HomeMy WebLinkAboutPermit Building 1993-5-27
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Ollice: 726.3759
LOCATION OF PROPOSED WORK:
} ~/"7 2.
SPRINGFIELD
ASSESSORS MAp.
LOT. /'~
BLOCK,
OWNER,
ADDRESS.
CITY:
MMK' L-C:;4J// rT
,j 3/ 3,;<1. S:j, 71,/)
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STATE'
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DESCRIBE WORK, ~/ 5E?) /O//r/l)
NEW"L{- REMODEL ADDITION
17M.
, /5', J:.
,
DEMOLISH
OTHER
.
JOB NUMBER_930~si
225 Fifth Sl,ool
Springfield, Oregon 97477
.TAX LOT, ~
, 'or ~ r'
SUBDIVISION, r~'.:.-L~~, - /;i!.
PHONE,
-7-11-- -t~?k~
ZIP,-!Z'Z!IJJ__
..
,',
ADDRESS
JvfN~ /~1T /,3/3 ;es-r#.J
PLUMBING, I??/~A
MECHANICAL: ilNItfy.'hl'eE
ELECTRICAL: LI/VA ,.s:
I
CONST.
CONTRACTOR'
(p!1.7~'"
5/~gS
t2t2d7'1
~ol
EXPIRES I'HONE
/G!h.'? 7--i7-~9,72
/ 2,'tt/fl-'$_Z-i~~9$31
&1bl<1? 7~~L~/
f
lo/i/9? 7Z'--=7.S?S
CONTRACTOR'S NAME
GENERAL:
QUAD AREA: ~R.. ") E
I
. OF BLDGS:
OCCY GROUP, fi 3 + M
3
. OF STORIES:
WATER HEATER.
E.
- OFFICE USE -
LAND USE,
JIll
I.
I
VAl
,\
FLOOD PLAIN:
ZONING CODE: -.bbi!{
. OF BDRMS, 3
SECONDARY HEAT: -EP
SQUARE FOOTAGE:_
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.rn, will be
made the same working day. inspections requested after 7:00 a.m. will be made the following work day.
~ Temporary Electric
K;( Site Inspection - To be made
~ after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
l'\::7f Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~ erected but prior to concrete
placement.
[:] Underground Plumbing - PrIor
.~ to filling trench.
r\;('Underflo<ll;.J::lumUII~echanfC7D>
~ - Prior to~n ~or deCKing.
c:::;;r Post and Beam - Prior to floor
)6..J Insulation or decking.
~ Floor Insulation - Prior to
~decklng.
~ Sanitary Sewer - Prior to filling
~ trench.
~ Storm Sewer - Prior to fIlling
~ trench.
r\7f Water Une - Prior to filling
~ trench.
. OF UNITS,
CONSTR, TYPE,
HEAT SOURCE: _F E
E
RANGE:
REQUIRED INSPECTIONS
~Rough Mechanical - PrIor to
~ cover.
~ Rough Electrical - PrIor to
~cover.
'fV7f Electrical Service - Must be.
~ approved to obtain permanent
electrical power.
R7l Fireplace - Prior to facing
~ materials and framIng Insp.
. ~ Framing - Prior to cover.
lV"1 Wall/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit.
~ Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
~Fence - When completed.
rvr Final Plumbing - When all
~ plumbing work is complete.
~ Final Electrical - When all
electrical work is complete.
~ Final Mechanical - Wilen all
mechanical work Is complete.
r'i7't Final Building - When all
~ required inspection5 have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel-Up - When all
blocking is complete:
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking..sct-up, and plumbing
inspections have been approved
and ttle homo is connected tv
the service panel.
O Final - After all requilcd
ino::"....,..tlnno:: ::Ir.... ~nnrnv..d :.nrl
. , .
Lot faces ..N~ Lot Type Setbacks ,* PROPOSED WORK IN THE
~ __ Interior I P.L HSE GAR ACC I HI ORICAL DISTRICT, OR ON
Lot sq. Ilg, IN I THE HISTORICAL REGISTER?
~~ ~ Corner 20
Lot coverage Is I If yes, this application must be signed
J/~ /5 and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total hclght 3<2 Cul.(je-sac
\ ~/~ I
APPROVED.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shali. in all respects. conform to the Ordinance
'adopted by:,ihe 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'~o'rdlnances.
Plan Check Fee: -2 ''/::PC. '7' ~ ,: 1"b ~
. ,./.:s6'C
'/. ..,'~
/'"
Date Paid'
BUILDING PERMIT
ITEM SO. FT.
Main
2.~O
'4~-
..". ':..,' .
X $/SO. FT.
-5? ~O'_
4/0
VALUE
L2~'$JI,() !)
-Lt2i9.o,bd
Garage
Carport
'lbit:Ij;;"t!fi0~II{)~c." ,
---- --
Toto' V'al,ue, .. ' ;( PI 0 /(611 L
BUilding Permit F C Ff!!C.
StalC Surcharge R~ . ~I --~
~ /JI#:J Al't(lfUJ
SYSTEMS DEVELOPMENT CHARGE (SDC)
-,.3
..........
Receipt Number:
Total Fee
-2#/63
~t~
....... "'.,\....
"
(B) .
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
P~UTV1B,ING PE~M.IT
ADDrrlONAL' COMMENTS ,J
,
ITEM
,
\ ~ " . ,
FEE
., .
, ,
" .
. ... . \."
'--
"
~h.
'~~~"??:507T
. ""-\ '
,
Fixlures
."
~ .,,;,i .... .,..
Acsidenlial Bath(s)
\
.~~~-------.-
,
,
Storm jSeVJer
::. LltJCtf1vJIA-{~
FT. _______
Sanitary Sewer
Water
,
MOI)iIC Hor:ne
Plumbing Permit
Slale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Mcchanic;d Permit
LW dfiW~ i5A
~
By slgnature,l'state and agree, that I have carefully exal1)ined
the completed application and do hereby certify that all
Informatlon hereon ;s 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 Springfleld, 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 tllat only contractors and employees who
arc In COfJ1Pll"ance with GAS 701.055 will be used on this
project.
Exhaust Hood
Vent Fan
N'
Wood StO'JeJlnSer~JFireplace Unit
Dryer Vent
Issuance
State Surcharge
Total Permit
(D)
I further agreo to ensure that all required Inspections are
requested at the pro~er time, that each address Is readable
from the ~treqt. that the permit card Is"located at the front
of the property, and the approved set of plans will remain
on the Slt~ ~.t~",du~onstructlon. J..'
~gnature /' fr /-~~/if
Dato ~/',;;)'i-7'3
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
State Surcharge
Sidewalk
It
CUlbcul
ft
Demolition
VALIDATION'
L-~
.J_ 1-
:::..~-,-
,
RECEIPT NUMBER
','
DATE PAID
TOTAL AMOUNT OUE (excluding electrical)
(A, B, C, D. and E Combined)
- ,
_.n __""""_____
AMOUNT RECElvon
RECEIVED BY
I