ted at the front
of the property. and the approved set of lans will remain
on the site at all times r~ co~/;/tJo_~
Signature (/'7 I ~
(1- J-Z~11'
Oat..
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
?~2(Qj
11-22... -5' J
/~,50
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RECEIVED BY