HomeMy WebLinkAboutPermit Building 1992-3-5
RESIDENTIAL
PERMIT APPLICATION
..
Inspections: 726.3769
Office: 726-3759
LOCfiI"lON OF PROPOSED WO~ ,() '-La
ASSESSORS MAP \1 n t) f..Jil1 n
BLOCK:
,-\{} ( m( J . f1.ltiJJ PHONe,'
Cy qrJ!JVLfU'( /"'i ..
!'~ ,~ STATE: _ OJ, 0 ,~DXJ ZIP: 11-7-4-J.::(
DESCRIBE WORK: r i )QJY\nl illJ) ~.\-Jw(riQJtb! '>L-/
REMODEL ' ADDITION DEMOLlSJ.-O OTHER
f
. OON~
C, ONTRACTO~'S NAME ~DD6J. ~e c:::. l'Y\~ ~EXPIRES~ P:ONE '1'1
GENERAL, _..' _ -U~, . <- \...J.v-LU - T lq....-,- ... f2JJ.o]u
I'LUMBING: -,.._..-,- -... -G- 'lJ..D9, ---- ~~..,
MECHANtCAL:
LOT:
OWNER:
CITY:
NEW
ELECTRICAL:
OUA~ AREA: Lgl~lu
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
- OFFICE U1E -
LAND USE: l \ \ I
. OF UNtTS'
CON,STR. TYPE:
, ,
,
HEAT SOURCE:
RANGF'
. ',-
JOB NUMBER ~-8,~
TAX LOT:
SUBDIVISION'
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
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
ma(le the same worl:<ing day, Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o
Site Inspcclion - To be made
nller excavation, but prior to
setling fOHns.
o
Undcrslab Plumbingl Electricall
Mechanical - Prior to cover.
o
Footing - After trenches arc
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - Afler forms arc
erected bul prIor to concrete
placement.
o Underground Plumbing - Prior
to filting Irc:nch.
o
Underfloor Plumbing/ Mechanical
_ Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or dccl<ing.1
o
Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o
Slorm Sewer - Prior to filling
trencll.
o
Water L1no "'"'7 p'rl~r 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 obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cove~ .
o Drywall - Prior to taping.
o Wood Stove. ~ After Installation.
,
o Insert - After fireplace approval
, and Instnllation of unit. .
. 0 Curbcut & Approach - After
forms arc erected but prior to
placement 01 concrete.
o Sidewalk & oriveway'- After
- excavation Is complete,.fonns
and sub-base. malerlai In place_
o Fence - Wilen completed.
o Stroet Trees - When all required
trees are planted.
o
Final Plumbing - When nIl
plumbing worl( is complete.
o Final Electrical - Whon nil
electrIcal work is complete.
o
Final Mechanical - Wilen all
mechanical worl< is complete.
o Final Building - Wilen all
required Inspecllons have been
approved and building is
completed.
f""' D~ rorl ihoo....
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When nil
blocking Is complete.
o Plumbing Connections - Wilen
home has been connected to
water and sewer.
o
Electrical Connection - When
blocking, set-up, ami plumblno
inspections have been approved
and the home is conneclCd 10
the service panel.
o Final - After all required
. inspections are approved and
porches, skirting, decks, nnd
vcnllng have been installed.
Lot raGes
Lot Type.
Lot sq. fIg.
Interior
Lot coverage
Corner
Topography
Panllandle
Total heigllt
Cui-dc-sac
BUILDING PERMIT
ITEM
SO, FT.
X $/SO. FT.
Main
Garage
Carpor!
Total Value
Bllilding Penni I Fec
Stale Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residonlial Bath{s}
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT
Mobile Home
Plumbing Permit
Slate SurGhar~Jc
TOlal Cllnroc
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StoveflnsertlFireplace Unit
Dryer Vent
Mecllanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
,Total Miscellaneous permils (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
HSE GAR Accl
I
I
W I
-L-_,~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
I P.L.
IN
Is
VALUE
FEE
IQCO
-101 ~ )
J~~()
Setbacks
., THE PROPOSED WORI< IN THE
"-I'~ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
This permit is granted on the express condition thatllle 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 revol~ed at any time
upon violation of nny provisions of said ordinances.
.Plan Check Fee'
Date Paid:
i Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Cl1;uge is due on all undeveloped
properties within tllC City limits whicll are being improved.
ADDITIONAL COMMENTS
,
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the completed application a~~o hereby certify tllal 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 thc worl~ described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify tllat only contractors and employees who
are In compliance wittl ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper lime, that each address is readable
from the street, that the permit card is located at the front
of the pr erty, and lhe approved sel of plans will remain
o t SIt ~imes du ing onstruction.
natur ~ Co
~-C; _CO _
VALIDATION:
-,,~Bq ({) ,
.~ ,Y'r-f-/
\~~-O
RECEIPT NUMSE~~
"
DATE PAIl"' (
AMOUNT REC~r@
RECEIVED sa (~