HomeMy WebLinkAboutPermit Building 1991-9-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
,
SPRINGFIELD
LOCATION OF PROPOSED WORK: -:ZS?B9 /M",~
ASSESSORS MAP: ~7J7' ,/~"'f.-,tf;>- ~~... .
LOT:.1}.q<~ ~ BLOCK'
I
JOB NUMBER 9//&' Y-,
225 Fifth Street
Springfield, Oregon 97477
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TAX J..9T: . I'"
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SUBDIVISION: 9/- 7b./.-:r~
OWNER: ~ Z:>&;jy'. Le::->v.c:>o$~~~
ADDR~"'" '7 Y'/B o/"~ 3'?7:? 57 .
<?~ ' STATE:
CITY'
~7-<
..:!',
PHON~'
'/26 -'9/.?-. 'r
ZIP'
~~;:>7
DESCRIBE WORK: _~~'r,q'J <:?-
NEW X REMODEL ~D~1TI0N
5.~.;t;'cs; f ~///~.{~~ ~_/.i....~~
CONTRACTOR'S NAME
GENERAl' ~W..y~~.
PLUMBING:
MECHANIC.^' .
ELECTRICAl'
c~.(< fl) C~
. OF BLDGS: I
OCCY GROUP: _Iq;), ~ i IV\.
. OF STORIES:_/
WATER HEATER: ~
QUAD AREA:
DEMOLISH'
OTHER
ADDRESS
CONST.
CONTRACTOR'
PHONE
~ Rough Mechanical - Prior to
cover.
I'iVl Rough Electrical - Prior to.
~ cover.
/(/] Electrical Service - Must be
t..,.&J approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
[2] Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
00 Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When cotnpleted.
r:7l Street Trees - When all requIred
I..4-J trees are planted.
EXPIRES
FLOOD PLAIN:
7~N~ r:
- OFFICE USE -
LAND USE:
UIJ
ZONING COD~'
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: '<;,"3(" I
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 after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
[1J Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
[Z] Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
IKI Footing - After trenches are
excavated. .
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
~ Underground PlumbIng - Prior
to filling trench. , .'
[Z] Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
rn Post and Beam ..:..- Prior to floor
Insulation or decking. ..".
lZl Floor Insulation - Prior to
decking. ..
IA Sanitary Sewer - Prior to filling
trench. 1J 5J!'rr/t:. ~
[E] Storm Sewer - Prior to filling
trench. ,7.; PRY WGU,$
~ Water Line - Prior to filling
trench.
l2:l Rough Plumbing - Prior to
cover.
. OF UNIT:'"
CONSTR. TYPE: \/ Ill' .
HEAT SOURCE: ..s:?AS F4~
RANr.~.
[Xl Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical - When all
~ electrical work Is complete.
c::M Final Mechanical - When all
mechanIcal work Is complete.
o
[E] Final Building - When all
required Inspections have been
approved and building Is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is comptete.
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, skirting, decks, and
venting have been Installed.
Lot facos -P- Lot Typl Setbacks . _S THE PROPOSED WORK IN THE
L~t sq. fig. ~~ X- I PL I I I I HISTORICAL DISTRICT. OR ON
Interior HSE GAR ACC
IN I?/~ I THE HISTORICAL REGISTER?
Lot coverage .12- Corner If yes, this application must be signed
1P~t? Panhandle Is /~ I and approved by the Historical
Topography 'Iw I Coordinator prior to permit Issuance.
~ ;?S'
Total height Cul.de.sac '; IE 7' I
APPROVED'
BUILDING PERMIT
ITEM sa. FT.
X $/SO. FT.
3".~
/€!./&>
VALUE
~C5Z5l5"~""<:::
,
I"f'~~~' 7_
Main
72"3'9
J/7~
Garage
Carport
Total Value 1"-5;1?'3b. ~
Building Permit Fee l/Yt:..5'O
State Surcharge -:z'2_~ ~
Total Fee (A) '1~~ .&~
SYSTEMS DEVELOPMENT CHARGE (SDC)
0<4> 1.3 (B))I /! .
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
/9:Z_.~
Plumbing Permit
/9;;;>.5C>
9. ~'?'
21P::a ./5
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
6.""0
'1. 6'0
'7'.-
Furnace
Exhaust Hood
'2
~
Vent Fan co
Wood StovellnsertlFlreplace Unit i
,
'3'. $00
Dryer Vent ..
~ ;z?;P/~.~ ~~4'~~:r &..0>0
. , .
Mechanical Permit ~ -!):P7::>
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It/~ ~
;z. ';2 r
Il? z?"
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance'
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
~<!E~. ~-c:: 4"~~
1/~V/~ . -
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) tl.?&.z./
(A, B, C, 0, and E Combined)
J/P.~
BUILDING VALUE,PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thatlhe said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City of..Sprlngfleld, 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:
~ "7t::J. "<'2.
&J-S.9/'
Date Paid:
Receipt Numbe~/?
Received By: .... ~- '
~,p.
Pla~ Reviewed By
5'/:,2~h/
Date I -
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 t.lr!le: that each address is readable
from the street, that tt}e.permlt card I~ located at the front
of the property, and the approved set of plans will remain
:::::u:~e 4~u~lng?~
Date 9~ 2. 71 /q~/
VALIDATION: ~
RECEIPT NUMBER "2/4 ""t (
')'-27-;/
e.z~ 2-1
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DATE PAIP
AMOUNT RECEIVEP
RECEIVED BY
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