HomeMy WebLinkAboutPermit Building 1995-6-19
LA b1~
,
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
III
LOCATION OF PROPOSED WORK: __~~R
II{ 1lJ~ '.' At./- I'rI"J
ASSESSORS MAP'
\'A
OWNER: ~~~ ~,~f' .~, . ~~~~'
ADDRESS: . .~ "
LOT:
CITY'
BLOCK'
STATF'
DESCRIBE WORK: _~.~: ~ Q.. t':I\o.~ f\'t\9- ,
NEW V REMODEL ADDITION DEMOLISH
OTHER
:3 - S'€5"
tit JOB NUMBE~ q'2(}\o~4
225 FI flh Street
Springfield, Oregon 97477
, ,
PHONF'
ZIP:
t',",'
.'{:-
CONST.
CONTRACT~S NA~ Ir\r\ ,..l- ADDRESS - CONTRACTOR'
GENERAL: ~q.~'N\lt:._. ~(p~ N. ~~ .~frD ()057z../~
PLUMBING: ~~~_500 ~f.(.er(Ct(/iJ6/~ OO%tJ1(P
MECHANICAL.~"m, ",~SCx\4~Yl mlJU ti;" OfXl70<6'L-
ELECTRICA~ ~" t't . {}Q'n\\\\ro.OJ'2.A%;;tj. &.~ pi':4.17r:ID ()()rJ'I'0
QUA~ AREA: ~~~\'l0
, '." ", , . ,,' . 4~ .... .. ,.
...~ OF' BLD'GS:'--.:.. \. ... . , .
OCCY GROUP: R?r\lJ\
, .
~
. OF STORIES:
WATER HEATER:
- OFFICE USE -
, \\\ \
....,...
LAND USE:
... ~F ~'N;;;; \
CONSTR. TYPE: \IN
HEAT SOURCE: t:'"q
RANGE:_ ~
EXJ;>IRES
1/.J:3J crti'
~!q5
2fJ/e/tf1
??1!2,tt:1 {p
PHONE
7W,. tlVl
f.p.;,f ~/C01
-1!f:fp~ 1ro11
'1t/f1-- J] ",5"
FLOOD PLAIN:
ZO'NING CODE: ~fU
~ -
SECONDARY HEAT: t: V
SQUARE FOOTAGE: ~c::jCfl/.
. OF BDRMS:
To request an Inspection, you must carl 726.3769. This Is a 24 hour recording, All Inspections requested betore 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.
o Temporary Electric
-
rY'"1 Site Inspection - To be made
~ after excavation, but prior to
setting forms,
D Underslab Plumblngl Electricall
Mechanical - Prior to cover.
rY1 Fo'otlng - After trenches are
~ excavated. .. '
D Masonry - Steel location, bond
beams, grouting.
rY1 Foundation - After forms are
/' erected but prIor to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
.r'?l Underlloor Plumbing/Mechanical
~ - Prior to Insulation or decking.
rYl Post and Beam' - Prior to floor
[Insulation or decking,
I'Vl Floor Insulation - Prlo;' to
~ decking.
ryq Sanitary Sewer :-- Prior to filling
l...f:::J trench, ,
\
J')(\J Storm Sewer - Pri~r to filling
~ trench. i ,
(, .' ." h "': "
r'X1 Wate; Line -. Prlor....to filling
~.. trench, .... ' " . ~
'~1 ~,~. , .'.
,rin ROU9h'~I~mbin.g ,~' Prlo'r.to
LJ.:::! cover. ~ . ,
'..
REQUIRED INSPECTIONS
r'il Rough Mechanical - Prior to
~c~et ' .'
m Rough Electrical - Prior to
~ cover.
rxl Electrical Service - Must be
I approved to obtain permanent
electrical power,
rYI Fireplace - Prior to facing
~ materials and. framing Insp,
~ Framing - Prior to co~er. "
m Wail/Ceiling Insulation - Prior to
f cover,
."
CjlI Drywall - Prior to taping.
D Wood Stovo - After InstallatIon,
m Insert - After fireplace approva.l
~ and Installation of unit.
f\TI <:;urbcul & Approach -'- After
~ forms are erected but prior to
placement of concrete.
r\. Sidewalk & Driveway - After
L.{J' excavation is complete, forms
and sub-base material in place,
D Fence ~ Whe~ completed.
IXJ Street Trees - When all required
f ..... trees are planted. .
f\:7l Final Plumbing - When all
r pl.umblng w9rk Is complet.e,
rYl Final Electrical - When all
~ electrical work is complete,
r\7I Final Mechanical - When all
LPJ mechanical work is complete.
I'7l Final Building - 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 Conne~tions - When
home has been connected to
waler and sewer. ~ .
. .
D Electrical Connection - When
blocking, set-up, and plumbing
InspectIons have been ap~-'roved
and the home Is connected to
the service panel.
D Final - After all required
inspectIons are approved and
porches, sklrllng, decks, and
venting have been Installed.
:"
-
" ~,;~ ~...;' ;;< _HE PROPOSED WORK IN THE.
Lot TYP. If! ~.
Lot faces ~ Setbacks
Lot sq. Itg. U,t:qS )( Interior I P.L 'HSE'GAR'ACCI HISTORICAL DISTRICT, OR ON
IN l5, I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is ~S I and approved by the Historical
Topography Panhandle
Iw' \(j7 I I Coordinator prior to permit issuance.
Total height ...ur Cul-de-sac
( ~0') IE L{~ I APPROVED'
\.
BUILDING ',PERMIT
ITEM . ',,~'4Jj
Main ~~
.~\
x ~~W -\\~~U\~~
\4:.\0 " 13, C6I
Garage
Carport
Total Value
~~~~
~,iL
S~\.lL"
Building Permit Fee
Slale Surcharge ~'-\,\~T\l..\,l4.~
, .,
Total Fee (A).
SYSTEMS DEVELOPMENT CHARGE (SDC)
, \, . \,' " \~ \ ," '. - . ..
.- " (B),.c...lY .A '.
j. . I . ' ~..
PLUMBING PERMIT
/.-'
ITEM
FEE
Fixtures
Residential Bath(s) N'
:4-
\fc,O_~'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
\b()_~
\~,~
\"\~.~
State Surcharge
G.tOtL.l.,~O
Total Charge
(C)
MECHANICAL PERMIT
c;,,'d2
l..\."iQ
~.~
60 ,sO-
3.Y:>.
s.tr()
'51.SQ
tb
L <::> -
.l.\,U
l~_lL
Furnace
Exhaust Hood
Vent Fan
N'
~
Wood Stovellnsertl Fireplace Unit
Dryer Vent
b--X>lL~ ~ t,,))bl..w.t
,
Mechanical Permit
Issuance
State Surcharge
~.ee* \.1~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
/
&8. 15
\ ...tor;
Sldewalk
ld-..S
~1
It
It
CU1.b,~ut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
J..j~.~
'8t'J~&
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, D, and E Combined)
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 said ordinances.
Plan Check Fee: ~\~.\Q:\
Date Paid: ,,,",: \l.l\~ '
Receipt Number:, \ \~5
Received By: .t1'\\J:::('\ J
. ~ PI~~ed By
C:,hc:-Ic.s
~
"
. .,Systems Development, Charge is duo on all undeveloped
''', ,
prope"rties within the City limits which,are being improved.
"
\~~\L COMMENTS
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By signature, I state and agree, that I have carofully examined
the completed application and do hereby certify that all
Informatfon 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 Stato of Oregon pertaIning to tho work described
herein, and Ihat 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,
Slgnatu~...Q.;:) c:..4A..~
Date ,-{q- qS
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
17~fY7
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RECEIVED BY