HomeMy WebLinkAboutPermit Building 1994-5-17
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RESIDENTIAL
PERMIT APPLlC~TION
Inspections: 726.3769 ..
Office: 726.3759
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SPRINGFIELD
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LOCA~ION OF PROPO,SED WORK: ? 5'" ~ iA G/<. ;f4vr=>>;", )
ASSESSORS MAP' /~/J 3 2. 7 ~d.. .
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REMODEL \DDITION
LOT'
O~NER:
ADDRESS'
CITY'
DESCRIBE WORK'
NEW
BLOCK'
STATF' '
C1;R
, DEMOLISH
OTHER
CaNST,
CONTRACTOR .
~C."71
CONTRACTOR'S NAME ADDRESS'
GENERAL: 7/01f, ~/h:: <''''Ittl-Ad1i:2~(
PLUMBING'
MECHANICAl'
ELECTRICAL'
----,.
-
, 9?073L
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: . /? 'Z~ I'Tl')
SUBDIVISION'
. PHONE:
7~ -1"'\ 7? <;"
ZIP: 9 ttf '7 ?
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EXPIRES'
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PHONE
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"?9!7 -1{7 '1 ')
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR,' TYPE: ~ OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
I WATER HEATER: RANGF' SOUARE FO.OTAGE:
To request an inspection, you must call 726-3769, This Is a 24 hour recording, All Inspections raquested before 7:00 a,m, wtll be
made lhe same working day, Inspections requested after 7:00 a,m. will be made the following work day,
REQUIRED INSPECTIONS
o Rough Mechanical"":' Prior to
cover. .
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. '
o Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected'but- prior to.concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor. Plumbing/Mechanical
- Prior to Insulation or decking,
o Post and Beam - Prior to floor
Insutatlon or decking,
o Floor Insulation - Prior to
decking. '.
o Senltary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
D Rough'-Electrlcal - Prior. to
cover. ..
o Electrlcal Service - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
MFra~lng - Pr'lor to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall .,... prl,or to taping,
o Wood Slove - After Installation.
o In.ert - After fireplace approval
and Installation 01 unit.
o 'Curbcut & Ap'proach - Alter
forms are erected but prior to
placement .of concret.e.
o Sidewalk & Driveway - After
,excavation Is complete, forms
and'sub.base material In place.
o Fen~~.':"" When completed,
o Street Tress - When all required
tress are, 'planted.
o Final Plumbing - When all,
plumbing work Is complet,e"
. ' . ..
D Final Electrlcel ~ When all
electrical. work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
"'R7f Final Building - When all
~equlred Inspections have been
approved and building Is, .
completed,
o O,ther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete. '. .
o Plumbing Connections - When
home has been connected to
water and sewer, '
o Electrical Connection - Wh.an
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
OJ- .~"
Lot Type ..
~ Interlo"""
Lot sq, ltg, ,
Lot coverage
Topography
Total height
Corner
Panhandle
Cul.de'sac
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BUILDING PERMIT
ITEM sa, FT. x $/SO, FT. = VALUE
Main
Garage '
Carport,fliP"'c 6.stsTt&
"
2hlrD C'O
'-
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) N/A
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N.
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
.
Mobile Home'
Plumbing Permit ,
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit ".
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ft
Curbcut
ft
Demolition
State Surcharga
(C)
(D)
Total Miscellaneous Permlis (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, c.' D, and E Combined) ,
FEE
'i' . .5/:
~.-
<5J(
Setbacks '
HSE GAR Accl
I
(..HE PROPOSED WORK IN THE. '
TOI'lICAL DISTRtCT, OR ON
THE HISTORICAL REGISTER?
If yes, this sppllcatlon must be signed
and approved by the Hlstorlcel
, Coordinator prior to permit issuance.
I
APPROVEP' '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the ssid
construction shall, In all respects, conform to the Ordinance
adopted by the' City ,of Springfield, Including the
Development Code, regulating the construction and useDf
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Systems Developmont Charge Is due on all undeveloped
properties within the City limits which are b,eing Improved,
ADDITIONAL COMMENTS
By slgnature,l state and agree, that I have carofully examined
the completed eppllcatlon and do hereby certl fy 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
heretn, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify thai only contractors and employees WhO
are In compliance with OAS 701,055 will be used on this
proJect,
I furth,ar. agree to ensure that all required Inspections are
re~uested at the proper t1me~ ~hat 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 constructlo~
~gnature ~h UJ2;.~ l.l lJl..JV'f1
Dat= j-/7-Y4' G
,
VALIDATION:
RECEIPT NUMBER
DATE PAIP
AMOUNT RECEIVEr>
RECEIVED BY
/2'7 l' J
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