HomeMy WebLinkAboutPermit Building 2000-1-18
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ADDITION DEMOLISH
v,
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LOCATION OF PROPOSED WORK: _
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ASSESSORS MAP:
LOT'
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAl'
rn Ctv:sh-~,s
QUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES: _,_
WATER HEATER:
.
BLOCK:
STATE: __f)"I<
.
JOB NUMBER -CfJ/)/D1h~O /
;II'
225 Fifth Street
Sprlnglleld, Oragon 97477
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SUBDiVISION'
PHOI\lE:_ryd tr> -()f)~?
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ZIP: Cf'747lr
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REQUIRED INSPECTIONS
M Rough Mechanical - Prior to
~ cover,
D Rough Electrical - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facIng
materlal~ and framing Insp.
D FramIng - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
o Wood Stovo - After Installallon.
D Insert - After fireplace approvlSl
and Installation of unit.
D Curbcllt & Approach - After
forms are erected but prior to
placement of concrete.
o Sldawalk & Driveway - Alter
excavation Is complete, forms
and sub.bast! ml\terlal In pIBCC.
o StOm. .Sawa, - Prior to liiUng .
trench.:..~ ... : ~.: r: P
:1 r "1 c.:' ' <.r.
.. .r t""' . 0
D Wate,r.tl~!t - Prior to filling ,~. I,.. Fence - When COi"'-lpletcd,
tre~9h,. :-:"... -.o. l.~' I _ I
J' (I' t".... _.) _ :' f"'..&.:
D ~-?u\g~ ,PJ~mblng - Prior tol ~: ~ ','i .0 Street Trees - When all required
cover: . .. { J " trees are planted,
~'~ . ",' -::; . :.
ADDRESS
CONST,
CONTRACTOR'
lillO O~~ +3.5710
- OFFICE USE -
LAND USE:_,_
. OF UNITS:
CO N STR. TY P E:
HEAT SOURCE:
RANGE: ___
. .-')
:t ,~. ~
'lY7-')l/:.4s
FLOOD i'LAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:_,
SQUARE FOOTAGE: ,__
To r~qllp.st ah!r.sp,:,r,t!on,Y0u rr::..:st C3l! 72537'3D..Tlii:::~ ..-':4.:"..;t;n"'~G0Iuing:-Aii rnspccliorl::> le4u~::>led before 7:00 a.m, will be
made the same working day, In'spections requested after 7:00 a.m. will be made the following work day.
D Final Plumbing - When all
plumbing worl< Is complete,
, ,
D Final Electrical - When all
electrical work Is complete.
~Flnal Mechanical - When all
~ mechanical work I~ complete.
D Final Building - When all
required Inspections have been
approved and buildIng is
completed.
RJ Other
~~ h/.f~ti
" - -""
r/"'Al4M
( ,
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbing/Electricall
MechanIcal - Prior to cover,
D
Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground PlumbIng - Prior
to filling trench, ,
o Undarlloor Plumblng/Machanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking,
o FJoor ~I!sulatlon - Prior to
clecking,
u' I::'"
O Sa'nilary Sewer - Prior to filling
trench:- ~
.~"...: I'
.
"
~ i ' .
'-
, '
- I
MOBILE HOME INSPECTIONS
o Blocking and Sat.Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
wafer and sewer:
o Electrical Connection - When
blocking, set,up, and plumbing
Inspections have been approved
and the home Is connecled to
the service panel. .
o Final - After all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed,
.
LOI faces
lot Typa
Lot SQ, ftg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM
'X $/SQ, FT,
SQ, FT,
Main
Garage
Carport
Tolar Value....
Building Permit Fee
Sl<tto Surchargo
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITEM
Fixtures
Residential 8ath(s) N'
Sanitary S,ewcr
!:.l~___
FT,
Waler
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertfFlreplace Unit
Dryer Vent
,
/,
Mechanical Permit
, ,
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (axcluding electrical)
(A. B. C, 0, und E Combined)
I P.L.
IN
Is
w
E
----
VALUE
"
FEE
Setb--:cks
HSE GAR ACC
~
I,
~
IS THE PROPOSED WORK IN THE,
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
alld approved by the Historical
Coordinator prior to permit issuance,
\
-APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
,
This permit is granted on the express condition, that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springflald, including the
Dovelopment Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check FQe:
Date Paid:
Receipt Number'
Received By:
"Plans Reviewed By
Data
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
\/r;due 3/' oj SS-$'
/
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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 donG In accordance
with tha Ordinances of the City of Springfield, and the laws
of the State of Oregon perlainlng to the work des-::rlbed
herein, and that NO OCCUPANCY will b. made of any
structure without permission of the Building Safety Division.
J further certify that only contractors and employees who
are In compliance wlth OAS 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 approved set of plans will remain
on the site at all times during construction,
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VALIDATION: ....0 Al '"
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RECEIPT NUrm~?J 0
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DATE PArtD .....~"2'" '=" - "'!>-t./v _.. ~
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SIgnature
Date
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