HomeMy WebLinkAboutPermit Building 1992-2-20
RESIDENTIAL
PERMIT APPLICATION
Inspections:.726.3769
Office: 726.3759
t'
LOCATION OF PROPOSED WORK:
18 02 05
ASSESSORS MAP:
LOT:
84 A'
..
SPRINGFIELD,
4439 Holly Street
2 1
..
q//~/~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
Springfield, OR 97478
TAX LOT:
7000
BLOCK: _,.
ADDRESS:
P.O. Box 22636
Capstone Homes, Inc. of Oregon
OWNER:
CITY: Euqene,
STATF'
OR
DESCRIBE WORK'
XX REMODEL
Single Farru1y Residence
NEW
CONTRACTOR'S NAME
ADDITION
DEMOLISH
OTHER
SUBDIVISION' Lucerne .Meadows
PHONF'
689-5567
ZiP' 97402
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES PHONE
_62018 10-18-92 689-5567
~5R 12-19'-92 n;~fc?,,:t
70545 12-21'-92 344-2481
54431 9-30-92 686-0905
GENERAL~~ps.tone Homes, Inc. of OR P.O.B. 22636 EUq.~97402
t,.(?f/'/.l.V-~? Z>",,",2~""...-'/"'<:""7~' ~...-
PLUMBING: ... l' 19'" D7l1rnhing- ..1:U=.~ -'-HalL St.~:e: , R 97177..
MECHANICAl' Garibau Heatinq 4207 W. 5th Ave. Euq. .OR' 9'7402
ELECTRICAl' Rose Corp. 89976 Day Lane Eugene, OR 97402
- OFFICE USE -
QUAD AREA: ?-'P-SC LAND USE: '-1.1 , FLOOD PLAIN'
. OF BLOGS' I . OF UNITS' I ZONING CODE: L-(Jl?
OCCY GROUP: ":R3,~ JV\ CONSTR. TYPE: '\/11/ . OF BDRMS: ,~
. OF STORIES' ~ HEAT SOURCE: C:;;~r-# . SECOND'tY HEAl
> SQUARE ~jG1 fi.7 ~'t
WATER HEATER:~~ RANGE: et:....tFC::-'7.
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested befor~ 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.
~TempOrary Electric
D Site Inspection - To.be made
after excavation, but prior to
setting forms.
~ Undersla~umbin9J:Eleclrlcall
~echanical - Prior to cover.
I'::A" Footing - After trenches are
~ excavated. .
o Masonry - Steel location, bond
beams, grouting.
fVr Foundation - After forms are
~ erected but prior to concrete
placement.
. "f'J1 Underground Plumbing - Prior
j,6l to filling trench.
fV1 Underfloor(Plumbin~echanigaj)
~- Prior to InsulatTon or decking.
~ Post and Beam - Prior to floor
~ Insulation or decking.
/
~ Floor Insulation - Prior to
J.<'S...(. decking.
RA Sanitary Sewer - Prior to filling
JAJ... trench.
~'Storm Sewer - Prior to filling
~trench.
l'V1 Water Line - Prior to filling
~trench.
C71' Rough PlumbinQ - Prior to
~cover.
REQUIRED INSPECTIONS
r\:/f' Rough Mechanical - Prior to
~ cover.
~ Rough Electrical - .Prior to.
~ cover.
~ Electrical Service - Must be
J6J approved to obtain permanent
electrical power.
D Fireplace - PrIor to facing
materials and framing Insp.
~ Framing - Prior to cover.. .
~'WaIl/Ceilin~ Insulation - Prior to
~cover.
~ Drywall - Prior to t~ping,
K71' Wood Stove - After installation.
l6.,[ ~ G~ce Ffl.
o Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
KA Sidewalk & Driveway - After
~excavation Is complete, forms
and sub.base material in place.
D Fence"": When completed.
~treet Trees - When all.requlred'
~ees are planted.
!"Vr'Final Plumbing - When all
~plumblng work Is complete.
~Final Electrical - When all
J....6.l.electric<;t1 work is complete,
~ Final Mechanical - When all
~ mechanical work is complete.
~ Final Building - When all .
~ require9 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 - 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
venting have. been-installed.
1 ~ / '/
1/
/ ,r
I / .. I~E PROPO~'EO WORK IN THE
Lot faces J:;/.!. Lot TY,-, Setbacks
Cfl20 ~terior I P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
Lot sq. flg: IN Wi I THE HISTORICAL REGISTER?
JT), Corner If yes, this application must be signed
Lot coverage Is I
.L~o' and approved by the Historical
Topography Panhandle I,w . fP'1.1 I. Coordinator prior to permit issuance.
Total height n' Cul-de-sac
IE fP~' I 'APPROVED:
BUILDING PERMIT -
fTEM 14 q so. FT. X
Main t l\J'O
Garage 40U
$/SO. FT.
VALUE
s,ro,lli
~~
Carport
Total Val ue
(dg2J '
,~ I!l..OD
/~,?S
~34.:!.5
Building Permit Fee
State Surcharge ..
Total Fee
(A) " ,
SYSTEMS DEVELOPMENT CHARGE (SDC)t$
, , ,'.. (B) ~'Ul1"~"
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO
3
;q 2. ,so
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
"State Surcharge
7~3
202!3
Total Charge
(C)
MECHANICAL PERMIT
r;;.() C
~JiO
::S. b'O
/5()()
~~
::2-~
'3~ ,5'0
/0.00
/. Ge,
"1-5/B
Furnace
Exhaust Hood
Vent Fan
N'
I
Wood Stovellnset!1Fireplace ~
Dryer Vent
-fi/K
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
,~
2<1
JCI,?> 0
J2.,~O
It
Curbcut
It
Demolition
State Surcharge
pW) ~Et()
4IJ(JO
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
213/7f?J
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 01 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.
Plan Check Fee: ~qt:).~,
Date Paid:
Receipt Number'
Received y:
~/J)iu.. _
Prlln Reviewed B'y .
'7 -//-'j 2-
Date
Systems Development Ch"arge is due" 'on all undeveloped
,properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~G~~~
41l./:2/ / y~ "'77 - (7'//02<1-\
" . J
~/Y\vLecfL,
~0f2.
..eX.J rf IVcJU.
/07?
\)~ <:$ II, ~30
/);-fty....d
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 dW~ construction.
Signature L ---K ~
Date
(2A.//~1
VALIDATION:
RECEIPT NUMBER ~ ~ I ~~
DATE PAIf'l f?-. - f1.b - y ~
AMOUNT RECEIVED..9. . <r\C\ h\ .~
RECEIVED BY'~' ,,~.)--.:> ~ \'...------
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