HomeMy WebLinkAboutPermit Building 1992-10-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Of lice: 726.3759
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SPRINGFIELD
ASSESSORS MAP:
LOT:
1703
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OWNER' VORct.; ~ '?I!", ,- \ \
ADDRESS:" '71-/ /:n/t1t0 5T-
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CITY'
DESCRIBE WOR/'"
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ADDITION DEMOLISH X
'M.o.. \.:J ~(t.J~~ (f?f".yo.N!}o.}E:.. Po...\,.\, o'~
NEW REMODEL '\S
BLOCK'
STATE: _/1)t!?,
OTHER
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92./ S9,4-
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
1-.:WrD
SUBDIVISION'
PHONE: 74'-"7 - .3, \.,:<, I
Of) &~c:O - 7-112-
97+'7?
ZIP:
CONTRACTOR'S NAME
GENERA" ~~0 \ \)
ADDRESS
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CONST,
CONTRACTOR ·
I ? 3'1 '2...
EXPIRES
'3- 27-93
PHONE
9~S-7qor
PLUMBING'
MECHANICAl'
ELECTRICAl'
.......'-
- OFFICE USE -
QUAD AREA: LAND USE: 0[1/ FLOOD PLAIN: <<
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. OF BLDGS' . OF UNITS: ZONING CODE: .-- . .~'"
OCCY GROUP' CONSTR, TYPE: . OF BDRMS'
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. OF STORIES: HEAT SOURC'" SECONDARY HEAT'
WATER HEATER' RANGE: SQUARE FOOTAGE:
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To request an Inspection. you must call 726.3769, This Is a 24 hour recording, All Inspections requested belore 7:00 a,m, will be
mnde the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
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.
o Underlloor Plumbing/Mechanical
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng.
o Floor Insulation - Prior to
decking, .
o Sanitary Sewer - Prior to filling
trench.
o Storm Sower - Prior to filling
trench.
O Water Line - Prior 10 filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical -. Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
. flFramlng - Prior to cover.
O' Wail/Ceiling Insulation - Prior to
cover.
~DryWall - Prior to taping,
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 - When completed.
o Street Trees - WhEUi 'all requ'lred"
trees are planted.
o Final Plumbing - When all
plumbing work Is complele,
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
.'
i::::71" Final Building - When all
~ulred Inspections have been
epproved end building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbln'g 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'Flnal - After aff required
.1.. ~J.nsr;)f~c!(o!t*;.~r~.:a'liR:royed ,ahd
" porchesj,sklrUngi'decf(s, -"and
.vent Ing ,nave.' been alnstalled:
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Lot,(,a~!'.~(,:~, ,,:~?t1Y.P~."'~i'" , "SetbackS',
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'Lotsq";ig' ',"..., ' '.' ",.,.',:"1'" : 'Irite~I~i'!" <"';<11- ' P.L:!', ,HSE, "AR, 'ACC
Lot c~~~ra~e - ":"J~iner u :~:', :;N'. : '''": ':11
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Topograp!'y 'p~nh~~dle ' I:' ..,'
Total hslght _ Cul.de.sac
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BUILDING PERMIT,
ITEM SQ,' FT,' .,X
.
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$/SQ, FT, =
VALUE
Main
.'
Garage
Carport
,<!jC) D era
/ :)OGJ
.?S'
/5,7-'
SYSTEMS,DEVELOP,MENT CHARGE (SDC)
, , ' (B) " A/I4
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT,
Water
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood SloveJlnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
'ft
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,
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[i
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Curbcut
ft
Demolition
Slats Surcherge
,
Total Miscellaneous Permits (E)
',' .
)575
TOTAL AMOUNT DUE (excluding electrlcel)
(A, B, C, 0, and E Combined)
IrA> THE PROPOSED WORK IN THE
~ISTORICAL DISTRICT; OR'ON\ "
. -.. '-'-" '-' .
THE HISTORICAL REGISTER?
If yes.'thl'- a'ppllceti-';n must be signed;
and approved by the Hlstorlcel
Coordinator prior to permit Issuance.
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APPROVED: ~'
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';BUllDING;:VALU E; :P.t:AN' CHECK
':AN.QBUILDINGPE~lVIp. .
This permit Is g;anted on the express condition thatlhe said
construcllon shall,ln'all respects, conform to the Ordinance
adopted by the City of Springfield, InCluding the
Development Code, regulallng the construcllon and use of
buildings, and may be suspended or revokedet any lime
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
;tIA
Plans Revlew6d'B~
Date
Systems Development Charge Is due on all undevoloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
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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 Ordlnanc~s 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 eny
structure wlthoul permission 01 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 f1"\ times during construction.
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VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
&'33/
/0-2 -72-
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RECEIVED BY