HomeMy WebLinkAboutPermit Building 1991-5-1
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RESIDENTIAL
PERMIT APPLICATION
Inspections:. 726-3769
Office: 726.3759
LOCATIONOF P~OPOSE~WO~: q~~
A!;;!:>.ES.SPRS MAP: l./ D,--)~
LOT:
. BLOCK'
-
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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SUBDIVISION'
OWNER t ~~ ~ ~.2 '( (\\~S\ . PHONE: -rt I-l~~'
ADDRE~-~~~\V,\~).Qf\ l~_\rl()~ JP~ ,4,-Q?SI
CITY',-'S\)~_r\L STATE:-'I~orn ZIP: ~14-'1
DES:xfORK' Cl 0 ~() (\0-; -
NEW REMODEL \ ADDITIO~ DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
I MECHANICAl' . ~
, ~LECTRIC-':'.: \\ )fl... )
QUAD AREA: A~"l~
. OF BLDGS: \
OCCY GROUP' t'J\
. OF STORIES: \
WATER HEATER'
ADDRESS
CON ST.
CONTRACTOR'
PHONE
- OFFICE USE -
LAND USE: \ \ \ \
. OF UNITS: \
CONSTR. TYPE: ~
HEAT SOURCE:
RANG'"
EXPIRES
FLOOD PLAIN'
ZONING CODEWU
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
f')~lo
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:0Q.a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o ,Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. . .
o Masonry - Steel location, bond
l?eams, grouting.
~ Foundation - After forms are
~rected ,but prIor to concrete
placeme0t.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
'- Prior to insulation or decking.
o
Post and Beam -:- Prior to floor
Insulation or decking. .
o Floor Insulation - Prior to
decking.
D Sanitary Sewer":'" Prior to filling
trench. -
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D R.ough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mecharyical - Prior to
cover.
o Rough Electrical - Prior too.
cover.
o Electrical Service - Must be
approved to obtain permanent
~Iectrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Fra.ming - Prior to cover.
o Wail/Ceiling Insu~ation - Prior to
cover. "
o Drywall - Prior to taping.
. .. --. -~
o Wood'St~ve .....:. After Installation.
o Insert - After fireplace approval
and Installation of unit..
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete. -
'0 Sidewalk-&.Driveway - After
excavation Is complete, forms
and sub-base material in place.
.: 0 Fen'ce .:.... When completed.,
D Street Tr~es - When allreQu'ired
trees are plan~ed. _ . .
D Final Plumbing - When all
. plumbing work Is complete.
D Final Electrical - When all
electr.1c~1 work .I~ complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
~'.....qulred InspectIons have been
approved' and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
o 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.
o Final - After all required
. inspections are approved and
.... porches, skirting, decks, and
venting have been Installed.
- i_
Setbacks _HE PROPOSED WORK IN THE
Lot faces Lot Type
Lot sq. ftg. Interior I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner Is ;2-3' I If yes, this application must be signed
and approved by the His torical
Topography Panhandle Iw 14-' I Coordinator prior to permit issuance.
Total height Cul.de-sac
IE ,6{,', I APPROVED'
"
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT.
VALUE
Main
(.~H ill ,
J
Garage
g..}{j)
14.\0
Carport
Total Val ue
Building Permit Fee
9B.<;O
4'13
/O~.43
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ---1!/A
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance.
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
/{J< .p
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: - (- ~1. 03-
Date Paid: ' 4. c!J.).l. " crL
6/
,
5 t~/'1 /
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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AN; psLh-/TRlcAL ~i74~,^ 5.
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 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 site at all times during construction.
Signature-fl,-o ~
Date C; - J _ 9/
VALIDATION:
RECEIPT NUMBER "1 q 39
17-1 -q /
AMOUNT RECEIVEI" I f)~ - L{ :s
(A~
I
,
,
DATE PAin
RECEIVED BY