HomeMy WebLinkAboutPermit Building 1994-12-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORI<' 21.:5'0 ~.di?A-
10DWlln
OWNER:~Qf\t It l~ mji'S
ADORE!''''' "t::)(JrQ4 ffiCtLr\ &~
CITY:~l1\C\~nJ) n) STATE:L~_
ASSESSO(:Q,iJEo
LOT: _
a""-:-.
BLOCI<'
~g
.JOB NUMBER Ofl(ft (q
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: (M(XJ
SUBDIVISION:J"22o?HnIl /aa.A :t::>A?V
PHONE::yLLP 2../7 I
ZIP:
q.~
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'P~~..m-t::u.rr
DESCRIBE WORK: .41A4.{.J;~~
NEW V REMODEL ADDITION
DEMOLISH
OTHER
CONTRACTOR'S NAME
GENERAL: h/PRA'r ft}R:<;"",,",A~
1 CONST.
ADDRESS ., CONTRACTOR'
S'/'):?d /h~".j, ~/,,( ~ ~7-","-
/"-,,z.-9.s-
PLUMBING'
'I
"
MECHANICAl'
ELECTRICAL: X~ .~~
"
"
'Ji?,i!J./'J7./JJ'/ /.#~~ ~.D'"
/'
EXPIRES
PHONE
??j!,,-Z,J7/
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i,
"
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- OFFICE USE -'
QUAD AREA: \Q t\Jl 0 LAND USE: \\7V FLOOD PLAIN: ~
. OF BLDGS' \ . OF UNITS' \ ZONING CODE:
OCCY GROUP: 'R~ .J-M CONSTR. TYPE: Vf\) . OF BDRMS' lA
. OF STORIES' \ HEAT SOURCE: ~~ SECONDARY HEAT:
WATER HEATER: U RANGF' V SQUARE FOOTAGE: \ nP::O
To request an Inspection, you must call 726.3769. This Is a 24 hour recordIng. All inspections requested before 7:00 a.m. will bo
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting for~\\ ^.--\ .. -..\ -. ()
r\:Al'nderslab ~~,
Lf'MeChanical - Prior to cover.
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grou.ting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Un"derground Plumbing - Prlor
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
,decking.
Msanitary Sewer - Prlor to filling
~trench.
o Storm Sewer - Prior to filling
trench.
,\
Ii
rv1 Water Line - Prior to filling
~ trench.
i
,
;
I,
-0 Rough rlU~bing - P~or}o
.. ,~~q~er. ..).: ~ ~~
t '/ _t'.o;., . I ~ ""::. . . ( .,~ .\
o Rough Mechanical - Prior to
cover.
r17PROUgh Electrica~ rior to
/' cover. ~Uyr
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 Wall/Ceiling Insulation - Prior to
cover. ;
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
an~ 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.
D Street Trees - Wh~n all required
trees are planted.
o Final Plumbing - When all
plumbing work is complet,e.
rcn:::final Electri'cal - When all'
Lf electricN t,.orJk ~lf!ete.
D Final M~wr ~hen all
mechanical work Is complete.
~Inal Building - When all
required inspections have been
approved and bill~~nj ~.r
completed. \.:..L^/y rl1
o Other
MOBILE HOME INSPECTIONS
~ Blocking and Set.Up - When all
blocking Is complete.
r\7I Plumbing Connections - When
a..p home has been connected to
water and sewer.
I'Q1 Electrical Connection - When
L,C:I blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
~Final - After all required
L..,1SJ Inspections are approved and
porches, skirting, decks, and.
venting have been Installed.
,-,;1,'
lol Type. '.~'~:W
Lol faces ,.- .,>
1"'-'"
lot sq, ftg, Interior I P,l.;.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total helghl Cul-de-sac IE
't,"
Setbacks
HSE GAR
BUILDING PERMIT
ITEM SO, FT, X $/SO. FT.
VALUE
Main
Garage
Carport
~59.
!J~-
Total Value
A~~
/?:;~.~
t-.~()q
4\.~
Building Permll'Fee . ~
Slale Surcharge 4;~O
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE.{,SDqD
(B) QYw4
PLUMBING PERMIT
ITEM
FEE
Fixtures
,Residential Bath(s)
. .Sanltary Sewer
N'
FT.
c!j ~.CO
~500
Water
FT.
Storm Sewer
FT.
Mobile Home
ISPc)
Plumbing Permit
Stato Surcharge ;- ~ (;)70
Total Charge (C)
l~~
.!S.?])
2n.'LO
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
'Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
Rf
MISCELLANEOUS PERMITS
Mobllo Home
l~~
~ O.CIJ
5..9S
Stale Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
0' L~
,:"'-'C c...~ ...9o/D
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excludlng..electilcal) , .A r
(A, B, C, 0, and E Combined) / ~S. ~.,.C-\q\O-:n--~
'----~ ".-. /
...
,.'
& THE PROPOSED WORK IN 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.
Accl
I
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 of any provisions of said ordinances.
Pfan Check Fee: ~ ~'" ~
Date Paid: ~ 'C}./"
Receipt Number'
Uffi 1\~n f-- ~
Plans Revie~
J~_. {IoYf
Date"
Systems Development Charge Is due on al! undeveloped
properties withIn the City limits which are b~lng 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 pormlt 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.
Slgnatu'0~{" ~ <
Dato
/Z-20-9"'"
VALIDATION:
/$"ft>/ /
DATE PAID ;-(,V~/7f!... ~
AMOUNT RECEIVED: 12.\3 .f)~ ':!:q~:J.qle.)~
RECEIVED BY /.P'~ . '*/5-~
RECEIPT NUMBER