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