HomeMy WebLinkAboutPermit Building 1994-12-13
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP'
/-;:1
LOT'
SPRINGFIELD
BLOCK:
OWNER' E-~/ c.-"'<. ., t/~,ot;?' ~,?'S~
ADDRESS.pJn V,~ \~ r\\~~ .
r A nR.c\ Q
- - (\
DESCRIBE WORK: ~/<?~~
CITY'
NEW Y
REMODEL
STATE: \ i:JLo ~
?:~c~E=S" (~Z-A..-~
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER
%"/7/'<..
PHONE:~4.CC1.tJ (
ZIP:~
c::::-::-:::.~~
~...~
CONST.
ADDRESs".,..... "%:> CONTRACTOR'
L::> I';;o.o--.....--.x- //~ ,
--Ch~.0::t:"'" ....?:'... }, _ .:::s;~____,,; ~~~~ q~~ S...,'S": ~"":;: ~
CONTRACTOR'S NAME
GENERAL:~~.
PLUMBINI>'
MECHANICAl'
ELECTRICAl'
,/
QUAD AREA: ~Q,,- 'l L ')
\
OCCY GROUP: R 7l-\-~
\
. OF BLDGS:
. OF STORIES:
WATER HEATER:
<(~
- OFFICE USE -
\ \ \ \
LAND USE:
· OF UNITS' \
CONSTR. TYPE: -\L.^-)
HEAT SOURCE: ~L
RANGE:_ ~
EXPIRES
?yy~~
PHONE
--
-~-
,
FLOOD PLAIN'
ZONING CODE: -L~~
. OF BDRMS: 4
SECONDARY HEAT: t='-P
SQUARE FOOTAGE:, ~ffi \
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 n.m. will be made the following work day.
[KJ Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
selling forms,
~.
o Underslab Plumblng/Elactrlcal/
. Mechanical - Prior to cover.
o Fooling - After trenches are
excavated,
D Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
erected but prior to concrete
placement.
~,
)'
o Underground Plumbing - Prior
to filling trench.
o Underlloor PlumbIng/Mechanical
- Prior to Insulation or decking.
lAI Post and Beam""",,:, Prior to floor
Insulation or decking.
C1l Floor Insulation - PrIor to
decking.
r71 Sanitary Sewer - Prlor to filling
L.4-J trench.
~ Storm Sewer.- Prior to filling
trench.
rn Water Line - Prior to filling
trench.
, G
r\";I Roug'~ Plumbing - Prior to
L,L.J cover.
REQUIRED INSPECTIONS
r-Y1 Rough Mechanical - Prior to
L,LU cover.
rA7I Rough Electrlc:!1 - Prior to
Lp-J cover.
rn Electrical Servlco - Must be
approved to obtain permanent
electrical power,
o FIreplace - Prior to facing
materials and framing Insp,
CXJ FramIng - Prior to cover.
rn Wail/Ceiling Insulation - Prior to
cover,
lXl Drywall - Prior 10 taping.
o Wood Stovo - After Installation.
o Inserl - After fireplace approvel
and Installation of unit.
rn Curbcut & Approach - After
forms are erected but prior to
placement of concreto.
r7l Sidewalk & Driveway - After
lLJ..-.1 excavation Is complete, forms
and sub-base material In place.
; 0 Fence - When completed.
lXl Street Trees - When all rC9ulred
trees are planted. .
r-....----
l2!J Final Plumbing - When all -
plumbing w~)(k is completc~
, J
r7i Final Electrical - When all
l,l.1J electrical work is complete.
[tr) Final Mechanical - When all
mechanical work 15 complete.
171 Final Building - When all
L4-J required Inspections have been
approved and bUilding is
completed.
DOlher
MOBILE HOME INSPECTIONS
...
" .
o Blocking and Set.Up ~ Wh,cn all
blocking Is complete, "
" .
D 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
~he service panel.
D Final - After all required
inspections arc approved and
porches, skirting, decks, and'
venting have been Installed.
(~
Lot faces ~
Lot sq. ftg. -::?5'S....-
Lot coverage I~
Topography . b-~
Total helghh~3: )
LOI ~ype . .'-,.:: . ~ :~ .':.~< ;...., ': : ;:_::' ~it \~~,:~ ,)- 'l- THEPROPOSEDWORK,tN THE,
Setbacks '
h~L. ACe' I ... !
Xlnterior HSE GAR HISTORICAL DISTRICT, OR ON
IN ." I THE HISTORICAL REGISTER?
Corner ;;1fH II yes, this application must be signed
Is , I
6 and approved by the Historical
Panhandle Iw I I Coordinator prior to permit Issuance.
Cul-de-sac ~~7'"
IE ~Ol I APPROVED: '
,
BVILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
1-'.0. """. ~ '
" j~? ~.90'=
Main
~ 3 <...
JIS'V"7
Garage
Carport
Total Val ue
I
~2~
~"- ;>'r
~.~
- /~-~"">
Building Permit Fee
~~
State Surcharge
"'7'.93
SYSTEMS DEVELOPMENT CHAR9E (SDC)
(B) -11"/1 (t5
1).~-14
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ?
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
/'9;;? 5'0
.../-,.
Plumbing Permit
.=- \ '
\
St~te Surcharge
/'9'.:2.. sz::-
~63
r:..,-..
~?9t:.
;.~
Tota! Charge (C)
\
MECHANICAL PERMIT
Furnac\l
e:::.. -
7<SP
/,e-
.?"S. --
3. CTIf>
":::2--
t/B: 5'e>
/a-
I~~
.62. 3.",
Exhaust Hood
Vent Fan
N' ~
Wood Stove/lnSert/Flre~~~nlt
Dryer Vent
-<:::::;;.i,' ~~~
Mechanical Permit
Issuance
7'"6"
7"-"3
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk //q I It
Curbcut ~ It
"'7 '7. /C7
log.he>
Demolition
I
I,
I
State Su charge / .^ ~1.
~~6W-=::>' ~
7e> ....--t<-~r.,....
o al Miscellaneous Permits (E)
TOTAL AMOUNT DUE <excluding electrical) 4Or~r-.,ffi
(A, B, C, 0, and E Combined) /i>2""3_S~
.-
, ,
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 Sprlnglleld, 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: 7t:>~.Sii:'7/
Date Paid: //_5i"-~c../
Receipt Number' /d:i ~'?""51"
/~.
~~~- ~
viewed By (,tr -./" -
/1'::<6-"7';1-
Date
Y(/
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~~ r-X ~I\wn Qt;)
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 acco'rdance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
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 Inspe::;tlons are
requested at the proper time,' ~hat 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 ~m~Opnstructlon.
I ture~'" .L\J
atp / ;). - J :3 - q ~
'.
4
, , 1-5'7:::>5-
VALIDATION: r: '-1., .
RECEIPT NUMBER ~ J} ~ \
DATE PAID 'TA"O \~. \?J ~
' fv23-$"3 /: r-' ,
AMOUNT RECEIV~ ' '_ ~
RECEIVED BY (I \}~ - - ~. . J