HomeMy WebLinkAboutPermit Building 1991-8-12
r' ' ~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
.
SPRINGFIELD
.
JOB NUMBER f/Oc;OS
225 Fifth Street
Springfield. Oregon 97477
LOCATION OF PROPOSED WORK: _K ,,,-/;/ r._/
ASSESSORS MAP' I Q()~ 0(,,';:). 'i
,\ 9\P~1I 0: J 1.tU7 k'/.vr~/~
TAX LOT' O::.J.LJ()O I
SUBDIVISION: ~A:.<'h7))//'tt/.-A-
LOT'
I
1\'1 Cw
DESCRIBE WORK'
NEW X' REMODEL
~ ..J
BLOCK:
-=B>2-
STATE:
0P-
ADDITION
DEMOLISH
OTHER
PHONE:
7 V (...- '7 II OJ
ZIP:
0) 11./ \- ~ -
.
CONST,
CONTRACTOR'
CONTRACTOR'S NAME ADDRESS
GENERA" r \o"V'> ....,,~"'....(,l to,.,\'
PLUMBING' ~V\l:.~) l\.M\ PL.......'.:,.:.
MECHANICAl' '\rv\1'>R,,\"'..ll <'I i l
ELECTRICAl' 'J) ~\I c E:t",d n I {I>l,
<.R..<.u...
. OF BLDGS: I
OCCYGROUP:_'U-:?' tt A/}
J
h_
QUAD AREA:
. OF STORIES:
WATER HEATER:
\
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE"
LLLI
I
\IN
EXPIRES
PHONE
')'Il,l)I<",
;tr
VI
1"7-J~<I\-
':'''L'
-(
J2.-..
cAN~ (eH)
FLOOD PLAIN:
ZONING CODE: LOQ. -iI. AIL-
.3
. OF BDRMS:
SECONDARY HEAT: _r j?
SQUARE FOOTAGE: 1<;(7 :5
To raquast an Inspection. you must call 726,3769, This Is a 24 hour recording. All Inspections requested before 7:00a,m. will be'
made the same working day. Inspactlons requested aftar 7:00 a.m, will be mad. tha following work day.' .
0' Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Undarslab Plumbing/Electrical/
Mechanical - Prior to cover.
I":/T Footing - After trenches are
~ excavated,
D Masonry - Steel location. bond
beams, grouting.
f':::A Foundation - After forms are
~ erected but prior to concrete
placement.
R'A Undarground Plumbing - Prior
J2!>.J to filling tranch,
.f L. ' ---..
Underlloor .nYmbJn~Mech8nlc81 ~
~ _ Prior to Insulation or'decklng.
~ Post and Beam - Prior to floor
~ Insulation or decking,
~ Floor Insulation - Prior to
decking,
IV1" Sanitary Sawar -Prior to filling
~ trench.
.0 Storm Sewer - Prior to filling
trench,
~Water Una - Prior to filling
trench.
!81 Rough Plumbing - Prior to
cover,
REQUIRED INSPECTIONS
~ROU9h Mechanical - Prior to
cover.
. ~ Rough Electrical - Prior to
. cover.
r\:::A Electrical Service - Must be
~ approved to obtain permanent
elactrlcal power,
J8J Fireplace - Prior to facing
matarlals and framing Insp,
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
,~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 Sldawalk & Drlvaway - Aftar
excavation Is complete, forms
and sub.base material In place,
D Fence - Whe~ completed.
D Street Trees - When all required'
trees are planted,' .
cs;r Final Plumbing - When all
plumbing work Is complete.
'0Flnal Elactrlcal - Whan all
electrical work Is complete,
o Final Machanlcal - Whan all
mechanical work Is complete.
IVr Final Building - When all
~ required Inspections have been
approved and building Is
completed,
D Othar
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - Whan all
blocking Is completa,
D Plumbing Connections - VYhen
home has been connected to
water and sewer,
D Electrical Connection - When
blocking. set,up. and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all requlrad
Inspections are approved and
'. p'orches, skirting, decks, and
venting have been Installed,
" '-.~ - 1
.Lot faces J&L Lot Type' Salb'lcks ., THE PROPOSED WORK IN THE
-;''1S0 ~nterlor I P,l. HSE GAR ACC I HISTORICAL DISTRICT. OR ON I
Lot sq, fig, IN I THE HISTORICAL REGISTER?
Lot coverage .n Corner 5 If yes, this application must be signed
J2... S /tJ( /c/ I and approved by the Historical
Topography Panhandle I Coordinator prior to permit issuance,
, 1.'i'(
Total halght L!:L Cul.de.sac W
E <l7( I APPROVED:
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT, ~
3'7, ?a
/4,",p
VALUE
_44 7!l~/ c,~
//9 9>-;t'.~o
Main
..Jj 25lJ
?:~~-
Garage
Carport
c~ 'l2$~!o
-1;01. CJCl
(e;, 0 1:;
-3..1 (,,0.:;
SYSTEMS DEVELOPMENT CHARGE (SDC)
, , " (B) -YVJ~-
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ,.;.I.
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
I fe;, e:c;
Plumbing Parmit
116&, &0.
'9f J! ()
16<1&0
State Surcharge
Total Charga
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
4, 5" c)
6', CO
I >. 00
3,1)0
Vent Fan
N'
,;Z
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
,2, Y 52:
Lf7 ,00
/ ,Cl?
'(0.'1- 3
Issuance,
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobil. Home
State Issuance
State Surcharge
Sldawalk
fI
Curbcut
Demolition
fI
State Surcharge
i.M;F &. :9~7/(!, .Rft3
J//) 5~D
Total Mlscella.neous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D, and E Combined) .
b~1' 16
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shal.l, in all respects. conform to the Ordinance
adopted by the City of Springfield. including tile
Development Code. re9ulaling the construction and use of
bulldl~gs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
/0 - ~j-
Plan Check Fee: _ 7 5 .
& -/& -)'1
Receipt Number: 20 ~S-4
Received By: 4~'
Pla~~
Date Paid:
&-1Z/1?
1 ~a~ I
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 Ihave carefully examined
the completed application and do hereby certify that all
Inform~tlon 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 Slale of Oregon pertaining to the work.described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
are In compliance with 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 addr.ess 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.
Signature
Datp
VALIDATION:
"2r) "1 '7 7
~ -72-9/
AMOUNT RECEIVED (;;fiY=? _ 48
','~~
RECEIPT NUMBER
DATE PAin
RECEIVED BY