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Home My WebLink AboutPermit Building 1991-9-13 ~.. 22'5 Fifth Street ...~, ' ~JI Spr~ngfleld, Olegon 97477 # D~ I~ L,\ / Q (' .J (_/'i-=LL1 0__ . '''~)~~-'''7rY. - ~------ TAX LOT l A... ,~.t'<.- t. .J SUBDIVISION GDld 0 f1'rQ fra l'JJ_, OWNER ,--t> ()~J) \ fj~\;1 , - PHt>NE'r:\\. \\ 0\ P, ADDREf'_~4Q.S d2.' "-~~\ Cl'SSDf'Q J:f.lHQJ-----(f:LL- . CITY '- ')(\~ ~ ,(i ~ STATE (\;V l)(}{) () ZIP -{ 1 r L7 '"\\ -' ~ / \:)f'\ q ~.~U> _. \. J _~ \. r\lD \'(\ ~ RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 LOT DESCRIBE WORK NEW>< REMODEL ADDITION DEMOLISH OTHER JOB NUMBER q J I 0( O~ CONST CPtC441 # CONTRACT~.'S NA~E ~1'\. ADDRESS GENERAL L1\(} 1 Qf\ '\ l \ J\5i \ffif\- PLUMBING ~~rWt) -:V\ /Dl A-) MECHANICAL j ~ . (\ ",' ~C\_ ~ ELECTRICAL \ s:':\ '- "') "[ \J "lA. ~ A _ ') QUAD AREA ~ e:J~ \ ~~ 1 # OF BLDGS OCCY GROUP # OF STORIES WATER HEATER F/ EXPI(1S ~'5'l. (I PHONE lr/i/r -1702 () ~ffi(-l C\ . \ ,(12-- .1L,/ Z23k. - OFFICE l)SE - LAND USE \\c::D # OF UNITS CONSTR TYPE HEAT SOURCF ~f:: ./ L(A ~) RANGE ~ FLOOD PLAIN ZONING CODE U)~~J ~ # OF BDRMS SECONDARY HEAT SQUARE FOOTAGE -resrL~ To request an inSpectIOn, you must call 7263769 This IS a 24 hour recording All inspections requested before 700 a m will be made the same working day, Inspections requested after 700 a m will be made the following work day D Temporary Electnc D Site Inspection - To be made after excavation, but prior to setting forms D Underslab Plumbing I Electncall Mechanical - Prior to cover I 1""",([ Footing - After trenches are I.LJ excavated D Masonry - Steel locatIOn, bond beams, glOutlng D Foundation - After forms are erected but prior to concrete placement D Underground Plumbing - Pilar to filling trench D Underfloor Plumbing I Mechanical - Prior to Insulation or decking D Post and Beam - Prior to floor insulation or decking D Floor Insulation - Prior to decking 1>-'1 Sanitary Sewer - Prior to filling ~ trench l'v"'f Storm Sewer - Prior to filling .~ trench ~ Water Line - Prior to filling trench r .~ Rough Plumblllg - Prior to .........J cover REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover D Rough Electncal - Prior to cover F;7] Electrical Service - Must be ~ approved to obtain permanent electrical power D Fireplace - Prior to faCing materials and framing Insp D Framlllg - Prior to Gover D Wall/Celllllg Insulation - Prior La cover D Drywall - Prior to tdplng D Wood Stove - After Installation D Insert - After fireplace approval and Installation of unit ~])(,,1 Curbcut & Approach - After ~ forms are erected but prior to placement of concrete ~ Sidewalk & Dnveway - After .~ excavation Is complete, forms and sub base material In place D Fence - When completed ~ Street Trees - When all required ~ trees are planted D FlIlal Plumbmg - When all plumbing work IS complete D FlIlal Electncal - When all electrical work IS complete D FlIlal Mechanical - When all mechanical work IS complete D Fmal Bulldmg - When all reqUired inspections have been approved and bUilding IS completed D Other MOBILE HOME INSPECTIONS r~=:-VBlockmg and Set Up - When all ~blocklng IS complete ~PIUmbmg Connections - When home has been connected to water and sewer ~ Electrical Connection - When blocking, set UP. and plumbing inspections have been approved and the home IS connected to the service panel ~ FlIlal - After all reqUired inspections are approved and porches, skirting, decks, and venting have been Installed Lot Type Setbacks Interior PL HSE GAR ACC Corner N Panhandle S \W Cui de sac IE Lot faces Lot sq ftg Lot coverage Topography Total hOlght BUILDING PERMIT ITEM SO FT X $/SO FT ~4i\OCD. Main Garage C{lr port \~ ,\,=\d- / , --:; To\al Value 12P()cO )- -- BUilding Permit Fee ~~.5() \ \(';2 &1~t;B State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) j? A-I q? (B) -{..t \1.2.;\ - PLUMBING PERMIT ITEM FEE '" Fixtures Residential Bath(s) NO Sanitary Sewer FT ~" (XI c{J:::S 00 r\")t). oCJ Water FT Storm Sewer Ff Mobile Home Plumbing Permit 75.oC.J '-~' 7.0 'J-E- ')5 State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS I f)C:),DO cf){). [JO ~'M \'420 Mobile Home State Issuance State Surcharge Sidewalk J O~... ft Curbcut ~ ft Demolition State Surcharge Total Miscellaneous Permits (E) J TOTAL AMOUNT DUE (excluding electrical) ~Wf)-L=S (A, B, C, 0, and E Combined) IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, thiS application must be signed and approved by the Historical Coordinator prior to permit Issuance APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT /Plans Reviewed By Date Systems DevelopnlOnt Cllarge IS due on all undeveloped properties within the City limits which are being Improved ADDITIONAL COMMENTS 1 -'_~ ~ -\ )\ DStG 0 ) ~)lr\ 0 t ~ 'D 0 _r ) -mAOJ %M~~/13f (0(1(11 L_ )/l /2,(!lG., '5Ylf\notalim/ntQ-,; f;f1l ~ ,CJ\.~~~_rC(.} h~ l Q- :"lQ_7_LO By signature, I state and agree, that I 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 pertaining to the worl< described herein, and that NO OCCUPANCY will be made of any structure without permission of the BUlldlJlg Safety DIVIsion I further certify that only contractors and employees who are In compliance with ORS 701055 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 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 construction 6? A6 . Slgn~\ ~~ (t. o/r Date q-/3 -9( VALIDATION RECEIPT NUMBER 7..ll-Cj'3 ~ ZI2$,c:) DATE PAID q -/";1-=q / AMOUNT RECEIVED r(YCPYi l~ ([/lU:U-- RECEIVED BY