HomeMy WebLinkAboutPermit Building 1992-10-28
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RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: die;:{)
ASSESSORS MAP: I '70,3Q7/ ( ) ~
VOJJ) x(f\'{) PHONf'
(luJL()_" \llLe~.
o STATE: Q1'J1l(\) ZIP:.JiiJ4-' I.!-/
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DESCRIBE 'WORU \$\ \I t 1 J ,~L D\ l '6\ ')l ym--;
NEW REMODEL AD~~ION DEMOLISH OTHE
LOT'
OWNER:
CITY:
BLOCK'
.
i " ,JOB NUMBER
Q815')O
'fI .
SUBDIVISION'
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.~
:, ::::::?M~O ~~ \-i;, j~t~\~~SS ~')~!x') A
PLUMBING~ Ofl.~ J~f"V\.. J
CONST.'
CONTRACTOR #
In\iJ5f)
LdR l\4(}
EXPIRES PHONE
~'18.qS
~~~
MECHANICA~1 -'
ELECTRICA~ -V't Q))A~O _
QUAD AREA: \ ~)u..J
# OF BLDGS: \
OCCY GROUP: ~~:\-Jv\
# OF STORIES: \
7-,
WATER HEATER:
lo ~ --)k~') I Q . {i)' 4'V
.'
.. 'r
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LAND USE: OFF\\ ~Oj
# OF UNITS: ~'. I
CONSTR. TYPE: _~/LI
r--FJ
HEAT SOURCE:
RANGE:_U
",',
,;
~.
FLOOD PLAIN' 'J
ZONING C~DE:U' IV
# OF BDRMS: ~
SECONDARY HEAT'
SQU.ARE.'FOOTAGE: ~)
To request an Inspection, you must call 726,3769. This Is a 24 hour recording. All insp'ectlons requested before 7:00 a.m. will be
made the same working dny. Inspections requested after ?:OO a.m. will be made the fOllowing work day.
REQUIRED INSPECTIONS
CJ Temporary Electric
o SlIe Inspection - To be made
after excavation, but prior 10
setting forms.
o Masonry - Steel locatlon, bond
boams, grouting.
o Foundation - Aller forms are
erected but prior to concrete
placement.
o Underground Plumbln'g - Prior
to 1IIIIng 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. .
~sanltary Sewer - Prior 10 filling
trench. _
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O Storm Sewer - PrIor to filling
trench.
mWat~r Line - Prior 10 filling
'T-' trench,
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o Rough Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
cover.
~ffif e;;~~'~p
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/e'olllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After I~stallatlon.
D Inserl - After fireplace approval
and Installatlon of unit.
o Curbcut & Approach - After
forms are"erected but prior to
placement of concrete.
o Final Plumbing - When all
plumbing work Is complete.
~Fln81 Electrical - When all
pelectrlc'al work Is complete.
~. . '.
O Final Mechanical - When all
mechanical work Is complete.
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Final Building - When all
.requl~ed)nspectlons ,have beon
epproved.and building Is.L
comPletedCDJL{Y)r L..-
OOther
MOBILE HOME INSPECTIONS
,.,
.' "'f' .', .
l rz5( Blocking a~d Set,Up - w~en al/
( blocking Is complete,
/J
P t'lumblng Connections - When
homO.has been connected to
water and sewer. '. "
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ffi' '.. I~c'trlca(donnecilon- WhIm"
. . " bIOcklng:set'up,:an:d~PIY'f,1~,\Dgl'
-':, 'Inspec, tlOnS,have,'be. en"approved'
,', :, a,:,d. the~9rrJetls'co:~ne~t,ea.~~o:;
>- ,t,he servlce,panel, '. ,,'.....
OF ',' . ,.I.. ""4'>.,,\_, .
once -'Whe,n completed. '. > "~' 1:-';, . ".'. .: :.' ':.: ""f-
, . _.. ,"I ",.....,'1"',' , \'r,
. "; " , ",: ..:: .,,~ '_, " '~.In'ol;.7- ~t~e!i'~c~l:lr~8l(l.re.d.' j,' ":f. .
" ',J-' " " .'" ":l-';""~,' "I _ ~'lnspeOtlons!are"approved,and I, ...'
. '" . ,...._,t~ - '.." """,'l,""",,,~'l.~_,... ~~ _ ,,-. .."........"~..',. -,~ ~......._'., '.,..' t:,
o St~eet-'Jree8 ,- When all requlrecb~;1 .~.v,' .,'~ip'o!ch.eSi ';sl<lrtl~g},deCK,9i a')~d; j 1~,!i7 ~ '
trees are planted. :'. \~ 'ventlng1have,'been Ins.talled:' '.
o Sidewalk & Driveway - Aller
excavation Is complete, forms .~ '.
and sub,base material hi .place: '
Lot fa~es
Lot~q:' 'ftg:J
. <~ ~ ' . 1 ,,' " , ,,'
Lot" cpverage
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Topog',aphy
Total height
Setbacks
- 't", '
HSE 'GAB' 'ACC
Lot Type. ,
. ~:'ilr\ieri6t,'J-"f .,1 P,L.
~~. .~ ::~; :~,'"' ' :'; ~~';,:;j ;'~::~'-:
,~.C~rn~r ,'/.\ ~.,"
, " -,' " ,
'pa~~~~dle 's
Iw
IE
Cul,de.sac
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1'1. ~'. 'l
~ THE PROPOSED WORK IN THEJ
-""lII/'f!STORICAL DISTRlqT, OR ON
THE HISTORICAL REGISTER?
: - \ ! ~ "
If yes:..th,l.~ ~pp.!Icatlon 'must ~e signed
and 'app.roved by tho Historical
. CoordInator prior to permit Issuance.
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APPROVED'
BUIL.DING' PERMIT
ITEM SO: FT:
Main
. '
Garago
Carport
Total Valuo
X $/SO. FT. =
VALUE
J1{ D,CU
.. (A)
0l~~
. I, l
A.4,1 '
Slato Surchargo
BuildIng Permit Fee
Total Feo
,SYSTEMS DEVE'LOPM,ENT :C'~A\R~A~DCj /,
, (B) ~
PLUMBING PERMIT
ITEM FEE
FIxtures
Residential Bath(s) N'
Sanitary Sewer FT.
Waler FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
~
/5 ,CD
L1J
Lo~.
l O'~'~
Furnace
MECHANICAL PERMIT
Exhaust Hood
Vent Fan
Dryer Vent
Wood Stovellnsertl Fireplace Unit
N'
Issuance
Mechanical Permit
State Surcharge
Total Permit
(D)
o
IOS,cfJ
,., c{)
C:) () .
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MISCELLANEOUS PERMITS'
Mobile Homo
State Issuance
State Surcharge
Sidowalk
Curbcut
Demolition
State Surcharge
ft
ft
Total Miscellaneous Permits' (E)
TOTAL AMOUNT DUE (excluding el~ctrlcal~ Id 1'1 ~
(A, B, C, 0, and E Combined) r rOd::5. /8) I
BUI~DING,VALUE,-:P,LAN CHECK
AND BUILDING. PE,RM!T
This porrnlt Is granted on the express condlllon th 11e said
construction shall, In all respects, conform to Ordinance
adopled by the Cily of Sprlngflefd ncludlng the
Development Code, regsng the con uctlon and use of
buildings, and may be sus ended revoked at any time
upon violation of any provis on of said ordinances.
Plan Check Feo: _~
Date Paid: ..)(
Plans Revlowed By
Dato
Systems Development Charge Is due on all undeveloped
properlles wllhln the City limits which are being Improved.
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. ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
tho eompleled application and do hereby cerllfy thai all
Information hereon Is true and correct, and I furl her 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 Stale of Oregon pertaining to the work described
herein, and Ihal NO OCCUPANCY will be made of any
structure wlll10ut permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance Witll ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections arc
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 approvod sot of plans will remaIn
on the site at all tlmes during construction.
Signature -~9~~vU" Sv~
Date j'fJ 10- J-r -1'1.
VALIDATION: ~
RECEIPT NUM~TQ. . ( ,-:).., _
DATE PAir H) ~Ir} . \
AMOUNT RECElmD, N" \;-ll)~ ,t oP1 (SD1,~)
RECEIVED BY V \Y
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SPRI.FIELO'
DEVELOPMENT SERVICES .
PUBLIC WORKS .
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
MOBILE HOME AND MANUFACTURED HOME AGREEMENT
UNITS TO BE PL.~CED IN A PARK
As required ~y the City of Springfield Development Code and/or the State of
Oregon, I understand and agree, as sho-n by my signature on this form, that .ith
the apEIoval~~ the attach~ft R~mjts for a home to be located at
.!) fh n C'ltl1J/l~ -+1Q/(Yq , Springfield, Oregon, Ci ty Job Number
~/~LJ() i .ill meet or exceed the below 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 side.'alk
Accessory Structure Setbacks
10 feet from a park building
20 feet from any public street
5 feet from the edge of a park street
2 feet from the in terior edge of a park sidevalk
3 feet from an interior space line or rear space line
I further state, by my signature belo., that I have been provided .ith the
folloving information:
Manufactured Home Blocking Requirements
Minimum Requirements for Permanent Steps
- Electrical Connection
Si:jf:1AM-L .
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10- J-O-Y 2-
Date