HomeMy WebLinkAboutPermit Building 1995-2-10
(",t; MA fAl
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT'
/7/):.
OWNER'
ADDRESS'
CITY:
c/~
2.2.1:;
'S..-? /5)
D7=
(
A/.
"'''~i.T ,,,';;>t''',:;;.\':''
:' .
~"r,)t ~r
-;-
<=1' 50/0d
-.
',. '-........
d'
JOB NUMBER
I
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
Ll3~O--O
SPRINGFIELD
PHONE:
72~- 7])(
~ 5f)
5.\
'~.rt74<..l S'r
3/
DESCRIBE WORK: ~wly"'t
NEW REMODEL
~. ZIP:" 7.;i 7 '/
ii~,uf/;/, 777A-~.Lu"" 2n'/~tI'~1 R __(.
ADDITION Y DEMOU;H OTHER .
BLOCK'
~A7/.A"AZ FrcZ:'J'
'* f -
5' P, S.T,
STATE:
CONTRACTOR'S NAME ~
GENERAL:!JJYfU".IW, .
PLUMBING:
CONST,
l AD~RESS CONTRAo/OR . XPI
.~ ". fil/?I/ B~t!J.11u~e.,ff9/2/,;"/" ,4
PHONE
9~&~r
MECHANICA' '
ELECTRICA' '
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
-
. OF BLDGS' · OF UNITS' ZONING CODE:_ *1
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURCE: SECONDARY HEAT: !f.
WATER HEATER' RANG'" SQUARE FOOTAGE:
To request an Inspection, you musl call 726,3769, This Is a 24 hour recording, Alllnspacllons reQuestad belore 7:00 a,m, will ba
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary ElectrIc
o Site Inspectlon'- To be made
after excavation, but prior to
setting torms.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Footing - After trenches 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,
. 0 Underlloor Plumblng/Mechanl~al
- Prior to Insulation or decking.
REQUIRED INSPECTIONS
o Rough MechanIcal - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
alectrlcal power,
o Fireplace - Prior to facing
materials and framing Insp,
o Framing - Prior to cover;
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Post and Beam - Prior to floor 0
Insulation or decking, .... Insert - After fireplace approvll.l
.. . and Installation ,of unit.
o Floor Insulatlcm .:_::P'rlor.'to,.~ "" \:~ t',. ,~;
decking, ,0 Curbcut & Approach - After
forms are erected bllt prior to
O Sanitary Sewer - PrIor to filling plac;:ement of concrete,
trench.
o Storm Sewer - Prior to filling
trench,
O Water Line - Prior to filling
trench.
O Rough Plumbing - Prior to
cover,
o Sidewalk & Driveway - Afler
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed,
o Street Trees - When all required
trees are planted,
o Final Plumbing - When all
plumbing work Is complete,
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete,
o Final Building - When all
required Inspections have been
approved and building Is
completed,
~Other
~F/A f;4
,
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
venting have been Installed,
Lot faces
Lot TYPJl
InterIor
. \"i':" ~. ....
..
" ~.
~S THEPROPOS~~ ~~~~ IN THE,
"HISTORtCAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
, I
Setbacks
HSE GARIACCI
I I
I I
Jw I I I I
~I
I PL.
IN
/S
Lot sq, ltg,
Lot' coverage
Corner
Topography
Total height
Panhandle
Cul'de,sac
BUILDING PERMIT
ITEM SQ, FT,
APPROVED:
X $/SQ, FT. ~
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
I \
Garage
"
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.provisLons. of said ordinances.
, ,
Main
Carport
,~~O>"f '
;
4-4'77 tnJ
. ~.. ('. .
.... \ .... -I .\.'. . p.... \\ ).';' '.\ ;,
~
\. 'I.
'.ptan Che'Ck;F~e.:' "',.
Date Paid: '.
t.: '\ '.' t -~
Total Value
Slate Surcharge
.... , .. . .. ,.r"..
. " '. r'
Total Fee
_..5'1") '>0
, 4. q.r:
. '.y~ ,"
~:;'~';,s- "
SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fee
Z~J+I.P.
"t"; -I.,. .:,
. (A)
\ ,~.
1 ~ '.
Receipt Number'
Received By:
. ,'..' j,. \ .........': - ~ ~'O-
. ') ... .", .l,
Plans Reviewed By
,
.
,': ~ .,~ ':"
',' ,;"".,..
i..' . . '''. .\. ;,
Date
PLUMBING PERMIT
tTEM
(B)
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are being Improved,
FEE
ADDITIONAL COMMENTS
Fixtures
Residential Bath(s)
N'
, ~~"'},C"
kL.Jtn
A3mt= 1iV0
I rr-
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'
By signature. I stato and agree, that I have carefully examined
the completed eppllcatlon and do hereby certify thet atl
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.
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that thJ:?ormlt card Is located at the front
of the property, a It"h';l~pproved t of plans will remain
x:the site at all rmes durin ons. tructlon,
. -L -;~'
S gnature J. ..
/ Date~1 2/,-; ,/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
DATE PAID
I&> 2 r~
rJ )/0/91-
'C;-~JT
-11~
Tolal Miscellaneous Permits (E)
~4.sr
,
AMOUNT RECEIVED
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. 0, and' E' Combined)
RECEIVED BY