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HomeMy WebLinkAboutPermit Building 1991-8-15 r R~SIl:i~TIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATION OF PROP~3Pror~i t)fq\y{ - \j ASS~SSORSMAP:.,. \ IlJutj' l\ ~. - q{mnj JOB NUMBER 225 Fifth Street TAX LOT' LOT: 'BLOCK' SUBDIVISION' OWNE(~l1lfL llJnfl(!1.L n~ PHON~' 1')4 \ -L\'\~<r1 A6DRE::Yh \~ ~~~r:cA .' , If t 1 CITY Y.-\. JO.R J\.Q j STATE: ----1d>) J\ 01\1 Fh\ ZIP: q ~) ~ .J 'IJ -' ( DESCRIBE WORK' '-..'1J'N\ ~ j\ 0 t.P ) b, t="'. ~ J::'l \ ;~ NEW V REMODEL A1DITION DEMOLISH OTHER I /'" CONTRACT<('\S N~ ,,0 1 GENERAl' LA. 1 ] \U.f--/ PLUMBING" MECHANICA' . ELECTRICAL' ". ADDRESS CON ST. CONTRACTOR' PHONE 'EXPIRES' - OFFICE USE - 'RtD\~ ') -, \ \ \ \ QUAD AREA: LAND USE: FLOOD PLAIN' . OF BLDGS: \ . OF UNITS' \ ZONING CODE: t...1J\U OCCY GROUP: \??V~" tv\ CONSTR. TYPE: VN . OF BDRMS: '~ J::J , ~P... . OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: t?~ RANGE: r. SQUARE FOOTAGE: 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. Inspections requested after 7:00 a.m. will be made the following work day. ~mporary Electric G Site Inspection - To be made .. after excavation, but prior to , setting forms. CJ Underslab, Plumbingl Electricall Mechanical - Prior to cover. o Footing - After trenches are excavated. :1 o Masonry - Steel rocatlon, bond beams, grouting. o Foundation - After forms are . , erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench, II . . . ~nderfloor Plumbing/Mechanical ~ :. Prior to insulation or decking. ~, Post and.'Beam - Prior to floor ~;nsulatlon or decking. - 1.><1 t-Ioor Insulation - Prior to ~decklng. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to filling , trench. lVI"RoU9h Plumbing - Prior to ~over. REQUIRED INSPECTIONS ~ough Mechanical - Prior to ~over. ~Rough Electrical - Prior, to ~ ~over. ~Iectrical Service - Must be ~ ;pproved to obtain permanent ~Ie~trlcal power. o Fireplace - Prior to facing materials and framing Insp. ~ming - Prior to cover. ~all/ceiling Insulation - Prior to ~~:'ver. . ~ryWall ,- Prior to taping, o Wood St~ve - Aft~~ Installatlo~. o Insert - Afte.r fireplace approval - and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. . 0 Fence - Whe,n completed. rn Street 1rees - When all reQUlrE!d trees are planted. . ~nal Plumbing - When all ~piumblng work Is complete. r IYI~t-inal Electrical - When all ~ electrical work I~ complete. /' D<1 t-inal Mechanical - When all ~mechanlcal work Is complete. -~nal Building - When all ~~qulred 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 water and sewer, o Electrical Connection - When blocking, set-up, and plumbing Inspections have been approved and the home Is connected to the service panel. o Final - After all required _ - Inspectlo'ns are approved and' " porche.s,. skirting, decks, and venting have. been Installed. ~ - . ~ d Lot faces Lot Type Setbacks IS THE PROPOSED WORK I~THE " Lot sq. Itg. 'f;Jl-Oi. ~nterior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN /'1' I THE HiSTORICAL REGISTER? Lot coverage ~ _ Corner If yes, this application must be signed' " Is ((/ I and approved by the HistoricaL Topography hi Panhandle Iw /f/ I Coordinator prior to permit issuance~" Total height Cul.de.sac IE ( I ,10, APPROVED: , " BUILDING PERMIT sa. FT. /;;(75 5BcJ X $/so. FT. VALUE ITEM Main Garage Carport Total Value cq~~ S< $f:.~o I '1-. ~ ,'1,00 -~I? Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) , ~ 1c.F-\9~ ~ (B) PLUMBING PERMIT ITEM FEE Fixtures N' "7 Residential Bath(s) IX Sanitary Sewer FT. Water FT. Storm Sewer FT. /6~.OO . ; Mobile Home <Cf{(=-i)1 r- J'os#Ef'crO>&fl> 75.00 ~q &0 4-,7--5 e 'f.At; Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT {{:. t!)O 4.5'0 (0 ,~o Fu mace Exhaust Hood Vent Fan N' :J.. Wood Stove/lnsert/Flreplace Unit Dryer Vent s,60 Mechanical Permit /q,5'O I A) .&0 /,if (j 30m3 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) I. TOTAL AMO~NT DUE (excluding electrlcatt! 7,) /J< (!), '5'( (A, 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 A said ordinances. Plan Check Fee' .J R~ .'-\('') Date Paid: ~. ;'.;. q I Receipt Number:--.::: ffi/ I.!::I- Re~eiv By: . IM~) ~//)/lR , Pl: S Re;;;~~6 iy- a.h~h '"' ~; Systems Development Charge Is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS \..l1J\.lf\r\{)hc"J1) (~~ lY 1 f\n 0 r (\rtJ ~ Aq()~0S 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 I n accordance 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 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 siteRall times during constructCYl \/':tature ~ '1rr1,......., -' J2. y\ J... "'.~._ ,I ~ I:ate 'X - /<) ~ q I VALIDATION: _ II :::::> RECEIPT NUMI}.ER CJ( \ ()~ ) DATE PAID cA\.'J() \ ~ \~ctT AMOUNT REC~IVEO ~\, fl'\ Il CY S1 RECEIVED B~ <:7\(,L)O ) .... .it . . -' Permit No: 9 \ffiCb ~ '" Add,,,, &m- \) Ctn.l Vf11 U ,Issued b : 0 _ ') Date: R.IS .q J STATEMENT: 'INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES' , Note: Oregon Law, ORS 701.055(4); requires residential building permit applicants who are not registered with ,the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), 'need . not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:, 1. ~' I own, reside in, or will reside in the completed structure. 2. ~ L-.J My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. [ I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and ao hire a !;leneral contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and, understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ,_Pf, ~..~,o~{2~~ Signature of Permit Applicant X'-J<::~?/ Date " '-"! CONSTRUCTION CONTRACTORS BOARD 0244J 10/24/89 ~ PY TO ISSUING AGENCY PERMIT FILE \,~g,y TO APPLICANT" , . . . .' .