HomeMy WebLinkAboutPermit Building 1994-12-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
,
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LOCATION OF PROPOSED WORK: _0~f C..r/ ../fnf/A.
1"7/').'3 22 I 'Z.
OWNER: m /Tc-fl.eU (~,l/ ",".r ~
ADDRESS::..../-,~ 1 C--~ ~.J/~
'9~,.nJ
ASSESSORS MAP'
LOT"
CITY'
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DESCR~ WORK:
NEW 1\ REMODEL
CONTRACTOR'S NAME .
GENERAL:
PLUMBING.
~~
MECHANICAl'
ELECTRICAl.
QUAD AREA: ~l)
· OF BLDGS.
OCCY GROUP'
~'
· OF STORIES:
WATER HEATER.
BLOCK:
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STATE: .
ADDITION
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
" TAX .LOT:
1".-, / ~ c:; <4
SUBDIVISION:
PHONE:
7~/ - g!.,~ 7D
ZIP: 97~/7
ADDRESS'
CONST.
CONTRACTOR .
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o RoughEleclrlcaJ - 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.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert -.After fireplace Bpprov~1
and Installa~lon 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 material In place.
o F~nce - When completed.
o Street Trees - When all required
trees are planted. ". .
EXPIRES
FLOOD PLAIN:
ZONING CODE: .LQ?
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: _I CoR
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.
- OFFICE USE -
LAND USE:
\ \ \ \
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Undarslab Plumblng/Elaclrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~ erected.but prior to.concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Undarlloor Plumblng/Machanlcal
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
o Walar Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
1\
· OF, UNITS:
CON~TR. TYPE:.lLAJ
HEAT SOURCE:
RANG'"
o Final Plumbing - When' all '
plumbing work Is complete.
, .
o Final Eleclrlcal - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
K/(Flnal Building - When all
~equlred Inspections have been
approved and building Is
completed.
OOthar
MOBILE HOME INSPECTIONS
o Blocking and Sat. Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connecllon - When
blocking. sel.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skIrting, decks, and
venting have been Installed.
2,-;b F~
~ 0'1
41. 5'<i'
SYSTEMS DEVELOPMENT CHARGE (SDC)
L/-fff
Lot faces
Lot ~ype'.
Interior
Lot sq, fig.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT, ~
Maln
Garage
Carport
572W A',&-/I':.~
/4~t:>
Total Value
Building Permit Fee
State Surcharge
/,,??> t-I/"
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
!ot.al Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fI
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D, and E Combined)
I'P.L.
IN
Is
lw
IE
VALUE
"
.2- ~~S
FEE
4( s'7
t
""," "'!': t':;i'~i;...'>& ).
'_ THE PROPOSED WORKtN THE,
'HISTO!'iICAL DISTRICT, OR ON .
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Setbacks,
HSE GAR ACc'I
I
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thatlhe said
construction shall, In all respects, conform to the Ordinance
adopted by the City 01 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.
Plan Check Fee: -::z.s: 0:3
Date Paid: _~(/ 2~/r~
Receipt Number' Ie: /~ / <:
Received ~ A'tJ>e....
~ < f
~.'.~.~
Plans "eviewed' By (
/.2.~~rr'
7D~e /
, ' ]
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
F/~~ /dJt{~4t),J'
hl/~/ ~d~F A- "'q/~
/ .!J~h?~
By signature, I stale and agree, that I have carefully examined
the compleled application and do hereby certlly 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 01 the City 01 Springfield, and Ihe Laws
of the State of Oregon pertaining to the work described
herein, and thai 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 the property, and the approved set of plans will remain
on the site at all times Ingnstr\
~nature . -.. ~
Date
VALIDATION:
RECEIPT NUMBER /5"&:2'7
DATE PAID /7-~~9C/
AMOUNT RECEIVEr> C-//- '~
/'" /' -- ,"".
RECEIVED BY A /~ -,......- ___
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