HomeMy WebLinkAboutPermit Building 1992-7-17
LOCATION OF PROPOSED WORK: ~ 0
ASSESSOR~rp: 17(\~/.J') L'3 - ,
LOT: 01 BLOCK' --5
OWNER: r=y:(){WJ})(!JU c)JI-nll~
ADDRESS:_UflGj tn. 11.JJJJL.u. ~ /:-
CITY _~ Q. ""', ~ t) - STATE: (() R1fJ(911 ~
DESCRIBE ~CA.(Vficb; maJ!_ 6/) ~)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' '
PLUMBING'
MECHANICAL'
ELECTRICA' '
QUAD AREA'
. OF BLOCS'
OCCY GFlOUP:
. OF STORIES:
WATEFl HEATER:
.
"
DEMOLISH
OTHER
!B NUMBER q 1017 L
225 Filth Street
S >ring field, Oregon 97477
PHONE:
La g-g , lofo'-t-(
ZIP:~
*.
CONST.
CONTRACTOR'
,
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
FlANG'"
EXPIRES
PHONE
FLOOD PLAIN:
ZONING CODE:_
. QF BDFlMS: _
SECONDARY HEAT:
SOUARE FOOTAGE:
To rOQuesl 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.
JDRESS
,/ 7'1 /"
\\'v \ l~
o Temporary Electric
D Sito Inspection - To be made
after excavation, but prior to
sotting forms.
o
Underslab Plumbing/Electrical'
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected t)ut prior to concrete
placement.
o
Underground Plumbing - Prior
10 filling trench.
o
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior 10
decking.
o
Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Pri.or to filling
trench.
o Water Line - Prior to filling
trench. .
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior 10 facing
materials and framing Insp.
o Framing - Pdor to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to iaplng.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base mater.lal in place.
o Fence - When completed.
o Street Trees - When 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.
D Plumbing Connections - When
home has been connected 10
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 - Aller all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
Lol Type.
Interior
,
Lot sq: ltg,
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
Main
Garage
Carporl
Total Value
Building Permi t Fcc
Slate Surchnrnc
Totill Fee
(A)
, 1
PL HSE GAR ACC
Setbacks
As THE PROPOSED WORK IN THE
~ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
N
2-
w
~---
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
!l!J." ~
SYSTEMS DEVELOPMENT CHARGE (S~).,
(B) /J.{Q. 'j
PLUMBING PERMIT
ITEM
Fixlures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
(/ {(}'dq
APPROVED:
This permit is granted on the express condition 1I1al the said
construcllon shall, in all respects, conform to the Ordinance
adopled by the City 01 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 CllCCk Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewcd By
Date
Systems Development Cllargc is due on all undevcloped
properties within the City limits which are being improvc<L
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify thai all
information hereon is true nnd correct, and I further certHy
that any and all work performed shall be done in accordance
with the Ordinances of tile City of Springfield. :If)d the Laws
of the State of Oregon pertaining to the work described
herein, and lhat NO OCCUPANCY will be made of any
structure witho~t 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 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 remain
VALIDATION:
RECEIPT NUMBER I..
DATE PAID -'L~
AMOUNT RECf~rfj
RECEIVED B-(/').J
J
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