HomeMy WebLinkAboutPermit Building 1991-4-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
-
LOCATION'OF PROPOSED WORK: ~\
,\ 9JOQ0'<::\ cp:)
ASSESSORS MAP:
.~,
LOT.
BLOCt<'
~OB NUMBER!lJ ()3f-5
OWNER: !JL~bJ4S--
ADDRE""~\() lO'rf\ ~ C'.
CIT;: ~~O
DESCRIBE WORK' _ <) , F _ 1).
PHONE:t4l,.R'l04
o\j\a p t-~,
ST~TE: ~Q~~ ZIP: ~141~
NEW N REMODEL
ADDITION
DEMOLISH
OTHER
CONST. q <::A - '3'lWl
CONTRACTOR'S NAME ADDRESS CONTRACTOR # E')PIRES PHO~~
GENERAL: fJ.~':1. IA f..hn,., '::-r"'. qY9~ 4f.(->;./-;.d-V ,j;l.9~7 LD lID/l'.l I 7'17'77"V
v 'Jh-H W'Y!J 1- .J ^-J . \ A. 51 \c-l'1!)....,o
PLUMBING: ~ _' /,1--_.1.''7 1I~7:!.m{u;:' ~IaLl:'"'\\!./J.!J-lI""\'J7'tf7S'1'Y"/
MECHANICAl' e." .., . - -'
13';;& ~/u..lrl ~
ELECTRICAl.
...317tl tv",t- II!
~'-1.~ IS;\ 412t~~4C'3D3
"./" ,','
_OOFFICE USE -
QUAD AREA: ::=\\C~~ LAND US'" \\ \ \ FLOOD PLAIN.
# OF BLDGS: / # OF UNITS' \ ZONING CODE: LL) \L-
OCCY GROUP: Q."6 -\ "-''-- CONSTR. TYPE: \JIV # OF BDRMS: .3
# OF STORIES: I HEAT SOURCE: w\-\ SECONDARY HEAT: '\
WATER HEATER: S RANGE: 7___ SQUARE FOOTAGE: \ tJ'\ ./
To request an inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectlons 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.
o Temporary Elactrlc
D Site Inspection - To be made
. . after excavation, but prior to
settlng forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing -After trenches are
. excavated.
D Masonry - Steel locatIon, bond
beams, grouting.
MFoundation - After forms are
~ erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench. ,
r-v1 Underllodr Plumblr!9>Mechanical
~ - .Prior to'rmsUIi':HIOn or decking.
K:71' Post and Beam -' Prior t~ floor
~nsulation or decking. .
~ Floor Insulation - Prior to
~ecklng,
~ Sanitary Sewer - Prior to filling
~rench.
~Storm Sewer - Prior to filling
~trench.
l\/rWater Line - Prior to filling
~ trench.
~ Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
;;;:;7f Rough Mechanical - Prior to
~cover.
~Rough Electrical - Prior to
~over.
K:7f" Electrical Service - Must be
~pproved to obtain permanent
electrical power,
r,
D Fireplace - Prior to facing
materials and framing Insp.
~Fra~ing - Prior to cover.
I'Cil'Wall/Celling Insulation - Prior to
~over.
~DryWall - Prior to taping.
D Wood Sto~e - After Installation.
D Insert - After fireplace approval
and Installation of unit.
K7f' CU;bcut & Approach - Aller
~orms are erected but prior to
placement of concrete.
~Sidewalk &,Driveway - After
~excavation Is complete, forms
.and sub-b~se material in place.
D Fence":"" 'When completed.
~,reet Trees ~ Whim'all'required-
~ees are plant~d.
'lS([
Final Plumbing - When all
plumbing work Is complete.
.of Final Electrical - When all
~electrlcal work Is complet~.
I'::A Final Mechanical - When all
~mechanlcal 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 connected 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,' skirting, decks, and
,venting have been installed.
Setbqcks
IHSE GAR1ACcI
"2,() t I
I
I
I
Lot faces }iL LOtType.
Lot sq. ltg, l#o 1 Interior I PL.
Lot coverage ~ Corner IN
Topography ~t Panhandle Is
lw
Total height Cul-de-sac IE
CJI
BUILDING PERMIT
\ \44T
'L\1O
X $/SQ. FT. ~ VALUE
~~nn 454-110.
14. \D 3lcAO
ITEM
Main
Garage
Carport
,~\D~lo
I .,.
? ~q db
J4.~
< 'S[)3' fS"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) $.e:;.B1
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N" ?
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
FEE
/bO~
(P,~
/6~~
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N"
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
/'11A,)
1~6-0
.
/.o~
J 2.5
2t::. 2.5'
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ Z lt
Curbcut ~ ft
-L,q,30
) ~ 'Ie>
Demolition
State Surcharge
,~Ck" ~
J~'7~5
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)tl~l<) \ 5U1
(A, B,.C, 0, and E Combined)
.
'IS TH E PROPOSED WORK IN THE
HISTORICAL DiSTRICT, OR N-;;-'\Q
THE HISTORICAL REGISTE ~ _}
If yes, this applicati~n mu
and approved b Historical
Coordinator prior to permit issuance.
51
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVED'
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 an{ Rrovisions of said ordinances.
Pian Check Fee: ......L~/l. 9->5
I
\
Date Paid:
Receipt Number:
t
I
I
Rec~A7UL.-
p~~~ew-;d- g;r.
~6.'Zh I
l~at.6
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 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 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.
Signaturp
Dat,o
VALIDATiON: ""'l CJ..
RECEIPT NUMBER ,\ g~;:--x: )
DATE PAin 1--' Q...3 . 'ef . c..
AMOUNT RECEIVEDY"<~ - '~. i Q ~S. ~7
RECEIVED BY (~ lJ \( A _ /. .