HomeMy WebLinkAboutPermit Building 1992-4-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP:
LOT:
.
SPRINGFIELD
.
JOB NUMBER
92c:P38./_
BLOCK'
225 Fifth Street
Springfield, Oregon 97477
TAX LOc
<::)060> .tC>
SUBDIVISION:
OWNER:_~~ ~~<:L IF''f:r'' PHONE:_7t/.t;-O..si?.:s ~.
ADDRESS If/55 4Yr./Yp.E~ ?-"'? - .~ .:..""
. . , ~_. .. r~
CITY: ;5Pt.-Z:> STATE: _.&:'~; ZIP: q?"I? ~
. .
DESCRIBE WORKfri > .~~'?~ ~"'5;::' fX;;;
NEW REMODEL' ,ADDITION X DEMOLISH OTHER
-- ....
,=N~
CONTRACTOR'S NAME' " - . - ,_ ,ADDRESS , C:ONTRACTOR N
G EN'ErlAL: ,t::?tnr/>!~(":L:r-. .:'-- _'''-:--~:'''- :~---.--~--~-;:.~..-" ,-- ---.-.--- - .... - --...
. ~ '... . to.... ~ .
PLUMBING:
MECHANICAl'
ELECTRICAL:
OUAD AREA: ~(\\l) '.
N OF BLDGS' (\
~'CCY GROUP: 'e..::,:>.
N OF' STORIES: ~~'
,
,
WATER I:iEATER:'
, . '
. "', : '"
"
- OFFICE USE -
_.I.,AND USE: l ~ I I
'/I OF 'UNITS: . \
CONSTR,TYPE:~
, , '
HEAT ~OURCE: 'LE"'JR:'T W'~
RAN~E:
.r:' ".,;'.
. ~.
..'
".
'. \ .~
EXPIRES
PHONE
FLOOD PLAIN'
ZONING CODE: L()J7 )
N OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: ~E!1 S
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.
o Wood Stove ~ After Installatlo~.
I
o Post and Beam - .Prlor to floor I
insul,aI!Of1 or:,!ecki;,g~.. 0 Insert - After flrepla~e approval
'~>~;..~.::" \ /"'; .. _-': ..........., ~nd InstallatIon of unIt.
'rv1' Floor Insul~lion - Prior to ." \
~decking" __') . .......~ . 0 Curbcut & Approach - Atter
~ fonTIs are erected but prior to
placernent of concrete.
. ,
!
o Temporary Electric
D
Site Inspection - To be rnade
after excavation. t)ut prior 10
setting lorms.
o
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Stecl location. bond
beams. grouting.
o Foundation - Artcr forms are
erected but prior to concrete
placement.
o Underground Plumbing"":" Prior
to filting trench.
o
Underlloor Plumbing/ Mechanical
_ Prior to Insulation or decking.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to tilling
trench.
'\.-.
"
"-.'- .~~ ., .
D- ~alor Lino - Prior to f1.f1Ir~U~
trench. " ..... .
. ~"\ "'"0 .
o Rough Plumbing....:.. Prior to
cover. " '.
REQUIRED INSPECTIONS
o Rough Mech~nlcal - Prior to
cover.
"tV( Rough Eleclrictll - Prior to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ramlng - Prior to cover.
~Wall/Ceiling Insulation - Prior to
J.6.t. cover.
~ Drywall - Prior to taping.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub~bas~ malerial in place.
o Fence -- When completed.
~
,
,
o Street Trees -:- W~en'all.rcquired
trees are planted. . ,;,'. :
o Final Plumbing - When all
'plumblng worl< is complete.
~ Final Eleclrical - Wilen all
~Iectrlcal work is complete.
o Final Mechanical - When all
mechanical work Is complete.
"1V1Final Building - When all
~requlred inspections havc becn
approved and building is
completed.
o Other J551sn; UvS/J(t/Cp. u-
l),(1/~ Tn 8&L.cl,<)/,(;G'
Fie""""'/~ .
MOBILE HOME INSPECTIONS
o Blocking and ~ct.Up - When all
blocking is complete.
o Plumbing Connections - Wilen
home has bcen connected 10
water and sewer.
o EleclricnJ Connection - Wilen
blocking, set.up. Lmd plumbing
inspections havc been approved
and tllC home is connected 10
the service pnncl.
o
Final - After all required
inspections are approved and
porches, skirting. decks, and
venting have been installed.
Lot faces
Lol TYPO.
Interior
, .....,. .-..
Lol s~, Ilg, .
'\ ,_" l
Lot coverage
Corner
Topography
Panllandle
Total tlcight
23-'
Cul.d9:sac
~ '
. .....~
~ " .
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
" '. .
. ' ,
'.' '.
Garage
t
Carport
4pO
~
~~9b
"
Total Value
S'uilding Permi I Fee
Stale Surcharoc
Total Fcc
(A)
._ SctlJaGI~s __
f P,L. HSE GAR ACC I
.S THE PHOPOSED WOHK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
,~- --...., -,-- -.-,
,
S
W.
. "
,E
VALUE
"J'.'1 ~t;?-::r:>,
_2152t:l
~/.Q, 7.&
Z~0.2i3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
NO
Sanitary Sewer
FT
Waler
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
Stale Surcllarge
Tolal Charne
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood SlovellnsertlFireplacc Unit.
Dryer Venl
"
" Mecllflnici!1 Permit
'..
Issuance . I' '... .,.,-"j, "
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Horne
State Issuance
State Surcharge
Sidewalk
II
Curbcut
It
Dcrnoll lion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
. . ......
7.?t.:;,.2. '0
If ye~:. this npplicalion lTlu:.t lJl~ :;ioned
and approved by the Historical
Coordinator prior to permit issuance.
"o-,!
I
"'1:'
.. :~
. , ,
A'p'!:~,O~ED'
.J ,..
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This penni! is granted on tile express condi lion 1I1atlhe said
construction sh~II, in'al(rcspects, conform to.tlie Ordinance
.. adopled by the .Cily, 01 Springfield, Inc1udlng the
; I Developmen't Code. regu"lat'ing the. construction and use of
J; buildings, and may be suspended, or revoked al any time
I upon violation of any provisions of said orOinan:ces.
Plan ,Check Fee: -,-L7't!:). o~
'.'" _V~~2..'
~
"":_-f'~'12
SysteIJ1S Dcvcloplluml Cl1aruc is due on all undeveloped
properties within tile City limits which arc being improved.
ADDITIONAL COMMENTS
-t?AII/-_!!..1
~f3 t-Ec7J!Z-Lt;:ttL-fil&/lU;C,/f?E122
M(cfl /JB! /?! IT .IJ;? ""r J?~ ~E..r#-
"
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true <1nd corrccl, and I furlher certify
that any and all work performed shall be done in accoreJancc
with the Ordinances of the City of Springfield, and the Laws
of the State of Ore~Jon pertaining to the worl~ described
herein, and' thaI "NO OCCUPANCY will be made of any
structure ,<<ithoul permission of IIle Building Safely Division.
I further certify that only contractors and employees who
are In compliance with QRS 701.055 will be used on this
project. '
I further agr,ee to ensure that all required inspections are
requested at the proper lime, that each address is readable
I from the street, that thc permit card Is locatcd at the front
of the property. and the approved set of plans will remain
V the sHe a lilTICS,dUrlng construction.
~gnature ~ ~
DatL ~/~~ ~.
VALIDATION:
RECEIPT NUM~l -:-~- _ iz.s;,1;,-. a ,...-
DATE PAID ~___~ ...,. '-f P3. 1,2-
AMOUNT RECEIVED 2h~ 1'3
~,. RECEIVED BY
/-?--
. "/-
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