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Home My WebLink AboutPermit Building 1991-4-4 ( ...~ RESIDENTIAL, PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT: CONTRACTOR'~AME ' GENERAL' \ ~J.. 1")(\ Q .p ) PLUMBING: MECHANICAl' ELECTRICAL' '\\ I Q). QUAD AREA --5 ~ \J \.0 . OF BLDGS: OCCY GROUP' )v\ . OF STORIES: WATER HEATER' h. SPRINGFIELD STATE: DEMOLISH OTHER . ...~ q I OMS ADDRESS CON ST. CONTRACTOR' , "JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 ZIP:~ v EXPIRES PHONE ..:. OFFICE USE - LAND USE: \ \ \ \ . OF UNITS: CONSTR. TYPE: -.JLf\.J HEAT SOURCF' RANGF' FLOOD PLAIN' ZONING CODE: J.[lP ;" ()Qt) . OF BDRMS' SECONDARY HEAT' SQUARE FOOTAGE: LoAl ') \ , , 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. Inspectlons requested after 7:00 a.m. will be made the following work day. D Temporary Electric '. ~ Site Inspection - To be made. ~after excavation, but prior to setting forms. S/1J6 ~T~" D Underslab Plumbingl Electricall Mechanical - Prior to cover. D Footing"":'" After trenches are excavated. , D. Masonry - Steel Iceatlon, bond beams, groutlng. D-Foundation - After forms are erected but prior to concrete pla~ement. D Underground Plumbing - Prior to filling trench. D Underlloor Plumbing I Mechanical - Prior to insulation or dec,~lng. D " Post and Beam - Prior to "floor Insulation or decking. D Floor Insulation - Prior to decking. D Sanitary Sewer - Prior to filling trench. , D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. D Rough Plumb'/ng - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cove~ . D Rough Electrical - Prior, to ,. ", cover. o Electrical Service - Must be approved to obtain permanent electrical pow~r. D Fireplace - Prior to facing , materials and framing Insp. ~Framing ~ Prior to cover. , 0 Wali/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping. . ". '- . D ,Wood sio,va - After Installation. D Insert - After fireplace approval and Installation of unit. . D Curbcut & Approach - After forms are erected but prior to . placement of ~oncrete. DSidewalk &.Drlveway - After excavation Is complete, forms af!d sub-bi3se material In place. , o Fe'nce - Whe~ completed. " ' D ,Stree,t ,Tr.ees ~'When all required' trees are planted. . D Final Plumbing - When all plumbing work Is complete. . . D Final Electrical - When all elect.ri~al, work !s comple!e, D Final Mechanical - When all mechanical work Is complete. 1':7f' Final Building - When all ~equlred InspectIons have been approved and building is completed. DOther 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, 'sklrt(ng, dec-ks~ and" venting have been Installed. lot Type . Setbacks Interior I P.L. HSE GAR ACC I I'N I Corner Is I Panhandle Cul.de.sac W I IE I Lot faces lot sQ. ftg. Lot coverage Topography Total height BUILDING PERMIT . ITEM SO. FT. X $/SO. FT. VALUE Main Garage t~?'n ,[)\O LP~3 Carport Total Val ue -0) L(),~l n3J. ~2 olj;o 3/3 Jo5".6J Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ----1Y/A PLUMBING PERMIT ITEM FEE F:ixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace 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 It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) . (A, ,B, C, D, and E Combined) ~~.63 ".. .THE PROPOSED WORK IN THE HISTORICAL DISTRICT. OR ~N THE HISTORICAL REGISTER? If yes, this application must'- e signed and approved by the Historical Coordinator prior to permit issuance. 1 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: 4(). lo ;.=\ Date Paid: A . PI) . C\ I Receipt Numb.er:~ Cl ~( 0 ReCeIVe~,.~r -> OLeo... ) #P:>(~~ 4-5-9/ Plana Reviewed By r , 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 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. . ~Ignaturp 6~ ';-. U)..dvu DOate '<//4/'1' VALIDATION: \0\ A Ll. RECEIPT NUMBER 4 ~ \ ~. \ DATE PAin ~.. <:.:11' . AMOUNT RECEI~f) T oS. \ r>~ RECEIVED BY (lYA -) -- -.-: ~-_. - , -. .~ . . Permit No: G\ \ O~ :) ')1:\ Address:\lroQ~ ~dQf\&I:1J Issued by(7) (J:iJ...) Date: 1.j1..fg I . FOR OFFICE USE ONL" :_ STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS . 'ABOUT.CONSTRUCTION RESPONSIBILITIES .. Note:.Oregon Law, ORS 701.055(4), requires.residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7).. need not submit this statement. This statementwill.be filed with the permit. . Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: / . { 1.~ ,'- 2. A.I I ow~, reside in, or will reside in the completed structure. Mygenera.1 contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR V B. ~ I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and (to hire a Qeneral contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~ Q.U)~ Signature of Permit Applicant ..y/d/q / Date. , CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 , ~U\-b ' waITE COPY TO ISSUING AGENCY PERMIT FILE ~Y TO APPLICANT . <!l.