HomeMy WebLinkAboutPermit Building 1997-4-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
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LOCATION OF PROPOSED WORK: ~ L:J"7 'I
ASSESSORS MAP: /& ~~~//~2::>
LOT'
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BLOCK'
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JOB NUMBER 9"pS'~::?
225 Filth Street
Springfield, Oregon 97477
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TAX LOT:
SUBDIVISION:
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OWNER'
ADDRESS:
CITY:
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STAT'"
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ZIP: '7-:;'0;./;;>::>
DESCRIBEWORK:-f~~?".A(~.?~~~ /2~~ 1"~~;ZI-""""'''''''--.c::>~>' &,.. 5-A'~~
NEW + REMODEL ADDITION DEMOLISH OTHER
CON ST.
CONTRACTOR .
CONTRACTOR'S NAME
GENERAL: ~U--.N<="'("
PLUMBING'
MECHANICAl'
ELECTRICA' '
ADDRESS
EXPIRES .. PHONE
- OFFICE USE _
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS: \
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANG'" 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.
REQUIRED INSPECTIONS
o Temporary Electric
D Slto Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Sleel location, bond
beams, grouting,
o Foundation - After forms arB
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench. ,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Boam - Prior to floor
Insulation or decking. .
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench. ,
o Storm Sewer - PrIor to filling
trench.
o Water Line - Prior to filling
trench,
O Rough Plumblno - Prior to
cover. ',.
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must 'be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to COver.
, 0 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prfor to laplng,
o Wood Stovo - After Installation.
o Insert - After fireplace approv41
and Installation of unit.
o Curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvew3\' - Alter
excavation Is compictc, forms
and sub.base malerlal In place.
o Fence - When completed.
o Slreet Trees - When all required
trees are planted.
o Final Plumbing - When ell
plumbing w9rl< Is complet,e.
o Final Eleclrlcnt - When all
electrical work Is complete.
o Final Mochnnlcal - When all
mechanical work Is complete.
rYr Final Building - When all
I,.oa.J required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Conncctlo~s - When
home has been connected to
water and sewer.
o Electrical Con,ncctlon - When
blocking, set.up. and plumbing
Inspections have been approved
and tile home Is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lot Type .
Lot sq, ltg, Interior I P.L.
IN
Lot coverage Corner Is
Topography Panhandle \W
Total height Cul.de.sac IE
Setbacks
HSE GAR
BUILDING PERMIT
ITEM SQ. FT, X $/SQ, FT. d VALUE
Main
'"
Garage
Carport
Total Value
~.<lOz::>
/5: 6-i?
.;?~
. V,
/~ ' :2P
Building Permit Fee
Stale Surcharge
t;:f
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.
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(A)
Total Feo'
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
t'
I
,
~
I
1
Fixtures
N'
Rosldentlal Bath(s)
Sanitary Sawer
Water
FT,
FT.
FT,
,
t
i
'j
i
\
Storm Sower
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
I MECHANICAL PERMIT
. 1 Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unll
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sldawalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~. ~ ~
(A, B, C. 0, and E Combined)
,....'
"".
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ACC I
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\. ..tHE PROPOSED WORK IN THE,
TORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
11 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 City of Springfield, including the
Dovclopmer)t Code, regulating the construction and use of
buildings, and may be suspended or revokod at any time
upon violation of any provisions of said ordInances.
Plan Check Fee:
~~~
Date Paid:
Receipt Number.
Re:/Z
Pfan~I~O<; ~ --:-~- -rr:.:''5''?
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are beIng Improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
In (ormation hereon Is true and correct, and I.further certify
that any and all work performed shall be done In accordance
with the Ordinanc~s of tho City of Springfield, and the Laws
of the State of Oregon p.erlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of lhe Building Safety Division.
I further certify that only conlractors and employees who
are In compliance wllh ORS 701,055 wlli be used on this
project.
I further agreo 10 ensure that all required Inspoctlons are
rOQuested at the proper time, that oach address Is readable
(rom the street, that the permit card Is located at the front
of the property, and lhe approved set 01 plans will remain
on the slte at all times during constructlon.
Slgnature~ ~
fLjs-//f97
Dale
VALIDATION:
RECEIPT NUMBER ? 5"'":30 ~
L./- /S" ~ /'
"2 '7. '/ ~ -
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DATE PAl"
AMOUNT RECEIVE"
RECEIVED BY