HomeMy WebLinkAboutPermit Building 1994-9-22
tJt9~.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
ASSESSORS MAP'
LOT'
OWNER'
r.:::; n 4'
"If.
.
LL-L~ .
ADDRF'"''
"
" -,~ ~ ..--
"....-4i/'~~
~?~07
CITY'
-.
SPRINGFIELD
.
9~ /30 ":<..
-'
-~-
BLOCK'
STATE:~~ ~
JOB NUMBER
TAX LOT:
SUBOIVISION:
225 Fifth Street
Sprlngfleld.Orego
PHONF'
'7 Vb- y2"'>'R
ZIP' <:::::J? <;/;>"7
NEW
)(
DESCRIBE WORK: 0~/",A"'C--~ -.b:: 'x29'~~(~-:-&r- ~-r''''' '-::~
REMODEL
CONTRACTOR~AME . .
GENERA' .C- ~..-:~.Jj7~
PLUMBING'
MECHANICAL'
ELECTRICA' .
QUAD AREA:a~0
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
J
\
ADDITION
DEMOLISH
OTHER
AODRESS '
CON ST.
CONTRACTOR'
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrIcal power.
o Fireplace - Prior to facing
materials and framing Insp.
~ra;"lng - prior:to cover.
D Wail/Ceiling insJ,latlon - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After 1~5ta"atlon.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
~""'- ~
FLOOD PLAIN'
ZONING CODE:
mv
- OFFICE USE -
\\l \
LAND USE:
. OF UNITS'
CONSTR. TYPE:$A}
HEAT SOURCE'
RANG'"
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
..3P>4
'w
To request an Inspection, 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 after 7:00 a.m. ~I" be made the following work day.
REQUIRED .INSPECTIONS
D Temporary Electric
o Site Inspectlon.- To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
MechanIcal - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~rected'but, prior to'concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water LIne - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
D Final Plumbing - When all
plumbing work Is complete.
, ,
,-
o Final Electrical - When all
electrical work Is complete."
o Final Mechanical - When all
mechanical work Is complete.
'~Flnal Building - When all
required Inspections have been
pproved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D BlockIng and Set.Up - Whep all
blocking Is complete.
D PlumbIng Connections - When
home has been connected to '
water and sewer.
D Electrical Connection - When
blocking, set.up. and pluR)blng
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
Lot sq. flg.
Lot cove~age"
Topography
Total Ijelght
.....'.:..
, \' ,~:'?': :;(":;;.'r.-~"~ ~.~.~ ~~{~:~q.;~.i'/:
Lot ~yp.
Interior
!'p.L.
IN'
Is
Iw
'1 E
Corner
Panhandle
Cul.de-sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT, - VALUE
$dSV
~SJ
1;7(5
t:J }.f:J3
SYSTEMS DEVELOPMENT CHARGE (SDC)
..I1k~
Main
Ga"'ge
Carport
~36c(
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fix~ures
Resldenllal Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
Stat~ Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
Total Permit
"
III /0 ~/~. c.;~
s% ~..-d,
(A)
(B)
FEE
/
/
(C)
/
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demollllon
State Surcharge
Total Mlsceilaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
_Iq.o~
Setbacks,
I HSE GAR I Acc'l
~S THEPROPOSED WORK.tN THE, '
....HISTORICAL DISTRICT. OR ON '
THE HISTORICAL REGISTER?
If yes. this appllcallon must be signed
and approved by the Historical
. Coordinator prior to permit issuance.
APPROVEr,.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In all respects. conform to the Ordinance
adopted by the City, of Springfield. Including the
Development Code, regulating the construction and use of
buildings. and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:~' '73
..g :2' ~ -qq'
Date Paid:
Receipt Number: ~~
ReceIVedi0BY: ..1' JP..~ e
'/~ ty .
./.12 ~_I
Plan; ~e~wed By (
~, ~A..'11
Oate /' r; I
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
..zf ~~ _.II?~PJ.-r /_<"
~ A4)11 E/ ~"R/~-A:::(
A---77 f1A.Jr ,
,R~~
" J( lK/( -
By signature. I state and agree. that r 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 work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division:
I 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 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.
,~gnatur~ ~ 4, ~~,
, ./ /
Date' '7'/2-2../9'd
I' f I
VALIDATION:
RECEIPT NUMBER
J<J.. 9, /2-
~/22.../5'~
&y:Cd
4~,",-
DATE PAir>
AMOUNT RECEIVED
RECEIVED BY