HomeMy WebLinkAboutPermit Building 1998-1-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
~SESSORS MAP'
..
LOT'
.
-
BLOC/<'
OWNER'
ADDRESS:
!~~#~ ;ZV~A'.
9'/47 ~a.A~-:~~-P/~
~~.M~~~
CITY'
STATE:
~A'.
. -
.
JOB NUMBER ~~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
.:P S"='e.::::>
SUBDIVISION:
PHONE:
~~~q~
'~
.q.)~~
-r(' ff""/ ';-'G/'bfA'L#C. A?~.
ZIP:
DESCRIBE WORK: ~~~ 6r.P.~ 4---C~,:" ~
NEW REMODEL ADDITION DEMOLISH OTHER
CONST.
CONTRACTOR'S NAME.. ADDRESS ~ ", CONTRACTOR # EXPIRES '." PHONE
GENERAL: ""~~~!:~'i'-?,-,,~ ~~~Z. /~/.<S^~.~ .6"R~..!
- . )F~ r ~ ' ~ .,-, /.. -,. r
PLUMBING'
MECHANICAl'
ELECTRICAl'
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
# OF BLDGS: # OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: _ SQUARE FOOTAGE: __
To request an Inspection, you must call 726-3769. This Is a 24 hour recordIng. AI/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
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placemont. I
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
- Prior to Insula lion or decking.
D Post and 8eam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing -_ Prior to
cover.
" .
REQUIRED INSPECTIONS
D Rough Mecha~lcal - Prior to
cover.
r:t7I Rough Electrical - Prior to
~ cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing ~ Prior to cover.
[Xl Wail/Ceiling Insulation - Prior to
cover.
[KI Drywall - Prior to taping.
D Wood StOVQ - After Installation.
D Insert - After fireplace approve!
and Installation of unit.
. .
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk 8< Driveway - After
excavation Is compiele, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing w9rk Is complet.e.
[E] Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work 15 complete.
r171 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.
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
ventlng have been Installed.
Setbacks
I P.L. HSE GAR
IN
I S I
I
,;l~
ACe' I
I
I
I
I
.
, IS THE PROPOSED WORK tN THE.
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
L~t ~ypft "
Lot faces
Lot sq. ftg. Interior
Lot coverage Corner
Topography Panhandle .
Total height Cul.de-sac
'I ~ : " \'i',~ \.;:
~;I.
APPROVED'
BUILDING PERMIT 'I
ITEM sa. FT.
x $/SQ. FT. -
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
J
"
'i
Garage
"
This permit is granted on the express condition that the said
construe"tlcn shall. In all respects, co~nform to the Ordinance
adopted by .the City. of Springfield, Including the
Development Code. regulat!ng the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
~
Main
Carport
Plan Check Fee: ~
I '7~,- Date Paid:
Total Value
;;<>9.~ Receipt Number:
Building Permit Fee
/, lS Received By:
State Surcharge . .Q4
"
Total Fee (A) '3/ <2 ':> Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
i'-
Furnaco
Vent Fan
N'
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 shail 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 wiil be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections arB
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 wiil remain
on the ~II t~s Y1ng :onstruction.
Slgnatu~~" .i?
Date /,h.~/~- d' .
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
Total Miscellaneous Permits
(E)
DATE PAID
':;i?9;~>
/- 2L,~~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
AMOUNT RECEIVED ~/ ffI? ~ ."
RECEIVED BY _ p?-~ #t