HomeMy WebLinkAboutPermit Building 1995-2-27
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: I tj)4-'7
ASSESSOR~ MAP: -.J R()30~ ~
LOT'
BLOCK'
OWNER~i\ 1(\(') \ \J\() ~
ADDR"ci." \ Ylo~ ~ ~O. \
CITY' '-.-\....~<'... - .
DESCRIBE WORI<' r\)'\J\It!\ \L...
NEW V REMODEL\) 'AD~1TI0N
~mti~
ST:TE: i ~\j h 0 ~OY\
DEMOLISH
OTHER
. nAI,(h"l/
JOB N U M B ~ R ..:::J....:j:fl 0 X
225 Fifth Street
Sprlnglleld, Oregon 97477
. TAX LOT:
SUBDIVISION'
() Q-~OCJ
PHONE:
~~ 7S.a\~\
ZIP:
q,l?_O
I CONST.
CONTRAClOR'S NAME I, . ~+. .,..,~DDRESS ' - I &l(>NTRACTOR .
GENERAL: f\(; 0 C\ rl [)\l..LlI..lU....Y I <.Sll?'\ \'M1J\ ~\, 4-\tft17
PLUMBING:
MECHANICAl'
ELECTRICAL: \ _ ~ 0 n i -\() f'lr~ J.)
QUAD AREA: ~\{\\.~
\
OCCY GROUP' ~
\
· OF BLDGS:
· OF STORIES:
WATER HEATER'
EXPI~S
\ \ .\9: ~ c:..
~~
,
\CfVt klJYY\ ~fuL 103\3'7
- OFFICE USE -
\ \ '7{)
LAND USE:
· OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
\ U,)
I{}<D~' 11m
FLOOD PLAIN'
zo~i,,!G CODE: --L~~
· OF BDRMS'
SECONDARY HEAT:
SQUA~~ FOOTAGE: ,~o
'i. .~,'.. "
, " '\ . :," ':', ,.,;,....,:" '...., '.. ....'.',
To request an Inspection, you must call 726-3769. This la a 24 hour recQrding:'AII'lnspeclions requested,l;>efore 7:00 a.m.'wlll,bo:'
made Ihe same working day, Inspections requesled after 7:00 a.m. wlll'be made the following work 'day.:, ' "
REQUIRED INSPECTIONS
o TemporarY ElectrIc
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underalab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
k:h\FoOllng - After tr.enches are
T excavated. : .
o Maaonry - Sleel locallon, bond
,beam., grouting.
~ Foundation - Afler form. are
erected but prior 10 'concrete
placement.
o Underground Plumbing - Prior
10 filling trench.
O Underfloor PlumbIng/Mechanical
- Prior to Insulation or decking.
o Poal and Beam - Prior to floor
In.ulatlon or decking.
D Floor Insulation - PrIor to
decking.
o Sanitary Sewer - Prior 10 filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to IIll1ng
trench.
D Rough PlumbIng - Prior 10
cover.
"/.
o Rough Mechanical ~ Prior to
cover.
~OUgh 'Electrical - Prior to
/ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior 10 facing
materials and framing Insp.
pra~lng - priori to cover.
o Wail/Ceiling InsJlatlon - Prior to
cover.
o Drywall - Prior to taping.
o Wood Slovo - Aflor Installallon.
o Inaer' - After fireplace approval
and In.tallatlon of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
O Sidewalk & Driveway - Aller
excavation Is completo. forms
and sub.base materIal In place.
D Fence - When compl~ted.
D Street Trees - When all required
trees are planted. .
o Final Plumbing - When all
plumbing work Is complel,e.
~al Electrical - w.hen all
T electrIcal work IS complete. C
D Final Mochanlcal - When all
mechanical work Is complete.
~Inal Building - When all
equlred Inspections have been
approved and building i.
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complele.
o Plumbing Connections - When
home has been connected to .
water and sewer.
D Electrical Connection - When
blocking, sel.up, and pluroblng
Inspecllons 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"
ventIng have been Installed.
..
," ~OI~Y. .., .,
Lot faces
'"
Lot sq. flg. Interior :r:L.
'. Corner
Lol coverage Is
Topography Panhandle
Iw
Total ~elght Cul.de.sac
IE
BVILDING PERMIT
ITEM sa. FT. x $/sa. FT. ~ VALUE
Main
4'lJ)
\4. .\1)
" \aft\rLL
Ga(age
Carporl
Tolal Val ue
\dl \Q ~
\ at. ~D
5.04>
lor]. ':>\
Building Permit Fee
Slale Surcharge + ?:lYO
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) \ )(~B
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
Residenlial Balh(s) N'
Sanitary Sewer FT.
,Water FT.
Slorm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
TOlal Charge
(C)
I
~t?5
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
N'
Wood Sloveflnsert/Flreplace Unll
Dryer Vent
MechanIcal Permit
Issuahce
State :Surcharge
Total Permit
./
(D)
/J
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slale Surcharge
Sidewalk
It
It
Curbcul
Demolition
~t~ _sUrCharge,
\JtU) 1\ (\ r
cJ{)ff
,Total Mlscellaneous:Permlts (E)
":TOTALAMOUNT DU~(~~;;ludlng eleclrlcaliB1..:5!
(A, B, C. D,a~d E Combln'.;d), ' ,', ' ' " ".::
.IS THE.PROPOSED WORK,tN THE. '
'.HISTOI'1ICAL 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 lhe 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 of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: ~
Date Paid: ,--rY
Receipt Number' NV
Received By: ~
Plans Reviewed By
Date
Systems Developmenl Charge Is due on all undeveloped
properlies within the City limits wljich are being Improved,
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed appllcalion and do hereby cerlify that all
Information 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 State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of Ihe Building Safety Division.
I further certify thaI only contractors and employees who
are In compliance with ORS 701.055 will be used on thla
project.
I further agree to ensure that all required Inspections are
,equested at the proper lime, that each address Is readable
from the slreet, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the alte at all times during construction.
Signaturp;~ /J~
Date
2 - 27 -f 5
,
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
/h 47_Pi
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