HomeMy WebLinkAboutPermit Building 1992-6-16
RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 726-3769
Office: 726.3759
LOCATION OF PROPOSER.W)?~; q~~
ASSESSORS MAP: \"l.Lk)d-f\\;~
LOT'
.
SPRINGFIELD
BLOCI"
- OWNER:t:A~ h<1\ \ 'lQ KL l ~~
ADDRESS \\C\C\ f\. ~('\,~
CITY_~ OhQ _ 0
DESCRIBE WOR~f\_r) i {\~l\~
NEW
REMODEL
~
CONTRACTOR'S NAME
CENERAI'
PLUMBING:
MECHANICAl'
ELECTRICAl'
STATE: . ~oY'--'
S.~.~_
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER C\\D'1~
~
TAX LOT'
U\~tY)
SUBDIVISION:
PHONE:1:()~~' \p~C\C\
ZIP:
4 ""l4:Q!L.J
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
*
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior 10
cover.
o Rough Electrical - Prior 10
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - AHer f1~eplace approval
and Installation ot unit.
o
Curbcul & Approach - After
forms are erected but prior to
placement 01 concrete.
- OFFICE USE -
QUAD 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: RANG'" 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.
o Temporary Electric
D Sito Inspection - To be made
after excavation, but prior to
settinu forms.
o
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
0" Fooling - After Irenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - Aller forms are
erected bul prior 10 concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o Posl and Boam - Prior to floor
insula~ion or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench. .
o Rough Plumbing -.~rior to
cover.
,
o Sidewalk & Driveway - After
excavation is complete, forms
and sub.ba$e material in place.
o Fence - When completed.
o Streel Trees - Wh~n all required
trees are planted. :
o
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
o
Final Mechanical - When all
mechanical work is complete.
o
Final Building - When all
required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
o Plumbing Connections - When
twme has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been Clf)provcd
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 faGes
Lot sq. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ. FT.
Lot Type .
Interior
Corner
Panhandle
Cul-de.sac
-.
Setbacks
P.L I HSE GAR ACe
_ THE PROPOSED WORK IN THE
~ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
N
L_____
w
If yes, this application must be signed
and approved uy the Historical
Coordinator prior to permit issuance.
~---
APPROVED'
Main
X $/SO. FT. - VALUE
~ _ ~,50~
'e~ ~~~~'\
Garage
Carport
Total Value
Building Permit Fec
State Surcharge
Total Fcc
(A>
SYSTEMS DEVELOPMENT CHARGE (SDC)
d1.~
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath{s) NO
Sanitmy Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
(C)
Dryer Vellt
Wood Stovellnsert/Flrcplace Unit
N'
Mechanical Permi I
Issuance
State Surcharge
Total Permit
(D)
Mobile Home
MISCELLANEOUS PERMITS
State Issuance
Stato Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
FEE
3D ,5.'5
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on tllC express condlllon that tile said
construction shall, in all respects, conform to the Ordinance
adopled by the City of Springfield, including the
Development Code, regulating the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation of an'y provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
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 correcl, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprinufield, and the Laws
of the StOlle of Omoon perlilinlng to the worl( de:;olhed
herein, and tllal NO OCCUPANCY will be Ilwde of nny
structure without permission of the Building Safety Oivi5ion.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on lids
project.
I further agree to ensure that all required inspections arc
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 r~ain
:~g:::~~WCrs drly :~;n\fili 56
Date ll)' \\n .q2-- \J
VALIDATION: ~ ~\4-n
RECEIPT NUMB~R .:.) V
DATE PAIl' \ Q - \ \ ("l' ' c+-->
AMOUNT RECEIV~~
RECEIVED BY \::::A\ 1)71..- J ~