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HomeMy WebLinkAboutPermit Building 1992-9-2 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Orfice: 726-3759 LOCATION. OF PROPOSED. WORI<' ASSESSORS MAP: /0.. t'J 2. LOT: . SPRINGFIELD ~~ 51tt ~ L.iLAc- '2..~ / J4-N L ,..,3 BLOC!" OWNER: )jrt~jb 1)c{l..(S ~"",-,gj".JJ"'" ADDRESS: ~5!L'C'i L ,-L.E1-",,-Lq "''-- CITY: _5]7 P-- J__ STATE: (fv- DESCRIBE WOR!'. CA ;1- f)" /1-1- NEW _X__ REMODEL ADDITION DeMOLISH OTHER . ~W17 L JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: SUBDIVISION' 1'?32,nC) PHON E: 7 f'l - C:;O S J CoA-O - :3v~ - 6GJl' ZIP: '17 '17 Y CONST. CONTRACTOR' CONTRACTOR'S NAME ADDRESS GENERAL: _.mQ~.I':"~______..___ I'LlIMElING: _ . _ N.::,_"" .~_u_______ __ ._. ___u..____...._._.__ MECHANICAl' Nu f'-JiF ELECTRICAL' N.. 0 ~ e QUAD AREA:~'S-,f.) . ~F ElLDGS: __., . OCCY GROUP: _~__~_ . OF STORI ES: \ WATER HEATER: ',. .. . , - OFFICE USE - I \ 9)() LAND USE: . OF UNITS: ~.-! CONSTR. TYPE: _V...J\J HEAT SOURCE: RANGE: ~ EXPIRES PHONE * J FLOOD PLAIN' ZONING CODE: ~ ~ . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE::rJ / To request an inspccllon, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be made the same \'JOrkin!] d~IY, in:,pcctlons requested after 7:00 a.m. will be made the following work day. 1=1 Temporary Electric I~ Site Inspection - To be tna(Ji~ ;lller eXCilvation, IJLII IHiol to setting forlllS. o Underslab Plumbing! Electrical! Mechanical - Prior to cover. !VrFooting - After trcnctles are ~ excavated. o Mnsonry - Steel location, bond beams, grouling. fc/( Foundation - After forms are ~ crcclccl but prior to concrete plocel1lent. SL-A6 o Underground Plumbing - Prior to filling trench. o Underlloor Plumbing!Mcchnnical - Prior 10 insulation or clccldno. 1=1 Post and Bcalll - Priol 10 flocl ill~;lIlation or clccl<inO. I 1 Floor Insulation - Prior to clecl<ing. o Sanitary Sewer - Prior 10 filling trench. o Storm Sewer - Prior to filling trench. o Water line - Prior to filling trench. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS '--I ROllgh Mcchnnical - Prior to -- (:ov(~r. '-I Rough Electrical - Prior to ~ (:ovcr. o Electrical Service - Must be approvl;d to oblain permanent electrical power. o Fireplace - Prior to facing malerials and framing Insp. ~Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to laping. o Wood Stove - After Installation. o Insert - Arter fireplace approval and In5tallo.llon of unll. CJ Curbcul & Approach - Arter forms arc erected but prior to placement of concrete. CJ Sidewalk & Driveway - Artor excavation Is complete, forms and sub-base material in place. o Fence - When completed. o Street Trees - Wilen all rcqlJJred trees are planted. CI Final Plumbing - When all plumbing work Is camplel.e. I I Final Elcctricnl - WllDn all electrical wOlk is complete. o Final Mechanical - When all mechanical work Is complete. 'K::7( Final Building - Wt,en all ~requlred Inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking rmd Sel-Up - When all blocking Is complete. o Plumbing Connections - When home has been connected 10 water and sewer. o Electrical Connection - Wilen 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, sklrtfn"g, decks, and ventlng have been inslalled. Lot faces Lot Typ6 Lot sq. Itg. Interior Lot coverage Corner Topography Total height Panhandle Cul-de-sac BUILDING PERMIT ITEM SO. FT. X $/SO. FT Main Garage Carport ;U'7 /0 :'0 Total Val ue Building Permit Fee State Surcharge Tolal Fee (A) PLUMBING PERMIT ITEM Fixtures Resldenlial 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 Stove/Insert/Fireplace Unit Dryer Vent Mechanical Parmi I Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Tolal Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A. B, C, D, and E Combined) Setbacks P.L HSE GAR ACC N S ==-31'. .S THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes. this application must bc signed and approved by the Historical Coordinator prior to pCll1lit issuance. J \1 W E _= S-Yz' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT VALUE ::2 o9o.1ftJ \ \ FEE /? /J . 2.(p APPROVEr>. This penllit is granted on the ex pless condition lllat the said construction shall, in all respects, conform to the Oldinance adopted by the City 01 Springfield, including the Development Code, regulating the construction and use of buildings, and may bc suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: ~? C;~ 03 . ~a//5'2- ~ I y' Receipt Number: ,.;-q'3o ~ Date Paid: Received By: __ .~ze:::~ ~_ ~~i-~evjewed By +tffL -=?g.5"O 193 -1iJ~ 1-3 SYSTEMS DEVELOPMENT CHARGE (SDC)f:Ig . (B) ~ 1'7 '6~ Systems Development Charge is due on all undeveloped properties within the City limits wtlich are being improved. ADDITIONAL COMMENTS I . ~RE:-~T~uJ/~_~L~-~~. ~_f2HL.U!fJM=/)._p-f)LF:<::' . By signature, I state and ayree. that I have carefully cx?mined the completed application and do hereby certify that all Information hereon is true and correct, and IlurlllCr certify 1I1al any and all work performed shall be done in accordance with the Ordinances olllle City of SpringficleJ, and ttw Laws of the Stale of Orc{lOn perlalning to (he worl( Ch.':5Cribcd herein, and IlIat NO OCCUPANCY will .bf~ made of any structure without pcrllli:ision of 1110 BuilcHn!) Safety Division. I furtllCr certify tllill only conlractors and ernployeus who are In compliance wi 111 ORS "/01.055 will be useel on ttlis project. I further agree to ensure 111.:11 all required inspections are requested at tile propp' time, that cactl address Is readable from the slreet, thai the permit card is focnted at IIle front of tho property, and the ap roved set of plans will remain on the sito at time d~~ constructlon. ~gnoture .-, / '" . Datp ~.2/<7i' VALIDATION: t;rJ78 9/2.-/5'2- , , 2~ AMOUNT RECEIVEn /20. -.-4~-.~- RECEIPT NUMBER DATE PAID RECEIVED BY