HomeMy WebLinkAboutPermit Building 1991-4-5
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RESIDENTIAi /-
PERMIT APPLICATION!
Inspections: 726.3769
Office: 726-3759
SPRINGFIELD
~tD
LOCATI~N OF PR~PO~~ORK: _ ( 0 ~ eoq ~ 10 (\ u E;
ASSE~SORS Mf-P:, ~U~Q~ \. \, '7'
LOT' . BLOCK:
OWNER\" Yl ~X r--rt- ~ ~~ I ; Orl... 0 r-", '
ADDRESS: R~11\?'~1 ,~Q , P0L
CITY:~ l~ 'STAT",-T\.Jb
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOc ()~
, l '8t Ma~U~~;VI~ION: (16\." D0MQ eM D irfd :>
PHONE: .:J21n~ 1~2...'"=\
DESCRIBE WORK-
NEW ,~ REMODEL
~o D\rlWf\Q ~'
ADDITION
DEMOLISH
OTHER
ZIP:
Ql4,.5
CONTRACTO~AM~ _
GENERAl' ~\Q.eJ
. PLUMBiNG: ~~~ )(l~)
MECHANICA - ~~~
E~~~RICAI, ,I i W ~
CONST,
5N6';O~'1 rrqEiClIl..
~q()\lo ~/AtJ J
!l..()2.A(,)4'/~ 1111
\ ~Q 4rJ lo'l7D/Q \
ADDRESS
PHONE
4\<.SE.. :.... OFFICE USE -
QUAD AREA: LAND USE: \ \ \ \ FLOOD PLAIN'
. OF BLDGS' \ . OF UNIT!" \ ZONING CODE: \DR.
OCCY GROUP: R~"'\ \'(\ CONSTR_ TYPE:-'i.1J . OF BDRMS' \..~-
. OF STORIES: A HEAT SOURCE: Sf- SECONDARY HEAT:
WATER HEATER: of: RANGE: ?, SQUAR~ FOOTAGE: dd Y Lp
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. will be made the following work day.
REQUIRED INSPECTIONS
~ Temporary Electric
~ Rough Mechanical - Prior to
~cover.
." 0 Site, Inspection - ,To be made
after excavation, but prior to
setting forms.
f':7f Rough Electrical - PrIor to.,
~ cover.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated. .
1':71 Fireplace - Prior to facing
~materlals and framing Insp.
o Masonry - Steel location, bond
. beams, grouting.
g Framing - Prior to. cover.
1':71' Foundation - After forms are
~rected but prior to concrete
placement.
gWall/Celllng Insulation - Prior to
cover. '
o
Underground Plumbing - Prior
to filling trench,
~ Underflo~chanic.ai>
- Prior fo I--;-;~"~,"'-.:v~'- o~r- aecKing.
~ Drywall - Prior to taping,
o Wood Stove -'After Installatl~n:
~ Post and ,Beam - Prior to "floor
~nsulatlon or decking.
o Insert - After fireplace approval
and Installation of unit. .
1':71 Floor Insulation - Prior to
~ decking,
.s Curbcut & Approach - After
forms are erected but prior to
placement of <;:oncrete.
~Sanitary Sewer - Prior to filling
~rench.
1"JI' Sidewalk & Driveway - After
~excavatlon is complete. forms
and s~b~base material In place.
~Storm Sewer - Prior to filling
~rench.
'F':A"Water Line - Prior to filling
~trench. ,
- 0 Fence"- Whep compl.~ted.
~Rough_ Plumbing -:-:- Prlo~ to
~over.
~eet Trees - 'Wh~n -all required'
~es are planted. .
"I:5<!"Final Plumbing ,- When all
~ ....lumblng work Is complete.
~ Final Electrical - When all
J2::S electrical work Is complete.
~ Final Mechanical - When all
~echanlcal work Is complete.
1'Qf Final Building - When all
~equlred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
, .'
o Blocking and Set-Up - When all'
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer. I
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
" Inspections 'are approved and
porches, skirting, decks, and
venting have. been Installed.
BUILDING PERMIT
::i: \BJ:(P xcP.S,~(~ ~fJiA~ 2..-
MQ \4,\0 lo:lD!lJ)
Garage
Carport
Total Value
~qJIIY ,
~ 7-=?~
Jrb.'-f
31 t.&. $
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
//~tP,""
(B)
. PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
~
-LCf2 10
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
\ Plumbing Permit
State Surcharge
q,t,3 .
-z7z .' 3
Total Charge
(C)
MECHANICAL PERMIT
?.co
./,ro
/'2.1'0
I I
Furnace
Exhaust Hood
Vent Fan
N'
4
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~.oo
Mechanical Permit
25_$0
J Q.".o
J.7~
3 7.2 ~
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge:
Sidewalk
q~
2~
It
It
?-.3 ,SO
/ 1.2.0
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
3~.oo
18.55. ~
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, 0, and E Combined)
-'E P~OPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON Y'\ ~
THE HISTORICAL REGISTER?' A U J
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
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 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" ~OViSiO.?\S :z!-,said ordinances.
Plan Check Fee: ,...y:f A ~ \ --J
Date Paid ~ . '2.'2 ,q l
, Receipt Number:--19~~ ')
Received : R~
-~~
R~vjewed By r -
4-1-7/
. Date
P.I
,.
Syst~ms Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONA.,L ~OMMENTS
~J\ f)~~o .Sir\OO']r\O~ /
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, andl further certify
that ?ny 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.
Slgna~\u ~~, 4~
'\ \
Date' - C;--"f
VALIDATION: ~
RECEIPT NUMBER ":'" ,(
DATE PAID 4- ~4 " '",
AMOUNT'REC!'!YE8 - )r<J(;fj3~'
RECEIVED BM Ii '{.tl --
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