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Home My WebLink AboutPermit Building 1991-8-26 ..~~::--~ RESIDENTIAL PERMIT APPLICATION Inspections:,726.3769 Office: 726.3759 J j, LOT: . I... SPRINGFIELD k.F/I/N tj- ~ C:L/,;AI<WA1-F/?. PJ<OLltAJ LN OWNER: ADDRESS: 15" '?() CITY: SP/=LD. , DESCRIBE WORK: !:IrJ/irF NEW x ADDITION REMODEL CONTRACTO~ NAME GENERA" \\!,I.. t.,"~\.~ PLUMBING: {\)..1 Jt\ (tV MECHANICAJ'C)..Q)f\Q \f'") ELECTRICAl K"'~ f'\f1 0 J2 / "- :--..:' -- - . I QUAD AREA: nRSc..., \ ~?'-TW\ \ 'P.. . OF BLDGS" oqCY GROUP: . OF STORIES' WATER HEATER: . C{ \,C67~h) , JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 o 9' ~() 0 SUBDIVISION" PHONE:i(j6 - <(/6''1 STATE: f)l?E. ~ ~ \! 0 .f}\(1 OJ\~ 9-...- REQUIRED INSPECTIONS @ROU9h Mecha':lical - Prior to cove~ " NROU9h Electr!cal - Prior to . cover. ~Iectrical Service - Must be \ approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. ~Framing - Prior to cover. ~Wall/ceiling Insulation - Prior to cover. ~DryWall - Prior to taping, o Wood Stove - After Inst~"atlon: 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 excavation Is complete, forms and s.ub.base material In place. D 'Fence .;.:., Whe~ completed. @,l&J S reel'T~ees ~ When all required' ees are planted. , j., '. ZIP" 971(1'['[/ DEMOLISH OTHER CONST, ADDRESS CONTRACTOR' EXPIRES PHONE ..~ FLOOD PLAIN" ZONING CODE: . OF BDRMS: ~~ - OFFICE USE - LAND USE: \ \. \ \ ". OF UNiTS: \ CON";TR, TYPE: V f\J HEAT SOURCE:f'lJ,\~ RANGE: -i:. ./ -' - SECONDARY HEAT" SQUARE FOOTAGE: aI\~.., 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. ~TempOrary Electric D Site Inspection ~ To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. I~ I""ooting - After trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting. \ ~Foundation - After forms are J2SJ.. ~rected but prior to concrete placement. ~ Underground Plumbing - Prior J6J to filling trench. ~U nderfloo~'P I u mblnqn." echanlcal .~ - Prior to Insulation or decking. ~Post and Beam - Prior "to floor ~insulation or decking. ~Ioor Insulation - Prior to decking. ,~ Sanitary Sewer - Prior to filling ~ trench. ~iorm Sewer - Prior to filling trench. ~ater Line - Prior to filling ~ trench. f":;?( Rough Plumbing -:-. Prior to ~cover. ~nal Plumbing - When all plumbing work is complete. . - ~inal Electrical - When all electrical work is complete" ~al Mechanical - When all ~ ~~chanical work Is complete. ~I Building - When all ~~~~~ired inspections have been approved and building is completed. DOlher L MOBILE HOME INSPECTIONS D 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. D Final - After all required . . inspections are approved and . ~,~ "porches,"skirting, decks, and venting .have been installed, Lot faces .J Lot Type . J'I~f &0 ./ Lot sq. ftg. _ Interior Lot coverage .006 Corner Topography -( Panhandle Total height '2L2 Cul-de-sac ITEM Main Garage Carport Total Val ue Building Permit Fee State Surcharge Total Fee (A) -~ ..,- ....." ..., . _THE PROPOSED WORK IN THE ""l"I'iSTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. I P,L. IN Is Iw IE Setbacks . HSEtGAR . ACC I I,I'f I . q7 I l{'J I ~o'l'I' I I cH Jf.BS 1~3.cv 17,15 .36 0 J!i SYSTEMS DEVELOPMENT CHARG~;i4C) (B) BUILDING PERMIT ~ ',<ff.I)b-~~~ 440BJQ 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) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' v Wood Stovellnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (0) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge ~ rh. oF}1I'{''' fC€ FEE Ib~.tJO , /6,j,OO ~.OO I ~t? t)() 4,1; () 9.&0 3.fJO I 6 ,t;? c) 10, (f}O 1.1'? ~7&3 /10;;0 Total Miscellaneous Permits (E) . TOTAL AMOUNT DUE (excluding electriCal)rJ;...:;;;: ..;. , 'f:j;,- (A. B, C, D, and E Combined) ~<5.9'~ ,.. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all re.spects, 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 an1\prc\Vir<\nS%Bi ordinances. Plan Check Fee: rl~rt- Date Paid: fl-!:). J=) . Receipt NumbeN VJB'8fJ7 Received By: ) J/~~ Plans Reviewed By 53..6./51 7 'i~te Systems Development Charge Is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS u2:\'(\ \\Q ~n.~\cA'eYt,O~OQ \..... Y'\.Dt- J, 5\ Q ('..11 l. .LJ\ O~ \, L~O~~O\C'~t-, 'll.~~.Cn lli 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 pro?perty. and the approved set of plans will remain on the sit at all times dU'N const~ctton. Slgnaturf' l.~~. V~ Dat~ ~-~c..-<; \ VALIDATION: RECEIPT NUMBER -:2 / /.c>~ .:if? - -::;>&" -?;/' DATE PAIl" AMOUNT RECEIVED ~C"<. ~~ , /~ ~~---,,~................. r/,/",/./' /- /- ..) v , RECEIVED BY - - .'_.. -- . . Permit No: <;1 /LJ?S 7_:;:;- Address: t.-//;/,c /~2/.g:-R Issued bY'~"""'-""" -P' - Date: ,R--?t:::.-'7/ t,/ . STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT, CONSTRUCTION RESPONSIBILITIES 'Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants; exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1. ~ I own, reside in, or,will reside in the completed structure. 2. A. L....J My general contractor is, Contractor registration number \ I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. L-.J I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and Clo hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. , k "~ 9 'V_-<r~ Signature o'f Permit Applicant ~ -.J.o -q I Dale CONSTRUCTION CONTRACTORS BOARD 0244J 10/24/89 WHITE COPY TO ISSUING AGENCY PERMIT'FILE PINK COPY TO APPLICANT 4'>.