HomeMy WebLinkAboutPermit Building 1994-6-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
LOT'.
.
SPRINGFIELD
.
JOB NUMBER <9r~ ':F...."
225 Fifth Street
Springfield, Oregon 97477
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BLOCK'
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O~NER:-1V1 ld".Il",J
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ADDRESS: J 7 ~J
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DESCRIBE WORK' rvJ <:Vn u. (!<L~J-"" y
NEW IJ...- REMODEL ADDITION
CITY:
CONTRACTOR'S J;J;.~
GENERAL: (Q L
PLUMBING' Vb S
MECHANICAL: ~l..
ELECTRICA;' (( ()~
CON ST.
CONTRACTOR .
~.::J.9YO
l.f /80S
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..
...e:
STATE: ~f)-I/?
J/.c.. .P
DEMOLISH
OTHER
ADDRESS.
. .
.mou/>.. -/g..'.,,^-
-Flu n.lo/~a
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m" I.NL +L vh.
U(.fJ,
QUAD ARE;~~
. OF BLDGS'
OCCY GROUP: ~
. OF STORIES: \
WATER HEATER: _~
.!:p~
1:1-1VV'9/:'
'.
TAX LOT:
ZIP'
9'7'/?"J
- OFFICE ~ -
LAND USE: . \ \C;;CJ
.. OF UNITS: _\
CONSTR. TYPE: ~t\J
HEAT SOURCE: ;y~ r-A.
RANGE: _p -
------
EXPIRES PHONE
IV~I.J h1rY~12Lf
...4f15. -Q5S(
" .
1,;~ /5<tQ
G,.lS' ~ (flOS
FLOOD PLAIN:
ZONING CODE: lliu
. OF BDRMS' ~
SECONDARY HEAT: g
SQUARE FO.OTAGE: -lq.Gf~
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
D Rough Mechanical"':' Prior to
cover.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting rm
'Kf-, Undersl P um I / Electrlcell
'f':! Mechanical - Prlo .
~ootlng - After trenches are
~~xcavated.
D Masonry - Steel location, bond
.bel':'lITlS, grC"ut!n~. - __ .-
~ Foundation - After forms are
l.2SI ~rected but prior to concrete
praceme"nt.
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
IC7ISanltary Sewer - Prior to filling
~ trench.
.Q1 Storm Sewer - Prior to filling
~ trench. .
,...,..,; Water Line - Prior to filling
~ trench.
. ,
o Rough Plumblrg - 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.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall .,... Prior to taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & 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.
D Fen~e. - When completed.
D,Street Trees - When all required
trees are planted. .
D Final Plumbing - When all
.plumblng W9rk Is complete..
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanl.cal work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is. .
completed.
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MOBILE HOME INSPECTIONS
~BIOCklng and Set.Up - When all
blocking IS complete.
/
~ Plumbing Connections -. When
home has been connected to
water and sewer. .,1
~ Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the' home Is connected to
the service panel.
~ Final - After ell required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
.;,.-.
~~~pe
A Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de'sac
BUILDING PERMIT
ITEM sa. FT.
~ . .:r; ;1. ..;,
~. ,.;'~ th:,,':1i~'1"~ .
:'" :'~"C ..:~~?i:'~:.
Setbacks.
HSE GAR ACC
'\
I P.L.
IN
Is
Iw
IE
X $/sa. FT. ~ VALUE
</h e>~ <;-
. Lo~ .c~.{)
+/ ~ l ~.i~
W1.57
Main
Garage
Carport .,
~/p:- ,~~-
Total Value
Building Permll Fee
State Surcharge
Tolal Fee
(A)
"
-.6.~
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
f/jj'1)],36
rls0
c9.a5 -l- <. ~;&
(C) f4 /.
PLUMBING PERMIT ,.
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Perml t
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk t') ~ It
Curbcut ~'U{
It
Demolition
FEE
I)
2~:~'
~S.UJ
.PI
)~g)
c;)n.
'--S.~
-211S
4.:\s
~~.rc~arg . 1\ \
:}-Jj'! J '--' 0- L c:;
C:K\.ll .
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcallcQ ./CfrQ,57
(A. B, C, 0, and E Combined)
I
I
I
:.S THE PROPOSED' WORK IN THE. .
....HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II 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 Clty.of Springfield, Including the
Development Code, regulating the constructIon and use of
buildings, and may be suspended or rev9ked at any time
upon violation of any provisions ofpid ordinances.
Plan Check Fee: ~ /
Date Paid: . \!.j/
Receipt Number:
Received By: /
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL CgJ}'IMENTS .
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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, ::Ind 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 property, and the app ved set of p~;'S7)aln
on the sit. at all Imes ,\"rl g cons!p}iI/" .,
Signature ::VJ
Date
VALIDATION: 1J.^,{l
RECEIPT NUMBER \ .:.::Jt-"~\
DATE PAID (0 .9V .qi-
AMOUNT RECe1C ~ {pr'Jh. q7
RECEIVED BY ell ri.J6 _ 'j