HomeMy WebLinkAboutPermit Building 1992-10-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK:~7"3 #/9(1t:tc1E'u
ASSESSORS MAP: -.--L7.d ':J. ~~-'2./
LOT
BLOCK'
OWNER: J /lmE~ uJ. d
ADDr~ESS: '.,6-J/ij !fRqd.e-jJ
CITV:~r'I,<)~c.E~ D
{/7
DESCRIBE WORK'{!J1.12.t!.-6e:T (J./Ht/!t:t!..
NEW 1.____ REMODELV- ADDITION I'
CONTRACTOR'S NAME
_CENERAL:_~L:
PLUMBING' ~L r
MECHANICAL:h ..$ &- Lr
ELECTRICAL: 5~LF
QUAD AREA rQ RJD~_
. OF BLDGS: ~_ '
OCCV CROUP: _~3-M
\
. OF STORIES:
WIITER HEATER:
.
JOB NUMBER !!2~2 ~8
225 Fifttl Street
Spllngfleld, Oregon 97477
(/
TAX LOT:
~~~
SUBDIVISION'
T ff.E:LJY1 /l L__ LC>!!f- PHONE 77"7- C; I J7'7
ltJ,e/1rc.-_-v.J~ ------,
_ STIITE:~ P __.. . ZIP: !l_2 ~ 7 7
h f1m,;/~if~~m-Jt:.I'-D .sft;~1:4E ~5.
DEMOLlSII 01111011. ~~7'--~Y~-~
REQUIRED INSPECTIONS
D Rough Mccllilnicnl - Plil.H 10
covel".
"N1' Rou{Jh Elcchir.nl - Pliur 10
~ cover.
D Electricnl Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior 10 facino
materials and fmllllng Insp.
~ Framing - Prior 10 cover.
~Wall/Ceiling Insulation - Prior 10
~ cover.
~ Drywall - Prior 10 l"pin!l.
D Wood Slove - After installation.
D Insert - AHer filcplaGc ;lppIUV:lI
and Installation uf unll.
o Curbcut & ApproClch - After
forms arc erected but priur lu
placement of concretc.
D Sidewalk & D."iveway - Afler
excavatIon is corn~lete, forms
and sub-base material in plac0.
D Fence - When cOI1l~leted.
D Slreet Trees - When all reqllirnd
trees are planted.
ADonESS
CONST.
CON'I HAClOH .
EXPIRES
PIIONE
FLOOD PLAIN: r f\ '" ")
ZONINC CODE: .J~AJJ2.7'--
. OF BDRMS'
SECONDAI1Y II EAT:
SOUAHE FOOTAGE: ___
To request an Inspection, you must call 726.3769. Tllis is a 24 hoUl' recOl'din~l. All Int;peclions requested before 7:00 <I.Ifl. will be
made tile same working day, Inspections requested after 7:00 curl. will be /Il<HJc Il1e rollowinH work day"
'"
- OFFICE UiE -
LA~D USE__L~.__ _
. . OF UNI,TS: -..-\v-ti--.----
, .
. 'CONSTH. TVPE: _ _ _ _____
HEAT SOUHCE: _G~G~z_8~
RANGE:
I --I Filial PlulI1binq - Whf~1l :dl
-- pllJllllJln~1 worl( h~ \:olllpleh.::.
~Finnl Electric,l! - Whl;n ,III
r-~;rccldcal wOlk i~; 1;('lllplull!.
l~ Filial Mechanical - Whl)n all
II1l']chill1ical work is cOlllplete.
'lVf Final Building - When all
~required lnspeclions hewe been
npproved and buildint) if,
compleled.
[J Other
MOBILE HOME INSPECTIONS
CI Olocking <Iud Sel.Up - When all
- blocldnO Is r.orllpIrJI!l.
[--I Plumbing Connections - When
- tWine Ilas been connected to
waler and sewer.
I I 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, skirting, decks, and
venting have been installed.
I~ Temporary Electric
I I Silo Inspection - To be made
nrtcr exc;:Ivnlion, but prior 10
scllfn~l forms.
D
Underslab Plumbing/ Eleclrical/
Mechanical - Prior Lo cover.
~ FOOling - After trenches are
~ excavated.
D Masonry - Sleel location, bond
beams, grouting.
Vf PJ;;~:r!ti~1l - After forms arc
~ erected but prior to concrete
placement.
D
Underground Plumbing - PrIor
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
'1"Vf Post and Beam - Prior to floor
~ insulation or decldng.
~ Floor Insulation - Prior to
~decklng.
o Sanitary Sewer - Prior to fillinO
trench.
o Storm Sewer - Prior to filling
trench.
o Water Lino - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
St~t1ncks
1- ----r-
~. J:'...SS .9AR ACC
~-
~---
~---
E
LOI faCIJS
1.01 Type
.
Lot sq. IIg.
lllteriOI
Lot coverage
Corner
Topo{Jraphy
Panllandlc
Total helglll
Cul.do.sac
BUILDING PERMIT
ITEM SO, FT, X $/50, FT.
VALUE
Main
Garag_~'Vr~~
-~~
Carport
7J<<;>- -~ ~
~~... '/~ . lid~,
'~/'S7~ -7-7
?'i~~
~.::ID
. 3..,t~
"l-{.! :3
SYSTEMS DEVELOPMENT CHARGE (SDC)
-~
Tolal Value
BulldinU PClllIil Fcc
Slate SlIrcll,ll tie
Total Fee
(A)
(El)
PLUMBING PERMIT
ITEM
FEE
Fixtures, t
Residenlial Balh(s)
N'
Sanitary Sewer
FT,
Water
FT.
'Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovo/ Insert/Fireplace Unit
Dryer Vent
Mcc~lalljcal Permit
Issuance
Stale Surctlargc
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcllt
It
Demolillon
Slatc 5urcharOe
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, El, C, D, ;md E Combined)
-P- 93
( .HE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
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 Clly 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: _~~ s:3
_'f~8 -9~
eO""'''' '"m""'_~>" .,
Received : __ _ _ _ ..
_ _ _ _A~/Z4-
cvlewed By 7D~-'-
Date Paid:
Systcms Development Chmue is due on all undeveloped
properties within Ole City limits wtlich are being Improved,
AD.!)!;IONAL COMMENTS
rAP/1/ / ,
_13!f~/&~~ )2cLLM./T !L
-dPtptl/PP,;,)- .
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 certHy
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 Safely 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 tho site at all tImes during construction.
~gnature ~ o(~
I if
Dato /U - 5-7'.2-
VALIDATION:
RECEIPT NUMBER
,_( ~.17 J 0:7,9:/
/0 -')-7' 2-
:/9 ~ ;19 ~/2.3
4~-
'. ,
DATE PAin
AMOUNT RECEIVED
RECEIVED BY