HomeMy WebLinkAboutPermit Building 1997-7-23
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP'
LOT'
SPRINGFIELD.
.....
.
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JOB NUMBER
97////
225 Fifth Street
Sprlnglleld, Oregon 97477
L!LouULCA F LOO?J
7 I TAX LOT:
SUBDIVISION'
BLOCK'
OWNER'
ADDRESS'
CITY:
/61r/c L.chZA..t-C.Q
:-S s .C;/ (l,JC -li/A.J(.,f-IftyvJ
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STAT~' . 19;(",
DESCRIBE WORK'
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NEW
REMODEL
CONTRACTOR'S NAME
J!tfl'A-
i!6r11<>u E.
ADDITION
DEMOLISH
OTHER
S/,z11J6H~UJ oJ1.
(J1e.r)0
PHONE:
34z-4/o 8'
ZIP'
CJ74D!
ADDRESS
(}~,Y:;772...x.7?aU . nn bl//Jl'Joc...J
CONST.
CONTRACTOR' EXPIRES
{/ 9'ko 12/ ri,> '5 fli
.,'7' PHONE
74f:,-77(P D.
FLOOD PLAIN' .
_, .co \NO~l'
· OF UNITS' ~f~OD't;~
CONSTR. TYPE: ~\C'\::. '\ ~~\.\. ~Y-~\,o; ~h~~
" ~tt\N\I ~\>. i "\~.........\\;'D rOp
HEAT SOURCE: 'ir\\:> '-O-I\~\) ...~ARY HEAT:
:\r\O'r'll/..~ \S fl."'''
JI.\l ~Gcon O\>. SQUARE FOOTAGE:
~(\,,^WI~\ -. ~e~\O\)'
J (\\]1"\"
To request an Inspection, you must call 726.3769, This Is a 24 hourj!.~I8l'r\g. All Inspections requested belore 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.
GENERA' .
PLUMBING:
MECHANICAl'
ELECTRICA' .
QUAD AREA-
'".. ,
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
.beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Post and Beam - Prior to floor
Insulation or decking,
O Floor Insulation - Prlo'r to
decking.
o Sanllary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior 10 filling
trench. ~
o Rough Plumbing - Prior to
cover. .
- OFFICE USE -
LAND USE:
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D 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.
~ Fra~lng - Prior to cover.
'1><fWall/Celllng Insulation - Prior to
,. ...over.
o Wood Stove - After Installallon.
o Insert - After fireplace approv~1
and Installation of unll.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - Aller
excavation Is complete, forms
and sub-base material In' place.
o Fence - \-\lhen com.Pleted.
D Street Trees - Wht!n all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complet.c.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
""1vf Final Building - When all
~equlred 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 15 connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventIng have been Installed.
Lot facos
'.
lol Type
lol sQ. fig.
Interior
lot coverage
To pog raphy
Total height
Corner
,.
Panhandle
Cul.de-sac
BUILDING PERMIT
ITEM SO. FT.
'0':,
\.t'.' '('''o:'~'-' ,;;:.Jt~:~Hr::~)"
-.
i IS THE PROPOSED WORK IN THE.
....HISTORICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks.
I P.l. 'HSE' GAR' Acc'l
I N I
I S I
Iw I
I E I
APPROVED:
"
BUILDING VALlJE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granled on the express condition that the said
construction shall, In all respects, conform 10 the Ordinance
adopted by the Clty.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.
X $/SO. FT, - VALUE
J ~ .,...0
( )..0
_~ 2.0
SYSTEMS DEVELOPMENT CHARGE (SDC)
MaIn
Garage
Carport
-IJl.FltL VOMJ..-
Total Value
Building Permit Fee
Slato Surcharge
,7f"-f-.~j
Tolal Fcc
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
"',
ON~,:':
Resldenllal Bath(s)
.
FTo'~ ,.~ t
Sanitary S~wer
Water
FiOl.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vont Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
Stale Surcharge
; ~O -r, r<(
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
$?/,;.J,
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
FEE
L/CV:-
;-/5 /"uA::~
1/lJ;~L.
./
-0';'1;,.1
lO-,:",o
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 done In accordance
with the Ordinances of the City of Springfield, and the Laws
ofthe State of Oregon perlalnlng 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 agreo to ensuro 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 Ihe approved set of plans will remain
on the site at /!;J:.,:ng construction,
. ~nature /I( ,_ J '.: ~~ '_
Date ~?-YD?
-J:[<?'O
;,#
VALIDATION:
IC).1-1
Jy.'-r;
2c:'~b
. DATE PAID Y23/fJ '?
AMOUNT RECEIVED' .t.f_,~~::'
RECEIVED BY _ ,.#"'~---.
RECEIPT NUMBER
L,