HomeMy WebLinkAboutPermit Building 1992-4-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSf,P WA,f1.Il" . bo 2\f4~ 1;. /(e fl. /
ASSESSORS MAP' (1 { )~-\.-~~'\.
OWNER: f<6YlaPd. Nt . Sherman
ADDRESS: t.,62 ICPj/.u 1!Jivd..
.$KJrtl7 v (ie(d .
/
LOT'
CITY'
BLOCi<'
STATE:
(}e. c. (V\..
,
DESCRIBE WORK:
/:< 'y ::2 0 I sivtu;-e .9r<2.d
NEW
v
REMODEL
CONTRACTOR'S NAME
GEN~RAI .
PLUMBING:
(J..uYl et?..
-
MECHANICAl'
ELECTRICAL'
()umeK
QUAD AREA: \ \Z j\ )l0
. OF BLDGS: \
OCCY GROUP: '~A_
. OF STORIES'\'
WATER HEATER:
ADDITION
DEMOLISH
OTHER
-JOB NUMBER 9d04 2'0
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION'
- ~
(T'j.J. (' ~ ')
PHONF'
/]4{" -'7 -5' q5
ZIP:_Cj747 7 ~J
"". ,Y
(1'.:'
ADDRESS
CON ST.
CONTRACTOR'
PHONE
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.
~ Framing - Pdor to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unIt.
o Curbeut & Appronch - 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 all required
trees are planted.
EXPIRES
FLOOD PLAIN: , [\ ~
ZONING CODE: ~C-J
. OF BDRMS'
SECONDARY HEAT-
SQUARE FOOTAGE:
fl.~E1
LAND USE: OF,I\.\ U,E -
. OF UNITS: \ )
CONSTR. TYPE: \l,A J
HEAT SOURCE:
RANGF'
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
mildc the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
selling forms.
o Underslab Plulnblng' Electricall
Mechanical - Prior to cover.
o Footing - After trenches arc
excavated.
o Masonry - Steel location, bond
beams, grouting.
lVT Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
~ Post and Beam - Prior to floor
~ insulation or decking.
D Floor Insulillion - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water line - Prior to tilling
trench.
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
pfumblng work Is complat.e.
D Final Electrical - When all
electrical WOI k is complete.
D.Final Mechanical - When all
mechanical work Is complete.
'lv(Flnal Building - When all
~equired 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
.....enting have been installed.
Lot laces
Lot TYP"
Interior
I PL.
IN
Lot sq. Itg.
Lot coverage
Corner
Topography
Panhandle
S
W
LE
Total height
Cul.de-sac
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT.
VALUE
Main
Garage
~porl
~~
2?f::2
2, 2../5 D-()
tI Z.rm
_-ii-so
2.2. 3
ft->,73
SYSTEMS DEVELOPMENT CHARGE (SDC~
(B) -e--
Total Value
Building Permit Fec
Slate Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Balll(s)
N'
Sanitary Sewer FT.
Water
FT.
Slorm Sewer
FT.
Mobile Home
Plumbing Permit
Slate Surcharge
Tolal Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFireplaco Unit
Dryer Vent
Mecllanical Pel/Ilit
Issuance
Slnlc Sll/{;l1ar~le
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
. It
Curbcul
It
Demolition
Stale Surcharge
.ELML~CV/a.u ,FCC
0fb'13
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C. 0, and E Combined)
$. "'~
Sctbacks
HSE GAR ACC
.IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by tllO Historical
Coordinator prior to permit issuance.
I
~I.-J
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVED'
This permit is ~lrantcd on Ihe express condlliun Ihal the said
construction shall, in all respects. conform to ttle Ordinance
adopted by the City of Springfield, including the
Developmenl Code, I"Cgulnting the construction ;:md u::'.e of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fcc: .-Zi!s."7':3
Date Paid:
Receipt Number:
Received By:
.~~
PI n Reviewed ay'
_~ /~ /:LZ-
rD~;:6-L
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 cmefully examined
the compleled application and do hereby certify that n/l
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 lhe Slale of Orenon perlnining to the worl< described
herein, and (hat NO OCCUPANCY will be made 01 nny
structure wllllout penni:;:,.;ion of the BuildinU Safety Divi:;ion.
I furlllOr certify III<lt only contractors and employee:; WllO
arc In compliance with QRS 701.055 will be used on this
project.
I further agree to unsure that all required inspections are
requested althe IJroper lime, that eacll addres5 is readable
{rom the slreet, that the permit card Is located at the front
of the property, and the approved set of plans will rClTwin
on the site a~l~s during construction.
Kignaturc _KU~_, _____
Dale
VALIDATION:
RECEIPT NUMBER 47J11
DATE PAID L\- --W ,Ql(
AMOUNT RECE~ED (( lf .~r
RECEIVED BY (~