HomeMy WebLinkAboutPermit Building 1994-5-23
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
ASSESSORS MAP:-.L~
LOT' !J. ()
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SPRINGFIELD
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JOB-::::'ER Gt~()~3\
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
S~~ON:/..et)1'10m~ fc;-w<;
OWNER._Ket1V\f'A-h ,.lLlLlP i1P(i~~~;HONEyg5'-4L1rA.
ADDRESS ~ t.^":".~,1~ ~,-reF-t-. , :3 -Por<:;I.tf"'..e - kJ(rr;1, ~..,--; fJ",,,J,p6
CITy::::fb',ul':' '?f(':v'\9~,,,!1i STATE:M ZIP~ '1/'1'7lJ
DESCRIBE WORK- ~ 1> ,1(\ N\o1' 0 .., \. o\-0rt _~ \....l\\r\ f\ l \. t. ~~
NEW REMODEL ADDITION \') DEM~H 'QTHER \ ')
CONST. U:~ 16~!)b2--
CONTRACTOR'S NAME ADDRESS..., CONTRACTOR # EXPIRES PHONE
GENERAL:..t:',{\l...~v.:>~K..~ (l"'Jl..'}s,,.- 1)~280 \sY"If'~IAL- ~ q~1~~'710
"-~V"A~~ OV". 9''1"j~ I
PLUMBING:
MECHANICAL:
ELECTRICA' .
BLOCK'
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS'
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspectlon, you must call 726-3769. This Is a 24 hour recording. AJllnspectlons 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 Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab PlumbinglElectrical/
Mechanical - Prior to cover.
o Footing - Atter trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
rI, Foundation - After forms are
~ erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
D Flo~r Insulation - Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filllng
trench. .
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior. to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~ .
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.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove":"" After l~stallat'lon.
o Insert - After fIreplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
. excavatlon Is complete. forms
and sub-base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
,'"
D Final Plumbing - When all
plumbing work is complet.e.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required 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 is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
, - '....,
Lot Type , i
. ,.
" .
Lot faces I Setbacks \ HE PROPOSED WORK IN THE
Lot sq. Itg. Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
- IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul-de.sac
IE I APPROVED:
BUILDING PE,RMIT
ITEM sa, FT. x $/SO: FT.
VALUE
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 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.
Main
Garage
Carport.
,< ~
Plan Check Fee:
Building Permit Fee
. ,
."", .
~
IC;S,
, ')~
., f '5,;15'
Date Paid:
Receipt Number:-A- -O~.J
Received By: '-- J.. \ I
- )
Total Val ue
Stat8' Surcharge \ ;
'. . .
,
, \
, <
,',I
, ,I
. lr .~
Date
Total Fee
,(A) "
. . PI~n.s ~eviewed By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withIn the City limits which are being improved.
PLUMBING P~RMIT
ITEM
ADDITIONAL COMMENTS
FEE
FIxtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By sIgnature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
informatlon hereon is true and correct, and I further certify
that any and all work performed shall be done j n 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 certlfy that only contractors and employees who
are In compliance with ORS 701.055 will be used on thIs
project.
Exhaust Hood
Wood StovellnsertlFireplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total PermIt
-~- (D)
I Jurther 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 pi s will remain
on the sIte at all times during construct! n.
'1) ,,~-
AMOUNT REC
RECEIVED B
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
DemolItion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and ECombined)
leD). '1.. s..