HomeMy WebLinkAboutPermit Building 1992-12-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oltice: 726.3759
ASSESSORS MAP:
LOT'
J
OWNER:-W.v
ADDRESS' 1../ {11. /
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CITY'
DESCRIBE WORK' . J/l u/
NEW ~EMODEL
CONTRACTOR'S NAME
GENERAl' /J, (','A, j./D1n~ 5
c.':UMBIN~~~.
~~~ICAL: All\. -tecK
ELECTRICAL: ~A/ r ;:; 1v
.
SPRINGFIELD
.
JOB NUMBER
&l'~ 1le..L~
225 Fifth Street
Sprlnglleld, Oregon 97477
l~ TAXLO~{~;~~; --0-
SUBDIVISION: mr /J{ K A/O.A/ Z;.f f...vU: '
/.II" (nrcfl
) -,
STATE: -.t2j')(
PHON~'
7 :L(,- 7.s-S 5
It I 'W/f-
IDeo t? rr
ZIP:_Y 7lf7!~
ADDRESS
~ q l ~ ])1.\",,<. ~.
fl. !l I&"'I";,J 'v'v' 'fM;)(L~ ~
P,o ~{/oSfJ?. P"f'.v(.
P,o, f)o x 'II" fQ/trtn /(
CONST.
CONTRACTOR'
2- (;0 c; 9
tl'7tj~S1 "
--~~. ,.,;-~;
. P9()t...Jl/.b
#::El ()/
REQUIRED INSPECTIONS
F::7f Rough Mechanical - Prior to
~ cover.
~ Rough Electrical - Prior to
~ cover. .
~ Electrical Service - Mu~t be
~pproved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
g Framing - Prior to cover.
~WalllCeillng Insulation - Prior to
~ cover.
~DrYWall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installat,lon of unit.
~ Curbcut & Approach - After
~orms are erected but prior to
placement of concrete.
("/( Sidewalk & Driveway - After
~xcavatlon Is complete, forms
and sub.base material In place.
D Fence - When completed.
~treet Trees - When all requlrec
~rees are planted.
EXPIRES PHONE
Slu/el'>, 7t,!t, ~O'2J-
'3J...:.I~ r....- -,. ,
'~""~-''-:-'~'\")lJ
3.b4/'l?o
10)51"1:>.
L/{J F-/~
7 ;J (, '7 fl!i.L
ADDITION
DEMOLISH
OTHER
OUAD AREA: --5 R:=sQ." LAND USE: l \ I \ FLOOD PLAIN'
. OF BLDGS: I . OF UNITS: I ZONING CODE:WP ~
OCCY GROUP: ~~ t. JII) CONSTR, TYPE: ~/ tV . OF BDRMS' ?
. OF STORIES' \ HEAT SOURCE: 1-'7_ SECONDARY HEAT:
WATER HEATER: 'i RANGE: f, SQUARE FOOTAGE: lb/~
- OFFICE USE -
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 B.m. will be made the following work day.
~emporary Electric
o Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Unde,slab PlumbIng/Electrical!
Mechanical - Prior to cover.
~ Footing - After trenches arc
~ excavated.
o Mosonry - Steel location, bond
beams, grouting.
f::7( Foundation - After forms are
JL:S..erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
~ Underflos>r!:'lumbln\lPN.lechanl<;:aJ>
~ - Prior to TiI::>UldUon 8roecKing.
~ Post and Beam - Prior to floor
~ln5ulatlon or deckIng.
~Floor Insulation - Prior to
~decklng.
'f";;:>( Sanitary Sewer - Prior 10 IlIlIng
~ trench.
~ Storm Sewer - Prior to filling
~trench. .
J<V'I Water Line - Prior to filling
~rench.
,~ Rough Plumbing - Prior to
~over.
D<rFlnal Plumbing - When all
.- -.....Iumblng w()rk Is complete.
'F;,?j FInal Electrical - When all
~Iectrical work is complete.
'f'::A" Final Mechanical - When all
J.O..lmechanlcal work Is complete.
I'Vf Final Building - When all
~equlred Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whon all
blocking is complete.
o Plumbing Connections - Wl1cn
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up. and plumbIng
inspections have boen approved
and the home Is connected 10
the service panel.
o FInal - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces .../;;:..:... Lot Type. Setbacks ., THE PROPOSED WORK IN ~~
Lot sq,. fig. /!),~ Interior I P.L. HSE GAR ACC "HISTORICAL DISTRICT'~ Q
~ IN J?/ THE HISTORICAL REGISTER
Lot coverage 8!b Corner If yes, this application De signed
..CZ~ Is /5' and approved by the Historical
Topography Panhandle Iw Coordinator prior to permit Issuance.
Total height ~. Cul.de.sac.
IE ,
,:;'Oi APPROVED:
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
/7~ 01 the property. and the approved set of plans will remain
/ X,~::":~}1' ii::~:"'i:r r?F"
Date
BUILDING PERMIT
ITEM sa. FT,
X $/SO. FT.
VALUE
~9,~
712(p
Main
/o?ifJ
6~/4
'.
Garage
Carport
/..../...J~4-
~'~ d ;;0
- - /
J?,.7lO
35"D.10
SYSTEMS DEVELOPMENT CHARGE (SDC)
---
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
FIxtures
Residential Bath(s)
N'
,/,
/t;,O~D
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.,
Mobile Home
Plumbing Permit
State Surcharge
6!'O
/ ~~90
Total Charge
(C)
MECHANICAL PERMIT
;;, ()O
i5.o
--.2~.o
Furnace
Exhaust Hood
Vent Fan
N'
.!
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
..~ ~-C
Mechanical Permit
~"7 /_,~O
/nl)O
, ).13
::?~ .~
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
_1e-_G?~ItI7'Y~.P'~~
State Issuance
State Surcharge
Sidewalk 220 fI
Curbcul 2..f fI
Demolition
d:2,DO
I :<..6tD
State Surcharge
",e?~ ,RQ)'/EuJ
,
-;#~
-Sc- .tLJ
~~
:t::!I/ R.. "7 3
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
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 Sprlngfield,,,includlng the
Development Code, regulating the construe n and use of
buildings, and may be suspended or revoke t any time
upon VIOlation~Of pro Isio~ of said ordina ces.
Plan Check Fe ' J X\()l R
Date Paid: 2 /Ptes C!!2lJ
Receipt Number' ~!!!:.. .
Received By:
PId!1!C~~
...
/2- /9 /: Z-,;
?r;a)!,
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~ 1&na.- .. ~ A Lj. 'iW A J c::., c:::: pt.)
0/7J 7<110
~~~
By signature, I state and agree, that I have carefully examined
tho 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 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 OAS 701.055 will be used on this
project.
VALIDATION:
RECEIPT NUMBER 7D(B _
DATE PAID IF . \ \ ' yL1 )
AMOUNT REC~~ C{4T, ~ tLC(
RECEIVED BY )
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