HomeMy WebLinkAboutPermit Building 1997-3-5
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RESIDENTIAL
PERMIT APPLICATION
VGtJ
Inspections: 726.3769
Ollice: 726.3759
.
SPRINGFIELD
.
LOCATION OF PROPOSED WORK:-L9"5'5"' p~..A/
ASSESSORS MAP: ~2">'7 ~
OWNER. '1 b-n ~;r:v ",?,,:,Cb .
ADDRESS.. /f?SS-:~-,f /~..< ~
CITY- <?FI-T'> _
-/ /" -/
DESCRIBE WORK. q~:v~.s:~ #~) ~~ ~~ ~.4
NEW RE~ 'L ~tdDI.f(~~~~ OT{fE~. c.. ?~~?5 '
LOT:
CONTRACTOR'S NAME
GENERAL: &~~
PLUMBING.
MECHANICAL.
ELECTRICA' .
QUAD AREA.
. OF BLDGS:
OCCY GROUp.
. OF STORIES:_._
WATER HEATER:
BLOCK:
~75 .
STATE:
~>>..
.
JOB NUMBER <J~-:r3&>
225 Fifth Street
Sprlngllcld, Oregon 97477
TAX LOT. A/pC>
SUBDIVISION:
PHONE:_ 7L~9''2-...
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ZIp. ?3?~>?
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ADDRESS
CONST.
CONTRACTOR'
PHONE
- OFFICE USE -
LAND USE:_
. OF UNITS:
CONSTR. TYPE:__
HEAT SOURCE: ____
RANGE: ___
EXPlnES
FLOOD PLAIN:
ZONING CODE:_
. OF aDRMS:
SECONDAFlV HEAT: __..
SOUARE FOOTAGE: ..._._.._
To request an Inspection, you must calt 726-3769. Tills Is <l 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 (ollowing worl< day.
o Temporary Electric
o
Sito Inspection - To be made
afler excavation, bUI prior to
setting forms.
o
Undcrslnb Plumbing I Electricall
Mechanical - Prior \0 cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundntlon - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to froor
Insulation or deckIng.
o
Floor Insulation - Prior to
decking.
'.
o
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - PrIor to filii no
trencll.
O Watcr Line - Prior to filli~g
trench.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanlcnl - Prior to,
cover.
o Rough Elcclricnl - Prior to
cover.
D Electrical Service - Must be
approved to obt<iin pClfll.1ncnt
electrical power.
o
Flreplaco - Prior to facing
materials and framing Insp.
o
Framing - Prior to cover.
rYl WallfCclling Insulation - Prior to
IA-l cover.
IAi Drywall - Prior to taping.
D Wood Stovc - After lnstalla:lon.
o Insert - After (Ireplace approvlll
and Installation of unit.
o
Curbcut & Appro<Jch - After
forms arc efCcted but prior to
placement Qf concrete.
o Sidewalk & Driveway - Alter
excaviltion Is complete. forms
aneJ sul).bnse ma!eri,11 in place.
o Fellce - Wt)cn completed.
D ~~Ircot Trees - Wilen all required
trees are planted.
cgJ
Final Plumbing - When all
plumbing worl< is complet,c.
l,KJ
Finnl Eleclrlcal - Wt1cn all
electrical worl( Is complete.
[ /f1 Finn! Mcchnnical - When all
/llccllanicaJ worl{ 15 complete.
1::1/1 Finnl Bllilding - When all
~ required Inspections have been
approved and buileJlng 15
complelcd.
D Other
MOBILE HOME INSPECTIONS
o Blocking nnd Set-Up - When all
brockln~J Is complete.
o Plumbing Connections - When
tlOrne 1111$ been connected \0
water and sewer.
o Electricnl Cotlnection - When
bloCI{inU, ~Cl.up, ond plumbing
inspections have been npproveej
Cinel Ille llollle is connected to
tile :jcrvicc panel.
o
Final - After all required
inspections are approved and
porcl)cs, sldrtino, decks, and
venting tHive bcen Installed.
Lot faces
Lol Type
.
Lot SQ. fig.
Interior
Lot coverage
Corner
Topography
Tolal height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM
so. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fec
~
Stilte Surcllarge
Total Fcc
(A)
aE PROP~SED WORK iN THE.
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
P.L HSE GAR ACC I
N
~-_.
W
IE
VALUE
..
-'i5:~~-
5(:;. 'Sf:?
-:z - :>::*
I'~
f'y. 57"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Rcsidenllal Bath(s) ND
Sanitary S~wcr
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
;?? fr#-~~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust HOOd
Vent Fan
N'
Wood Stove/lnserl/Flreplacc'Unlf
Dryer Vent
Mechanical Perml t
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slale Surcharge
Sidewalk
[I
Curbcu I
II
Demolilion
?Iate Surcharge
Total Mlscollaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
/6.~
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._2~r/~
I
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APPROVED:
---l
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
adopled by the City o[ Spring[leld, 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 Fcc:
Dale Paid:
Receipt Number'
Received By:
---. --------
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL yOMM~j)lTS
~6 rMBY 97"'/.< /" ~
~ En/ft~ ..
/
By signature, I state and agree, that I have carefully examined
the completed application and do hereby eartHy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordanco
with the Ordinances of the City of Springfield. and the Laws
of the Slate of Oregon pertaining to the work described
herein, and ttlat NO OCCUPANCY will be ma(Jc of any
structure without permission of the BuildIng Safely Division,
I further certi fy Hlat only contractors and employees who
arc 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, ttlat each address Is readable
from tile street, that the permit card Is located at the front
of th ty, and the appr ved s t of plans will remain
on the site at I I _durin con tr tion.
Signature
Date
VALIDATION:
RECEIPT NUMBER -:2 7"7~::2...
?' 5,"'7 ?
AMOUNT RECEIVED '/.tt?...?5
-::~~d~
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DATE PAIr>
RECEIVED BY