HomeMy WebLinkAboutPermit Building 1999-1-11
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK' '7';- J
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ASSESSORS MAP'
LOT'
OWNER' /I1(L 4c-:-e-IA/
ADDR~""" '57 2-7 m"",~
CITY- 5tJlZ,';J.; he//
,
DESCRIBE WORK'
h AI'( t
NEW
REMODEL
CONTRACTOR'S NAME
Fe1JUt.A{
GENERA' '
PLUMBING'
MECHANICAl'
ELECTRICAl'
'.
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
BLOCK:
I-k,s' f3 I;v €
W
STATE: tJlZf;-r~
&" Mi::.1J7
ADDITION
DEMOLISH'
OTHER
225 Filth Street
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION:
dt<J06
.'
PHON'"
qlJ' (. '17--}
ZIP: _"7?- V 7 .:?>
". .". u .',
CONST.
CONTRACTOR'
EXPIRES 0 PHONE
REQUIRED INSPECTIONS
~//
I [9...R~U9h Mechanical - Prior to
over.
~~h Electrical - Prior to
G;;6~er,
, 0 Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
',0 Curbcut & Approach - After
.' (orms are erected bul prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place,
o Fence - 'Nhen ~Oi.'l'pleted,
o Street Trees - Wr~n all required
trees are planted. ' ,.
, "
_' .c \I\IOR\(
~O\\~t.;_ C'\JC>.LL c'i.?\RE \~_~',:~ IS NO\'
.....U\c. P't:.~N\' \...- _...0 i\4.\8 t'(,;.\ u'" _....n
" OR\lE.ll UIW- l'lOON~u' v'.
f\\.lirl \r "0 OR \S f\'af\ ,
^O\JI\JIE.~F'CbOD PI!AIN'
...,; ,,'\/ rt;..(\\....-
\J II,) n,...,
.'I.\'oh '~ ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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,
ADDRESS
t-r:tJ/IR~
,
- OFFICE USE -
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab PlumblnglElectricall
Mechanical - Prior to cover,
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior .to concrete
placement,
o Undorground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o Post and Beam - Prior to floor
insulation or decking,
61'oor InsutaUon - Prior to
decklng..1 ~
C*CMN ,
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench,
o Water LIne '..-.. Prior to filling
trench. '. ,
, \
o Rough Plumbl~g - Prior to
cover.
:<
LAND USE:_
. OF UNITS:
CONSTA. TYPE: _
HEAT SOURCE:
RANGF'
o Final Plumbing - When all
~p)mblng work Is complete,
Final Electrical - When all
[3;.electrlcal work is complete,
I ~al Mechanical - When all
mechanIcal work Is complete.
cz:r Inal Building - When all
required 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.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and ~he home is connected to
the service panel: .
o Final - After all' required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
,
"
Lot faoea
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'" ~
. .' ",: }!': ~";::\:i
...!;i,"J
'S THE PROPOSED WORK tN THE,
'...HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot sq. ltg,
Interior
Setbacks,
I PL HSE I GAR ACe' I
I~DO 0 Date Paid:
/'C?r?> Racel pi Number'
Rec;JlBtJ~
5:0 '.17- ,/7/77
1/1. ]r
(A) Plans Reviewed By I Date
Lot coverage
N
Corner
Panhandle "
S
Topography
Total height
Cul-de.sac
W
----
"
E
BUILDING PER~IT '1
,'~ 'If
ITEM
SQ, FT,
VALUE
X $/SQ, FT,
Main
Garage
"
Carport
f7A1fr J. /?A/fC7</lV/
Total Value
Building Permit Fee
State Surcharge
Total Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT,
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood'
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
()f/tc,7
!;vOIl.t' I4Je-J
Mechanical Permit
Ino
(0, c)v
<{!; 7)'
2 t. 14)
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
~;rA?~.M~
42(1..
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical.... ".':1.-':- -lJ1-
(A, B, C, D. and E Combined) 2: J;;;J. ro
APPROVED:
BUILDING VALl1E, 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, reg'ulating the construction and use of
ouildings, and may be suspended or revoked at any time
upon violation of any provisions of saId ordinances,
7(.~3>
.Plan Check Fee:
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS ,
;:)tY~ ~~. .#A/tt?/JY{?' IS /{~J
If, II; EL.ez-rlLf...' . J'- CI...e....!5
F; P/{ 1 J+fC'.It tr"vT
Note:
Building Inspector may require
additional plans information,
----; and/or fees for the eomp:etion of
this project
I
-,-
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 et of plans will remain
on the site at all tl durl 0 nstructlon.
X
Signature
Date
VALIDATION:
~ ? '5"/9
II itl5'? .
( .I.
AMOUNT RECEIVED _2_ c:;- r,..r-'O
Jt1~~
RECEIPT NUMBER
DATE PAIl"
RECEiVED BY