HomeMy WebLinkAboutPermit Building 1994-2-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WOR\<' .;.. '5' Zo
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ASSESSORS MAP'
LOT'
BLOCK'
OWNER:
ADDRESS'
CITY'
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STAT~'
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DESCRIBE WORK'
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ADDITION 1/ DEMOLISH
NEW REMODEL
c
CONTRACTOR'S NAME
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MECHANICAl' \!\\'I/a.~_
ELECTRICAl' Q\)(O~
OTHER
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1L{o/t7
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
SPRI'j:){; F(eLD - L-tSB
TAX LOT: _1'77)/ f\7'l
SUBDIVISION'
PHONE:'
~.
ZIP'
ct7'-/77
CONST.
ADDRESS CONTRACTOR #
92.3J3 LO!.fUJ..tf!D: bll<.\i~ 77S-~~
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PLU,w..ia I NG.
21L.0rl2J8E.ceb
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GENERA' .
PLUMBING'
QUAD AREA:0RJl10
# OF BLDGS' /
OCCY GROUP: _~ ~
. OF STORIES' /
WATER HEATER'
. ,
- OFFICE USE -
LAND USE:-VJj
# OF UNITS: _I .}
CONSTR. T.YPE: V N
HEAT SOUElCE:
RANGE:
EXPIRES
(t)-2{' -'ll(
PHONE
't$7' 2$")
If';i"[.,2,
(6-2'; -1ft
"t ~-) '2s"~:
FLOOD PLAIN'
ZONING CODE: WP J
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ~)
To request an inspectIon, you must call 726.3769. This Is a 24 hour recordIng. All inspectlons requested before 7:00 a.m. will be
made the same working day. Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
G:Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
[{f Foundation - After forms are
. erected but prior to concrete
placement.
rn Underground Plumbing - Prior
to filling trench.
0' Underlloor Plumbing/r'au~all:...ul
- Prior to insulation or decking.
0' Post and Beam - Prior to floor
Insulation or decking.
c:tI Floor Insuiatlon - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
~ trench. .
o Water Line - Prior to filling.
trench. ~.
. .
o Rough Plumbing,-.P.rjor to
cove~ .
. ,
REQUIRED INSPECT.IO~S
.,
o Rough Mechanical - Prlor..to
cover. .
~ 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.
~ Fn:tming - Prior to cover.
~ Wall I C"eiling Insulation"": Prior to
cover. '. . .
o Drywall - Prior to taping.
. .
. .
o Wood Stove - After installation.
o Insert - After 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.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
~ Final Plumbing - When all
plumbing work is camplet.e.
~ Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
mechanical work is complete.
o Final Building - When all
required inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blockln9 and Set. Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D 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
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type.
~ Interior
Corner
Lot sq. ftg.
Lot coverage
Panhandle
Topography ---0-/
Total height --LL
(C\, )
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Cul.de.sac
Main
'-f~6
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge,
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
If
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
}
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permil
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D. and E Combined)
._ THE PROPOSED WORK IN THE
'-"HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
I P.L.
IN
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IE
Setbacks
HSE GAR Accl
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I
VALUE
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,
FEE
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7... (J ()
112- "0
15_()1J
15,no
--1" .fJO
_75
7~ . 7 .5
7.{5.tP!
i
.~, tf50 <9
Ift'l.50
.
'1~
/91.13
SYSTEMS ,DEVELOPMENT CHARGE (SDC)
~
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
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: --L7;? . t:;.":1.;
"Z- - y-q '-f
I
I
Date Paid:
Receipt Number:~
Recp>'ed 'By:
/\~ J1(~ . '/..- Q,-f3
Pf1rr1s Reviewed By} Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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 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 compl!ance 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
:::::u:~e 01ZJ:u~~
2-'1-11.(
Date
VALIDATION:
RECEIPT NUMBER //~,.c:, 0
7'~/.~~'9o/
:;:~~:DR:~EIVED ~~~:: ~
~~
DATE PAIr>