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HomeMy WebLinkAboutPermit Building 1991-7-15 RESIDENTIAL PERMIT APPLICATION Inspections 726-3769 Office 726-3759 SPRINGFIELD ! JOB NUMBER <J /,c>$:<~ 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK 4 ;Z-/ /~7-'?~Y~/~ t//~u.) 5f'I'IJI)fFlt!!./J oR, TAX LOT <o<7":9'~ ASSESSORS ~MAP LOT OWNER 'OfJtJ ADDRESS CITY ~ LJ r I ~ j) 1_ iI ~Co.r () l 4;;./ F,eld DESCRIBE WORK c. tt 0) tJ 1? e.. v NEW REMODEL r~:L Z; I BLOCK rn,dd e.1-rb v - r!,7:I VII:. tAl -, STATE /) R. C-A I' /IJ /) ,.. T Tt; I () d. f' ~ f11 r<- v OTHER ADDITION DEMOLISH SUBDIVISION PHONE 7#/ -J j J'J: ZIP CONTRACTOR'S NAME GENERAL _Oc7/c. I.Jv:15e~ 0>>.) ljI . CONST ADDRESS 'jlf 3 ~ ~~It:.'lIlt!';CJCONTRACTOR # ffr)N!~le(J.. 7 D 973 EXPIRES PHONE 1- ;47- C? ;/..., 'Jif7-J JI;1.0 , PLUMBING MECHANICAL It} 6-- JJ -e AJ-~ /J 'r' A) ~ JJ -c:. . ELECTRICAL QUAD AREA # OF BLDGS OCCY GROUP # OF STORIES WATER HEATER - OFFICE USE - LAND USE # OF UNITS CONSTR TYPE HEAT SOURCE RANGE FLOOD PLAIN ZONING CODE # OF BDRMS SECONDARY HEAT SQUARE FOOTAG E To request an Inspectl_on, you must call 726-3769 This IS a 24 hour recording All inspections requested before 700 a m will be made the same wor~lng day, inspections requested after 700 a m will be made the following 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 rvJ Footing - After trenches are l,C::J excavated D ry1asonry - Steel location, bond beams, grouting D Foundation - After forms are erected but prior to concrete placement D Underground Plumbing - Prior to filling trench D Underfloor Plumbing/Mechanical : - Prior to insulation or decking D Post and Beam - Prior to floor Insulation or decking D Floor Insulation - Prior to decking D Sanitary Sewer - Prior to filling trench D Storm Sewer - Prior to filling trench D Water Line - Prior to filling trench D Rough Plumbing - Prior to cover REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover D Rough Electrical - Prior to cover D Electrical Service - Must be approved to obtain permanent electrical power D Fireplace - Prior to facing materials and framing Insp (XJ Framing - Prior to cover D Wall/Ceiling Insulation - Prior to cover IZl Drywall - Prior to taping D Wood Sto've - After installation D Insert - After fireplace approval and IlJstallatlon of unit I , D Curbcut & Approach - After forms are erected but prior to placement of concrete D Sidewalk & Driveway - After excavation IS complete, forms and slub-base material In place D Fe~ce - When completed D Street Trees - When all required' trees are planted D Final Plumbing - When all plumbing work IS complete o Final Electrical - When all electrical work IS complete D Final Mechanical - When all mechanical work IS complete ~ Final Building - When all reqUired inspections have been approved and bUilding IS completed D Other MOBILE HOME INSPECTIONS D 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 Type , Setbacks THE PROPOSED WORK IN THE Interior I PL HSE GAR ACC I r(ISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Corner Is I If yes, thiS application must be signed Panhandle and approved by the Historical \W I Coordinator prior to permit Issuance Cul-de-sac IE I APPROVED Lot faces Lot sq ftg Lot coverage Topography Total height BUILDING PERMIT ITEM SQ FT X $/SQ FT VALUE Main Garage Carport tf#-'L~~ ~/'J-7 ~.o...:-~.--~ Total Val ue I C:;-. "s-6> v - .7S r- - It.} - .?~ SYSTEMS DEVELOPMENT CHARGE (SDC) BUilding Permit Fee State Surcharge Total Fee (A) (B) PLUMBING PERMIT ITEM FEE Flxtu res ReSidential Bath(s) NO Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Su rcharge ~ ~Yf'~"'-v r~'::: 9' ../:S Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) 2~~S~ (A, B, C, D, and E Combined) 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 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 9.;?~ '/ -;/::;--7'/ Date Paid Receipt Number 2~3 :~ece By ~.~~~- .c- L ~., .~ "~~ ~~~/ 77/~-:?7 Date Systems Development Charge IS due on all undeveloped properties within the City limits which are being Improved ADDITIONAL COMMENTS By signature, I state 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 descrl bed herein, and that NO OCCUPANCY Will 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 701055 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, and the approved set of plans Will remain on the site at all times dUring construction Slgnature~~-- Date ? --f~---,-r / VALIDATION RECEIPT NUMBER /t!/6e 7 } DATE PAID -'::>-/5""-7" / AMOUNT RECEIVED L,S";,c:.;-o RECEIVED BY ./2~ '// .r'