HomeMy WebLinkAboutPermit Building 1991-4-25
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RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD
Inspections: 726,3769
Office: 726,375~
ASSESSORS MAP:
LOT:
BLOCK'
OWNER: \( ()\\ if' \(~'(' \\et~
ADDRESS' C:\)lV:\- _ l S1"'J\...Q.Q t .>
CITY: 6r~l~ - .
STATE:
DESCRIBE WORK' '--~t 00/\ 0, ~ m", \i 1 V
NEW ~ REMODEL 6ADDITION DEMOLISH C:l
OTHER
.
Q \ [)'2.~{)
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
n-, a"Y'')
SUBDIVISION:
PHONE:
14, \ - II Q2..5
CONST:
::::::~~otarnr\~~ .\J~~~ m~ls C05~~
PLUMBING.l ur';\-n-n ~'2...4~ \<~~YM F
f
MECHANICAl'
ELECTRICA" ~Mm
~QL\~-O ~l->
OUAD AREAO'Rt\) u. '}
. OF BLDGS' I
OCCY GROUP: R. O~ N\ I
bl.
~
-' OFFICE USE -
. OF STORIES:
LAND USE: \ \ \ \
. OF UNITS: \
CONSTR. TYPE: V t\J
HEAT SOURCE: \-\ 0
E.,-
WATER HEATER:
RANGE:
EXPIRES PHONE
Lo.loQ.\ lo~~.~
4BC)-1\4In
6L\4"1~
FLOOD PLAIN'
ZONING CODE: If)~
-3
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: ~9-.4
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
--Rf Rough Mechanical - Prior to
~ cover.
~Site Inspection - To be made
~ after excavation, but prior to
setting forms. FPcIoJT i Re.>c~
-sera-.cV S
D Underslab PlumbinglElectrical1
Mechanical - Prior to. cover.
~ Rough Electrical - Prior to
~cover.
~ Electrical Service - Must be
approved to obtain permanent
electrIcal power.
D Footing - After trenches are
_excavated.
D Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
~ Framing - Prior to cover.
~Foundation - After forms are
)Or{ erected but.prior to concrete
placement.
~ Wall/Ceiling Insulation - Prior to
~over.
D Underground Plumbing - Prior
to filling trench.
;g Drywall - Prior to taping.
~ Underfloo( t"lumolntJi"&echanic.i1J
~ - Prior to insulclllon or decking.
D Wood Stove - After Installation:
l'vr Post and Beam - Prior to floor
~ Insulation or decking.
D Insert - After fireplace approval
and Installation of unit.
'fQ1' Floor Insulation - Prior to
~ecklng.
~ Curbcut & Approach - After
~ forms are erected but prior to
placement of ?oncrete.
1':7f' Sanitary Sewer - Prior to filling
;.c:s. trench.
~ Storm Sewer - Prior to filling
~ trench.
D Sidewalk & Driveway - After
excavation Is complete, forms
aryd sub.base material In place.
iV7I Waler Line - Prior to filling
~ trench.
D Fence - When completed.
( 15I )r.eet Trees - When all required
ees are planted.
~ Rough Plumbing - Prior to
~ cover.
~ Final Plumbing - When all
~plumblng work Is complete.
~Final Electrical - When all
~electrlcal work is complete.
15<( Final Mechanical - When all
. ".echanical work Is complete.
~Final Building - When all
~requlred inspections have been
approved and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
D 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.
D Final - After all required
, Inspections are approved and
porches, skirting, decks, and
venting ,have been ,Installed.
Lot faces -=-- Lot Type . Setbacks _ THE PROPOSED WORK IN THE
Lot sq. ftg. //.J~ _ Interior I PL. HSE GAR ACC HISTORICAL DISTRICT. OR ON .D
IN THE HISTORICAL REGIST~
Lot coverage 2.3% $ Corner /1'1 If yes, this application mu signed
~ Is /0' and approved by the Historical
Topography Panhandle
28' Iw Coordinator prior to permit issuance.
Total height Cul-de-sac
IE ,4f', APPROVED:
BUILDING PERMIT
so. FT.
,.()\\~
"C) \ 'L
X $/SO. FT.
_--10 S- J
-,-1.'0
VALUE
t;$' 6<<; ,IJ'
~595'''O
ITEM.
Main
Garage
Carport
ClTV~L).
4/")'2,~
~/S
4Z5./J
SYSTEMS DEVELOPMENT CHARGE (SDC)
I hi""
(B) N/Iti:. -
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' 2-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home )
10/J,tHJ
Plumbing Permit
State Surcharge
IG(J('./'&)
, PJ<<;
1.691:'0
Total Charge ...
(C)
MECHANICAL PERMIT
L~
-
45"
C,tH>
Furnace
Exhaust Hood
Vent Fan
N'
?
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~6-0
Mechanical Permit
-8:50
/0.00
. /~
~.9fJ
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
V", ft
J3.90
Curbcut
Demolition
State Surcharge
C)a/V'Y ~o/Pf' - ,~
Total Miscellaneous Permits
jI'Jr:; ~O
(E)
TOTAL AMOUNT DUE (exciuding electrical) -9 :S' ~
(A, B. C, D, and E Combined) '7, l03
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, regl:llating 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: to ( 0 /. q _I:)
Date Paid: .(~.j).q~
Receipt Number: J q I /) nL
Received By: ~ tm )
J'/Y~~.R .
Plan(t{~ed~BY , -
4-J- "j /
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 compliance with ORS 701.055 wilt 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 a proved set of plans will remain
on the Si~ at all tP\'es d ring construction.
/' Signature \~~\ ~~"~
Datp ~(t '7 Ai\.
VAliDATiON:
RECEIPT NUMBER / 9' ~ 74-
DATE PAID 4'/2. ::,/,"9/ .
AMOUNT RECEIVEn -74 J, o)
/ J< /}'
dV /v,., ;; t7lI'-<..
RECEIVED BY