Loading...
HomeMy WebLinkAboutPermit Building 1991-9-23 R~SID'~NTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 ' LOCATION OF PROPOSED WORK:>'- ASSESSORS.MAP'~ /8-o'?-o 2,- -y ~ LOT' . SPRINGFIELD ZtJ / J.., .II'! iJ//'/ lJ I///9Y BLOCK' OWNER: ... ADDRESS:' ,- CITY' ':- /!JO/p I rlt..jUY/J .$P/?/I'i'(P FIO-J) .B;::;j?BIl~n o/--Pn r /..-1917./3 LIJ Jtl Y . DESCRIBE WORK' '\:hI A.lrJ'", 1:- ADDITION NEW v REMODEL CONTRACTOR'S NAME GENERAL:.\'~"~ ~. PLUMBING:' MECHANICAl' ELECTRICAL: a---",,~ ,,7 " QUAD AREA- . OF BLDGS: ! OCCY GROUP' . OF STORIES: WATER HEATER' STATF' o~ " .. 9//c? '3'7 JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT' ~:%!: ~ SUBDIVISION' PHON~' 7U- inl ZIP' 17'-177 'U\ J.,.1 0 MI-I+ k4L"-'~/.5 .47 66:-~ " REQUIRED INSPECTIONS o Rough Mechanical ~ Prior to cover. D Rough Electrical - Prior to . cover. [X] Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wall/Ceiling Insulation - Prior to cover. . D Drywall - Prior to taping. D Wood Stove - After Installation. D Insert - After fireplace approval and Installation of unit. . D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk &. Driveway - After excavation Is complete, forms and sub-base material In place. D Fence :-' When completed. [KJ Street Trees -.. When ~II requir'ed trees are planted. . ,. .CONST. ADDRESS '2.. . CONTRACTOR' . ~611 !99',,/W'c./1fI' __ v..::> ~-:A"."Y~':_ 7/292.- ,. . EXPIRES PHONE DEMOLISH ,.OTHER /- :;?:>-"S:? _ /y/~S'? " FLOOD PLAIN' ZONING CODE: . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: 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. o Temporary Electric o Site Inspection - .To be made after excavation, but prior to setting forms. D Under~lab Plumbing/Electrical/ Mechanical - Prior to cover. [K] Footing - After trenches are excavated. o Masonry -.Steellocatlon, bond beams" grouting. D Foundation - After forms are - erected but prior to concrete placement. [L] Underground Plumbing - Prior to filling trench. . IF €xTG/ypeo. o Underfloor Plumbing/Mechanical - Prior to Insulation or decking: D Post and Beam - 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 t'o filling trench. . D Rough Pll:Imblng .- Prior to cover. .... - OFFICE USE - LAND USE: . OF UNITS' CONSTR. TYPF' HEAT SOURCE: RANG~' o Final Plumbing - When all plumbing work Is complete, D Final Electrical - When all electrical work Is complete. D Final Mechanical - When alt mechanical work Is complete. D Final Building - When alt required Inspections have been approved and buJlding is completed. DOther '. MOBILE HOME INSPECTIONS rJl Blocking and Set-Up - When all L,.LJ blocking Is complete. r-YI Plumbing Connections - When ~ home has been connected to water and sewer. [11 Electrical Connection - When blocking, set-up. and plumbing inspections have been approved and the home Is connected to the service panel. r'it1 Final - After all required L,tJJ inspections are approved and po'rches, skIrting; decks, and' . venting have been Installed. . Lot faces lot Type. Setbacks .S THE PROPOSED WORK IN.-rHE '" lot sq. ftg. Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON - IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de-sac IE I APpROVED: BUILDING PERMIT ITEM SO. FT. X $/SO. FT. VALUE Main Garage Carport ~r/____-Y- ~.::sao. '"""" Total Value Building Permit Fee ~tP.!>C) 2 -53.. ~tP3 State $urcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) t/Gp (3 (B) 11:-'1 . PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. FT. FT. Water Storm Sewer Mobile Home ~.,..-p /.0=;: _4P Plumbing Permit /<;":~ . ? S-- /~"""7~ State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood StovellnsertlFireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home / c?5'" <>&> State Issuance ;Z~.- State Surcharge ~=?5 Sidewalk ft Curbcut ft Demolition .' State Surcharge Total Miscellaneous Permits (E) J~~.'Z5 /99.~ ~ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D. and E Combined) 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: 'S~.B"" ?-y..q/ ?//~ Date Paid: Receipt Number: ~Receiv d By: d ~.:? . - -~~- .-? ad~e;r;?e6'~~ - 9';;;:~'7/ Date , Systems Development Charge is du'e 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 compliance with ORS 701.055 will be used on this project.' I further agree to ensure that all .requlred 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 during construction. Signature~L7--'/~~~ Date f-..?J -;J/ VALIDATION: RECEIPT NUMBER "2138? ",,-2~_,,?- ,r AMOUNT RECEIVEn -:::< ~~~ RECEIVED BY ~~ -- "/-'" ~ DATE PAif' ~ ~ . SPRlalELD DEVELOPMENT SERVICES PUBUC WORKS METROPOUTAN WASTEWATER MANAGEMENT 225 FIFTH STREET SPRINGFIELD. OR 974 77 (503) 726-3753 " MANUFACTURED HOME SET-UP AGREEMENT As required by the City of Springfield Development Code, I understand and agree that with the approval of the attached permits, one of the'following manufactured homes will be placed at "2 Q /2 //Y~Hn ~ So-' Springfield, Oregon, Ci ty Job Number '~h'P ~ 7' - - [gJ Class A Manufactured Home. A manufactured home of not less than 24 feet in width and 16% (not less than 2:12) roof pitch, with exterior dimensions enclosing a space of at least 960 square feet, with roofing . and siding ma terials tha t are commonly used or compa ti ble wi.th si te buil t homes. , o Class B Manufactured Home. A manufactured home of not less than 12 feet in width and 16% roof pitch, with exterior dimensions enclosing a space of not less than 500 square feet, with roofing and siding materials that are commonly used or compatible with site built homes. I further state, by my signature below, that I have been provided with the following information: - Mobile home blocking - Sanitary sewer. connection Yater line connection - Electrical connection Street tree standards - Minimum requirements for permanent steps /l//A~~~.a--- Signature rZe-t5(5-~/ .... .... . . -. Permit No: '7//~":3? Address: -::>0/'2 /A//.~-:7>!~4- Issued. bY:f .- ."" -- Date: .a=,-::? ~-s " STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7),.need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: . - 1. L..frJ I own, reside in, or will reside in the completed structure. 2. A. L...-J My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. L...-J I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and 00 hire a general contractor, I will contract with' a contractor who is registered with the Construction Contractors Board and I will immediately notify the office " issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ///4 //~~'(/~'-- Signature. of~Permit Applicant . fl-;l-fl Date . . CONSTRUCTION CONTRACTORS BOARD 0244J 10/24/89 r1tL(L/ . ; \ I ~~. . WI:!ITE COPY TO ISSUING AGENCY PERMIT FILE ~v \.\.Ai.-. ~NK'COPY TO APPLICANT ~.