HomeMy WebLinkAboutPermit Building 1991-9-27 (2)
LOCATION OF PROPOSED WORK' -:Z.J?B~ ,~V~
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
AS~ESSqRS MAP:
LOT:;&.RC,cc
OWNER'
ADDRESS'
CITY:
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TAX \.9T: _ . 1 .
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SUBDIVISION: . q/- 7C/"'t"::>
-
SPRINGFIELD
-
JOB NUMBER '.>9//&lCZ,
225 Fifth Street
Springfield, Oregon 97477
<;'':
.'.~1L
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PHON~'
726-'9/2<)
\
BLOCK'
STATE:
~ )':?
ZIP:
-9/0/:::>7
DESCRIBE WORt<.
.x
~"""'~~~'c.7- .-5~.71C5. ~ ~/7'~{~~ 0./1:~d=
REMODEL ADDITION DEMOLISH- 'OTHER
NEW
CONTRACTOR'S NAME.
GENERA" /?.I.V~~~.
pLUMBING'
MECHANiCAl'
- .
ELECTRICA' .
QUAD AREA:
sf< II) {'./
J
~~ ~/Vl
. OF BLDGS:
OCCY GROUP:
. OF STORIES:~
WATER HEATER: 6~
ADDRESS
CONST.
CONTRACTOR .
PHONE
- OFFICE USE -
LAND USE:
u_U I J
EXPIRES
FLOOD PLAIN: 2~.g~ R
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: '<., "'3Ial
To reql:lest 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.
W Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setttng forms.
IZl Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
[KJ Footing - After trenc~es are
. excavated. .
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
I1l
Underfloor Plumbing/ Mechanical
- Prior to Insulation or decking.
[If Post and Beam - Prior to floor
Insulation or decking. ..
o Floor Insulation - Prior to .
~ecking.
~ Sanitary Sewer - Prior to filling
trench. r.; 5Jf'Pr/<. ~
o Storm Sewer - Prior to filling
trench.l.6 .t>R~ WGU.,$
o Water Line - Prior to filling
trench.
[C] Rough Plumbing .:- Prior to
cover.
. OF UNITS'
. ,
CONSTR. TYPE:
HEAT SOURCE:
\11ll' .
0A5 /://~
RANGF'
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
cover.
riVI Rough Electrical - Prior to.
~ cover.
IUl Electrical Service - Must be
L)kI approved to obtain permanent
electrical power. .
o
Fireplace - Prior to facing
materials and framing Insp.
~
Framing - Prior to cove~. .
, "
~ Wall/Ceiling Insulation. - Prior to
cover. . . _
[Xl Drywall - Prior t? t,';-~I.~9: .
~. .
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
~ ...;
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - Whe~ completed.
o Street Trees - When,,:" req~jred
trees are planted. ~"...'. .
[Xl Final Plumbing - When all
plumbing work Is complete.
I'\A Final Electrical - When all
~ electrical work is complete.
~ Final Mechanical - When all
mechanical work is complete.
~ Final Building - When all
required Inspections have been
approved and building is
completed.
..
OOther
".
,
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to .
the service panel. .
o Final - After all required
inspections are approved and
.. porches', skirting; decks, and
. v~nting have been installed.
.
, THE 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.
Lot faces ~
Lot sQ. Itg. ~~
Lot coverage ~
Topography "~t?
,.,/ - '
Total height ~
Lot Type_' Setbacks
_X Interior I PL. IHSE GARIACCI
Corner IN I??~
Panhandle Is I~
Cul-de-sac "; Iw #1
IE 71
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
ti!ii':. 6'_, ~C
,
Main
723~
/17~
3?~
j SI. / e::>
I~~t:>. 7.
Garage
Carport
Total Value 1~5;$l~ ~
Buiiding Permit Fee t/t(~. 5'0
State Surcharge -:z'2.~ ~
Total Fee (A) ~ "-' .:J?:!
SYSTEMS DEVELOPMENT CHARGE (SDC)
04~ (B) I//!.
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
19.:2_.~
PlumbIng Permit
State Surcharge
/'92S"C>
9.~"i'
2e>2 ./5
Total Charge
(C)
MECHANICAL PERMIT
tt. t!>O
'1. '0
9'.-
Fu mace
Exhaust Hood
2
N' 3
Vent Fan
Wood Stovellnsert/Flreplace Unit
'3". a...
Dryer Vent
~;:7;PF~_ttt~~~~ ,B.6c>
,
p~~-'
It:!~ ~
;2. ';2 r
'/7. Z 1i""
MeChanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance.
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
~~~. ~.-<::: <j"~/=-//
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Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) 9:...zt3.2.1 .
(A, B, C. D, and E Combined)
/I~.~
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 City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plan Check Fee:
~ '70. 'Z'Z
&:J-'5'."9/
Date Paid:
Receipt Number: -:::it /-;2./:5
Received By: A~
",
I.,P
Pia" Reviewed By
5'/::,2~h/
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 c:ertlfy
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 OAS 701.055 will be used on this
project. ,'-,
I further agree to ensure that all required i~spectlons are
requested at the proper tl!"!le; that each addr~ss Is readable
from the. street, that t~e.per~it card I~ I~cated at the front
of the property. and. the approved set, of pl~.ns will remain
:~g':::u:~e 4~u~i:g?~
Date #. 2? ("CjS/,
VALIDATION: .d
RECEIPT NUMBER 214""T (
/'-27-;/
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DATE PAID'
AMOUNT RECEIVEr>
RECEIVED BY
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