HomeMy WebLinkAboutPermit Building 1991-9-4
RESIDENTIAL
PERMIT APPLICATION
_e,
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK' /t:/6 If rUO.c:;.,? /?"Z)
ASSESSORS MAP: /7"t:> 'Y- "?V-,.2..
LOT:
CITY:
DESCRIBE WORK'
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NEW
x
REMODEL,
ADDITION
CONTRACTOR'S NAME
GENERA" ~/!/~=?'?
PLUMBING'
MECHANICAl'
ELECTRICA' .
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
)VJ~!
I
. OF STORIES:
WATER HEATER:
.'
JOB NUMBER. ~//.:7~d)"":"
225 Fifth Street
Springfield, Oregon 97477
BLOCK:
...TAX LOT: o>a."7"~o
SUBDIVISION:
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.
o Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover.
o DryWall.- Prior to taping.
o Wood Stove - After instarr~tion,
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - 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 Str~et 'Trees - When all required
trees are planted.: .
PHONF'
? V?-/5' 7"'9
OWNER: p E?7P.R-/3,,') 1A/~ALrrC-:HF7p
ADDRESS: _/h/O KeLt::. /0>'<::; ~ R/?
/)?rz7.5
STATF'
..-? ;<? .
ZIP'
ADDRESS
CONST.
CONTRACTOR'
PHONE
EXPIRES
*
'. ,
FLOOD PLAIN'
ZONING CODE:
L 7J7":f
/-;2, X/b" ' C:::;AZ?~Z5 0
DEMOLISH
OTHER
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested belore 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.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
~FoOting' - After trenches are
excavated,
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placeme0t.
o
Underground Plumbing - Prior
to filling trench,
o Underfloor Plumbing/Mechanical
- Prior t9 Insulation or decking.
o Post and Bea~ .....: Prior t!=> floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench,
O Water Line"": p'rlor to 1lIlln.g
trench.
o Rough Plumbing '- Prior to
cover.
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTR. TYP'"
HEAT SOURCE:
RANGE:
o
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work !s complete,
o Final Mechanical - When all
mechanical work Is complete.
rvl Final Building - When alt
~ required 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, de-cks, 'and
ventlng"have been Installed.
Lot faces lot Type . Setbacks .I.E PROPOSED WORK IN THE
lot sq. Itg. Interior I P,L. HSE GAR ACC I HISTORICAL DISTRICT. OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner Is I If yes. this application must be signed
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance,
Total height _ Cul-de-sac IE I
APPROVEr>'
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Carport
4{A:2E;137 /92
/.:?./tt>
/"N: 9. 52'>
.Thls 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 suspend~d or revoked at any ttme
upon violation of any provisions of said ordinances,
Main
Garage
"'
Plan Check Fee' "2./. /"3
Date Paid: ~. 7/- 9/
Receipt Number' ---::l //"7?-
Received By: ~---
/k'L~<-- /
Plam Reviewed By' " r F
""5-V""/ /'
Date
Total Val ue
Building Permit Fee
"":?::?~-&>
/. ~":3
3if./~
State Surcharge
Total Fee
(A)
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
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
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 done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, 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.
Exhaust Hood
Wood Stovellnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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.
Signaturee.~- ~,/
..;.-: .~~{ ;
Date. /
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
-
State Surcharge
J2..#-"'Y' /l~V/E~ N-c
VALIDATION:
7</./?
-:;;;:://&''} --:L
P} -'0- '7 r
AMOUNT RECEIVED 5'S.26"
RE~EIVED BY 4~~---~
DATE PAIr>
RECEIPT NUMBER
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D. and .E Combined)
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