HomeMy WebLinkAboutPermit Building 1999-10-13
OWNER:~0NI(lI\() I ~
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CITY: _<,o.c '5
-"~IAL
PERMIT APPLI~TION
Inspectld!is: 726-3769:::>
Office: 72~o"
ASSESSORS MAP'
LOT'
ADDRESS'
.
SPRINGFIELD
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/ ~G;7A-' ~
BLOCK:
STATE: '
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DESCRIBE WORK' (1/ /), <: / IV r1 /IV (.J 1I A. r"(.l, C
NEW REMODEL X ADDITION DEMOLISH
CONTRACTOR'S NAME
n 10 / A/d.
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GENERA" .
PLUMBINI>'
OTHER
.
JOB NUMBER
f7'lll.f7
i
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
()S76'b
SUBDIVISION'
PHONE:
/J~ b --) ) 7q
ZIP:~"7~-?X"
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ADDRESS
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CON ST.
CONTRACTOR #
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EXPIRES '::'> PHONE
HEAT SO.URCE:
'RANG'"
o Rough Mechanical - Prior to
cover.
~
/0 ~oughElectrlcal - Prior to
~over.
o Electrical ServIce - Must be
approved to obtain permanent
electrical power.
o Insert - After fireplace approv41
and Installation 01 unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete,
o Sidewalk & DrIveway - Altel
excavation Is complete. forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. .
NerICe;
MECHANICA....._~J\.ITI""'~I.,.-b....nnr. ,o:;.\A' n.::>n'lllf-,.., '... THI'"' ~~
ELECTRICAt;li~;~~i~~ '~d~pted by the cireqon Ul ' , AII~Q~'~:~ ~~~LL_EXP'RE IF THE WORK
Nntili~atinn Center. I nose rul"~ <lit.' ~". 'v __. , ":-Jv",uf:1'1 I HI::; PERMIT I~ r.lnT
in OAR 952-001-UU1 ~ mrol~gl1 UN' C'1oJC- -~~ OFFICE UAIC"VlC:l~lJ!:U UR IS ABANDONED FOR
OOHO. You may obtain copies 01 the rUle.,. ANY 180DAYPERJO
QUAD AREA: .,_'''M .ho Mntor {Nnte: the Ifl!ANiFuSE: D. FLOOD PLAIN'
.:n~u-;:;;b~rforthe Oregon Uiiliiy Notificatiot
II OF BLDG~:' ,.. GenWFlS 1_r'l"l.'P:~~j-M";I~.:.4~:!?\ .u,,!IT~: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, yo'u must call 726-3769.'Thls 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.
REQUIRED INSPECTIONS
o Final Plumbing - When ail
plumbing wC;)(k Is complet~.
/"'~Flnal Eleotrloal - When all
V"~lectrlcal work Is complete.
o Final MechanIcal - When all
mechanical work Is complete.
~FI al Building - When all
r qui red Inspections have been
approved and building Is
completed,
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When ail
blockl ng 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 ail required '
Inspections are approved and
porchos, skirting, decks, and
venttng have been Installed.
("
# OF STORIES:
WATER HEATER'
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Waler Line - Prior 10 filling
trench.
o Rough Plu~blng - Prior to
cover.
"
Lot faces
.
Lot l'ype
Setbacks .
, HSE ' GAR' Acc'l
I
I
I
I
',' .: r"l {.;'i:;~::\~ \
Lot sQ: ftg, .
I P.L.
IN
Is
Interior
Lot coverage
Corner
Topography
Total height
.,
Panhandle
Cul.de,;sac.
w
----
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BUILDING PERMIT I
ITEM sa. FT. x
. .:~
( ..,IS THE.PROPOSED WORK IN . '
HISTORICAL DISTRICT, OR ON
'THE HISTORICAL REGISTER?
II yes, this appllOatlon must be signed
and approved by the Historical
'. Coordinator prior to permit Issuance.
APPROVEf"
VALUE
. .'...... .t
BUILDING VALliE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express cond1tlon that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, Including the
Dovelopment Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
.t
$/SO. FT. =
Main
Garage
'.
Carport
Plan Check Fee'
z.,Ol"O .... Date Paid:
Total Value
, Receipt Numbel'
'Building Permit Fee 5M ~
3.2..'5 Received By:
State ~urcharge
Total ,Fee (A) 2;5_'15 Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
jJ- 3IJ FIool/,z E- 'Io u2...
t?e ~tJJ . /
E2ez.,-A-J ~,ut>-I II.-,c./ J
By signature, I state and agree, that J have carefully examined
the completed application and do hereby certify 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 perlalnlng to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J 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 are
requested at the proper time, that each address Is readable
from the "treet, that the permit card Is located at the front
of the property, and the approved set of plans will remain
00 '" J 7'." '"''"' oooM
Slgnatule ~ V\/) /",//0 .
Date ?~-/ 7?'f
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
FT.
I1hll-k ~
bo-.J~
j7C-t,
r
Storm Sewer
Mobile Home
Plumbing Pelmlt
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
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VALIDATION:
RECEIPT NUMBER
DATE PAID
iAMOUNT RECEIVED
RECEIVED BY
State Surcharge
Total Miscellaneous Permils (E)
..
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Gomblned)
.1 '5 <;G 7 0
!u} /1/71
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