HomeMy WebLinkAboutPermit Building 1996-10-15
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RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
LOCATION OF PROPOSEO WORK:
ASSESSORS MAP:
/7 ('=) J.
LOT:
OWNER.
ADORE'"''
CITY:
DESCRIBE WORK:
NEW
REMODEL
~t@
1'7 Ill- LolVI 011/ rI 4 VE
2 ~ / 2
.
SPRINGFIELD
..... ,
BLOCK:
STATF'
O/<C6-(JtV
~ F It E+f tfJt..Ir.t 41
ADDITION
DEMOliSH
OTHER
.
JOB NUMBER
/0 /~f
225 Filth Slreet
Springfield, Oregon 97477
TAX LOT'
<:9<9 V~
SUBOiVISION:
PHONE: _
7 V-{,- 705L
ZIP:
0;7 Y-Z!
*
J'rJ~
ADDRESS
CONST.
CONTRACTOR'
PHONE
CONTRACTOR'S NAME
GENERAl.
PLUMBING'
MECHANICAl' fh1~tJo/ 9--- (Jf</(~ ((J
ELECTRICAL'
QUAD AREA-
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
;,./.(}/:;, NI./(nrq r,v~
AJ/.p.,/~ fJiP 'T1l/~3
. "'
- OFFICE USE -
LAND USE:_
. OF UNITS.
CONSTR. TYPE:
HEAT SOURCE:
RANGE: __
EXPIRES
tJd() 17
to -3/-7(, 7 i.HJ -I"~I
FLOOD PLAIN'
ZONING CODE: __
. OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE:_
TO request an Inspection, you must call 726.3769. Ttlls Is a 24 hour recording. AlIlnspecttons requested before 7:00 a.m. will be
made the same working day. Inspections requested Dfler 7:00 a.m. will be made the following work6day.
o Temporary Eloctrlc
O Sito Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Fooling - Atter trenches are
excavated.
o Masonry - Steel locatlon, bond
'. beams, grouting,
o
Foundation -' After forms are
erected but prior to concrete
placement.
o Undorground Plumbing - Prior
. to filling trench.
o Underfloor Plumbing/Mechanical
- PrIor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior 10
decking.
O Sanitary Sewer - Prior 10 filling
trench. ",1
o Storm Sewer - Prior to fillIng
trench. . -
O Water Line - Prior to rilllng
. trench..
,
o Rough PlumbIng ..,:' Prior to
cover. , .
REQUIRED INSPECTIONS
~ Rough Mechanical - PrIor to
~cover.
rvf'Rough Electrical - PrIor to
~cover.
o Electrical Service - Must be
approved to obtain permanent
electrlcal power.
o Fireplace - Prior 10 facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/C'olllno Insulation - Prior to
cover.
o Drywall - PrIor to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
. and Installation of unit.
o Curbcut & Approach - Aher
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complcte, forms
and sub.base material In place.
o Fence - When completed.
o Stroot Treos - Wht;ln all rcqulred
trees arc planted.
o Final Plumbing - When all
plumbing W9rl< Is complct.e.
r')<( Final Elcctrlcnl - When all
~ectrlcal work is complete.
~ Final Mochnnlcal - When all
~ mechanical work Is complete.
o Final Building - When all
required InspectIons have been
approved and building Is
completed.
o Othor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blockIng 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 all required
Inspections are approved and
porches, skirtIng, decks, and
venting hnvc been Installed.
Lot faces Lot TYPO. Setbacks . _ THE PROPOSED WORK IN THE,
I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. ftg. Interior IN I THE HISTORICAL REGISTER?
Lol coverage Corner II yes, this application musl be signed
Is I and approved by Ihe Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cui-dc-sac
IE u I APPROVEO'
BUILDING PERMIT
ITEM SO. FT. X $1 SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granled on the express condition thai the said
construction shall. In all respects; conform 10 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 lime
upon violation of any provisions of said ordinances.
Main
Garage
"
Carport
Plan Check Fee'
Dalc Paid:
Tolal Value
Receipt Number'
Building Permit Fee
Received By:
Slate Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is duo on all undeveloped
properties within tile City limits which are being Improved.
PLUMBING PERMIT
tTEM
ADDITIONAL COMMENTS
FEE
Fixtures
Resldentlat Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Pormll
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
"
Vent Fan
N'
. By signature, I state and agree, that I have carefully examined
the compleled 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 Ihe City 01 Sprlngtleld. and the Laws
of the Slate of Oregon perlalnlng to the work described
heroin, and Ihat NO OCCUPANCY will be made of any
structure without permission of the Building Safety DivisIon.
I further certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnserllFlroplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree 10 ensure that all required Inspectlons are
requested at the proper time, that oach address Is readable
from tho slreet. that the permit card Is localed at the fronl
of the property, and the approved set of plans will remain
on the site al Imes d,U;~J~~'yCtl~!:" . dcYL-
Signature "n ~ X tfJ~ to.
(/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Oale
/tJ-IS--c;6
Curbcut
ft
Demolition
"
State Surchargq
VALIDATION:
RECEIPT NUMBER
2..? ~fF2-
/J) -/.,--5'c,
2-,6 ?-/l
vr/~
Tolal Miscellaneous Permlls (E)
DATE PAtr>
TOTAL AMOUNT DUE (excluding electrical)
(A, B: C, 0, and E Combined)
AMOUNT RECEIVED
RECEIVED BY
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