HomeMy WebLinkAboutPermit Building 1993-1-27
RESIDENTIAL
PERMIT APPLICATION
,:.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPoT~~ AI\. 1.
ASSESSORS MAP' 1n...l-Y(J::t19-
LOT:
{!M;fA'y
. 7.4 /t
ADDRESS: I.( t( 'f '1 s. t" /(
5/4/;/vF('"~C#.
/
N~rv
OWNER:
Bv;f;rfar
CITY:
DESCRIBE WORK'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
BLOCK'
.4~
STATE: _n4p
#1!"47
(&'-"'/
DEMOLISH
OTHER
,,/\
JOB NUMBER
q~\1\~
225 Fifth Street
Springfield, Oregon 97477
-'
TAX LOT:
[)g::J( '4-
, I
SUBDIVISION'
PHONE:
7f/C- 9f"C/
ZIP: 9'7V?%
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES
PHONE
MECHANICA' .
ELECTRICAL:
~4~/~~Y'
C~..s
//"',..,?('"4, v;; 07
, .
ElG'c-7d'/C
41.>-7'4'
OUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYP'"
HEAT SOURCE:
RANGE:
7 os-y F
1")...2/-'.3
t:.r..Y'~Y1l/
FLOOD PLAIN'
ZONING CODE: '*
. OF BDRMS:
SECONDARY HEAT:_
SQUARE FOOTAGE:
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.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
D Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to (illing
trench.
D
Storm Sewer - Prior to filling
trench.
D Water Lino - Prior to filling
trench.
D Roug~ Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and (raming Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and installaiion of unit.
D
Curbcllt & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Fence - When completed.
... D Street Trees - ....'Vhp.n all required
trees are planted.
D Final Plumbing - When all
plumbing work Is complete.
o Final Electrical - When all
electrical work is complete.
r;:2:r!Jnal Mechanical - When all
( ~.echanical work Is complete.
D Final Building - When all
required 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 - Arter all required
Inspections are approved and
porches, skirting, decks, and
vent!ng have been Installed.
Lot ~,taces Lot Type" Setbacks '.'HE PROPOSED WORK IN THE
I P.L. HSEIGAR ACC I HISTORICAL DISTRICT, OR ON
Lot'sq.'iflg. Interior IN I I THE HISTORICAL REGiSTER?
Lot coverage Corner Is I I If yes, this application must be signed
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul.de.sac
IE I APPROVED:
BUILDING PERMIT
ITEM sa. FT, x $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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
Developmenl 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.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipt Number'
BuildIng Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the Cl!y limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanl tary Sewer
FT.
Water
FT.
FT.
Storm Sewer
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
Information hereon is true and correct, and I furl her 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 1I1at only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stovellnserli Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
State Surcharge
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
01 the prope:ttr:Jd the approved set of plans will remain
O~g:a :~e 1I;;S z;;2?
Dale
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Sidewalk
It
/
Curbcut
It
Demolition
State Surcharge
VALIDATION: n'2 I c:::
RECEIPT NUMBEf} . fv. W )
DATE PAIr> /-rLlrzJ..f ~~
AMOUNT REckJ.J .r44 S < 2.5
RECEIVED 8C'-7\,I./ }1J )
-. --'-------
,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)