HomeMy WebLinkAboutPermit Building 1995-4-27
LOCATI~~ OF PROPOSED~: , . t;'.'S ,~;
ASSESSORS MAP: \ '1 U0\9~,).
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOT:
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OWNE~: fl tt-rf'e(J. 12iJIe-r
ADDRESS' 217 0 ." ,.?
5 - I I) .1/
CITY:, '. l (\, .7.~; eJ....Q)
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SPRINGFIELD
QF{()4SQ
. JOB NUMBER
.
. . .225 Fifth Street
.
Springfield, Oregon 97477
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TAX LOT:
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BLOCK:
SUBDIVISION:
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PHONE:
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$TATE:
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ZIP:
97Y'?77
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ADDITION
.II-W/1/~~ _
DEMOLISH/" OTHER
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
iJr~/
/ / JI;flESS,
I1BL: '\ . tQ"
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CONST,
C~7RACTOR #
;"~9 c: if os. 0 < "'I/, /
~jj..:t It 9' t .
7;'{72,,?7
GENERAL:
PLLJMI?It:-JG:
MECHANICAL:'
ELECTRICAL:
, ~ .
aUA~ AREA: ~~ <'J:~ ;
# OF BLDGS:
OCCY GROUP: ~
# OF STORIES: \
WATER HEATER'
EXPIRES
PHONE
. ;
, .';/(/16'
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.,',"'
. ."~ ,"
" .
'- OFFIS USE -
LAND USE: \ \~O . .
..
FLOOD PLAIN'
# OF UNITS:
(~
ZONING CODE:
. CONSTR. TYPE:
HEAT SOURCE:
1LL{/
# OF BDRMS'
..,..,..
RANGE:
SECONDARY HEAT:
saUARE FOOTAG E:
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,
o Temporary Electric
.Do Site Inspection,.7."' To be made
after excavation, but prior to
setting forms,
o Underslab Plumbingl Electricall
Mechanical' - Prior to cover.
o Footing - After trenches are
excavated, . .
, .'
o Masonry .,.... S'teel location, bOfld
beams, grouting, .
o Found'ation - After forms are
erected but prior to concrete '
placElment.
o Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
. --: Prior to, Insulation or decking,
[j Post 'andBeam'- Prior to flo.or
insulation or decking, .
D. Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench, '
..:. .,.
'."
o Storm Sewer - Prior to filling
trench,
D Water Line - Prior to'filling
trench.
o Rough Plumbing -:- Prior to
cover,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Final Plumbing - When all
plumbing work Is complete, .
D Rough Electrical..- Pr.lor to
cover.
D Final Electrical - When all .
electrical work is complete:
. .
D Electrica.1 Service - Must be
. ' approved to obtain permanent
electrical power.
D Final Mechanical - When all
mechanical work Is complete,
D Firep,'ace - Prlor'to facing
, materials and framing Insp,
flVr'Final Building - When all
~ required, inspections' have been
approved and building is
completed,
~ Framing - Prior to cover,
D Other
o Wall/Ceiiing Insulation - Prior to
cover" '
D Drywall - Prior to taping,
MOBILE HOME INSPECTIONS
D Wood Stove - Afte; Install~tio~',
'. "',....
"." ,. .
o Insert - After fireplace approval
and Installation of unit. .,
D Blocking and Set.Up - When all
blocking Is complete,
o Curbcut & Approach - After
forms are. erected but prior to
placement of concrete,
o 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,
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
D Fence'- Whe,n completed.
o Final - After all required
. Inspections are approved and
. ~ ..
. . porches, skirting, decks, and
venting have been installed,
D S~reet Trees ....:;' When all'requir'ed' '.
trees are planted, , . ,'.' ,
o'
o
Lot faces Lot Type. Setbacks
I I I ACC I
Lot sq, ftg, Interior p.L. HSE GAR
Lot coverage Corner N
Topography Panhandle S
Total height Cul-de-sac W
IE
. THE 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.
APPROVED:
BUILDING PERMIT
ITEM sa, FT, . X $/sa, FT, = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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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,
Main
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
State Surcharge d d~ \33
~ .C:O
Receipt Number:
Received By:
Total Fee
~~ plO
SYSTEMS DEVELOPMENT CHARGE (SDC)
(A)
Plans Reviewed By
Date
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
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~,~O-
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 Ordinances 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 who
are In compliance with ORS 701,055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
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 time uring on ction,
/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su rcharge
r- '\
Sidewalk ft
curbcu~'-," ft
Date
/
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
, . .. ~ .
~.Up
VALIDATION:
RECEIPT NUMB oR .Ill) lSS
DATE PAID L-.2D .cr.s
AMOUNT RECmV 0 - ~.a..n
RECEIVED BY ~~
" .
State Surcharge
Total Miscellaneous Permits (E)