HomeMy WebLinkAboutPermit Building 1992-3-16
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JOB NUMBER -3l1~/7_
, I
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
~
- ~J/' 0:2300
If TAX LOT: -i):~
~\ 'v SUBD;VIS'IONli]J1Qw l)LllD-,
';;'\ L},!~jl1Jftl~PHONE: ,4lo-il\Y
,~~Oo.J:)t)~H.[L .
" STATE: (GJO~ ZIP: qf4~CS_
Q L(\l d f) n(lL
225 Fifth Slraet
Springfield, Oragon 97477
LOCATION OF PROPO,s~ ~F}l\ -1\,,' ry;f1
ASSESSORS",k1 AP:/ nLN ()((:~-\J4
LOT- ,..-)/ BLOCI<"
OWNER:
ADDRO:, '
CITY:_ .
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DESCRIBE WORK: ..~ - \=='.
REMODEL
ADDITION
DEMOLISH
OTHER
NEW
CONST,
CONTRACTOR #
CONTRACT~' AME
GENERAL. f In R f:)
PLUMBIN ',_ l!.I1Lt{lJ1Q OJ!~~
~ECHANI;At.' N\(\A-Snn fLS .
ELECTRICAL:~h' )(lU1L ?- UfJ1'NfA' .J
o - 0 -
QUAD AREA: ,,~RsC./
# OF BLDGS: L
OCCY GROUP: \(, ~ -\- f\J\
# OF STORIES' ,- 1 ~
WATER HEATER' ( ..-'
ADDRESS
EXPIRES
PHONE
~
,
- OFFICE USE -
LAND USE:--.ilL(
# OF UNITS' \'
CONSTR, TYPE: V N
HEAT SOURCE: _/-If>
y.-/
FLOOD PLAIN:
ZONING CODE: ill U
# OF BDRMS: . ~
SECONDARY HEAT:
SQUARE FOOTAGE: 1Jif1.-~
RANGE:
To request an inspactlon, 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
~ Temporary Electric
f':7f Rough Mechanical - Prior to
~ cover.
rV1 Final Plumbing - When all
~ plumbing work Is'complete.
,-D Site Inspection - To be made
after excavation, but prior to
setting forms.
"f':7I Rough Electrical - Prior to
~ cover,
~ Final Electrical - When all
~ electrical work is complete.
1Vf Final Mechanical - When all
~ mechanical work Is complete,
o
Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
rvr Electrical Service - Must be
~pproved to obtain permanent
electrical power.
l'J1" Footing - After trenches are
~excavated. '
~Final Building - When all
~requlred Inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting, _
~'Framing - Prior to cover,
o Other
1'i21' Foundation - After forms are
~ erected but prior to concrete
placement.
~ Wall/Ceiling Insulation - Prior to
~ cover.
1V1 Underground Plumbing - Prior
I.C>\, to fililng trench,
~ Drywall - Prior to taping,
MOBILE HOME INSPECTIONS
"R;71' Underfloor Plumbing/Mechanical
~- Prior to Insulation or decking.
D ~~od Stove - After'l'nstallatlon.
o Blocking and Set. Up - When all
blocking Is complete,
~' Post and Beam - Prior to floor
~lnsulation or decking,
o Insert.:.... After fireplace approval
and installation of unit. . .
'1'V'1 Floor Insulation":" Prior to
~dacking,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Curbcut & Approach - After
forms are erected'but prior to
placement of concrete,
f':If'Sanitary Sewer - Prior to filling
loCS.lranch, 'To SGl1T/c. /1'l;<J.c:.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material' in, place,
'f;7I Storm Sewer - Prior to filling
~ trench.
.
D Fence - When completed.-
~. Watar L1na - Prior to fliling
~ trench. '
o Final - After all required
. inspections are approved and
". porches, skirting, decks, and
venting have been Installed,
~treet Tre~s -:- 'When ai, req'uirea
~trees are planted. .
,
!'VI Rough Plumbing -' Prior to
~ cover,
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Lot faces ..-W: Lot Type . Setbacks . THE PROPOSED WORK IN THE
Lot sq, ftg, 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
L~ Is I and a p proved by the Historical
Topography Panhandle lw I Coordinator prior to permit issuance,
Total height )6.:. Cul-de-sac
IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT.
Main /3?f1
G;:!,r~"15'td
Carport
X $/SQ, FT,
:'39,70
VALUE
:S.B/5~
I (J~~O
_/;,:? 9> ~
~~oo
/6.'2';;
~J.~s
SYSTEMS DEVELOPMENT CHARGE (SDC)
, (B) ll0. p.,
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N" rz.
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
/hrJtlO
Plumbing Permit
State Surcharge
0th/
/ h ~/'.?
Total Charge
(C)
MECHANICAL PERMIT
t, 1>0
.,;. ,;-'.J
~O-.@
Furnace
Exhaust Hood
Vent Fan
N"
J
Wood Stovellnsert/Flreplace Unit
Dryer Vent
.3 00
Mechanical Permit
/~:z;o
,
jrJ.OO
.03
2'133
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
DemolItion
L.AP~ Q). SEj!J77 e
~~_,....,a,,:,~
~1 AEI//l?W rFE
/7o.~fC)
~I /I~!;"
3~ I."~
CfJ 1 SJ
Total Miscellaneous Permits (E)
, TOTAL AMOUNT DUE (excluding elactrical)
(A, B, C, 0, and E Combinad)
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.
2. / /. 2-.>
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
~~~
Plans Reviewed By
/-25 -'i'L
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which ar~ being improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
informatton 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
herain, 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.
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 prop d the approved set of plans will remain
on the site at II ti es duri1 \ons~u<f\on.
)(Signature ~ tL \ ~(~:~,
Data ,<, J ~ ~ 9
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VALIDATION: sqOJ\
RECEIPT NUMBER c..)i
DATE PAID ,~. I( 0 ,C('~
AMOUNT REC~II' ' cg'), R ~
RECEIVED Byl_F'/ n' _ ')