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HomeMy WebLinkAboutPermit Building 1991-9-27 (3) RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 . SPRINGFIELD , JOB NUMBER q //C:>-W 225 Fifth Street. ..d6ll Springfield, Oregon 97477 ~ LOCATION OF PROPOSED WORK: -;29~9 /&~E4!V t9~. ~?::> . . - ASSESSORS MAP' ~R r 6P /7-<::>::r ~ /'9- ~<... TAX L9T: _ ~ ~ ~ LO~: /~.€/ '3 . . BLOCK' SUBDIVI~IO~~~s..>w.(~-:p.?~ ..r........""", L . L.tPY.-r;>~-KF~ ~ 7?:Z-- ~ , OWNER' /!/<:51>FB' ADDRESS: _7~~ ff~ 5?.,Q-i::::> / DESCRIBE WORK: ~~~~ NEW X REMODEL ADDITION CITY' CONTRACTOR'S NAME . GENERAL: PfAr~ G-??'- pLUMBING' MECHANICAl' ELECTRICAl' QUAD AREA: <; flN c.- / ~~M . OF BLDGS: OCCY GROUP: . OF STORIES: WATER HEATER: 4~ STATF' ~. PHONF' '7~.q/.?~ ZIP: &??C/? 7 ./bX;tZ/.~~c;-_~~ , REQUIRED INSPECTIONS r7l Rough Mechanical .- 'Prio~ to ~ cover. ell Rough Electrical - Prior to cover. [lI Electrical Service"": Must be approved to obtain permanent electrical power. . p D Fireplace - Prior to facing materials and framing Insp. C:(] Framing - Prior to cover. [2] Wall/Ceiling Insulation ,.- Prior to cover. IZl Drywall - Prior to_ t_aPing.~ o Wood Stove - After installation. o Insert - After fireplace approval and Installatlon of unit. D 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. D Fence - When completed. D Street ,Trees - Wh~n~ all .req~ired trees are planted. '." . , EXPIRES PHONE DEMOLISH OTHER FLOOD PLAIN: Q~A""""" ~ ADDRESS CONST. CONTRACTOR' ,ZONING CODE: . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: ~ )::J - OFFICE USE - LAND USE: U1J I vIII 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. D Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. [K] Underslab Plumbing I Electricall Mechanical - Prior to cover. ~ Footing - After trenches are excavated. o Masonry - Steel locatIon, bond beams, grouting. r;::7l Foundation - After forms are Ii1-J erected but prior to concrete placement. IKl Underground Plumbing - Prior to filling trench. D Underfloor Plumbing I Mechanical - Prior to insulation or decking. D Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to decking. IE] Sanitary Sewer - Prior to mUng trench. 7~.~c~ [Z] Storm Sewer - Prior to filling trench. ~ ~.,.IM"~ [K] Water Line - Prior to filling trench. [l] Rough PI~mbing - Prio,r to. cover. . . OF UNITS' CONSTR. TYPE: HEAT SOURCE:~~ /~'.'7>.. RANGE: c::C c-<-/' , [E] Final Plumbing - When all plumbIng work is complete. [Xl Final Electrical - When all electrical work is complete. [Xl Final Mechanical - When all mechanical work is complete. ~ 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 complete. D 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 .', inspec-!Ions are approved and . porches, skirting, decks, and' ..:ventlng have been Installed. Lot faces LL- Lot sq. ftg. . 5~C> Lot coverage B- Topography o-Z~ /:?!/' , Total height - Lot Type t -A Interior Corner Panhandle Cul.de.sac BUILDING PERMIT ITEM SO. FT. X $/SO. FT. Main Garage T .. THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. // I PL. IN Is .Iw IE Setbacks HSE GAR ACC -;18' ~ SF'I Y3'1 ~Q'I. . VALUE Carport /7// ~~~ 5A)< /y./(> T / Total Value ~uilding Permit Fee State Surcharge Total Fee (A) 72 /9.:;;;>C bB.$O ~.W 7/.~? SYSTEMS DEVELOPMENT CHARGE (SDe) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home .Plumblng Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan (B) ~ N' /)1..4.. FT. FT. FT. (C) Wood Stove/lnserllFireplace Unit N' / Dryer Vent ~ 7?'p/AtA 7 ~T 5':- M/ff. as: 6'c> A:>.-e> /.:2S"' ~6.;2.5 Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) FEE ~.'-' <0 <Se> ';?,$"P 5"2~~ 6.-0 -=J.- TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) / c5" t'.b~ 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 time upon violation of any provisions of said ordinances. Plan Check Fee: _crt/.?3 9-5'~ " Date Paid: Receipt Number:~ S ~ Received By: ~~~ . -",. - , !,~( Plans Reviewed By "1'- zc,. -11 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 c~mpliance 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 times du~con~ Slgnatur..a ~ ;/:Z::: Date j.J>~~ ;? 7/7?( :- VALIDATION: . .-/ RECEIPT NUMBER 9 /4 -r- Z- '7--:2-7-// AMOUNT RECEIVEr> '.; ~J~': ~ RECEIVED BY ~rl/7~t/ DATE PAID