HomeMy WebLinkAboutPermit Building 1994-8-12
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RESIDENTIAL
PERMIT APPLICATION
9S///7'?
JOB NUMBER
Inspections: '726-3769
Office: 726-3759
225 Fifth Street
Springfield, Oregon 97477
L./"k.J~AL
LOCATION OF PROPOSED WORK' '2""::J"<75
ASSESSORS MAP' /?~~-<?~/~
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, TAX LOT:
SUBDIVISION:
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LOT'
BLOCf<"
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OWNER:
ADDRESS:
CITY'
PHONE:
STATE:~~,
47 C/??
ZIP:
L~'::'-~77"'? CJcY- /2 1% ::;:> yl" ,./"..t;:Z-.?=;>~./'"'"'"'
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DESCRIBE WORK:
, DEMOLISH
ADDITION
NEW
REMODEL
OTHER
CONST,
CONTRACTOR'
ADDRESS'
EXPIRES
PHONE
1
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- OFFICE USE -
QUAD AREA: f:j ,1\ ,AI 'IV LAND USE: .//i/ FLOOD PLAIN'
. OF BLDGS' 'J . OF UNITS' ZONING CODE: /Zf )j /(l
M VN " ,
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES: I HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: 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
made the same working day. Inspections reQuested after 7:00 a.m. ~III be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical ...:., Prior to
cover. '
o Final Plumbing - When all
plumbing work Is complete.
, ,
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Roug'h,Electrlcal - Prior to
cover. .
D Final Electrical - When all
electrical work Is complete.
I
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical work Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
I'\7(Foollng - After trenches are
~excavated. .
)o;;:;;('Flnal Building - When all
~Qulred Inspections have been
approved and building Is
completed,
o Fireplace - Prior to facing
materials and framing Insp.
o Mesonry - Steel location, bond
.beams, grouting. .
o Foundation - After forms are
erected.but- prior to 'concrete
placement..
JRl. Fra~lng - Prlor:to cover.
o Wail/Ceiling Ins..ilellon - Prior to
cover: .
o Other
o Underground Plumbing - Prior
to filling trench,
o Drywall - pr',or to taping,
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
-,Prior to Insulation or decking,
o Wood Stove - A,fter I~sta"atlon.
o Blocking and Sat,Up - When all
blocking Is complete.
o Post and Beam - Prior to floor
Insul~t!on or decking.
o Floor Insulation - Prior to
decking,
o Insert - After "ieplace epprovel
and Installation 01 unit.
o PlumbIng Connections - When
home has been connected to
water and sewer,
, 0 Curbcut & Approach - After
forms are erected but prior to
placement of concret,e.
o Sanitary Sewer - Prior to IIIlIng
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the ho'me Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is complete. forms
and.sub.base material ,In place.
. , " ~
o Storm Sewer - Prior to filling
trench. .
o Fence. - When ~o~'Pleted.
O Water Line - Prior to IIIlIng
trench.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I'
o Rough Plumbing - Prior to
cover.
o ,Street Trees - When all required
trees are planted: 4. . " ~ ,
Lot faces
Lot~ype' I
LOI sq, ltg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul,de.sac
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"( tTHEPROPOSED WO~KIN THE..
'-"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcatlon,'!!ust be signed
and approved by the Historical
, Coordinator prior to permit Issuance,
.:.: '. ' .. Setbacks.
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BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, ~ VAWE
rv,1aln
Garage
"
/2x-2.4 ..LC2/0 2"'i't;9 <j
,~,$'"O
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I~' -
-4-,' 5''9
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SYSTEMS DEVELOPMENT CHARGE (SDC)
Carport
Tolal Value
Building Permit Fee
State Surcharge
'3'~, ~4J ,
(A)
Total Fee
~
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resld,entlal Balh(s)
Sanitary Sewer
N'
FT,
Water
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk It
Curbcut It
D~Z;;;
Cel. ,._"-/CW
'P-.WOP
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
QS'.o3
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..J/J~ /2..
APPROVEP'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thatlhe 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.
Plan Check Fee:
Date Paid:
Receipt Number:
Recel~~:
Pla~~~~
~(/;, peL
-;r-"cAte 1
Systems Development Charge Is due on all undeveloped
-
properties within llie City limits which are being Improved,
ADDITIONAL COMMENTS
'.
By signature, I stale 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 t~at NO OCCUPANCY will be made of any
struclure without permission of Ihe Building Salety 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 permit card Is located at the front
of the property, an he approved et 0 plans will remain
on the site at al mes durin ruction.
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VALIDATION:
RECEIPT NUMBER
DATE PAIr>
/13/2-
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AMOUNT RECEIVEP
RECEIVED BY _