HomeMy WebLinkAboutPermit Building 1998-7-14
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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SPRINGFIELD I.k ."j ,
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' (; t :s 0
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ASSESSORS MAP:
LOT'
OWNER'
ADDRESS'
CITY:
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL: (JW A/1;;.7t J
PLUMBING'
MECHANICAL:
ELECTRICAL:
t5~CfO/;)
BLOCK:
TAX LOT'
SUBDIVISION'
PHON""
STATE: -&rz
ZIP: q~ L; Z5
15A-7~'om
ADDITION
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DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
,~
PHONE
EXPIRES
-N0nCE:
TU'~ P=FlMIT SIIALL EXPIRE iF inc: VVUHK
AI IT1-40RIZED UNDER rf liS :-:F;r,;IT ,6 1~'Oi
COMMENr.P.n OR IS P.B.A,NDON:~ :-01';
\"" r -- -
, '\1 I....V .....", rli.t1IIJU
- OFFICE USE - '
QUAD ARE'" LAND USE: FLOOD PLAIN'
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: - CONSTR. TYPE: _ # OF BDRMS'
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGf' SQUARE fOOTAGE:
To request an Inspection, you must call 726.3769. Tills 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. wIll be made the following work day.
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab PlumblnglEleclrlcal1
Mechanical - Prior to cover.
D Footing - 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 Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
~SUlatlon or decking.
o FI or Insulation - PrIor to
cking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
~Ch'
D Ro h Plumbing - Prior to
er.
~IRED INSPECTIONS
C-D Ro h Mochanlcal - PrIor to
~L c er. .
~ RO~h Electrical - Prior to
~er.
~
F al Plumbing - When all
plumbing work Is complet.e.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
Fi al Mechanical - When all
echanlcal work Is complete.
D Fireplace - Prior to facing
materials and framing Insp.
D FI al Building - When all
qui red Inspections have been
approved and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
D Wood Stovo - Atter Installation.
D Insert - After fireplace approv41
and Installation of unit.
D Blocking and Set.Up - When al/
blocking Is complete.
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Sidewalk & Driveway - After
excavatIon Is completc. forms
and sub.basc material in place.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Fence - When corl1pleted.
D Street Trees - Wh~n all required
trees are planted.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
HSE GAR Acc'l
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BUILDING VALl1E, PLAN CHECK
AND BUILDING PERMIT
Lot ~yp' ,.
Lot faces
Lot sq. Itg. InterIor
Lot coverage Corner
Topography Panhandle ,.
Total hel ght Cul.de-sac
I P.L.
IN
Is
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BUILDING PERMIT ",
'11 'y
ITEM
sa. FT.
X $/ sa. FT.
VALUE
Main
Garage
Carport
"
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_ 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.
APPROVED:
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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Date Paid:
Total Value
tJ...S7J Receipt Number"
Building Permit Fee
State Surcharge S;,IV Rec;; BWJ ~(fP
(, 7. S7J
Total Fee (A) Plans Reviewed By
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures S sO ~
Residential Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit ~()~
State Surcharge ~t.io
Total Charge (C) ]i 40
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
NO
I
SYSTEMS DEVELOPMENT CHARGE (SDC)
Wood Stove/lnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
l~dD
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I. V<J
U,l..o
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demollllon
State Surcharge
.etA Sf} L
I
Total Miscellaneous Permits (E)
'1,/1,. lf8
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Setbacks.
Plan Check Fee:
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 stato 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 tho 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
(rom 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.
Slgnatu-::21A. tI/Jd14.w-
Date -fJ-P-'
VALIDATION:
(JJ~ 7tJ
DATE PAIl' 711'-/ Iff"
AMOUNT RECEIVED / ~ 7 I g- /l
RECEIVED BY ;:.j/ tJ a:.J .
RECEIPT NUMBER