HomeMy WebLinkAboutPermit Building 1995-12-5
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RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: \ ~\')
ASSESSORS MAP' \l f) ~Id., ~ r:\. 'A..
OWNER: \ ~~ ~J\ " ~OQ.....\'U> f2...)
ADDRESi'''- \~ t/1!\'11 t\.fllnI)~ ,\\"
CITY: ~'\~l\ ^ .<'C\~9J) N (J STATE:' \~,lJ{jj('~r
DESCRIBE WORK'\ Xl \) N:f"I~ )j) C'\Cl.J\C'\ f\{__ ~
REMODEL V ADDITION DEMOLISH OTHER
LOT'
NEW
CONTRACT9~ NAME {
GENERAI,l\h. ~ ~o {C/
PLUMBING'
MECHANICA' '
ELECTRICAl'
BLOCK'
.
C\5\~rf-
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
PHON'"
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ADDRESS
CONST.
CONTRACTOR'
PHONE
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,
~ramlng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
[] Wood Stovo - After I~stallatlon.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
EXPIRES
- OFFICE USE -
QUAD ARE..' LAND USE: FLOOD PL";:IN'
· OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR, TYPE' . OF BDRMS'
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To requesl 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, Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be mado
after excavatIon, but prior to
settIng forms.
o Underslab Plumblng/Electrlcall
MechanIcal - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
.beams. grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing ~ Prior.
to filling trench. .
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
,0 Post and Beam - Prior to floor
Insulation or decking.
f
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to fUllng
trench.
o Storm Sewer - Prior to filling
trench. .
o Waler Line - Prior to filling
trench.
. 0 Rough PlumbIng"":" Prior to
cover.
. 0 Sidewalk Be Driveway - After
excavation Is complete, forms
and sub.base material In place.
.0 Fence - .VVhen completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complete,
o Final Electrical - When all
electrical work Is C?mplete.
o Final Mechanical - When all
mechanical wor1< Is complete.
~al Building - When all
f required Inspections have been
approved end building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot ~ype.
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Is TI;IE PROPOSED WORK iN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Topography
Total height
Panhandle
I P.L.
IN
Is
\W
IE
Setbacks
HSE GAR Accl
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APPROVED'
, .
LOI sq, fig,
Interior
Lot coverage
Corner
Cul.dc.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
ThIs permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City ,01 Springfiel~, including the
Development Code, regulating the constructiGn and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of saId ordinances.
Main
Carport j
Plan Check Fee' ,
~(J) _ Date Paid:
TOlal Value
\S,W ReceIpt Number'
Building Permit Fee
Lib Received By:
Slate Surcharge
Total Fcc lto, ---..-
(A) Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(6)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT,
Storm Sewer
FT,
Moblie Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have carofully 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 wlil be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on thIs
project.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permlr
Issuance
State Surcharge
Total Permit
Stale Surcharge
Sidewalk
It
I further agree to ensure that all required Inspectlons 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
on the site t all times during constructIon.
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VALIDATION: Jt:-rr~
RECEIPT NUMi~, _ . I ~ ~
DATE PAIl' !J.. 5 . ~_
AMOUNT RECEIQ):D J \ \Q ,W
RECEIVED BY 1 [\(i"\. )
...,- -
Oat'"
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Curbcut
fI
Demoli lion
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 6, C, 0, and E Combined)