HomeMy WebLinkAboutPermit Building 2000-1-7
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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JOB NUMBER
00 -btJO)..S-oJ
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK; ~-d;;)~ FO(,<;~k1,])rl ~
ASSESSORS MAP'/ r:>O 2. e~ 2.JJ ' TAX LOT'
LOT'
BLOCK'
OWNER: <:;;, 'tY:Jr\ :TeilD.ina S
ADDRESS''7"" Sa;jd FO~/~
CITY: ,<\ ()rl~frO U
l~
DESCRIBE WORK: JD...<i1zJJA ~)/f'.fl1tj1)
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL: ~1.!s
ELECTRICAl'
/1 Z :> /.r2;)
SUBDIVISION'
. PHONE:
7tj0-4~?t
Dn'(fe
STATE: 0~, ZIP: q 74'7?-
tY/Ltputop 4- J=;2() Cot' /
o Rough Mechanical - Prior to
cover.
r9T Rough Electrical - Prior to
~ cover. .
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - Prior to facing
materials and framl.ng Insp.
o Framing - Prior to cover,
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Install all on.
o Insert - After fireplace approvZlI
and Installation of unit,
o Curbcut & Approach - After
forms are erected but prior to
placemont ot concrete.
o Sidewalk & Drlvew.y - After
excavation Is complote, forms
and sub-base material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
OTHER
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ,,:;'0 PHONE
,L(L!() O~C s-r;-~fd #Cb~
747-74tD-
- OFFICE USE -
QUAD AREA' LAND US'" FLOOD PLAIN:
. OF SLOGS: . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE:_ SQUARE FOOTAGE:_
ADDITION
DEMOLISH
. ",:,To r~quest-ai}, lnspec,tlon, you ;nust cali 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.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab PlumblnglElectrlcal/
MechanIcal - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting,
o FoundaUon - After forms are
erected.but prior to concrete
placement.
o Underground Ptumblng - Prior
to filling trench. '
D Underlloor Plumblng/Mechanleal
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o S.torm ~wer - Prior to filling
tr~!l5:b.;-
<r: a:
~ 1- c::
o ~~.)'!~I~a - Prior to filling
trencn.~=, C":I
0<<" <I:
. .y:;(~ Q;!
D R?l.!Q.!I. ~"!.I1]t?Ir:'g - Prior to
cover.- :J:. r:'1
l,...,""I":1o..;.
,..:.,,...... .1'"\ ':'S::: ..
'7';" :,. ,:,...)
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o Final Plumbing - When all
plumbing worl< Is complete.
rs<r Final Electrical - When all
~ electrical work Is complete.
r;::::::( Final Mechanical - When all
pmechanlcal work Is complete.
o FInal Building - When all
required InspectIons have been
approved and building Is
complet~d.
DO'her
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 a" required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I,
Lot faces
.... H: :;.1: \
. ',J "
Lot 'TYpe Setbacks
Interior I P.L HSE GAR Accl
IN I
Corner
Panhandle '{ Is I
Cul.de.sac W i=C_J
E
'(
a; PROPOSED WORK tN THE.
HISTORICAL DISTRtCT, OR ON
THE HISTORICAL REGISTER?
" yas, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
, Lot SQ. Itg. ~,
\ ' . . ~.r ,~
Lot coverage
Topography
Total height
X $/SO. FT. _
VALUE
>,APPROVED:
. ,. . "
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 tha
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.
,
BUILDING PERMIT
ITEM SO, FT.
.~
Main
Garage
"
Carport
Plan Check Fee:
Tolal Value
Date Paid:
Building Permit Fee
Receipt Number:
Slate Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Resldentlal Bath(s) N'
SanItary S~wer
Water
FT,
FT,
Storm Sower
FT.
vi 1 lL}f' _ f!
---., ,.., II W
~") 1// ,~
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Mobile Home
?7kAt-x= r:?Br:..;r: ,~~
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
,
Vent Fan
N'
By slgnature,l state and agree, that I have carefully examined
the completed application and do hereby certHy 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.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
.
I fu.rther 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 a~lIJ'es durin -co t;uctlon.
Signature ---J' fllt/-_ '.L1ff)
i.f!4 (1)'/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Date
Curbcut
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
DATE PAIP
AMOUNT RECEIVEP
RECEIVED BY
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:t: 1
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rn .:r -J 0
~_I"W "--'
"ZCl'NO
o G1. C:)t.......
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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