HomeMy WebLinkAboutPermit Building 1995-6-26
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726.3759
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SPRINGFIELD
LOCATION OF PROPOSED WORK' Z!;(;,(p ,
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ASSESSORS MAP:
LOT
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JOB NUMBER qS().:L! I ~
225 Fifth Street
Springfield, Oregon 97477
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, TAX LOT: O'::::>"//b
SUBDiVISION: GAA::<.lP\J\~ G:<;~~
PHONE: i'Z..<., -'2,81~
OWNER'
ADDRESS:
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CITY:
STATE:
()'/L.
ZIP: on.~1.1
DESCRIBE WORI,:
NEW
IlEMODEL
PLUMBING'
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MECHANICAl'
ELECTRICAL:
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR'
1'--1, Il.o-\-l-- c,,+r
- OFFICE USE _
ADDRESS
GENERAL: J.iQ~ ,.. ~~\Ilo\e,,-':;;' "3"l.Bi
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. '.\'-..- "';;1 Co. J
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OUAD AREA: _
. OF BLDGS:
OCCY GROUP: _____
. OF STORIES:
WATER HEATEn:
-.'------.---.--
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
EXPIRES
Co 2... CiZ7
PHONE
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Co <;::.';;3,-2. <;'L( '\
FLOOD PLAIN'
ZONING CODE: _
. OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE: _
To request an inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons reouested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 B.m, wIll be made the fOllowIng work day,
o Tcmpor<JrY Electric
o Site Inspection - To be mado
after excavation, but prIor to
setting forms.
o Underslab Plumbing I Electricall
Mechanical - Prior to cover.
rYl Footing - After trenches are
~ excavated.
o Masonry - Steel locatlon, bond
beams, grouting.
~ Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to fllllnQ trench.
o Underlloor Plumbing/Mechanical
- Prior 10 Insulation or decking.
rv;l Post and Bea~ - Prior to floor
~ lnsulatlon or decl(lng.
f\ril Floor Insulation. - Prior to
'-">,! decking.
o Sanitary Sewer - Prior 10 filling
trench,
o Storm Sewer - Prior to filling
trench,
o Water L1no - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
Cover,
rYl Rough Electrical - Prior to
~ covor. ,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o FIreplace - Prior to facing
materials and framing Insp,
CAl Fram,lng - Prior to cover.
rvJ Wail/Ceiling Insulation - Prior to
o cover.
[1SJ Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
forms are erected blll prior to
placement of concrule.
o Sidewalk & Driveway - After
excavation Is compicto. forms
and sub.base material In place,
o Fence - When completed,
o Streol Troes - When all required
trees are planted.
o Final Plumbing - When all
plumbing wc;>rl< Is complel.e,
rvJ Final Electrical - When all
~ electrical work Is complete,
o Final Mechanical - When all
mechanIcal work Is complete,
M 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
waler and sewer,
o Electrical Connoctlon - 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
porchos, skirting, decks, and
ventlng have been Installed.
Lot faces
Lot Type.
LOI sq. Itg.
InterIor
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
'.' .
.
IS THE PROPOSED WORK IN THE
.. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Se I bac ks
I P.L. HSE GAR ACC
IN
Is
Iw
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = VALUE
Main
\cm
t;;Co,Q,() s:...h~.r)
"
Garage
Carport
Total Value
Building Permit Fee
State Surcharge ~,~~ I.to "1
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical PermIt
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
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'l
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 13, C, 0, and E Combined)
FEE
.tf5
(l
3.b. 13..
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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 01 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 ordinances.
Plan Check Fcc:
Date Paid:
Receipt Numbcr:.__..___
Received By:
~~"R ________
PI~ Reviewed By
~,
Systems Development Charge Is duc on all undeveloped
properties within the City limits whicll arc being Improved.
ADDITIONAL COMMENTS
,By signature, I statc and agree, that I have carofully examined
the completed application and do hereby certHy 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 01 Springfield, and the Laws
of the Stale of Oregon pertaIning to the work described
heroin, and that NO OCCUPANCY will be mad. 01 any
structure without permission or 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 tt1<:1t <lit roqulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is locoted at the front
of the property, find the approved set of plans will remain
on the site at all limes during construction.
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Signature VA AA-- <; 1. AJ,.,t
Datp
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VALIDATION:
RECEIPT NUMBER /A' 6/ '3
DATE PAID' h - :a;;:-95"
AMOUNT RECEIVED ___ '\ 1..If~
/?-~"$..
>. RECEIVED BY ./ ~:- -01.- " ...... ~
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