HomeMy WebLinkAboutPermit Building 1995-1-26
OWNER: :S;;7J=IM. II/' /l
ADDRESS:' t' '/7 (l/ h~
CITV: ~,e,1#J::117eL/) .
'7'" / ./
DESCRIBE:wORK~nfJ.... h:J;-n/~
NEW ~ REMODEL ADDITION '
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOT'
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BLOCK:
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DEMOLISH
OTHER
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q4r~77
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
IL~ I ~...a-."'tt v;s-\.'- 1)2..
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, TAX LOT: tnlOlJJ/707p1c
'4P/6V
SUBDIVISION: 4~ .a,;~ f, ~i
PHONE:
7,.;)(,- ~g-g-
7L//- $23'1- l6IdA<
ZIP: 9 7~7 &'
CONTRACTOR'S NAME ADDRESS
GENERAL: t7.N {"JY~ ~
-
CONST.
- CONTRACTOR'
(j7 It 7 'l
PHONE
h HI I /6
PLUMBING'
MECHANICAl'
j ELECTRICAL: 7JI)ln~'
EXPIRES
d/s-/ U
"
QUAD AREA: _5C. \\)\1 '> - OFFICE USE -
LAND USE: \\ \ \ FLOOD PLAIN'
j , \ - ZONING CODE: J:Dl~
' OF BLDGS: 1 ,.: , OF UNITS: \
OCCY GRoup:~M CONSTR. TYPE: \fA/ , OF BDRMS: . ~ ..
FG W
' OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATEI"I HEATER: r-, RANGE: 9 SQUARE FOOTAGE: ,3B/5
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, Inspecllons requested after 7:00 a.m. will be made the following work day.
~
% TemporarY Elect~lc
D Site Inspection - To be mado
after excavation, but prior to
settlng forms,
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
'fV'I Footing - After trenches are
~ excavated. ~
D Masonry - Steel, location, bond
.beams. grouting.
K7f Foundation - Alter forms are
).A.t erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
tv( Underlloo(J>lumbln!li Mechan~1
~- Prior to 1'1\...... ,,,,"uon or deCking.
1'V>f Post and Beam - Prior to lIoor
JL:S...lnsulatlon or decking,
K7Floor Insulation - Prior to
~decklng.
~ Sanitary Sewer - Prior to f11f1ng
)<::I..!.. !rench. JljJ TIS' "/;1'l7c. TiVV,<<:.
d ~torm Sewer - Prior to filling
~ trench, ,
K7I Wator Line - Prior to filling
;o...L trench.
i\7f Rough Plumbing - 'Prior to
~cover.
REQUIRED INSPECTIONS
. . Y. ...),
..,. fC/f Rough Mechanical -...:. Prior to
~cover. ~...., F-I':_\,' _'.;
~ Rou~.hElectrlcal - Prior to
~ cover,
t'9( Electrical Service - Must be
~approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framIng Insp.
M Fra~lng - PrIor. to cover.
I
~WaIl/C'elllng InsJlatl'g~',-'PrJor to
~ cover.
~ Drywall - Prior to taping.
o Wood Slovo - Aftor Installation,
o Insert - Aftor fireplace approval
and Installation of unit.
r<;;>1" Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete,
i"VrSldewalk & Driveway - After
~excavatlon 15 completc, forms
and sub.base material In place.
D Fence - When completed.
- ~~, I '..... \....,
D Street Trees - Who,"! .al~,r~qulred
trees are planted. ' 1
, ,
'.~' " ,. .
o Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final ElectrIcal - \N.hen all
electrical work 15 complete. t.
o Final Mechanical - When all
mechanical work Is complete.
D Final Building - Whon all
required Inspections have been
approvod and building Is
compl!3ted.
~Other 6-1:f 1.IA'~,
c.,\\. IS.\
Siiffl~ - ~
W!r,v.=. 00,
MOBILE HOME INSPECTIONS
o Blocking and Sot. Up - Whon all
blocking Is complete.
o PlumbIng Connoctlons - When
home has been connected to .
water and sewer, '
o Electrical Connection - When
blocking, set-up, and plu"lblng
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
ventfng have been Installed.
/1:..;'7",,/$(,'
5~.2.S-
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(o~S."1
SYSTEMS DEVELo/Mgn CHARGE lSDC)
$?1C'" fP 1/,1' ~-~~r.f l.'f-p.,
PLUMBING PERMIT
,.
Lot faces .:JAt-. Lot TYP.
Lot sq. Itg. /!/:rL..~ _ Interior
Lot coverage ez..ft, ~ Corner
TOPograPh~L.2.... ~ _ Panhandle
Total heigh _ Cul-de-sac
, . 4f)'" +0 ffi oot )
BUILDING PERMIT
ITEM sa. FT.
Main
271'1:.
-1/~
X $/sa. FT. a
<'"~ ~ 0
14'/1> "
Gacage
Carport
Total Val ue
Building Permit Fee "
State Surcharge ~"l i"11 +-/7,t;,1"
Total Fcc
(A)
ITEM
Fixtures
.
Resldenllal Bath(s) N' .~
Sanitary Sewer FT.
. Water FT.
Storm Sewer FT.
Mobile Home
~~~FJ"" J ]w/UJ.
Plumbing Permit
State Surcharge /l).'Ij+- _~t~ ~
Total Charge (C)'
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO J.
Wood Stove/ln~t'\t~re&;;.~((J'nlt
Dryer Vent
~ L./A);:': / UJ/a
,
Mechanical Permit
Issuahce
\
L._ r
State Surcharge /. 7S" + /.05"
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk /1n It
Curbcut , to It
Demollllon
State Surcharge
tA.MB &. ~.17(!'
. ""- -~ .,.
., ',' r r' ,.{. oill.
" . ,:....~'.'.~,'
Setbacks .
HSE GAR ACC'
I~
. ~.
! P.L
IN
Is
3h
/~
.~.
W
.E
VALUE
J~2.. Z51.~
/55/0~
FEE
/~_>o
/1000
"7G2> .5"/)
I~. ~'f\
~t::,1?
~.tHJ
1>0
/2~
4.-!i'O
~,~
,<:;, t?'O
~ 5,00
-.LOpo
2~f)
.f7~
3LtXJ
/510
~ 2-S.C'C
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) /277.70 '
(A, B, C. 0, and E Combined)
a THE PROPOSED WORK.IN 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.,
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 Clty.of Springfield, including the
Development Code, regulating the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation of any'provlslons of said ordinances.
Plan Check Fee: ?i!:.2..'~
",.,;" 11~
Receipt Number: i ~
Recelved~ A~
~~~ ':
Plan1fRevlewed By -
j/8'r/fo;{
D;;Je r / .
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
PAT# /
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DL./~/./c.. J~~~At JTr'1 ,.J6R~
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~i)fJll ~P8u4y ,;:1/J1'~/7" /5'J'~
By signature, I state and agree, that I have carefUlly examined
the completed application and do hereby certify that all
Information he,reon Is true and correct, and I further certify
.that any and all work performed shall be done In accordance
with the Ordinances ollhe City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai 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 site at all times during construction.
Anature
Date'
VALIDATION:
RECEIPT NUMBER
/&11-3
~2~r
::2JA:/Q~90
-~ ~
DATE PAIP
AMOUNT RECEIVED
RECEIVED BY