HomeMy WebLinkAboutPermit Building 1993-12-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
-.
SPRINGFIELD
LOCATION OF PROPOSEO WORK' 25" C5 Ge~-yV //,4. LA:7
'1
ASSESSORS MAP'\ '1 ~ r~ ~~
- - ----
LOT'
OWNER'
ADDRESS:
CITY:
PA-r
'25.fZ,
-;P.elfl/ID Flu:-o
r.:, 12J.-r.. rr
G REe'lV
BLOCK'
UA-Lf::
STATF'
r-,~
OESCRIBE WORK:
;?!'m,,, ,r;: q... Ifr.f>,"'-' r-
NEW
REMOOEL
CONTRACTOR'S NAME
I. ([). 8 O(~6$
GENERAL:
/'~
PLUMBING'
MECHANICAl'
ELECTRICAl'
-e-
o
~
~B -~~MBERC\0\"\~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' qr 2(1\
SUBDIVISION:
PHON~'
i<-{t.!-
ZIP'
DEMOLISH
20' x '-10 f>OOL- CoVL.=iC..
REQUIRED INSPECTIONS
D Rough Mechanical - PrIor t.o
cove~ .
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp,
~ming - Prior to cover.
~IIICeiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After l~stallat.ton.
D Insert - Atter fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
D Sidewalk & Driveway - After
. excavation Is. complete, forms
and 5:ub-base material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
ADDRESS
~o: f.o Av/:S'-
CONST.
CONTRACTOR'
-;2'-1'i "20
PHONE
73~/707
EXPIRES
11- 9-5
- OFFICE USE -
QUAO AREA: LAND USE: FLOOD PLAIN:
. OF BLOGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPF' . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT'
WATER HEATER' RANGE: SQUARE FOOTAGE:
ADDITION
OTHER
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspeclions 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 made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
- . erected but, prior to concrete
placemel"!t.
D Underground Plumbing - Prior
to filling trench.
D
Under"oor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
D Water"Line - Prior to filling
trench.'.
D Rough Plumbing - Prior to
cover.
D
Final Plumbing - When all
plumbing work Is complet,e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
- m71cal work Is complete.
~~~!.~~lIdln9 - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
";:b-~'
-=:- =--.--"--
Lot faces
Lot Type.
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
I P.L. '
IN
Is
Iw
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = ,.vALUE
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
(~
C\.43,
\C\\ ,~
.
l...IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON, 'l~
THE HISTORICAL REGISTER?)...J ~
It yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setb"cks
HSE GAR'ACCI
I
,
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 th'e City of' Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of a'('.fAvl~ of said ordinances.
Plan Check Fee: t'CC. ..
Date Paid: '\{2 ;- \ ..Q~
Receipt Number: \\C-)'- \~_
Recelve~' ...
" -)
c-'\ "
Plans Revi~eci By
\ Q -G:, -ao
Date
SYSTE~ DEVELOPMENT C~ARQE (SDC) Systems Development Charge Is due on all undeveloped
.~ l ~ 'i,...\ ~~ ~ '(l ~\ "\""\W\.~.\ properties within the City limits which are being improved.
PLUMBING PERMIT '\ \ '"-J ADDITIONAL COMMENTS '
ITEM FEE ' ,
~\Q.L~'\r~\:': N'\:f ~,;..)\\r,Q)
"" '("J\. \.. lo-:'C \.\. ~(\R(\ ~..~ ~ I\~
C'J;\ ~n~~ 7'P~~\~ ~~~~
~f'\~\ .~t\ ~(> \(>G\ \\...N?f\
, \C'\'\ ~\. f'('\. ~ \..\. ~ ~''('''l J .
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 Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, Co 0, and E Combined)
J.... ') \ \\.,
\C\l.~~
'",
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 Sprlngfleld, and the Laws
of the State of Oregon pertaining to the work descrlbed
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 Sit" apuring construction.
Slgn~.' D ~Al-.L7
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Oate '<?) ID J D>"]:
VALIDATION:
RECEIPT NUMBER
DATE PAID
}) IJd
Jd-)~.,.,
.z I en.Cf?,
~
AMOUNT RECElv~n
RECEiVED BY