HomeMy WebLinkAboutPermit Building 1991-4-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726,3759
.
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OWNER- ('j ,5\0[') ~~.. !('\ r 0- i"j ...I\HONF'
ADDRESS:. 5~\~ t\K \()O J \ J....l." ~ (\
CITY: 6~?\^ ll\ \b ~N)... ." , STAT~: (\) k ~ ~
DESCRIBE WORK' (; S\.()1:),.e.....- / ~0
~ /1 ~'~~,
NEW~ REMODEL ADDITION
LOT:
CONTRACTC(f~'S^NAME
GENERAL..x1. \ \\ f\~
I( ,t lCS
F:'LUMBING:
MECHANICAl'
ELECTRICAl'
OUAD AREA: ..3~~ Q..,
\
Y'
# OF BLDGS'
OCCY GROUP:
# OF STORIES'
WATER HEATER:
BLOCK' .'
DEMOLISH
OTHER
e
q\~
JOB NUMBER
SUBDIVISION'
,4; 10 - R~YJI
ZIP:
qfl4-f)~
CON ST.
A~RES~ .:. , ( .0') CONTRAWOR # 111 ~XPI')fT(11r PHONE
~() ~)f., 1'lC)(()\C1DfhlQ lo5\\~ 'PP~ ~~I 0
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
. 0 Rough Electri~al - Prior to
cover. .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
.% Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After Installation.
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
.ar:td sub~base material in place.
D Fence - When completed.
D Street Trees ~ Whe~ all required
trees are planted. ..
~' , '
,.. ~.
FLOOD PLAIN'
ZONING CODE: LJ)'?-
# OF BDRM<:'
SECONDARY HEAT:
qf:()
- OFFICE USE -
LAND US". \ \ \ \
I
CONSTR. TYPF' V tV
# OF UNITS:
HEAT SOURCE:
RANG'"
SQUARE FOOTAGE:
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. wlJl be made the following work day.
o Temporary Electric
D Site Inspection - To be made
, after e'tcavation, but prior to
I setting forms.
O .Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ooting - After trenches are
~ ~xcavated. ,
D Masonry - Steel location, bond
beams, gro!Jting.
lVf Foundation - After forms are
~erected but prior to concrete
Placement(St.A6 /WIlfJI#'&}
o Underground Plumbing - Prior
to filling trench.
[J
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
o
Post and Beam - PrIor to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - 'Prior to
cover.
D
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
erectrl.cal work is co,!,plete,
o Final Mechanical - When all
mechanical work is com.plete.
lVf Final Building - When all
~requlred Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking Is complete.
, .
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - Whefl
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
venting have been installed,
Lot Type- .
Lot faces - Sett acks . IS THE PROPOSED WORK IN THE
Lot sq. Itg. Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Panhandle Is I and approved by the Historical
Topography Iw I Coordinator prior to permit issuance.
Total height Cul-de-sac
IE I APPROVED:
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. ~._~ VALUE
Main
\4\0
1Ai OC{U
Garage
qCD
Carport
-
~~~
4:13
/f'J? - '" 3
SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Fireplace Unit
,
Dryer ~e-nt
, '.'
.'
Mechanical Permit
.j
/
Issuance
/~ State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
ItJ3,.(3
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 an{;~O~Slons of said ordinances.
Plan Check Fee: ~ ~ .()~
Date pai~: . -4 - .f).- q: \
Receipt Number:~/JS~
Received . C'\~Do..)
_~0;?AM
Plans eviewed By -
~-/SAI
Datl
Systems Development Charge is due on all undeveloped
. properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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
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.
Signatur~2/~ L(~#V)
Date' 4' j /"i / 7'1
'j' /
VALIDATION:
RECEIPT NUMBER i q~ f D
DATE PAIP Lj -/q -7 J
AMOUNT RECEIVIfi / ()j.4 :i)
RECEIVED BY (1 ~