HomeMy WebLinkAboutPermit Building 1994-4-19
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· JOB NUMBER94rYJL
RESIDENTIAL
PERMIT APPLICATION
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT' ) \ \l.
SUBDIVISION:
Inspections: 726,3769
Otfice: 726,3759
LOCA;ION OF PROP01ll~~K~ ~ 50
ASSESSORS MAP' I' /LA ~f71 ( )
. .
BLOCK'
LOT' .
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CITY: '-.: . STATE: -ffjl) 0 ~
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DESCRIBE WORK' (1(0 1I t y Yr') .
NEW -I- REMODEL' ~DDITION DEMOLISH OTHER
ZIP:-E!.J4 ( II)
CONST.
CONTRACTOR'
EXPIRES ~
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CONTRACTOA NAME
GENERAL: ri )ill n Q
PLUMBING'
ADDRESS
f)
MECHANIC!' ,
ELECTRICAl'
- OFFICE USE -
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QUAD AREA: ~ R tl.Jl;)
:~:Y B~:::~: ~
. OF STORIES'
WATER HEATER:
FLOOD PLAIN: J' I
ZONING CODE:,-ill1C.J
. OF BDRMS'
LAND USE:
. OF UNITS'
CONSTR, TYP='
HEAT SOURCE:
SECONDARY HEAT: '
SQUARE FOOTAGE:~A()
RANG='
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,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~ .
o Final Plumbing - When all
plumbing work Is complet,e,
o Temporary Electrlo
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical -..When all
electrical work Is complete.
o Final Meohanloal - When all
mechanical work Is complete.
o Underslab Plumbing/Electrioall
Mechanical - Prior to cover.
o Electrical Servloe - Must be
approved to obtain permanent
electrical power.
'c7f Footing - After trenches are
~ excavated. .
I\J'Flnal Building - When all
~~equlred Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
~ramlng. - Prior to cover.
D Masonry - Steel locatIon, bond
beams, grouting.
o Other
D Foundation - After forms are
. erected but prior to concrete
placement.
o Wall/C'elllng Insulation - Prior to
cover. "
D Underground Plumbing - Prior
to filling trench.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
-,Prior to Insula~on or deoklng,
-
D Wood Stove - After l~stallat'lon,
o Blocking and Set.Up - When all
blocking Is complete,
D Post and Beam - Prior to floor
Insulation or decking. ."
D Insert '- After fireplace approval
and Installation of unit.
o Plumbing Connections - When
home has been connected to
water and sewer. .
o Floor Insulation - Prior to
decking,
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - Alter
. excavation Is complete, forms
and 5;ub-base material In place.
o Storm Sewer - Prior to filling
trench. . .
D Fence - When completed, '
o Water Line - Prior to filling
trench. '
o Final - After all required
Inspections are approved and
porches, sklrtln'g, decks, .:nd
venting have been. Installed:
o Straet Trees - When .all required
trees are planted. .'
o Rough Plumbing - Prior to
cover.
I'
Lot faces Lot Type . Setbacks l~ THE PROPOSED WORK IN THE
Lot sq, ltg, 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
APPROVED:
I
i
I
.'
BUILDING PERMIT
'~'^.
/ H..J
x $/WJ!j = VALUE~
/(J. lAin
'J
, ITEM
Main
Garage
~
;,
Carport
t
I
\
I
Total Value
...:~\ ,cO
155
3~5S
SY~TE~S DEVELOPMENT CHARGE 0C)
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PLUMBING@eRMIT
Building Permit Fee
State Surcharge
Total Fee
(A)
,
I
j
I
I
i
;
,
,
i
i
,
,
ITEM
Fixtures
, N'
Residential Bath(s)
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Ch~rge
FEE,
(C)
MECHANICAL PERMIT
Furnace
I,
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
.,
,
,
!
i
,)
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)
TOTAL AMOUNT DUE (excluding electrlcall~~ .b.L..:J
(A, B, C, D, and E Combined)
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 constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received 'By:
Plans Reviewed By
Date
Systems Dev,?lopment 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 haye 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 01 any
structure without permission of the Building Safety 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 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
Kn the site at all times durin construction.
, .
", Slgnatu
Dato
VALIDATION: \
RECEIPT NUM~ER '
DATE PAir <-t. \\J\ .
AMOUNT REPf.IJ"D', ~,')'
RECEIVEDc;;::JJff'Q './
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