HomeMy WebLinkAboutPermit Building 1992-1-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
-
e
q3'>~~~~
SPRINGFIELD
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: 'f)Z.:/.c> p#/:>"". ~/ #:;-
ASSESSORS MAP' )-?...O'2. :;>"3"- rr
. .~ - .r
,~,~~ ~~
/' I~~'~.ef. -;2 ~p
5?~T:>
LOT:
OWNER:
ADDRES~' .
CITY:
, -
DESCRIBE WORK:
BLOCK:
TAX LOT: _ 6/ y~
SUBDIVISION: .>';1P'/,/. - ~C:.~- r:' ~
II' '
PHONE:
STATE:
~/~
ZIP:-t::? '/C/,;??
DEMOLISH
OTHER
NEW
REMODEL
, ADDITION
CONTRACTOR'S NAME
GENERAL' ~~~~~
~ - -, - "
PLUMBING:
MECHANICAL:
ELECTRICAL'
QUAD AREA'
1/ OF BLDGS:
OCCY GROUP:
1/ OF STORIES:
WATER HEATER'
ADDRESS
CONST.
CONTRACTOR 1/
PHONE
EXPIRES
-.
"
, '
, .'
- OFFICE USE -
. .
~
LAND USE:
FLOOD PLAIN:
ZONING CODE:
1/ OF UNITS:
CONSTR. TYPE:
1/ OF BDRMS:
HEAT SOURCF'
RANGF'
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
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day,
D Temporary Electric
, 0 Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated. '
o Masonry - ~teel location, bond
beams, grouting. , '
Ii[] Foundation -' After forms are
L,l::r 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
Final Plumbing - When all
plumbing work Is complete. "
D Rough Electrical - Prior to
cover. '
D Final Electrical - When all
electrical work is complete:
D Electrical Service - Must be
approved to obtain permanent'
electrical power.
D Final Mechanical - When all
mechanical work Is complete.
D Fireplace - Prior to facing
materials and framing Insp.
~ Final Bu'i1ding - When all
required Inspections have been
approved and building is
completed.
D Framing - Prior to cover.
D Other
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Wood Stove - After installation.
D Insert '- After fireplace approval
and Installation of unit. '
D Blocking and Set-Up - When all
blocking is complete.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub~base material in place.
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
D Fence"":' When completed.
D Final - After all required
'. inspections are approved and
, porches, skirting, decks, and
venting have been installed.
D Street Trees -When all required
trees are planted.
Lot faces Lot Type_ Setbacks -. THE PROPOSED WORK IN THE
Lot sq. ftg. Interior I P.L.. HSE GAR ACC HISTORICAL DISTRICT, OR ON
IN THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I
Panhandle and approved by the Historical
Topography \W I Coordinator prior to permit issuance.
Total height Cul-de-sac
IE I
APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ, FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
?:l~
/t:J../~
7~..<<-~
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: ~c:!!i '3
Main
Date Paid:
Total Val ue
State Su rcharge
~ ;5c>
~P.?~
~~~
SYSTEMS DEVELOPMENT CHARGE (SDC)
Receipt Number'
Building Permit Fee
Total Fee
(A)
Received By:
#:':8-/ -
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
/"7'.:::>-9"2-
Date
(B)
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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 Ordinancl:ls of the City of Springfield, and the Laws
of the State of Oregon pertaining "to the work described
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 wliO
are in compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
~
~~ Vent
Wood Stove/lnsert/Fireplace Unit
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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.
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Signature' ',;(
Sidewalk
ft
Date
~'- t)(
/ -/~--? ~
i
~
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
6S~Y6
RECEIPT NUMBER -"3 S/~ 7
/-/6~7-
AMOUNT RECEIVED &::: ;:>....... Vb
d~'~-A ,e:. ~
. [.~~._U '.
DATE PAID
Total Miscellaneous Permits (E)
RECEIVED BY
'"