HomeMy WebLinkAboutPermit Building 1998-2-9
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RESIDENTIAL
PERMIT APPLICATION
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SPRINGFIELD
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: S3 3.S-
ASSESSORS MAP: /7n 2- ~/)
LOT:
OWNER~Q'#Jt;1~ ~<'C'C~
ADDRESS' 5~3) Dal'>'-f
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CITY:
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JOB NUMBER~ !'l::blof2"'.
225 Fifth Street
Springfield. Oregon 97477
:i19o
rJn
BLOCK:
97: -if- 90
STATE:
o~~
DESCRIBE WORK: BItc~ '~5
NEW )( REMODEL ADDITION
,
CONTRACTOR'S NAME
GENERA;? q/Yk.e~ ~f.-
PLUMBING:
MECHANICAl'
ELECTRICAl'
DEMOLISH
OTHER
TAX LOT:
SUBDIVISION:
Ol.~a-a
,
PHONE:_ 7-1-,4 - ?~6/
ZIP:
ADDRESS
.37~3 ~/\-<.tl ~
"
CONST,
CONTRACTOR #
11Y'..0-)
.~ PHONE
.',
Y'85'''' 337/
EXPIRES
G--Lf-?b
- OFFICE USE -
aUAD AREA: LAND USE' FLOOD PLAIN:
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR, TYPE: # OF BDRMS:
# OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: saUARE 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 Electrfc
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanfcal - Prior to cover.
D Footing - After trenches are
excavated, '
D Masonry - 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 ~o 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.
l><:( Framing - Prior to cover.
/'
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
\ "
D Curbcut & Approach - After
. '. \ forms are erected but prior to
, .. . placement of concrete,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed,
o Street Trees - Wh~n all required
. trees are planted.
D Final Plumbing - When all
plumbing W9rl< Is complet.e,
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
~equlred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
D 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 ~yp.
"
..., ,
?::.
.,' ".,
, ,
Lot sq. ftg.
,. p.L.
IN
Is
Interior
Lot coverage
Corner
Topography
Total height
'.\'
Panhandle '.
Cu"-de'sac
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E
BUILDING PERMIT ""j
ITEM sa, FT.
. ~~
"
't
X $/sa, FT, =
VALUE
Main
Garage
'.
Carport
~)
.L' ~
~CTD.
Total Value
"
ffi,eo
)~2P
.
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SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fee
, State Surcharge
,7 S- -t ,fJ-
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
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 Surcharge
-p'/h.) ~cJl/M ~
- I
q,75"'
,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
?&),9S
, -; ;. ~il~:i}r..:'1::'
.
( IS THE PROPOSED WORK tN THE.
HIST081CAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks .
.1
HSE GAR ACC
I L-"
APPROVED:
.. ~~.. ,!'. '~t
BUILDIN'G VALliE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
, construction shall, in ail 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 revo'ked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: .. 9,7.[' "
,
Date Paid:
Receipt Number:
Receive(j ~Y/1 '
l '.\ -#~
Plans ReViewed By
, .
2~~~
I D~e:"
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 Ordinanc~s 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.
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.
;<ignatur~ ~ .
Date a1/q /CJ~
I-' ..
VALIDATION:
RECEIPT NUMBER
DATE PAID
'Z ~ 7 ~r:;,
:;./ 7' /,. 'b
( I 2-5'""r
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AMOUNT RECEIVED
RECEIVED BY