HomeMy WebLinkAboutPermit Building 1994-5-5
,RESlbENTIAL
PERMIT APPLICATION
Inspections: '126,3769
Office: 726.3759
.
SPRINGFIELD
OviNER:~ ~-r;{ll41/1 UA!.-+
ADDRESS: ,:;;z, 7 L( A.J c)i:::,-rv.. Sf-,.
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ASSESSORS MAP'
LOT'
CITY'
DESCRIBE WORK'
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NEW ./ REMODEL
ADDITION
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STATE: '
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, ' DEMOLISH
OTHER
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ClL\tB1s
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
IDS
TAX LO'r.
SUBDIVISION'
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PHONE:
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ZIP:
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CONST,
CONTRACTOR'
CONTRACTO}l.'S N~~E lh ADDRESS
GENERAl' (<-fnrO Q 1~ (j~ n n I j\C'\\'\.J
. '- '\... . -'-.:... ,
PLUMBING:
MECHANICA' ~^ - ~
ELECTRICA~' ~\..~ ~l rJ i))"'-.. ./
l{{~,\ ?--,I]
\ ~\\)l0 - OFFICE USE -
QUAD AREA: LAND USE: \\((\0 FLOOD PLAIN:
· OF BLDGS: - \ . OF UNITS' I ZONING CODE: ,l! jp )
OCCY GROUP~~~ CONSTR. TYPE:-IDJ · OF BDRMS: ~
. OF STORIES: I HEAT SOURCE: F'9.... SECONDARY HEAT: Ibl:)
WATER HEATER' 8 RANGE: _y--, SQUARE, FOOTAGE:
-
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections requesled before 7:00 a,m, will be
made the same working day, Inspections requested after 7:00 a,m, wlfl be made the following work day,
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcal/
Mechanical - Prior to cover.
O Footing - After trenches are
excavated.
o Masonry - Steel location, bond
.beams. grouting.
o Foundation - After forms are
erected but prior to .concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumblng/Mechanloal
- Prior to Insulation or decking,
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
~ Sanitary Sewer - Prior to filling
~rench.
"
o Storm Sewer - Prior to filling
trench. .
, / Waler Line:"" Prior t~ filling
lZ:itrench.
O Rough Plumbing - Prior to
cover.
o Rough Mechanloal .....: Prior to
cover.
D 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 10 cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior 10 taping,
o Wood Slove - After Installallon.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcul & Approaoh - 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 F~n~e. - When completed.
D ,Street Trees - When all required
trees are planted. .
o Final Plumbing - When all
plumbing work Is complete.
. ,
D Final Electrical - When all
electrical work Is complete,
o Final Mechanical - When all
mechanical work Is complete.
J& ' ,
Final BUilding - When all
required Inspections have b
approved and u Id n
completed.
o OJher
.'
MOBILE HOME INSPECTIONS
'\L Blocking and Sel.Up _ When all
~blOCklng Is complete.
I
~ Plumbing Connections - When
home has been connected to
water and sewer. ..1
~ Eleclrlcal Connection - When
blooklng, sel,up, and plumbing
Inspections have been approved
and the home Is connected to
I4lhe service panel. .
, Final - Alter all requl red
Inspections are approved and
~. -.porches, skirting, decks, and
venting have been Installed. .
.. ~- ,,:\
Lot faces
Lot Type .
Interior
Lot sq, ltg, ,~
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de~sac
BU,ILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
LV?f:)
\[), \[)
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
,.. ," -!'l;i ;', ;',..
'. '. 'J 1..A\!~"'I'''i.~'i '
..,. 'li..;-'\ !. '.fl"lj1 ,~Jj" T.
:::.." ;.r~'_:~."'~',_'
Setbacks
,I 'p.L. 'HSE' GAR ACC
IN
Is
Iw
IE
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, -~ '5 :'t ':
,
VALUE
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c() .53
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SYSTEMS DEVELOPMENT(~HARm4L.
PLUMBING PERMIT
ITEM
,
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
N'
FT,
Storm Sewer
FT,
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
..,;g;t.
Wood StoveJlnsertlFlreplace 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)
FEE
C_THEPROPOSED WORK IN THE..
"'l!I'!'STORICAL DISTRICT, OR ON " ,
THE HISlORICAl, REGISTER?
If yes, this application must be signed
and 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 Springfield, Inclu Ing the
Development Code, regUlating the constructlo nd use of
buildings, and may be suspended or revo at any time
upon violation of any provlSloJS of sal rdlnances.
Plan Check Fee:
Date Paid: \ ~
Receipt Number'~X
Received By: /
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
"'-~~~. n-ht5r\ 00' 0n \11 YJlt
CD, \Jl 0 \_LL Qjj~, w -r{) \
jJg CD lAb n ~ 0 fI~Al\ \ P. \
'. -:--c, l' ,.\r\, ('). \\l d'{\D 0 P )
IS,OU
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~ ),,.qc;
L~R.~S
E
1rt;,CD
("\ ~ () ,cv
-'.S Q5
TOTAL AMOUNT DUE (exoludlng electrical) \~.L.\'L..::13
(A, B, C, 0, and E Combined)
\Jvom~-.rJ)J)\'t\!)rvnft), .
UJ Y1\ UnO fiIJ,J\J\J AI to '
l oJl Q A:fx\ ~f) 0\\ \\.D\c\.\.UlG.tidl'-.
By signature, I state and agree, that I have carefuUy 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 Ordlnanc~s 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 wlU be used on this
projeot.
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 ttie property, and the approved set of plans will remain
+q:::"'~
Date f '
VALIDATION:
.
SPIGFIE~:'
MOBILE HOME M~D MANUFACTlffiED HOME AGREEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726-3753
FAX (503) 726-3689
UNITS TO BE PLACED IN A PARK
As required by the' City of Springfield Development Code andior the State of
Oregon, I understand and agree, as shovn by my signature on this form, that vith
the~.~ge~~/1t~~ ~~tac~~d ~its .for a home to be located at
cV 1'::::1.. ) uM/I(.A! ....::p- /( D ' Springfield, Oregon, Ci ty Job Number
, 'ftl )..l::...,c, 1 .,,111 meet or exceed the belov listed minimum setbacks.
Home Setbacks
10 feet from a park building
20 feet from any public street
5 feet from any rear space line or interior space line
5 feet from the edge of a park street
2 feet from the interior edge of a park sidevalk
Accessory Structure S",tbacks
10 feet from a park building
20 feet from allY public street
5 feet from the edge of a park street
2 feet from ~.he interior edge of a park sidevalk
3 feet from en interior space line or rear. space line
I further state, by my signature belov, that I have been provided vith the
folloving information:
Manufactured Home Blocking Requirements
Minimum Requirements'.'for Permanent Steps
- Electrical Connection
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