HomeMy WebLinkAboutPermit Building 1991-4-23
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CITY.' , \r<L..- .
- \ - - ,
S.F, O.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.~759
DESCRIBE WORK'
NEW -.J. REMODEL
.
, SPRINGFIELD
BLOCI<"
DoT
STATE:
(UA
ADDITION
DEMOLISH
OTHER
.
~I()319
, JOB NUMBER
PHONE:-=:t:/-i --f3i04
ZIP:
Cfl4i?;(
GENERA' '
CONTRACTOR'S NAME ADDRESS
e/~u f..I.-n,,~ '/;mWIM $9"~
... 1 L
S - V ;/1,/7 z. /ru,;"
CONST.
CONTRACTOR'
3:l.9t17
4{olo(04.
EXPIRES PHONE
~/fdql ?'h8'7t1t./
0/1 ?;/qe 71./7S9N
PLUMBING.
MECHANICA' '
I!/J"> ...
f? /;1 J
ELECTRICAl'
QUAD AREA:
~ Q. SQ.,
~~
\
. OF BLDGS.
OCCY GROUP:
. OF STORIES:
WATER HEATER:
e~
a-/7JP
tb4-~ 112
8 \35\ 4/24
13 'r'~/.3S3
- OFFICE USE -
LAND USE: \ \ , \
\
CONSTR, TYPE: V'r\J
HEAT SOURCE: __ tlI #
RANGE: ~.
. OF UNITS'
FLOOD PLAIN:
ZONING CODE: \.,\ ')1.)
~
. OF BDRMS:
SECONDARY HEAT: F'\J
SQUARE FOOTAGE: J.Lo8-L\
To request an Inspection, you must call 726-3769. ThIs 15 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.
m Temporary EI~ctrlc
.. D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
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
placeme~t.
D Underground Plumbing - Prior
to filling trench.
~ Underflo~lIechanical
~ - Prlor~f~;~'I;t'i~V;~~ decking.
~po~t and Beam ..:....: Prlo~ to floor
~ Insulation or decking.
~ Floor Insulation - Prior to
~ decking.
~Sanitary Sewer - Prior to fiiling
~ trench.
.,. .
~torm Sewer - Prior to filling
~ trench.
r"Q(Water Line - Prior to filling
~ trench. .
~ Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~Rough Mechanical - Prior to
~ cover.
~Rough Electrical - Prior to.
~cover.
rc;;<Electrical Service - Must be
~ approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Im~p.
~ Framing - Prior to cover.
'IV'1 Wall/Ceiling Insulation - Prior to
~cover.
~DryWall - Prior to taping.
~ Wood Stove - -After Installation.
~U.to dCAt(. F,P.
D Insert - After fireplace approval
and Installation of unit.
l"'2T Curbcut & Approach - After
~orms are erected but prior to
placement of concrete.
~idewalk & Driveway - After
excavation Is complete, forms
" nd sub-base material In place.
D Fe'nce - Whe~ completed.
C ~)treet Trees"": When all required
aes are planted.
, ' .
f"v'( Final Plumbing - When all
~ plumbing work Is complete.
~~Inal Electrical - When all
eJectrj~al. work is co,;,plete.
~~Inal Mechanical - When all
mechanical work Is complete.
~Final Building - When all
~ ~equlred inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been con nected to
water and sewer.
D Electrical Connection - 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 are approved and
",' , . .porches:ski"rting, decks; and
.' venting have 'been .Installed.
~ L~e. .
Lot faces Setbacks IS THE PROPOSED WORK IN THE
Lot sq. flg, ~ ~ Interior I PL. HSE GAR ACC I HISTORICAL DISTRiCT, o'R ONJW
IN I THE HISTORICAL REGISTER?
Lot coverage ~ Corner If yes, this application must be signed
L~ Is IS' I and approved by the Historical
Topography Panhandle
Iw 5' I Coordinator prior to permit issuance.
Total hei ght Cul-de-sac
IE 'Cr I APPROVED' I
I~
BUILDING PERMIT
\\44
49D
X $/SQ, FT.
-~
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' 2-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
l~ofP
Plumbing Permit
State Surcharge
a.OO
I~B~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
1-.SD
----6 ...
jS.1JO
--3, f,D
N'
'2
Vent Fan
Wood Stove/lnse&ePlac~
Dryer Vent
Mechanical Permit
"? -9- '50
/nOO
, -
/.93
~tf3
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ ft
Curbcut ? / fl
17'.30
/.'~ . 'JO
"\
Demolition
~e~l (X)
Total Miscellaneous per~ (E)
\<&-\ qO
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
L.5CID- '6\
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 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~ said ordinances.
Plan Check Fee: \9-q. C4l ) ,
Date Paid:
Receipt Number:
R~~
'Plabs Rev"'ewe&'B~
~;V~l
7~\'!
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certi fy 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 Oreg~on 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 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 during construction.
Signature
\
Date
VALIDATION: {q (J A ~
RECEIPT NUMBER Tn,
DATE PAin ~ I '7_ ~ ,C\
AMOUNT RECEIV~ . I ~
RE~EIVED BY C'\\}\n)
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