HomeMy WebLinkAboutPermit Building 1994-8-16
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT:
/<?,o 2.
OWNER'
ADDRESS'
CITY:
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OESCRIBE WORK'
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL' CLJ2a~,."..
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PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
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BLOCK'
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JOB NUMBER
q 40 50!
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225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
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STATE: .
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PHONE:
7-;/7 - 62Ac;j
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ADDITION
DEMOLISH
OTHER
ZIP:
9'1~7~
ADDRESS'
CONST,
CONTRACTOR .
PHONE
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
EXPIRES
~
FLOOD PLAtN'
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.
REQUIRED INSPECTIONS
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,.TO / ~ - OFFICE USE -
.j1)~ ~ LAND US".
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---
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms. .
O Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
~cavated.
o Masonry - Steel location, bond
.beams, grouting.
o Foundation - After forms are
erected-but prIor to concrete
placement.
o Underground Plumbing - Prior
to {lIIlng trench,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to tilling
trench. .
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
cover.
o 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.
~ramlng - Prior: to cover,
O Wail/Ceiling Insulation - Prior to
cover. I
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv41
and Installation of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete. forms
and.sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. .
o Final Plumbing - When all
plumbing w~Hk Is complet.e.
D Final Electrical - \^.then all
electrical work Is complete.'
o Final Mechanical - When all
mechanical work Is complete.
fV('Flnal Building - When all .
~ulred Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whefl all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up. and pluiVblng
Inspecllons 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 ~eenlnstalled.
... ".:"-:'
" ,.
" Lot faces . Lot Type
Lot sq. ftg. Interior I'P.L
IN
Lot coverage Corner Is
Topography Panhandle
Iw
Total h/llght Cut.de.sac
IE
1'11{.;;
~/) ..9iJ
2-?') :
r"-'
5-1.5Y .
SYSTEMS DEVELOPMENT CHARGE (SDC)
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BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport . ,-
Total Value
Building Permit Fee
State Surcharge
:?.p. ~H.r..v,
(A)
Total Fee
(B)
PLUMBING PERMIT
ITEM
Flx~ures
Residential Bath(s)
N'
SanItary Sewer
FT,
Water
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unlt/
Dryer Vent
Mechanical PermIt
Issuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
/4) br,.~w
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
VALUE
"
FEE
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Setbacks.
HSE GAR ACe' I
I
I
I( IS THE PROPOSED WORK tN THE_
""HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
i.'
This permit Is granted on the express condition that Ihe 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 any provisions of said ordinances.
Plan Check Fee' 3 z.. ~ :>
d
Date Paid:
Receipt Number'
Received By:
~~
Plans 'Reviewed By
g~wA>'l
Date I.
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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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 )hat 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 t~e street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
Athe site at a~ times d rl g co structlon.
(~"sr;;'nature~J)M' -
Date . Og' ~ /5 - 'iLl
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEn
RECEIVED BY
/f 7. 3 7
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