HomeMy WebLinkAboutPermit Building 1992-12-7
RESIDENTIAL
PERMIT APPLICATION
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Inspections; 726.3769
Office: 726.3759
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LOCATION OF PROPp.sf~~ I !J\. \QU
ASSESSORS MAP; \ I I Vl>:-i \ \ ( )
OWNER; ~ ')lun P f ~ .J lr p omtJ_).::b:--
ADDRESS;AJ \ S~ (N'n I I /l fA' I
CIT'" ~ ~_ '---' r - STATE; I (\ \ 0 (\) iJY'\. .
_ \ \) , ..\JI... - \
DESCRIB5J WORK' (!{~ q. dI-Pr{( La 0
NEW \.$ REMODEL I ADDITION DEMOLISH r OTHER
/
CONTRACTOR/YtJAME )
GENERAL' ({)J j JIlOl?
LOT'
,-
PLUMBING'
MECHANICAl'
ELECTRICA' .
QUAD AREA; J Q f\ l/ .1.)
N OF BLDGS:_'
OCCY GROUP;_~
I
N OF STORIES;
WATER HEATER;
BLOCK'
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J~B- NUMBER .iltL(~~-
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION;
( r\4t")-)
PHONE; f")Ltln-Lt~~_
ZIP;
c{i4-'-+.-
ADDRESS
CONST.
CONTRACTOR N
PHONE
- OFFlCr7-.9Si\.-
LAND USE;_[ I~)( )
N OF UNITS:
CONSTR. TYPE;
HEAT SOURCE:
RANGE;
\/1\)
EXPIRE~
-~~
~
FLOOD PLAIN'
ZONING CODE;
fOP)
N OF BDRMS'
SECONDARY HEAT: /\ ~ VL
SQUARE FOOTAGE:~.
To request an Inspection, 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.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
~ Footing - After trenches are
P 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 Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After I~stallatlon.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - Alter
excavation Is complete, forms
and sub.base materIal In place.
o Fence - When completed.
D Street Troes - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work 15 complete:
~. Final Building - When all
l.L..J'--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 - Aller all required
. Inspections are approved and
porches, skIrting, decks, and
venting have been Installed.
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Setbacks
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I P.L. HSE GAR ACC I
IN I
S I
W I
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Lot faces
Lotge
Interior
Lot sq. Itg.
Lot coverage
Topography
Corner
Panhandle
Total height
Cul.de,sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garage
~,cl104
JloD
'.
IT'), \0 ~ Lp(fl (p
\ 4 . \ () <19.5lo
Total Value
~
4-Y8~'
~).
A .,C)
33.03
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
., (B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
FEE
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
It
Demolilion
~r\~0L~ ~
TOla', Miscellaneous ~mlts (E)
TOTAL AMOUNT DUE (excluding electrical) R. ~. 5lf;
(A, B, C, 0, and E Combined)
. \. IS THE PROPOSED WORK [N THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
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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, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation or any j.[OVjSi~ ~said ordinances.
Plan Check Fee: \ '~A~I').~ .
Date Paid:
Receipt Number'
Received By:
Jt:Ce~~-
_12/7k:-?
/Da~
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 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.
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 aU times during construction.
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VALIDATION:
RECEIPT NUMBER
DATE PAIr<
AMOUNT RECEIVED
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I;) 1, J ,,)-:l
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RECEIVED BY