HomeMy WebLinkAboutPermit Building 1991-4-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
qlD'2-~2-
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
'Ib~ l r::"'_ F.L
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: ---1..'7' - 0'2 - 1<=1
. ....:.je.~ '~OIF ' .
LOT:~""""",,'-4 ...~ =2.ot:::>, BLOCK'
"
OWNER:' 1=~" ~ ... C.""1:l{,l~
~"!"2l..a ..uc;:'.....
CITY'
6 PI=- 0
ADDRESS::""2.. 7'Z.1:>, '60A..I""lF-. ~ toot 12~
STATE:
~r;f
R-06..a
:TAX LOT
SUBDIVISION'
PHONE: -..2.14 7-..5~?O
ZIP: Q74-??
DESCRIBE WORK: --ti- p:_~V
NEW -/ REMODEL
2.4Se. .sF
OTHER
..to.-1 E... .) (4) ""lit. .: (,::!,) 9->A.~ ~ r>=r=,....""
CONTRACTOR'S NAME
ADDITION
DEMOLISH
ADDRESS
CONST,
CONTRACTOR'
cFf2.. 4fl ':\
GENE, RAL: O"Tl!...P~ )111...11';'.... ...,..,ti!.T.:
PLUMBING' .'l:lrs\\ \.0 D
MECHANICAL: l-IA.Q,/e......~.J.
ELECrRICAI ' Q.D<;J
QUAD AREA: ~~C' .J
. OF BLDGS, \
OCCY GROUP: R.~,~ ffi \
. OF STORIES: _?-
L
WATER HEATER'
EXPIRES PHONE
\ !110./ '''4&J-~Ia5
,.Q I~LDJq ~
. I
5'61062.
'- OFFICE USE -
LAND USE: \\\\
. OF UNITS' \
CONSTR, TYPE: \JtJ
HEAT SOURCE:,~ \), . ~ OI' t
!RANG~' L
FLOOD PLAIN:
ZONING CODE:L()E. ~\ -:Gf>.
. OF BDRMS' 4
SECONDARY HEAT:
SQUARE FOOTAGE:
\. ~{)14
.- ,
To request an Inspection, you must call 726-3769. This 15 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.
D Temporary Electric
D. Site Inspection ~ To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel Io:catlon, bond
beams, 9routl':l9.
~ Foundation - After forms are
~erected'but prior to concrete
placement.
REQUIRED INSPECTIONS
"fC7l" Rough Mechanical - Prior to
~ cover.
~ Rough Electrlcal.- Prior ,to
~ cover.
1'5<'r Electrical Service - Must be
~pproved to obtain permanent
electrical power,
D Fireplace"":" Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
~ver. .
D Underground Plumbing - Prior "F;7'1 Drywall _ Prior to taping.
to filting trench. ~
~ Underfloqr:Plumbin~echanicay '" ,""
~ Prior to InSulatIon or Ul;!I..K.lIlg. D ,Wood Stove.....:. Afte; Installation.
"FV71' Post ~nd Beam - Prtor to floor
~Insulation or decking,
-.01 Floor Insulation - Prior to
)C'ol.decklng,
~ Sanitary Sewer - Prior to filling
~trench.
~Storm Sewer - Prior to filling
~trench.
,
lVrWater Line - 'Prior to filling
~rench.
f':7( Rough Plumbing - Prior to
~cover.
D Insert .:.... After fireplace approval
and installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete. .
D Sidewalk &.Oriveway - After
excavation Is complete, forms
an~ sub-base material In place.
D Fence - When completed.
o Street~"rr~es - When aIr required , .
trees are plan:ed. _ _, .
~ Final Plumbing - When all
~plumbing work is complete,
gFinal Electrical-'When all
ele9tri,cal work is complete.
.'
~Final Mechanical - When all
~mechanical work is complete.
"F;7I Final Building - When all
~eQulred inspections have been
approved and bullding is
completed.
DOther
MOBILE HOME INSPECTIONS
_t',
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
. " Inspe9~lons are appro'{ed and
porches, skirting, decks, and
venting have been installed.
'-.
~ Lot Type. .
Lot faces Setbacks IS THE PROPOSED WORK IN THE
/5"16. I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON D
Lot sq, ltg, Interior IN I THE HISTORICAL REGISTER? J~
Lot coverage 2~:b V Corner /'0"]14(;: If yes, this application must~ signed
Is I
45 and approved by the Historical
Topography Panhandle
c:QQ' Iw 14J I Coordinator prior to permit issuance.
Total height Cul.de.sac
IE If)' I APPROVED'
(() 5:122-
11~~O
2.2..'33
*;3.93
SYSTEMS DEVELOPMENT CHARGE (SDC)
BUILDING PERMIT
SQ, FT.
1455
550
X $/SQ, FT,
8Q,70
\1\ .\0
ITEM
Main
Garage
Carport
Tria I. rr ,O{)\4
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
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/lnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
lt
Curbcut
lt
Demolition
State sur~
~ellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
VALUE IsC
Cf1,58~,
, dA lJ
" 'is:TI,
FEE
-L92,'5"0
t?~3
202!J
~fKJ
4.00
~~
30<:>
19,,,"0
/D. <>a
/.1'
~IJ '?s
)[l~.aJ
K(Y 0 ,Cfj-
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: ~ (), ~ ~
Date Paid: ~./R.q (
Receipt Number:~,q~\4
Received By: lm )
~~'^"~ . 4--1-9'/
p~ ~;vtew;d B'y - 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 tI d ring c uctio
Slgnat&
Date
VALIDATION: n
RECEIPT NUMBER ~ ct~ '\ l
DATE PAID' 4,2 C\ ,q )
AMOUNT RECEI~ <44'?> .~
RECEIVED BY \=::J\ I M