HomeMy WebLinkAboutPermit Building 1995-1-19
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TAX LOT: rti' nW
RESIDENTIAL
PERMIT APPLICATION
-
SPRINGFIELD
Inspections: 726,3769
Office: 726.3759
ASSESSORS MAP:
LOT:
BLOCK'
OWNER:
(1~(1. ~wmo~ J
,1:)1/SO.7T!( Ln
. .' iie) .
STATE: \!)10 \\(')v\
DESCRIBE WORK' Y \ 1\ 1 t\~ ) 1_ ~ f\Q ('(\0 f'Tt:,
NEW REMOD'~' ADDITION DEMOLISH OTHER
CITY:
CONTRACTO~NAME _.-Jl,l-j, ADDRESS
GENERA" J (t, fY l' }Uf'TfJ1J) J'\ ')
--
PLUMBING:
tl<,
CONST,
CpNTRACTOR .
MECHANICAl'
ELECTRICAL'
--
JOB NUMBER l14j6&Fl_
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
PHONE::J{lh- rM/
ZIP:
Q14lPJ
EXPIRES
PHONE
- 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' RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording, AI/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
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
'-
o Footing - After trenche a
excavated,
o Masonry - SteJlo~"tl
:beams, grouting. \...- \
o Foundation - Aft~r forms
erected but prior to con e
placement. '~'
o Underground Plu bl rlor
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
o Wood Stovo - After Installation,
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approval
and Installation of unit.
D Floor Insulation - Prior to
'decking,
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete,
o Sanitary Sewer - Prior to filling
trench.
O Storm Sower - Prior to filling
trench.
I '
O Water Line - Prior to filling
trench,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place,
o Fence - When completed,
o Rough Plumbl~g ,- Prior to
cover.
D Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing wc;>rk Is complet.e,
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete,
o Final 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 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,
Se t bac ks
I :L. 'HSE 1 GAR I ACC i
I S I I I I
Iw I I, I I
lLLLLJ
Lot faces
Lot Tyrtl
Interior
Lot sq: flg, '
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, ~ VALUE
Main
Garage .
Carport
Total Value 0J~
'} ,
Building Permit Fee , !>6l,50
Stale Surcharge -r '390 ~j.
Total Fee (A) 3 CS D~
SYSTEMS DEVELOPMENT CHARGE (SDC)
J75
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/ Fireplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total 'Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcul
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and' E' Combined)
'.
..
;.;.,...
'\~ .~:
~S THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
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 any provisions of sald ordinances.
Plan Check Fee' ./
'V
Date Paid: ~%
Receipt Number'-~~ '
Received By: /'
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
.
By signature, I stale 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 01 the City of Springfield. and the Laws
of the State 01 Oregon pertaining to the work described
herein. and that NO OCCUPANCY will be made of any
structure without permission of Ihe Building Safety Division.
I furthe'r 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 s a all times during con~truc~n, A /J /7
Slgnat ~
/"" I -
Date ,/9/ /99-"
VALIDATION: \
RECEIPT NUMBER \ I Q9~ .
DATE PAID /- /4-ClC:\
AMOUNT RECl~ ,--'3:=)~11
RECEIVED BY ~ IIJ^----