HomeMy WebLinkAboutPermit Building 1995-5-26
RESIDENTIAL
PERMIT APPLICATION
,
Ins'pectlons: '726,3769
OUlce: 726.3759
ASSESSORS MAP: /B115
LOT" ..5-3..J 5 L/
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SPRINGFIELD
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OESCRIBE WORK: s-~.R lI"~ P -- \ f\' ( Q ~~'i St-:cy'-r:t lU'\ J\ .Qoyt:
NEW..A- REMODEL ADDITION" "DEMOLISH -\ OTHER \
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,
OVllNER'
Ii "'^
~-
ADDRESS'
cr~Y:
.
CqNTRACTOR'S NAME
G~NERAI' (1 W V\e. fl
PLUMBING'
MECHANICA' '
ELECTRICAl'
QUAD AREA: "c:;'~
. OF BL:DGS' I
OCCY GR'OUP:_10\
. OF STORIES: \
WATER HEATER'
I
STATF' '
DiL-e.,
.
JOB NUMBER
c; ~ 4,'~
225 Fifth Street
Springfield, Oregon 97477
uJo'\/:-
~AX LOT' 00 cpr) 0,
SUBDIVISION: ~, {. Ll~,e'-i t 11011;-' -If S
PHONE:
7{1- 7077 (1'!.~
" Y"'1j1t)
ZIP' i ?L/7 ')
ADDRESS'
;2073
, CONST,
. , CONTRACTOR'
..TNLA,J~ vJp..y _
PHONE
"
REQUIRED INSPECTIONS
D Rough Mechanical"": Prior to
cover.
D Roug'ti Electrical - Prlor'to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrlcel power.
D Fireplace - Prior to facing
materials and framing Insp.
~Fra~lng - Prior to cover,
D Wail/Ceiling Insulation - Prior to
cover. .
D Drywall - prl,or to taping,
D Wood Stove - After Installation.
~ Post and Beam -.Prlor to floor
~,'Insulatlon~or decking. -: ,". ....... .0 Insert - After fireplace approvel
01 ,,";\ ~:"\... '<. ~~ '., ''- ~ ,">'_ ~ and Installation of unit. .
o Floor Insulation - Prlor..to
" "decking, '_ ,<,..., _ >- O:C.urbcut & Approach - After
, "'-) forms are erected but prior to
D Sanitary Sewer - Prior to filling placement of concrete.
trench.
- OFFICE USE -
LAND USE: IIS(,;
.. . OF UNITS'
CONSTR, TYPE:
\I ^ /
HEAT SOURCE:
RANGF'
EXPIRES
.. !I;
FLOOD PLAIN'
ZONING CODE: ~12-
. OF BDRMS'
SECONDARY HEAT'
SQUARE FOOTAGE: /~1 'd'
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
m~de the same working day. Inspections requested after 7:00 a,m. will be made the following work day,
,
I
D Temporary Electric
,
o Site Inspection - To be made
.. after excavation, but prior to
: setting forms.
D Underslab Plumblng/Electrlcall
, 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
placement.
D Underground Plumbing - Prior
to filling trench,
,
D Underlloor Plumbing/Mechanical
, - Prior to Insulation or decking,
D Storm Sewer - Prior to filling
trench. '
~
,
GJ Water Line - Prior to filling
trench. ' ' ..
"
o Rough Plumblng..l_ Prior to.
cover.
l I
D Sidewalk & Driveway - After
excavation Is complete, forms
and .sub.base material In place.
D Fence, - When completed,
D,Street Trees - When'all required
trees are planted., ' .
D Final Ptumblng - When all
plumbing Work Is complete,
D Flnat Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanl,cal work Is complete.
"R7f' Final BUilding - When all
~ required Inspections have been
approved and building Is
completed.
D Ojher
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. .' I. .
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
venting have been InstalledJ .,'
\ .1 :':i ,; ~ ~"!"."i>~'\ ~ ~"d ~~':~,&~i~~.t/
Lot faces
( ~\. .' ,
LOllYpe'
Interior
,I'P.L,
IN
Is
Iw
IE
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de,sac
BUILDING PERMIT
ITEM 'SQ, 'FT: X $/5Q, FT, = VALUE
<MJ!n
to,\. I
G,a.rage
Carport
372..
" 5""245-"'"
-" <:) c,. ,S--o
. <""c:" So
4.5"3
--t:::/.6J 3
SYSTEMS DEVELOPMENT CHAR11Eg)
(B)
Tolal Value
Building Permit Fee
Stale Surcharge
/. 7() -t- Z~ ~
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
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'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
~/.t:)3
A
Setbacks
HSE GAR Accl
I
;6 THEPROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
'APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
I
J
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Cily, of Springfield. Including the
Development Code, regulaling lhe construction and use of
, buildings, and may be suspended or revoked at any time
upon violation of any provisions of saId ordinances.
3073
{/2J/54
Recelpl Number: / 2~4 7
Rece~~ <~
Pla~I;;;~ 4VLR
Plan Check Fee:
Date Paid:
'.
,c:/2.L.A~ '
/ Daie/ ,
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certlly 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
stru~ture 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.
j
I
I further agree to ensure that all required Inspections are
requested at the proper tlme~ 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 al'3::(s d~9 construction') / /
Xgnature ~~-~y-/ ~./~
, ,. /' ~ /"
Date "- r- :;? ~ - 97'"'-
VALIDATION:
RECEIPT NUMBER /3 () 3 3
DATE PAID ~/).."'(''f'f
AMOUNT RECEIVE!" '/;,/&..3
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RECEIVED BY