HomeMy WebLinkAboutPermit Miscellaneous 1996-06-27RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
SPrlI^|GFTEIO
ASSESSORS MAP: TAX LoT:
JoB NUMBE a %R--->.
, 225 Fifth Street
Sprlngf leld, Orelon 97477
SUBDIVISION:
--
PHONE:
STATE:ZIP:
^)er
q )q1 8LLO
SD
!gB-,u,c,CITY:
ADDRESS:
OWNER:
TION DEMOLISH OTHER
DESCRIBE WORK:
NEW- BEMODEL A
GENERAL:
PLUMBING:
MECHANICAL:
--
ELECTRICAL:
ADDRESS EXPIRES PHONECONTRACTOFI'S NAME CONST,
CONTFIACTOR #
RANGE:
r OF BDRMS:
_ OFFICE USE -
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN:OUAD AREA:
* OF BLDGST
SECONDARY HEAT:
SOUARF. FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
Temporary Electrlc l---l Rough Mechanlcal - Prior to[--J cover.
Final Plumbing - When all
ptumblng worl< is complete.
Slte lnspectlon - To be madc
after excavatlon, but Prlor to
setting forms.
Rough Electrical - Prior to Final Electrlcal - When all
electrical work is complete.cover
tl Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Eleclrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work is complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
Flnal Buildlng - When all
required lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
Other
Foundatlon - Alter forms are
erected but prlor to concrete
placement.
WalllCelling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.|.-l orywall - Prlor to taoing
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decking.Wood Slovo - After lnstallatlon
Post and Beam - Prlor to floor
lnsulatlon or decking.tnserl - After flrePlace aPproval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
btocklng ls comPlete.
Floor lnsulatlon - Prlor to
decklng.Curbcut & A1:Proach - After
forms are erected but Prlor to
placemcnt of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to fllllng
trench.Electrical Connection - When
blocking, set'uP, and Plumbing
lnspections have been aPProved
and the home is connected to
the service Panel.
Slorm Sewer - Prior to filllng
trench.
Sidewatk & Drlveway - After
excavation ls complete, forms
and sub-base material in Place.
Water Llne - Prlor to filling
trench.
l-l Fence - When comoleted.
Final - After all required
inspectlons are approved and
porches, sklrting, decks, and
venting have been installed.Rough Plumbing - Prior to
cover.
Street Trees - When all required
trees are Planted.
I
LOT:
-
BLOCK:
Oetoo) _
') t+1-13Lr
# OF UNITS:
-
E
tl
E
r
tl
E
E
E
E
E
E
tl n
E
n
D
ACCP.L.HSE GAR
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type.-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
--iS THE PROPOSED WORK iN THE
HISTOFIICAL DISTRICT, OR ON
THE HISTOFIICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historical
Coordinator prlor to permit issuance.
APPROVED:
VALUE
(A)
X $/SQ. FT.
Main
Carport
Garage
Total Value
Building Permit Fee
State Surcharge
Total Fec
BUILDING PERMIT
ITEM SO. FT.
BUTLDING 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.
Plans Reviewed By Date
Receipt Numbe
Date Paid
Received By
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblte Home
FEE
(c)
No
FT.
FT.
Plumbing Permit
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
ADDITIONAL COMMENTS
By slgnature, r state and agree, that r have carefuily examrnedthe completed application and do hereby cerilfy that alllnformatlon hereon is true anct correct, and I f urther cerilfythat any and ail work performed shail be done in accordancewlth the Ordinances of the City of Sprlngfield, and the Lawsof the state of oregon pertainrng to the work describedherein, and that NO OCCUPANCy will be made of anystructure wlthout permission of the Buildlng Safety Divislon.I further certify that only contractors and employees whoare ln compliance with ORS 7O1.O5S will be used on thisproiect.
I further agree to ensure that all required insrequested at the proper time, that each add
from the street, that the permlt card ls Iof the property, and the approved set
Signature
Date c-)f .1G
pections are
ress is readable
ocated at the front
of plans will remainon the site ng constructlon.
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
MECHANICAL PERMIT
Total Miscellaneous perrnits
(D)
(E)
No
Mechanical permit
lssuance
State Surcharge
Total Permit
Mobile Home
State lssuance
State Surcharge
Sidewalk tt
Curbcut __- ft
Demolition
State Surchargp
Furnace
Exhaust Hood
Vent Fan
TOTAL AMOUNT DUE (exctuding etectrical)(A, B, C, D, and E Combined)
'7aZ^z 2DATE PAID
4-AMOUNT RECEIVED
FIECEIVED BY
. FT.
VALIDATION:
REoEIPT NUMBEFI-@