HomeMy WebLinkAboutPermit Building 1999-10-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT'
.
SPRINGFIELD
.
JOB NUMBER
91/LfL{ f
BLOCt<.
225 Fifth Street
Springfield, Oregon 97477
A-tJp./l( }(J
TAX LOT: /r; 59 dD
SUBDIVISION:
OWNER:_f,<r1Ir()~('pf\r:l [02.,n
ADDRESS:' rl-l Cf'?l. CnrI"cLfY1::.. kr}Q;Yl p-~__
CITY: Spn0Jhf'Jri . STATF' nR. ZIP: Q'l477 .
DESCRIBE WORK: _I n ~ I A ft,<z" -f7'~.p - <+-fJ.fL.~ Orp'-!!3 ~
NEW REMODEL AD~ITI N DEMOLISH OTHER l. K
CONTRACTOR'S NAME
PHONE:
7;)~ - 't1a9/J
ADDRESS
CONST.
CONTRACTOR'
EXPIRES .,::- PHONE
GENERAl'
PLUMBING: 1
MECHANICAL: rr /flt'flMiA'.") 4110 O~.
ELECTRICAl'
QUAD AREA-
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
=*-~.~'L9D '747-7t14S"
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mberlor "~,:-<_P;OO-33<l-",;rr"
nu Cen\SQUARE FOOTAGE:
- OFFICE USE -
. LAND USE: -
TO request an Inspection, you must call 725-3759. This-Is a 24 huunecorolng;"Alllnspectlons requested before 7:00 'a,,,( will be .1
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
NOTICE: J!jRl! ~'ntl\(
lHlSPERMITSHALLEX I ~lif'l\~OT
~OR~EDUNDER~SP B
COMMt:I\lCEB OR IS ABAtElA.0MSQ~~.
., 'r-~,....vr::II:::DIOD. RANGE:_
1\1'11 IUW"";"t't"'F"t-I'
o Temporary Electric
o Silo Inspection - To be mado
'after excavatIon, but prior to
. setting forms.
o Undersleb Plumbing/Electrical/
MechanIcal - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected-but prior to concrete
placemont.
o Undorground Plumbing - PrIor
to filling trench, .
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - PrIor to
decking.
o Sanitary Sewer - Prior to IIll1ng
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench. .
o Rough PlumbIng - PrI?, to
cover. ' \
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover. .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Flnel Plumbing - When all
plumbing w9rl< is complet,e.
rI Final Electrical - When all
....-:? ....)trlcal work Is complete.
~ ~I Mechanical - When all
~I ",echanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved end building I.
completed.
o Fremlng - Prior to cover, W /1_.... .
OtherU-......5 ~
. .
o Wail/Coiling Insulation - Prior to 7\ (2A-~ Q., 1.1< c.../-
Cover. L/
o Fireplace - Prior to facing
materials and framing Insp.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
~rt - After fireplace approval
'~d Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placomont of Concrete.
o Slde'walk & Driveway - Afler
excavation Is complete, forms
and sub.base materIal In place.
o Fence - When completed.
o Slreet Trees - When alf required
trees are planted.
MOBILE HOME INSPECTIONS
o Blocking end Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection ~ When
blocking, sel-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After ell required
Inspections ere epproved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
.
Lot lype
Lot sq. ftg,
Interior
Lot coverage
Corner
Topography
Total height
,.
Panhandle
Cui-de-sac
Setbacks
P.L. HSE I GAR
I
I S I I I
; i : t_~
". ", 'I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
N
BUILDING PERMIT
ITEM SO. FT.
'{
X S/SO. FT. _
Main
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
-,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s)
N'
Sanita-ry S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
Wood Stovellnsert/Flraplace Unit
Dryer Vent
Mechanical Perml!
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
Slale Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
FEE
.... "'::\~ \
&E PROPOSED WORK IN THE.
. "HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
ACCI.
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
APPROVEf"
This permit Is granted on the express condlllon thallhe said
construction shall, In all respects, conform to the Ordinance
adopted by the City 01 Springfield, Including the
Development Code, regulallng the construction and use of
bUildings, and may be suspended or revoked al any time
upon violation of any provisions of said ordInances.
Plan Check Fee'
Date Paid:
Receipt Number'
Racelved By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City II mils which are being Improved.
ADDITIONAL COMMENTS
I
. / I ,
tIT11 AP
"
Ov
--
-."
By slgnalure, I state and agree, that I have carelullY 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 Ordlnancus of the Clly of Springfield, and the Laws
of the Slate 01 Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission 01 lhe Building Safely Division.
I lurther certify thai 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 slle at al times d ring coos~ructlon.
Signature 7jp'0.. 7'IiM I~
Date If)f /ftj99 /
J/
VALIDATION:
RECEIPT NUMBER
DATE PAIf'
AMOUNT RECEIVED
RECEIVED BY
03 rer ~ 7
(() / I Ef / 7' f
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