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HomeMy WebLinkAboutPermit Building 2000-1-7 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP' LOr- /?n~ '. SPRINGFIELD J,.." . JOB NUMBER 00 -t>CJt).; '3, -01 225 Fifth Street Springfield. Oregon 97477 TAX LOT: SUBDIVISION: /;) I"'> 7/'r?") ~~ 1132 ~.I'.>"'1; ?~<) /2 BLOCK: OWNER: ~f=:\l r-: ~ It...\ Q ,rib d , - ~Ji.rv\ Lc\Q{'<,(jfY\ PHONF-it..f,/- t+s,r;:; V ADDRESS: - I c:rs., L I1YV\ I'rv\ ,I ~\ (l CITY: S-..or I V\ (15:;, 0 \ rl STAT~- 0-( ZIP: 0, '14-/l I ( DESCRIBE WORK' \ V"I S,A L\ C-J\s' \,01'\ \{--;-"IC.. NEW REMOOEL -.,/ AOOITION OEMOLISH ~ p.;r>, R / 'G,.... ~ Q..r OTHER /' , CONTRACTOR'S NAME GENERAL' ,PLUMBING- MECHANICAL' /'}/.1 ~1lJ?:l. ELECTRICA' . QUAD AREA: . OF BLDGS' OCCY GROUP: . OF STORIES: WATER HEATER: D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. D Footing - After trenches afe excavated. D Masonry - Steel location, bond .beams, grouting. D Foundation - After forms are erected but prior to concrete placement. o Undorground 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 decking, D Sanitary Sewer - PrIor to filling trench. D s.!o!!.1l1Sewer - Prior to filling trench:- ....~ ~-:::""-r:':: r., rT1 ,.,., D Water:.tlne - Prior to filling ...-.....,;; n t!.~n.2.h.. << ~";"'$V1 S;'! Rough'l'PJUmblng - Prior to 'o";er.4~li:: 0C.1LoJ::';: .. J.._l.-. . ~,-, .~ ," /.;\-..- cooc:..,...l-J ADDRESS CONST. CONTRACTOR' .0 - OFFICE USE - LAND USE: . OF UNITS: CONSTR_ TYPE: HEAT SOURCE: RANGE: _ REQUIRED INSPECTIONS ~~ugh MechanIcal - PrIor to )C{cover. D Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wail/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. o Wood Stovo - After Installallon. 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 compiele. forms and sub-base material in place. o Fence - When completed. D Street Trees.- When all required trees Bre planted. EXPIRES PHONE FLOOD PLAIN- - - se.:- 2:QNI~if()'i~'lF._WOR":. NV ~ ~C:Qt-Mi S\i~\..I.. \::)\.~ ._--=~i:\Sf'I(j, \\1'''' '" LlNOE:~~M~~ i-lf,,;U()R\IE.~OOR \~~HEAT: CnMNlE.NC ?E.R\0lIDARE FOOTAGE: '1:\ ,Q,(\O~'{ '" To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspecttons 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. rs;;:;j'Flnal Plumbing - When all ~ plumbing w9rk Is complet.e. D FInal Electrical - When all electrical work is complete. ~ Final Mechanical - When all ~echanlcal work Is complete. D Final Building - When all . required Inspections have been approved and building Is completed. ~ Other ,,::; A'5 ~ -dA-< WJ/= <ibP~c MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumb1ng Connections - When home has been connected to water and sewer. D Electrical Connection - When blocking, set-up, and plumbing InspectIons have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venttng have been Installed. .,..;../ .::' ~,;" '..' 'I ::..::'~I>.~-ifC~~)' L~t~ype '. ~. Lot faces ,,' Lot sq. ftg. ......,.- Interior Lot coverage Corner \' Topography Panhandle' Total height Cul-de-sac. . " ,. \ IS THE PROPOSED WORK IN THE. ....HISTOI;1ICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. '." Setbacks. I 'P.L HSE GAR ACC' ~-,- S _"Y.._ _ E BUILDiNG PER~IT;~.';;!ut ITEM sa, FT, x $/sa. FT. = VALUE Main Garage Carport " Total Value Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) "PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary S,ewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge / Total Charge (C) !' MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood StovellnserllFlreplace Unit Dryer Vent Mechanical Perml t -'. Issuance: "''". J. f-, , .~ ,-- State Surcharge Total Permit (0) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut fl' Oemolltlon '\". State Surcharge Total Miscellaneous Permits (E) \ " TOTAL AMOUNT DUE (excluding electrical) ~ ','::':' (A.,~ C. 0, and E Combined) . , \ APPROVED: "'1 ,~, 'J 'I. BUILDIN'G \fALtlE, 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 01 Springfield. Including the Development Code, regulating the construction and use of ouildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee': Date Paid: Receipt Number: Received By: Plans RevIewed By Date Systems Development Charge is due on al/ undeveloped properties within the City-'lImlts which are being Improved. ADDITIONAL COMMENTS By signature. I stale 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 dons In accordance with the Ordlnancos 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 Inspoctlons 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 wilt remain on the site at all times during construction. Slgn.,ur./d L ~z~--t:<>---- Date /- 7 - CJO VALIDATION: ~o~ :Do:Do ::0 -< :z Mt!'ti" 1i;""J.. ij:t: n t:::Je....... n .. DO U.J p.J .c;.. r-- :I: I t--tn_oo 1'1 -.. ............ ::0 :Do .p. 0 ..:?;:c....Ji'JO RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY .. .... - -. ~"OOCD