HomeMy WebLinkAboutPermit Building 1992-1-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFtELD
LOCATION OF PROPOSED WORK' -5""79h k"",~/.A /~.
ASSESSORS MAP:/~'~2~bc/-/.~
LOT-
BLOCK'
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OWNER'
ADDRESS'
CITY'
DESCRIBE WORK: - ~4P~....... C
NEW Y REMODEL ADDITION
STATF'
.
JOB NUMBER 9 //"'~~~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ....-'Y?~
SUBDIVISION'
*
PHONE:
ZIP'
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- OFFICE USE -
LAND USF'
. OF UNITS'
CONSTR. TYPE:
~-p.
.,
DEMOLISH
OTHER
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
B::s~/, .
GENERAL~"",~'''''r.~...~~-~~'~~~~''''/ "Y-4=3! ~-~'3"
I?LUMBING' "
MECHANICAl'
ELECTRICA' '
QUAD AREA'
. OF BLOGS:
OCCY GROUP: }'/7'-/
. OF STORIES: ___{
WATER HEATER'
HEAT SOURCF'
RANGE:
FLOOD PLAIN'
ZONING CODE: ,t:.,,/../!!"
. 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.
o Under.lab Plumbing/Electrical/
Mechanical - Prior to cover.
DFooting -" After trenches are
excavated.
D
Masonry - Steel location, bond
beams, gr~uting.
o Foundation':':'" After forms are
, erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underfloor 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 ~ough Plumbing :- Prior to
cover.
REQUIRED INSPECTIONS
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,
lXJ Framing - Prior to cover,
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
.0 Wood Stove - After Installation.
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 sub-base material In place.
o Fence - When completed,~
o Street Trees - When 'ail requlre"d
trees are planted. . . ~
o
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical. work is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
~ required Inspections have been.
approved and building is
completed.
o 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.
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 all required
Inspections are approved and
--' porches, skirting, decks, and
. venting have been installed.
~
Lot faces lot Type . Setbacks
lot sq, Itg. Interior I P.L. HSE GAR I ACC
- IN I
Lot coverage Corner
is
Topography Panhandle
Iw
Total height Cul.de.sac
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT,
Main
Garage
'"'3'-"6
:/2.,;;,,9
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
~?C"Y.
~~ 1i2:?
-::2 ...-~
-5'3.0 '3
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
/?--N'h' t-
~ /1.-,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~S/~
~~
. THE PROPOSED WORK IN THE
HISTORICAL 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
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.
Plan.Check Fee:
-g:=? J'?'::'>
Date Paid:
Receipt Number
Received By:
. //;..6 11 ,.,.-'7
~ie~ea By
/-b> -9'2..
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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.
v
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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