HomeMy WebLinkAboutPermit Building 1995-3-21
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
BLOCK'
OWNER: L'{)~:>UJ" ~<::;;}H/\~ 11 ,/,'i/;X"J
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ADDRF,'"'' /06/->:,:;'U '
CITY: {)1Ji',^Ir.,.."',cUJI
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STATE: e;,.CG"p(}
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.
JOB NUMBEA :,950/3-1
225 Fifth Street
Springfield. Oregon 97477
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SUBDIVISION'
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PHON~;' 7'i(~" OUe}
ZIP'
"1'7'(77
DES~~IBEWORK:' '-~. ~7j.:Q ~ dt\ rol ~ 1 f' ~,O !\lrl 0 (\l'~
NEW ,/ REMODEL ' '-'\)ADDITION DE~L1SH .,OTHER
'CONST,
, .' ADDRESS ,CONTRACTQI3;" EXPIRES, PHONE
GENERALZ.V. ))/~e>t\Ak~ / /sYO R.,..Ad rl'eS I -., ',dt~.5 -: J: <--9i;< .:.,::' J n~r;
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CONTRACTOR'S NAME
1
PLUMBING'
MECHANICAl'
ELECTRICAl'
/'
QUAD AREA: X Q f\ ) II ') - OFFICE USE -
LAND USE: \ \ \ \ FLOOD PLAIN:
. OF BLDGS: \ . OF UNITS: ~tJ ZONING CODE: ( .ft--
OCCY GROUP: '?,~ -\- "^ CONSTR. TYPE: . OF BDRMS: :3
. OF STORIES: \ HEAT SOURCE: rf,k' SECONDARY HEAT: ~;f
WATER HEATER' ~ RANGE:_ p. SQUARE FOOTAGE:&. _
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 ~fter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
, ,
g} ROU~h Mechanical -':'Prl~r.to
cover, ~ ,-,,d'. '
D Temporary Electric
D Site Inspection '- To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
MechanIcal - Prior to cover.
~Footlng - Alter trenches are
l6.t ~xcavated.
D Masonry - Steel location. bond
.beams, grouting.
1V1"'"""Foundstlon - After forms are
~rected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
~ U nderlloor J>lu m blDlllM echan!iiiJ>
~ - Prior to'lnsul8\lon v1 .........."mg.
..J:::"/I Post and Beam - Prior to floor
~Insulatlon or decking,
~ Floor Insulation - Prior to
~decklng,
1'V"f Sanitary Sewer - Prior to filling
~ trench.
,1';7[' Storm Sewer - Prior to filling
~trench.
~ Water Line - Prior to filling
~ trench.
rl Rough Plumbing - Prior to
~ cover.
~ Rough Electrical - Prior to
J,.L:S..cover.
l'C;(Electrlcal Service - Must be
~approved to obtain perm,anent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp;
~ramlng - Prior to cover:
IV'(' Wall/Celllng Insulalion - Prior to
~cover. .
~OryWall - Prior to taPI~g. . r .
D Wood Stovo -, After Installation.
D Insert - After fireplace approvel
and Installation of unit. .
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
o Fence - When completed.
~treet Trees - ~hen all req~I'red
~ees are planted. ". .
~' , <. ", . ..
~lnal"'Plumblng -'When all
~ plumbing work Is complete.
, ,
~FJnal Eleclrlcal - When all
~electrlcal work Is complete.
I2t Final Mechanical - When all
mechanical work Is complete.
~Inal Building - When all
~requlred Inspections have been
, approved and building Is
completed.
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MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complele.
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, skirring, decks, and
venting have been Installed.
Lot faces
-S..-
,~
>,
L~pe~
_ InterIor
'.
Lot s,q, fig.,
Lot coverage
Corner
Topography L2.?..
as'
Total height ~
BUILDING PERMIT
, ,
SQ, FT, X
;;M~
~,
'76~
Panhandle
Cul'de,sac
ITEM
$/SQ, FT, b
:5' c... .tel
Jf./O
Main
Garage
Carport
Total Value
(B)
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
FT. /t:n~ I
Water " :: ,: ~..~
.," .',
Storm Sewer , FT.
Mobile Home
Plumbing Permit
State Surcharge /{);3i + <;:;,}. ~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
-I
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
~L/",# ~~,
Mech'anlcal Permit
,
Issuance"' ~~. .;. .
~.'\ .
,
State Surcharge !.60,:f' . '7~
~,
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk fI
Curbcut
-
fI
Oemolltlon
Slate Surcharge
~ ~tI.rr.
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~S THE PROPOSED 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
I P.L. I HSE ! GAR I ACC I
I N I I I I
Is 11/<;111/' I I
Iw 124>1 I I
lLLLl, I
VALUE
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" -!~ ~:J..'5'
FEE
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/5 CO
2.L) 7. S"D
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Building Permit Fee 987r. ~2.?7r
State surcharge{2/01.1f ~ -/.~!w . : 4~/:a
'Total Fee '-~ (A) \~9-.J~~
- .
SYSTEMS DEVELOPMENT CHARGE (SDC)
\ ') G::t P:,
5. e,.
Total Miscellaneous Permits (E)
, 'fI8 - l.!!l ~
TOTAL AMOUNT DUE (excluding electrical) "':"
(A, B, C, 0, and' E' Combined) , ,~~, '31
~
APPROVED:, '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on tho express condition Ihat the said
construction shall, In all respects, conform to the Ordinance
adopted by the City 01 Sprlnglleld, InClUding the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any ~provislons of said ordlna~ces.
Plan Check Fee: 34J ,J~ I ~~ {$6
, ++-, ~;'j'
Date Paid; V ~,/~ . S- , O.
Rece;pt Number: /,h/f'7 .iff = S",SF
R;~~~ .f~A-o?1J
Plans Reviewed By 1 Dale
Systems Development Charge Is due on all undeveloped
properlles within the Clly limits which are being Improved,
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carelully examined
the compleled 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
01 the State 01 Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission 01 lhe Building Salety Division,
J further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
I further agree te ensure that all re9ulred Inspections are
requested at the proper time, thaJ 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 slt~a 4ii) times dUfl g c02str ctl~n.
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nature "7lh.-"t/t'.-4/ ,A.. /,' <t-/ ~ _
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Datp
VALIDATION:
RECEIPT NUMBER / /, /.-; I'.. ~
DATE PAID ? /2.//)')-
AMOUNT RECEI;EI" ~~. S-lO 3 1
RECEIVED BY?~~