HomeMy WebLinkAboutPermit Building 1995-12-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMBER
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225 Fifth Street
Sprlnglleld, Oregon 97477
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BLOCi<'
OWNER'
S/~4LJL..y'
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DESCRIBE WORK'
14 s;.T,-t /'l
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAl'
b,fpfILf~Y
C ,rS
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
· OF STORIES:
WATER HEATER'
STAT'"
o4e
. TAX LOT: ~":?::;:>=E:)
SUBDIVISION:
PHON"'
7<//-/37'2..
;z;i /0-1/
/'Wod//e lIo~e
ZIP:
'7' 77" 7 g
ADDITION
DEMOLISH
OTHER
,ry/"""'7 /",v-'1/'/
ADDRESS
CONST.
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
I.LI Rough Mechanical - Prior to
cover.
o 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.
o Framing - Prior to cover:
o Wail/Ceiling Insulation - Prior to
cove~ .
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv,,1
and Installallon of unll.
o Curbcut & Approach - After
(orms Bre erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compieto, forms
and 'sub-base material In place.
o Fence - When completed.
o Street Treos - When all required
trees are planted.
EXPIRES
70~y S
1;7-.2/"/'.>
:3 Yf'-:ZYJ'/
;/1"'.47/'7 ,,/;207
j;:: lEt"7-7' /c
C<J 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 Inspectlon.- To be mado
after excavation, but prior to
setting forms.
o Undersleb Plumblngl Electrlcall
Mechanlcel - 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 IIl1lng trench,
. 0 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing ::- Prior to
cover. ) _ ..
',_.- ..-
- OFFICE USE -
LAND USE:
· OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
o Final Plumbing - When all
plumbing work Is complete,
o Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When ell
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel'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 10
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
";'.'
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~S TH~ PROPOSED WORK IN THE,
. . HISTORICAL DISTRICT, OR ON
THE HIS10RICAL REGISTER?
If yes, Ihls application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
,~
Lot faces
Lot Type.
InterIor
-
Setbacks
HSE GAR I ACC I
I I
I S I I I I
I wl.1 \,1 -
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I PL.
IN
Lot.~,f,tg, ~
Lot coverage
Corner
Topography
Total heigh I
Panhandle
Cul'de,sac
APPROVED:
BUILDING PERMIT
ITEM
so. FT.
X $/SO. FT. =
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on Ihe express condition thai the said
construction shall, In all respects, conform to the Ordinance
adopted by the City .of Springfield, Including the
Development Code, regulatfng the construction and use of
buildings, and may be suspended or revoked at any time
upon vIolation of any provlslo'ns of said ordinances.
Main
Garage
Carport
"
Plan Check Fcc:
Tolal Value
Date Paid:
Building Permit Fee
Receipt Number:
Slale Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Syslems Development. Charge Is due on all undeveloped
properties wllhln Ihe CI.ty IImlls which are being Improved,
FEE
ADDITIONAL COMMENTS
Fixtures
Residential Balh(s) N'
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Mechanical Permit
~#, /~ <:>00
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1':5' . /~
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By slgnature,l slale 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
Ihat any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, end the Lews
of Ihe Slate 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 wllh ORS 701,055 will be used on this
project.
Ven t Fan
N'
Wood Slove/lnsertl Fireplace Unit
Dryer Vent
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensuro that all required Inspoctlons 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 propert1:%d the approved set of plans will remaIn
on the slto at;;~lmes pring construction,
Slgnalure ~ ..M.,.-~A- .
I?-- // - 9' S-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Date
Curbcut
fl
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
RECEIPT NUMBER
DATE PAID
/"'J'?8 "
/2,//'97"
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72 ~___-
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1
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and. E. Combined)
AMOUNT RECEIVED
RECEIVED BY
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