HomeMy WebLinkAboutPermit Building 1997-9-12
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' / 7 t:7 3
LOT'
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OWNER:JA..-.x hlbSEL
ADDRESS: ~ h?cBJI7P1 k1~ .Es,f;frE
CITY: d /J, 6D)( 7~ 2 s hr"btJe..
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JOB NUMBER
225 Flllh Street
Springfield, Oregon 97477
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TAX LOT: (') I '7 0'f'"'J
SUBDIVISION:
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. PHON'"
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DESCRIBE WORK'
RE'JlrJl/~ ~/~,f'LAd
NEW
REMODEL
CONTRACTOR'S NAME
iJrlEA-
ADDITION
IV
r '
OTHER
DEMOLISH
ZIP:
974"1
ADDRESS
Lb".x;7?lJc:..77tJ,u
CONST.
CONTRACTOR' EXPIRES '.... PHONE
/726 ,h'1-J/?IJt() L/ 5'/R11 /Z)fj~7, ~a- "74" -771'00
GENERA' .
PLUMBI N(>'
MECHANICA' .
ELECTRICAl.
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNIT'" ZONING CODE:
OCGY GROUP' CONSTR. TYPE: # OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RAN"'''' 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 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D SlIe Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water LIne - Prior 10 filling
trench. .
o Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Elactrfcal Servlca - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp.
~ Fra;"'lng - Prior to cover.
t7rWall/Celllng Insulation - Prior to
r- cover.
% Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
, and Installation of unit.
o Curbcut & Approach - After
forms are erected but j)rlor to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compioto, forms
and sub.base material In place.
o Fence - VVhen completed.
D Street Trees - When all required.
trees are planted.
D Final Plumbing - When all
plumbing work Is eomplet.e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
~Inal Building - When all
equlred Inspecllons have been
approved and building Is
completed.
Doiher
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
D PlumbIng Connections - When
home has been connected to
water and sewer.
o Electrlcal1Connectlon - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections Bre approved and
porches, skirting, decks, and
venting have been Installed.
Lol ~p. ".!:.
Lot faces
Lot sq, fig. Interior
Lot coverage Corner
\
Topography Panhandle .
Total height Cul'de-sac
i '
BUILDING PERMITi
ITEM SQ, FT.
;, I
X $/SQ. FT, _
Main
Garage
Carport
,fM?((lJ/~;=:1) f IAJ,PltC ~/
Total Value
Building Permit Fee
/,-'1. + .Jj"l
State Surcharge
Total Fee
(A)
,l.-;", ....1 "Ii:"! 01 ~;;,l7~;.~M/~.(':
'S THE PROPOSED WORK IN THE.
""HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Goordlnator prior to permit Issuance,
Setbacks.
I P.L. HSE GAR ACC'
IN
Is
Iw
IE
VALUE
"
r77~ S"3
.'
? '9 ';-0
2..~7
'\ f t>7
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s)
Sanitary Silwer
Water
Storm Sower
N'
FT.
FT.
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Gharge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issl.lance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS'
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
fI
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
\,
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0. and E Combined)
FEE
APPROVED'
BUILDING \i~LljE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the exp<oss condlllon that Ihe said
conslruction shall, in all respects, conform 10 the Ordinance
adopted by the Gity of Springfield, including the
Development Gode, 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 Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By slgnalure, I stale and agree, Ihat.1 have carefully examined
the compleled applleallon 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 0/ any
struclure wllhout permission of Ihe 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 ensuro that all required Inspections are
requested at the proper lime, that each address Is readable
from the street, that the permit card Is located at the Iront
of the property, and the approved set of plans will remain
on the site at allnS during con;yucllon.
Slgnature--M'~-_' --2. ;f0 '-- -
9- I 2 r 9 ?
Date
VALIDATION:
7]Jn?
1//2/5'7
AMOUNT RECEIVED"? /, g?
_d~
RECEIPT NUMBER
DATE PAID
RECEIVED BY _