HomeMy WebLinkAboutPermit Building 1996-12-11
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: t.; h g to
ASSESSORS MAP' Jl/( 0:20 5" /:2 '
OWNER: JIIJl//IWJ 1 j~ /i )~
ADDRES~~ /P?^--HfJ/ly . ~+-
CITY: ~p fi r of
LOT'
DESCRIBE WORK:
NEW
REMODEL
,-
BLOCK:
~
K Iilb)Yfrb2(
STATE: _ (J r<::...
1-/ OfJa/r
N DEMOLISH
.
JOB NUMBER 1&( (t;(1 &
225 Fiftll Street
Springlleld, Oregon 97477
TAX LOT:
/jt(r107j
SUBDIVISION:
PHON~'
ZIP:
q 7L17~
OTHER'
CONST,
:::::::~O~;~r/r~ 5l~fu;R~S ~1_2hRJLvt5rA~;:h~1:2. 3:2~.q7
PLUMBING' ~.pA-(a 'S\/r:;}tVvlA. <::.,
/ -
MECHANICAl'
ELECTRICAL'
PHONE
7:J{, .Q!1Q5 -
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: _ . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Atllnspecllons requested bcforc'7:00 a.m. will be
made the same working day. Inspecti'ons requested after 7:00 a.m. will be made the following work day,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumblngl Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
~SUlatlon or decking.
~ Insul,a.ljon -, o/JP lor 10 II ~
decking. e€l!~(Wti/l~
D Sanitary sewer-.-Jprior to (illlng
trench.
o Storm Sewer - Prior to filling
trench.
o Water line - Prior to fil/lng
trench.
o Rough Plumbing - PrIor to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
~OU9h Electrical - Prior to
~er.
D Electrical Service - Must be
approved to obtaIn permanent
electrical power.
D Fireplace - Prior to facIng
Verlals and framIng Insp.
~ Framing - Prior to cover.
D Wall/C"elllng Insulation - Prior to
cover.
~YWall - Prior to taping.
D ~d SIO~O - Arter Instal/aI/on,
D Inserl - After fireplace approval
and Installation of unit.
D
Curbcut & Approach - After
(orms are erected but prior 10
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
Final Plumbing - When all
plumbing w~:HI< is complct.c.
o Final Mechanical - When all
mechanical work Is complete.
kina, Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When air
blocking Is complete.
D Plumbing Connections - When
home 11a5 been connected to
water and sewer.
D
Electrical Connection - ,When
bJocldng, set-up. and plumbing
inspections have been approved
and tlle home Is connected to
the service paner.
o Final - Arter all required
Inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed.
---,---"
Lot faces
Lot sq, Itg.
Lot coverage
Topography
Total height
Lot Type '.
Interior
Corner
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
Main
Garage
Carport
.
IS THE PROPOSED WORK iN THE.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
, .... .' ,. ~ '. " \,'.; \.,~ ;.. ~ 1
~ 1 '.
Setbacks
I HSE GAR ACC I
I
I P.L
IN
Is
\W
IE
VALUE
"
Total Value ~Y.t ~ fef 77 mTD
Building Permit Fee _?It; 7:ur)
State Surcharge +'3"70 City AdW\;V\ t~lf_
( (A) mt, '?h
Total Fcc
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
Stato Surcharge
Total Charge
N'
FT.
FT.
FT.
VV-l1I\
Furnace
MECHANICAL PERMIT
(C)
Exhaust Hood
Vent Fan
Dryer Vent
Wood Stove/Insert/Fireplace Unit
N'
Mechanical Permi t
Issuance
State Surcharge
Total Permit
~
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
Curbcut
Oemoliiion
~tate Surcharge
ft
It
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and ~ Combined)
FEE
~,
, "f'j--
Jt, .20
~:,-
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 01 Springfield, including the
Development Code, regulating the construction and use ot
buildings, 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 8y
Date
Systems Development Charge is duc on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
Qj'~LptA{VW4 {~
-2iL<4~~ d/lt {t;eI4{'t'd ~
By signature, I state and ~gree, 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 Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Bulldlfl9 Safely Division,
I further certify that only contractors and employees who
arc 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 Iront
of the pro~erlY' and the approved set of plans will remain
on the sit' a all times during construction.
SignaturE" ~~
Date HI J;>~/ftf ./
77/ /
I
VALIDATION: /J / / .
RECEIPT NUM~R ~ vim 1..-/
DATE PAIr> I'L'II-i/{ ~
AMOUNT RECEIVED If/;;.?~
RECEIVED BY ll{ /