HomeMy WebLinkAboutPermit Building 1994-8-18
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RESIDENTIAL
PERMIT APPLICATION
Inspections: "726.3769
Office: 726,3759
LOCATION OF PROPOSED WORK: /Jlsf
/ASSESSORS MAP' /7/:/-=\ 4'::;-
mVNER' > f c. V''f' X c.;'c.hl':GR'tI
ADDR''';'': 1--'.5 V /r9/YJdJ) Ave
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DESCRIBE WORK' / ';f /..of II d. / J1 i
NEW X REMODEL ' ADDITION
LOT'
1
QUAD AREA: ...~)0
I
OCCY GROUP' . "^
· OF BLDGS:
. OF' STORIES:
WATER HEATER'
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SPRINGFIELD
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BLOCK'
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. DEMOLISH
OTHER
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JOB NUMBER
9~///<;,
225 Fifth Street
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION'
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PHON'"
ZIP: P7LJ 17 ~
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ADDRESS.
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F/L'Y1.kL''"
CONST.
CONTRfCTOR .
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PHONE
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o Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior' to
~over.
o Elactrlcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ra~lng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover:
~ Drywafl - Prior to taping.
o Wood Slave - After Installation,
o Insert - After IIreplace approval
and Installation of unit.
o Curbcut & Ap'proach - After
forms Bre erected but prior to
placement of cancrot.e.
o Sldawalk & Driveway - After
excavation Is complete, forms
and "sub-base" material In place.
o Fen~e - When completed.
D Street Trees - When all required
trees are planted.
EXPIRES
e/e..c (17./ ('_Oil
FLOOD PLAIN:
ZONING CODE:
u\~
CONTRACTOR'S NAME
GENERAL: { ,{ ,., rn "'.;;t f:b..tt,e <..
PLUMBING: No /1 tI/hI-/VI/"
MECHANICAl ~/J,~ /' /J1e C~f1 )nr~/
ELEcTRICA~ OW .17 ~ 12.. ,,} <1): n t1 (7 1/1/ ./1
/
- OFFICE USE -
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LAND USE:
· OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
\I~I
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
5W
RANG'"
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be ;-
made the same working day, Inspections requested after 7:00 a.m. '"."'111 be made the following work day. . /
. REQUIRED INSPECTIONS '
o Te":,porary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
O Underslab Plumblng/Electrlcalt
Mechanical - Prior to cover.
~ Footing - Alter trenches are
J2S.t excavated.
o Masonry - Steel location. bond
,beams. grouting.
~oundatlon - After forms are
~;rected.but prior to'concrete
placement.
o Underground Plumbing - Prior
to IIIl1ng trench.
o Underlloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o .I:"i\8ry Sewer - Prior 10 filling
~~;'nO'l.
,
o Storm Sewer - Prior to filling
trench. .
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
,
o Final Plumbing - When all I
plumbing w9rk Is complet.e.
~Flnal Electrical - When all
~Iectrlcal work is complete.
o Final Mechanical - When all
mechanical work Is complete.
~Flnal Building - When all
/' ....qulred Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
o BlockIng and Sel.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 have been Installed.
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Lot faces
L,:t J)t-pe
....0 Interior
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
::s
\1.5'
Cul.de.sac
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PP.L.
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Is
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IE
BUILDING PERMIT
ITEM sa. FT. x $/80. FT. - VALUE
Main
Garage
5Z0
Carport
Total Value
Building Permit Fee
Stale Surcharge
:s '? /11)"" t'U '
(A)
Total Fee
"
7.3,~ 2-
/.:...>~FO
3:tJ
~ ~r"
..c- ;-- tp
"'7-:.J.. .99
---, - -
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
(B) I;~B
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
1\
\Plumbing Permit
,
state Surcharge
,
,
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t 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
Curbcul
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
CA. B, C. 0, and E Combined)
FEE
7~.99
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Setbacks.
HSE GAR ACe' I
( 18 THE PROPOSED WORK IN THE. .
'~.HISTOI;lICAL 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
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.
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Plan Check Fee: ~,
7-2/-5'4-
Receipt Number' /~:? V
Received By: AV'?~
~j1)?'~
ph,WR;;viewed By
Date Paid:
I
P307Hd
ID:ltf l
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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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 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
pro/ecl.
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.
~nature -fod fj~
Date' rJ'- I f~ '=r '/
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VALIDATION:
RECEIPT NUMBER / V::r.::>~
DATE PAir' g-rf?-"7 V
AMOUNT RECEIVEo?'r. <99
RECEIVED BY ~""'...?h.-- .
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