HomeMy WebLinkAboutPermit Building 1992-9-17
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
.
. JOB NU~BER ',ill l!:lj
225 Fiflh Slreel
Springfield, OlOgon 97477 ,
~ c:J1: 2.-~
I TAX LOT: 0 <-(.:{CO-:;t9
SUBDIVISION:~ ~_
BLOCK'
STATE: tJ?&___..
? Lli (eiIA.UJ---
LOCATION OF PROPOSED Y'l,9JJ'- .;:L ( 5' 0
ASSESSORS MAP" I VJ 0 ') (I 0
~d.L/
OWNER: G.d-"" r. )JAl.A? .zL.n-// - --
ADDRESS _ d 8n~ ~/ -t12sU...
CITY ~.,.A/V/f!I~utd
DESCRIBE WORK: ,Vd\"
NEW / REMODEL
ADDITION
, -.
DEMOLISH
- OTHER
PHONE:
7 "-/"____1-15:.25
ZIP: 227!.Zl-"-
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CONTRACTO~NAME
GENERAL: ::::1<:1P""7
ADDRESS
\J..... )~~) (" ^ \. ')
CONS'r.
CONTRACTOR' EXPIRES PHONE
'XY8~~~~fol::\~_\,'.,:'{1.-9.2_J.~-2\) \
PLUMBING'
MECHANICAl'
ELECTRICA' '
QUAD AREA'
'. OF BLDGS: \-
. OCCY GROUP ~\\
, OF STORIES: ~
WATER HEATER:_
- OFFICE USE -
"LAND U~E~ ~
" OF UNITSE:pK.~\.u.o.~
COr:;;TR TYPE~l \~\ 0.. ~ . ..
HEAT SOUIlCE: _.'___''''_
RANGE:
FLOOD f'LAIN: ~_\~
ZONING CODE: _
JI OF UDrtMS: ______
SECONDAHY HE^':
SQU^n1::' F001^GE:
To requ9st an lflspcctlon, you must catl726-3769. This is a 24 110ur recordin~J. All imipecHons requested befolc 7:00 .un. will be
made the same working day, Inspections requested after 7:00 a.m. will be made tile followin~} work day.
D Temporary Electric
D Site' Inspection. - To be. made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~~g - Atter Ironches are
excavated.
D
Masonry - Steel location, bond
beams, grouting,
D Foundation - After forms arc
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Under'loor Plumbing/Mechanical
- PrIor to Insulation or deckintl.
o Post and Beam - PrJor to floor
insulation or dccl<ing.
o Floor Insula lion - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench. .
D Water line - Prior to ruling
trench.
o Rough Plumbing - Prior to
cover. .
REQUIRED INSPECTIONS
'D Rough Mechanical - Plior 10
cover.
D Rough Electrical:"" PriOI lu
cover.
D Electrical Service - Must be
approved to obtain pennnnent
electrical power.
D
Fireplace - Prior to facirl{l
materials and framing Insp.
D
Framing - Prior 10 COVI)!'.
D Wall/Ceiling Insulation - Prior 10
cover.
D Drywall - Prior to tnpinu.
D Wood Slove - Artc.r in~;lall;lljon.
D Insert - Aftor (Ireplace approvul
and Installation of unit.
D Curbcul & Approach - AHcr
forms arc erected but prior to
placement of concrete.
D Sidewalk & Driveway - Aflcr
excavation is complete, forms
and sub.base material in place.
D Fence - When completed.
D Street Trees - When nil required
trees arc planled._. " i.'
,
[:=]
Final Plumbing - Wilen nIl
plumbing work is complete.
[~ Final Eleclrical - Wilen all
clcGllical wol'l, is cOlllplclc.
D
Final Mechanical - Wilen ;111
mechanical worl, is complete.
D
Final Building - When ill!
required Inspecllons have been
approved and building is
compleled.
CI
Olhcr
MOBILE HOME INSPECTIONS
I 1 OIocking ond Sct.up - When ,]I!
blocking 15 complctf~.
I I Plumbing Conncctions - When
home has been connected 10
water and sewer.
o
Elcclrical Connection - Whon
blocking, set.up, amJ plumbinu
inspecllons have been approved
and the home is connected to
the service panol.
I 1 Final - After all required
Inspections are approved and
porches. skirling, dcr:ks, and
ventlng have been Installed.
Lot faces
lli-~'nt.ot 11'1'0 .
Lot sq, Itg.
_ Interior
_Lcorner
Lot coverage
TopograpllY
Total height
Panhandle
CuI-dc-sac
BUILDING PERMIT
. ITEM SO, FT. X $/ SO, FT
Main
Garage
CHrpOrl
('.::..-:::'\.---_.- - ~ --
~~~<\:)_~\.J_ ,\_
Tatar Value
Building Pennit Fcc
State Surcl1argc
Total Fee (A)
'I
l .HE PROPOSED WORK IN THE
'-. HISTORICAL_ DISTRICT, OR ON, <..\"
THE HISTORICAL REGISTER? )...) Io'r'
If yes, this application must be signed
and approved by tho Historical
Coordinator prior to permit issuance.
Setbacks
~J:!~~ GAR _AC.Q,
~a__
\,1
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W \\
E
VALUE
8C{~~~
~~\,.-
___L~~
.-.. ._-~~
.YS .12-
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential 811tt1(S)
N'
Sanitary Sewer
FT.
Water
FT.
'Storm Sewer
FT.
Mobile Horne
Plumbing Permit
State SUlcll;IIQe
Total Ctlarge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnscrtlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcl1mge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
FEE
,
~
D--I-~
~l\:-
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exclucllng electriC1) \~. i.L
(A, 0, C, D, ..nd E COIllblncrl)
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 constructlon and use of
buildings, and may be suspended or revol<ed at any time
upon violation of any provisions of said ordinances.
Plan Checl< Fee:
Date Paid:
Receipt Number.
Received By:
--:--J -...........,. ,( r\~P
~~---~-
Plans Reviewed By ,
C\.- \'\ -C\~
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improveeJ.
ADDITIONAL COMMENTS
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By signature, I state anel agree, that I have carefully examined
the completed application and do her~by 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 certl fy 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 carel Is located at the front
of the property, and the approved set of plans will remain
on the site a}1all tl,#S during construction.
Signature ~ ~
DatP' (/9-/1- 9d.-
r
VALIDATION:
RECEIPT NUMBER & 2? ~
DATE PAID q-t7 ~tr ----
AMOUNT RECElv:n, v6, '3
RECEIVED RY _.._~