HomeMy WebLinkAboutPermit Building 1999-3-16
RESIDENTIAL
peRMIT AI!!PLlCATION
Inspections: 726-3769
Office: 726-3759 .
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LOCATION OF PROPOSED WORI'" q 71
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ASSESSORS MAP'
LOT'
BLOCK:
. OWNER'
ADDRESS'
CITY:
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DESCRIBE WORK'
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NEW
REMODEL
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ADDITION
DEMOLISH
OTHER
~
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JOB NUMBER.1fti ) 'f7
225 Fifth Street'
Springfield, Oregon 97477
TAX LOT' (l?1 f) b
SUBDIVISION'
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PHONE:..2iJ - (T2/0 PJ
.~.::l,9J-:~? 82-
Cf-:J- I.{ ?9J-
ZIP'
CONST.
CONTRACTOR #
~JnT!f'\~_
EXPIRES
-11
~N .
.~i~
CONTRACTOR:SNAME . ADDRESS
-1\1 1 t:N IIUI'l:9r~g<?~ law reqUIres you to
GENERAunllnw rlll,:ac:. ~~ho ()!o~l"\n r IHli.;'
PLUMBI~.tification Center. Those rules are set forth
In t,,,n "''''-UU I-UU I U mrougn UANl:I::><!-UU1-
MECHA~J'49(L:Yolrm;:l~1 ,,",h,t~ln ,..~oc:-,.."f th'a.!OlloC' h~,
cr. C calling the center. (Note: the telephone
ELE RI AI. .
'. mJllIUta IVI 1I1~ ur~yulI uumy l'''OlITlCatlOn
1."..t;:tIW:H I:) ,.ouu-""t:::-,e:::"q,q).
QUAD AREA'
# OF BLDGS'
OCCY GROUP'
# OF SlORIES:
WATER HEATER'
-~.... ..--.
Tl!:~ IJJ-nu''''''''.I-J/ I I
, ,_. , -....." >,'.'''LL CM'IHt: IF THE WORK
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_ OFFICE USE _ 'v,,,...,,, r-CMIUl'.
LAND USE:
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANG':'
FLOOD PLAIN'
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
D Temporary Electric
o Site Inapectlon - To be mado
after excavation. but prior to
setting forms.
m~deralab Plumblng/Electrlcall
'/-- _ --7Chan,cal - Prior to cover.
'i ~ootlng - ~!J~ryencl].es,are
17 excavated. V4LA) ~
D Masonry - Steel location, bond
.beams, grouting.
D Foundation - After forms are
erected. but prior to.concrete
placemo,!t.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and 8eam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench. .
D Storm Sewer - Prior to filling
trench.
. D..Wlltsr Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
olectrlcal power.
D Fireplace - PrIor to facing
materIals and framIng Insp.
@amlng - Prior to cover.
D Wall/Cefllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
D Curbcut &. Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - Alter
excavation Is compietc. forms
and sub.base material In place.
D Fence - VVhen completed.
o Street Trees - When all.'requlr.ed
trees are planted.
D Final Plumbing - When all
plumbing work Is complete.
. .
o FInal Electrical - When. all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
~.
F al BUilding - When all
D qulred Inspections have been
approved end building Is
completed.
DOther
MOBilE HOME INSPECTIONS
D 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
blocking. sel-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are'approved and
porches, skirting, decks, and
venting have been Installed.
r ~
Lot faces Lot ~ype.
Lot sQ. Itg. Interior
Lot coverage Corner
Topography Panhandle "
Total height Cul-de-sac
." i:;'; .\,;~\::
;~ THE.PROPOSED WORK IN THE'_
. "'HISTORICAL DISTRICT, Oft ON ~
THE HISTORICAL REGISTER?
Setbacks
I PL. HSE I GAR ACC'
~---
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
S I
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BUILDING VALd'E, PLAN CHECK
AND BUILDING PERMIT
APPROVE""
1
BUILDING PERMIT'
ITEM SO. FT.
"
X $/SO. FT. =
VALUE
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
Dovelopment 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.
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Main
"
Garage
Carport
Plan Check Fee'
/(Jil ..c Date Paid:
Total Value
2L.?<J Receipt Number'
Building Permit Fee
J.!i..\,7l' Received By:
State Surcharge
Total Fee (A) 2.2 ()U Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
N'
Residential Bath(s)
FT.
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Totai Charge
(C)
MECHANICAL PERMIT
Furnaco
By signature, I state and agree, that I have carefully examined
the completed application and do hereby'certlfy 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 01 the City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein. and that NO OCCUPANCY will be made of any
structure without perrn.'sslon 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.
Exhaust Hood
N'
Vent Fan
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
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 III remain
on the site at ;J0'mes d~ ~onstrucllon.
Slgnatur~,.s7~( A-~-
Date 3j / )'/9 CJ;
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
VALIDATION: 0
RECEIPT NUMBER ,~~\ t"')
DATE PAID 3, \ ~o .40\
AMOUNT RECEIVED N.~. ~ ~
RECEIVED BY \ ~, .
........... \-
Slate Surcharge
4JZ~
Tolal Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined) .