HomeMy WebLinkAboutPermit Building 1995-7-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
""
I ASSESSORS MAP'
'X
LOT'
OWNER: .dCJ.l,4J<J 2:> p~
ADDRESS" 'lS'tJ ~i-I.4./<<~ Ave-.
CITY: (<)p,e.Al-M4'k.A
.
SPRINGFIELD
.
.
JOB NUMBER 9f:'o~2 y
225 Fifth Slreet
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
C7$/~
BLOCt<'
STATF' tJl!!'.
PHON F' 74 /- /7(,,~
ZIP: -.fl.4~
~
DESCRIBE WORK: EX;!)",,./>-,
NEW REMODEL.)(
6f~n"/4- J6 &m-I n 1;lt2L.u'1>~ -r,;~J~W~
CONTRACTOR'S NAME
/}1A/;/r.J€7
/JoIN&:#
GENERAl'
PLUMBING'
MECHANICAl'
t ELECTRICAl' /J,,JA'~
OUAD AREA' Ir1NW
. OF BLDGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER:
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST,
CONTRACTOR'
PHONE
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 to facIng
materials and framing Insp.
rn Framing - Prior to cover.
rvl Wall/Celllng Insulation - PrIor to
~ cover.
rn Drywafl - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms afe erected but prior to
placement of concrete.
- OFFICE USE -
LAND USE:-LLLI
. OF UNIT""
CONSTR. TYPE: ~I rJ
HEAT SOURCE:
RANGF'
EXPIRES
FLOOD PLAIN:
ZONING CODE: _GO t2-
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspectlon, 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 afler 7:00 a.m. will be made the fOllowIng work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/EIE!ctricall
Mechanical - ~rlor to cover.
o Fo'oUng - 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,
IX]
,
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and BcallY ,- Prior to tloor
Insulation or dccl<lng.
o Floor Insulallon!- Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Water Line - Prior to filling
trench.
r;(t Rough Plumbing - Prior to
( cover.
...
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - V'Jhen completed.
D Street Troos - When al/ r17qulred
trees are planted.
r'i71 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.
f)(f Final Building - When all
~ required Inspections have been
approved and building is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o 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
Lol Type.
Lot sq. llg.
InterIor
Lot cover'3.ge
Corner
Topography
Total height
Panhandle
Cul.do-sac
BUILDING PERMIT
ITEM
SO. FT.
X $/ SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Slale Surcharge I.SS~s.:!
Total Fee
(A)
. ;" : f?~ ;,
'U'.
i. THE PROPOSED WORK tN THE.
HISTOR'CAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the. Historical
Coordinator prior to permit Issuance.
I P.L.
IN
Is
Iw
I
IE
Setbacks'
, , , I
HSE GAR ACC
I
I
I
I
VALUE
'.
/~-
S \. C.Q
ci...'&
'S3 'ij..
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) :ftqO'il.z "*'
PLUMBING PERMIT
ITEM
Fixtures
I
ResIdential Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge .1S -t- ,~So
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
\ () <'o:l
IS,~
\W
\6 ~
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ff
IL.l.D,~
APPROVED'
BUILD!NG VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express co.nditlon that the said
construction shall, in all respects, conform to the Ordinance
adopted by the "Cityol, Springfield, Including the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revo'ked at any time
upon violation of any provisions of said ordinances.
. Plan Check Fee:
/9.$
__1kB -9S-
Dete Paid:
Receipt Number:_ /?L:4i"7
~~--
Received By:
PI~~vlewed By
"?/ ,(5~
---'t-1tte
Systems Development Charge Is due on all undeveloped
properties within the City limits ~~iCh are being Improved.
ADDITIONAL COMMENTS
J:::. " ....,,, 1 r,;}n ,,~. ~ ~ 1 r ,', 0
...~ ~ ,
~r-.f\ hid.~ ~ .n.t\ ~Ci...u~ <
By signature, I state and agree, that I have carefully examined
. .
the completed application and do hereby certHy that all
Information hereon Is true and correct, and I further cerllfy
that any and all work performed shall be done in accordance
with the Ordinances of tho City of Springfield, and the Laws
of the State of Oregon pertaIning to the work descrlbed
herein, and ,thai NO OCCUPANCY will be made of any
structure wilhout permission of the Building Safety Division.
I further certlfy that only contraclors and employees who
are In compliance with CRS 701.055 will be used on this
project.
I further agreo 10 ensure that all required Inspecllons are
requested at the proper time, that each address Is reada?le
from the street, that the permit card Is located at the front
of the property, and~the proved s~et 0 plans will remain
on the site ~ '" dur g cti
Signature ~;;
Date ~h ~~
VALIDATION:
RECEIPT NUMBER /~/$
DATE PAID 7~ 7-~
.--:::k' S'2 /A:> 2. ~.r
AMOUNT RECEIVE['l _ \ l ), -=.
/./~
RECEIVED BY
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