HomeMy WebLinkAboutPermit Building 1993-5-10
OWNER: P~~E 1'- .t?~L'~~ ~7:>
ADDRESS ' -5~F"
- ??~~. STAW ~.
,. r-r- ,r - r -
DESCRIBE WORK: ~~9 ~-"
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT:
CITY'
NEW
y
, .
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL: ~~~
PLUMBING'
MECHANICAl'
ELECTRICAL: c7*,,~~
OUAD AREA: ",,3~ )
. OF BLDGS' \
OCCY GROUP: ~
\
, OF STORIES:
WATER HEATER:
SPRINGFIELD
BLOCK:
.
JOB NUMBER 92/?96
225 Fifth Street
Springfield, Oregon 97477
TAXLOT:~~?~
SUBDIVISION:
PHONE:
7Z~ "'2/://
ZIP:
t:9?~/g.
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DEMOLISH OTH~R~,~.&:~Al,.~~
ADDRESS
CONST.
CONTRACTOR #
PHONE
- OFF1S!S UJ!'.. -
LAND USE \ \'-2i )
# OF UNITS'
vtJ
EXPI RES
'*
FLOOD PLAIN.
ZONING CODE: ( .f)L
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:l Ora
To request an inspection, you must carl 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
D
Site lii'~pection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing! Electricall
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Steel locatfon, 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
decki ng.
D Sanitary Sewer - Prior to filling
trench.
~ Storm Sewer -, Pdor to filling
~ trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - ^fter fireplace approval
and installation of unit.
CJ
Curbcut & Approach - After
10(I'lS an~ erected but prior to
pl;:lccmcnt of concrete.
D Sidewalk & D:ivew<lY - After
excavLl:i()n !~ complete, forms
and su b-brtse material In place.
o FeilCp. -- When r:orr>pfetcd.
[I Strt:nt Trees - \.'\./her' 211 required
- - trc(:~. :=ue planwd. .
D Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work is complete.
KA"Final Building - When all
~ required inspections have been
approved and building is
completed.
D 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.
D Electrical Connection - When
block:ng, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After ali required
inspectiof1s are applovE:d and
porches. skirting, decks, and
venting have been :Itstalled.
,
. .
Lot faces lol Type Setbacks " IS THE PROPOSED WORK IN THE
lot sq. Itg. Interior I P.L. 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 :1
APPROVED'
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT.
VALUE
Main
Garage
~
6$~
1f/./4'>
Carport
;,
m~ /~~ffi/')I* -
~-.-
c;. .......
5"~~
~.S"'o
2.133
~'t.13_
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) HS
(B) -e-
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT. L "5"0
:z "5 fJ'O
Mobile Home
Plumbing Permit
State Surcharge
p....
~.'J..S'
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
-ES58
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 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.
Pian Ch~ck Fee:~. /'-5
~...;Z~~ ,
~:?5?:>
.;....--:;;;: ~
Received By: ~~~ --e- .
/~
Plans (Reviewed By -
Date Paid:
Receipt Number"
5"-~ -5'..?
Date
Systems Development Charge is due on all undeveloped
properties within the City limits whicl:l arc being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed applicalion and do hereby certi fy 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
IJroject.
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 property, and the approved set of plans will remain
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VALlOATION:
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RECEIPT NUMBER
DATE PAIl'
AMOUNT RECEiVEI'
RECEIVED BY