HomeMy WebLinkAboutPermit Building 1994-03-21Lorene Schafer Blume
1135 Mill Street
Springfield, OR 97477
JOB ADDRESS: 1135 Mill Street
l
LAST ACTMTY DATE: February l, 1993
INSPECTION RECORDED: Rough Electric
OTHER:
JOB # 900762
Your permit expired on August l, L993.
If you plan to start or resume work on the project, a new permit must be applied for.
If we do not hear from you by March 3t,1994 (ten (10) days from date of letter), we will
clear our files of all related information with regard to the pennit.
OREGO'V
SPFlI}{GFIELE'
D EV ELOPM ENT SERV I CES D EPART M ENT 225 FIFTH SIBEET
SPRINGFIELD, OR 97477
(503) 726 3753
FAX (503) 726 3689
March 2L,1994
Lorene Schafer Blume
L135 Mill Street
Springfield, OR 97477
,
Dear Ms. Schaffer Blume:
The Springfield Building Code Administrative Code requires that, for a permit to remain
valid, construction work authorized by it must begin within 180 days from the date of
purchase of the permit. If work is suspended or abandoned during the course of
construction for a period exceeding 180 days, the permit will automatically expire.
If a permit has expired and suspension and/or abandonment of work on a project has not
exceeded one year, a permit to start or resume work may be purchased for one half the fee
required for a comparable new permit, provided that no changes have been made in the
original plans and/or specifications.
If a permit has not yet expired and a permit holder anticipates the need for more time to
begin construction work, the Community Services Manager may choose to grant a one time
externion of the permit not to exceed 180 days upon receipt from the permit holder of a
written request explaining why the extension is necessary.
The attached form indicates the most recent information in our records with regard to
construction activity associated with your permit. Please advise this office of your
intentions with regard to the permit by ten (10) days from the date of this letter.
Please direct inquiries to me at 726-3664 Mondays, Tuesdays and Thursdays, 8:00 a.m. -
5:00 p.m.
Sincerely
Deanna Buckem
Community Services Secretary
8,,^
attachment
CITY OF
)
qlryofsPnrucFrEt ,
DEVELOPMENT SEFY'CES
PLANN/NG / BUILDING
DAVID J. PUENT
BUILDING OFFICIAL, BUILDING SAFETY D/V/S/ON
DEVELOPMENTSERY'CES
PUBUC WOFKS
M ET R O P O L'TA N WA ST EWAT E N M A N AG E M E NT
Hay 3, 1991
Allce Lorene Schafer
1135 UiII StreetSprlngfleld, Oregon 97477
Dear Hs. Schafer:
Slncerely,
Llsa Hopper
Butldtng Techniclan
cc3 Dave Puent, Bulldlng 0fficlal
th
i;
Your request for an extension of your permits to construct an additionto your residence rocated at 1135 Milr street, springfierd, Oregon,Ctty Job Numbers 900762, has been revleved and approved.
The extenslon may onry be granted one tlme and virl explre 1g0 daysfrom the date of the granting of this extension (NovemLer 3, 1991).
If loy have any questlons, or if r may be of any assrstance, pleasefeel free to phone me at 126.3790.
iLD,v q
SPRINGFIELO
225 FIFTH SIFEEI
SPRINGFIELD, OR 97477
(503) 726-3753
-7)"
C'TY OF OFEGO'V
'(rg'"--)
SPRIXGFIELO
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,osEPH tr PERRIN. P.C.
ATTORNEYS AT IAW
777 HIGH STREET
surTE 110
EUGENE, OR 9740I
(501) 345{OOl
IN THE CIRCUIT COURT OF THE STATE OF OREGON
In the Matter of the Marriage of
ALICE LORENE BLUME,
Petitioner,
and
GREGORY ROME BLIME,
Respondent.
No. 15-90-08801
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This matter came on for trial on April 9, 1991-, and the
parties appeared in person and by and through counsel. The court
heard testimony and reviewed the exhibits and now being fulIy
advised, the Court finds that it has jurisdiction herein and that
irreconcilable differences between the parties have caused the
irremediable breakdown of the marriage. It is the further
finding of the court that no children have been born as issue of
this marriage.
NOW, THEREFORE, IT IS HEREBY DECREED that the marriage of
the parties is hereby dissolved and said dissolut,ion is finally
effective on ae{hday of gH* les1.
IT IS FI'RTHER ORDERED, ADJUDGED AND DECREED thAt:
1. Each party is hereby awarded the property in his or
her possession free and clear of any claim by the other except as
set forth below.
2. Respondent shall deliver to petitioner any and all
documents in his possession, including, but not necessarily
limited to, building permits, floor plans and other sirnilar
L
ENTERi.r.r riir{29 Egf
?,
JUDGMENT OF DISSOLUTION
OF MARRIAGE
losEPH t, PERRIN, P.C.
ATTORNEYs AT LAW
777 HIGH STREET
surTE 110
EUGENE, OR 9740I
(501) 145OOOl
ll
documents pertaining to the addition being constructed at 1135
MiI1 Street, Springfield, Lane County, Oregon.
3. Petitioner,s former name of Schafer is hereby
restored to her.
4. Those facts required by ORS 107.085(3) are set forth
in Schedule rrArr attached hereto and by this reference are
incorporated in and made a part of this decree as though fuIIy
set forth herein.
DATED at Eugene, Oregon, this
Edw E. Allen, Circuit Judge
PETITTONER'S ADDRESS:
1135 MilI St.Springfield, OR 97477
RESPONDENT'S ADDRESS:
1150 S. 26th
Springfield, OR 97478
tZ/.q
day of April, l-991-.
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(
.. RESIDE-\tTIAL..
APPLLCAII0h/ PE[lllIT
225 North |th Street
Springfield, O"eqon 97477
Buildtng Diuision
ooF 20E2( uL)-O I Ut)
13,
SPFlTNGFIEI-D
I"tob Loc.tti:ttt:
lsoessoro IIoP d
Subdtttision:
Ante t,
rt\9 z
resaonsibtlity of the permit holdet'
tre'et. anC that the Permtt card is-p;i|t';u" ,ry;rot;ed pl'an slu:ll renttin
tof the propertY.
all Lines.
?cr tnt ll
t^JO(\tA
€.f{E.,JE BLuvne-*d^
Phone AG
Zi
to aee that al! tnspect'i.ons are nade at tle ptoper
Located at the fronldiryt ::ion tlta Bu'i
26-3769 (teaortler) st:(tLa !!out' City Jes igrnted job nunber
antl plane numbct'.
tine, that ecch cddreas is iea':ab':e
'. iob a&i!'ess' ttJPe of i'ncPec:tat' -Requeste receiued befcre 7:0C cn
D7
Atldt'e:,s
Ci
IL is tlre
)'rom the g
, !ui.! di ng Lc ctt
I': ! O.,' :: N 1," E F O N I N 5 P E C"I I O II .O.I.QYE :;T: C A L L 7
r'.:,7rresf .'J d.d D.t:t:rt tolt ilLLI l'e ready ]ot'
l'iit tte nade the satne dcy, nequests mcde
'lo be nnde at'ter
prtar tc set uP of
P[,UM3 :;!:wx?
pt.Lot'bo
NIC,
nsta LLa of
No uork to
inspcction Contractorri ot' Otmerg ru:me
a!'ter' 7 :00 orr uiLL bc nade the ncxt uorki'ng day'
Your City Desigrttted Job Nwnbcr fs:
I N:;UI,A ttA
I'o naCe {,u ticn
requ:-red oaPor
but beJbre anY
tnLL couering i.
ay insulation
il :: t'!!: I ber uLes:.:aoaticn,
forns.Larriers ate in Place
l.ath, gYPstun baatC or
:; applied, arul before
is concealed.
u :'t !tf:!t, t.A 8 !' t,ulttB I NC, E LECTI? I C,l I.,q
itlti:u,:it.: 'lo be nade befot'e anY
,.ii*'i{,ioucred.
t-|Ulj!!-:--l9l!!!UJ9!' ?o be made
i;J'n;1;;;i;s ,tt'e etcauated aru{
li:rtns ore erected, but Priot' to
PLtuPitig c'cnaret€.
UN,!)!RC
i:tittat;t:: 'l'o be nrt''1.'i'fi-t.n,n,')et.
I t;r I1I:lFLt)()ll
P tion or clecking.
to
DRYHALL INSPECTI)N: ?c be nade;f;a;-;nZ;i;n- b .in ptace'
but Prior bo cttY taplng'
MASONRI: Steel location, bond
iiifrlg*outitq or uettiaals in
accordalrce Dith u.B,c. section
2415 ,
y99W9!E: After tnstallab'ion is
acnltle ted.
CUIiB ,9 APPRCAT:I! At'iON: Alter .fonns
atie eretLerl but Pyir;r' to Pourlng
conctete.
STtryHALK ,t DRrt!"t!!,!: For all con-
Vrete parlirrJ aithin st?eet right-
nf-rxti. to be naCe after all etca-
iLt';"i,t'"rnptete 3 fotn wrk & sub-
base inatertaL in Place.
tl
I
T
l
7;,,be nr
ll r.,or tntnt
P\:.:'f AND BEAII: To be natle pri'ot' to
T;;s t" ftat ;;- of floor insulation ot'
dt,:king.
4.J-1i4,w:ttL tlrcse inspections ltarte beer
nktle ilLl dPlD'oDe1.
11 tr:,u'u,'tt t),ion Lo plccir4 facingI | ,,r:t".;,tis ,trul bcfore fratning inspee-
bion.
t'fiAf'!Ill, j: ttuct be requestetl af ter
,uiroo"L oJ' roulth plwnbing, electv'i'
,iil I n,',:lnrrtcal. Al! tooJ'ing
l,ya,:ituJ 'P, chinmi:ys, etc. mtst be
aornple tctl. llo ucrk is to be con-
cec'Letl until tlds inspection has
b.:cn tiddi: onrl aPPt'oUecl.
IENCE: hhen conPlate -- I'YouiCe
jit'6u "n motsable sections thnough
P. U. E.
r'r ilAL Pt,UtlB t ttc
r I i'l,t t, r.![,:c M il I cA L
I,' ! N A L I,: t,I: tI' lI I CA I,
ALL pt,o,jcct aontltcitlns, suck cts tt.te "i.nstal^lation of s!,,eet t_fees' eolwletion of bhe
requiretl Lantlscapirg,'-Lt,:., nat:tb be ,oti"f;;rt- b;;fol""-lt'n BUTLDTN-, FI1AL can be nequested'
F.1NAL BUI;,DINC: 'lhe l"irutl Blrilding fnapectiott mtlt be reouested alten ttv linal Plwnbing
(j'i'ri2i,'"tZl"l;li Xid ue.t n,i"':L rnspecb'iois'ha'uo been mad'e atd' apptotec'
r ALt. r.l,1l'lllcl,t{: A
DeseYibe filot'k:
C,h.e"* 4,^* $rm [6D u'^fr
Zo E 'r* ,",? P f'Ul <<-
1o
-l
VaLue
ldtliticn
ii,no,le l.
Itatc of Applicatic
lol't? c
\|Zl CirC\,trt5 Date:
al*clr-rA
Rccei,t'
sr-l ()il r1)llt t-il('t()l-
(irncrrt I
['l urnlr irrg
f,lccltittt lr-:l,t
Strtt t-r I;vctt,)7--l l'l lt:ctrit iitti
(lil.et:Lri-l:it
DETIOLITruil OR )BUI
Sanilaty ,*t* nPPr:id,",:,,,0;:fri:'? 'i",1 ,
Septic tank p:upecl and fil|ed u'tth gna:tel
Final - lrhen abcue itens alle ecrnpleted
and. uhen Cemolition is eanplete or $tnir-
ture moueC and ptemises cleaneC up'
llob'tLe Ilcmes
Bloeking arul Set-uP
Plwnb'tng connectione '- sa)e" and uater
Elecbrical Ccnnection - Blocking, set-ue .
and plwnbinq eonnections m:st be aPprctad
iefon" requ-eating eleclrical inspeclion
Acceacoril BuilCitrg
Final - After pcnches, skirting, decks'
etc. are canPleted.
Ptl:e 1 of il
rl
l_l
NI)CLl;ANOU',l:tltrrBI;:,lcct:;sT\tti,AI)J:I|T\IENITOBEN'4nr:11'lt)rcsTT0ct'ly
n
|
--r
L-COGJOB NO SOLAR ACCESS REQ.-
t Fetlroons
,t(te [:Lot Faces -
AacesallouseCaP,I,
L';
st
Iat So. Fto.
7 cf lct Cooeraqe
LOT TYPE
_ Intericr
Co?ner
Panhandte
CuL-d.e-sac
Iotal Height
TopograPhY
! of Stories
X Val.ue. rTcrTr:t't
TOTAT, VAI,UE
eS.D,C. 1.5 x
Building Volue & Permit
ThispermiLislpantedontheerpresscond.i.ttonLtntthes'ti'i)'c'trtttt';t"ti'"rtslaLl, in atl respccts,-.oi,1ir*'Lo th-e. ordinance edop.te'J l1y Lhe t,it1r ,';i
ii,iiriftita, Lrrotl"al"g- the 2oniry1 crdinanc-e, 'l'elTulctittg
tlu: actt::L i';i 'r ; ''ri
and use of buildtngs,'"",i,,y bi'sucpende'l or ;euokaC aL ':ti'' L'-r:" ;t1" ''l. r'ir -
tntion of a.ny proui.sions of sai,d ordirances'
-- Fees --
!le-a
ter
Duilding Perwit
Total Clnt'ges
Sttate
CNARCENO.FT:EITEI'I
I'ittw'ea
Residential (1 bath)
Seuer
Plumbing Permit
No nerson shall constt'ttct, ins!al!', alLer or changc -t;ny 're?.ct' c':lstirit:
iirjri'ti".'r2i"aziz-'ii"|n r1" r,toi." or in part, L,zl,tss such pet.s,trt i:: r/r,'.rnjo1-p"oo""rro, o1'o rllia pt*ranr,s Licens'e, elcepb Lhat a pc:,t;on ndi (l<'
plut.abing uork to pr.$"ty-iniii-i" ou"na, Leased o'r operateri by Lhe,t;i,Li-
cant.
*
Plu.nbing Pernit
State
Total
CHANO
7zz-Naa/Eetend Cincuits
Seruice
o7
ve
Electricol Permit
IlhereS!;ateI'attrequit'esth.attheelectt'icalaorkbedonebyanElectrtcol'
Contnactot', th, efe.trZi"t eo,tto"- of this -perrnit shall not be uali'd unti;
the Label i*s been :;igned by the ElecLrical Co'tttactor'
Total
Stctc.
CIIARCENC.ITXM
rs
bhanet llood
Yent Fdn
l,lcodstoi)e
Mechqnicol Permit
llechanicel Permtt
-- ENCROACHMENT --
Parmit
Cvt'bcu!
Sida'talk
L La.bel
Mobile llone
'TOTAL AMOUNT DUE: A
I)al;c fa'ttl
Ile.ceiltt ll
Signed:
DaLePlant Etcmtrtet'
I HAVE CAR1FULLy EXAMINED tlw compleLed appLi.cation fo-r permit' and do
i"';.:;L; "i"7t,fy-ln"t aLL-in1o-:rnatibn hereoi is tnue and correct, and I
n"llZi L"rtliiy that ong o,A aLL ao.rk perlorted ehall be dote i:t ac::o'"
'iinle- vtth thZ' Ordinri,c'ea- of ttte Ciq bf bpringfield, .an'l th.e La;a of thc
iiTL if o"ngo, p"*toii;:ig "to the aoik Ces'cri-bbd herein, *,d !'nt No occ!!-
pANCy r,/1L be rade "r'ii,i'ntr"iiiri ultto"t permisaion of the Buildtnit DL-
Dision. I further certiiil that otly contractors and enplcyees t';t:o dr(' Lii
Lrrpf i.or"n'rltt ons zol.bss uiLL be- ueed on thie ry'oiect
Total *
htl.;:
z8-?
i
Permit fssuance
I
APPLICATi
225 Notth ith Street
Sprtngfteld, 1regon 9?47?
Building Dittision
? 26-3? 53
SITE INSPE*IQN: To.be nade aftet'ffirlonfri prtor to oe! up of
forms.
UNDERSLAB PLUI"IBINC, ELECINICAL A
ny
ffiiF-Fi6ucred,
FOOTINO & FOUNDATICN: To be IACeAF;; t G areztcaoated and
forns are erected, but prior to
puring ccncrete.
UND9RGROUIID PLU\TDTNC, SSIIER L l.t.tiTER-
Tf,$-Tiinchee.
r-:1 INSULATTON/VAPOR I'ARNIEN IIISPECTION :txt7 rcquined oapor barrtere ate in plaoe
': but before any lath, gyPaurn boar4 ot
unll covening ts applied., atd befone' @ty inaulation is concealed.
f ,-r D4YHA|,L INSPEtrI0N: To be nndo
IXJIfG at|@Tra .in place,
but pfLof Yo any tapLng.
..RESIDFNTIAL..
SPE'NGFIEI.D
,/PERMrr
conotete.
SIDEIIALK E DRfVWAI: Por all con-
"r.ete@ Dlilfr etreat tight-
of-tny, to bc nnde after all erca-
vating caapleta & font tllonk t sub-
base nstertal in Place.
0k-
It io the reoponaibility of tle permit holden to aee that aLL inapectione are nade at the propar tine, that aceh cddreas ie readabie
lrar the atreeb, and that the pormit ootd' ia Loaated at -Qhe ftolt of the-ptoperty.'tguildiwJ D.lviciot appror;od plan.slu:Ll remain on the Duildiryl Sitc at aLL tines.
pt?gcsDupE Fon rNSpEr7!9N_RSglEsT:rCaUU726-3769 (recoyden) atate youn City deoigna_ted iob nunben, lob a&i.reaa, \Ue1 of inspe-c!^i-cn
eadyforinopcotion,contfaotorooia,,,ere-,t,,,aLndphonenunbcn.Requegt8leceived,befole7:00e'tt,ill be tmde the eone dcy, requests nade aftet ?:00 on viLL be tmde the ncst:,nrking dau.u5' GAn, fi) "n ;
rour ciLy Deaigr.atcd Job Nutnbet' rr, - \L[ :' I ( [ 4--l
Date
s---
E
x fo
E
?oSI,t!!! DEttM: To be nnde pniot toiifr-Ll.i|ltrol floon insulation ot
decking.
inspections have been
I|ASONRY: Steel location, bond.
dffiilgrcrting or uerticale in
accordance tith U.D.C. Section
2415.
of
Ka vooosrovt: After inatallation ie
I Xl anpleted.
CURB E AP!!ele!!__AP!tOtt: Aftet fornsa";;;;;tAEt p;6i to poutins
floon inau tion or decking.
FI/iIAL PLUMDTIIG
FINAL MECIIANICAL
FINAL ELEEINICAL
nnde arul approoed.,
Fil?EPLAcE: Wior to plccirg faoingAtffiG arul befone'fratning inopec-
tion,
F0AHINC: l,lust be requeoted after
apptoual of rough plwrbing, el.ectri-
cal E neclanical. All wofiryj
btaeing E chinmeys, etc. mtet be
. comptetod. No lurl,.k ia to be coF
'.!eclc{ vnt"il this inapufien r,aa
'beo.n iiii<lc anil ippfri6€1, ,
?ENCE: l{hen canPlete " Pt'ouiCejaGi ov nouable eectiono thtough
P.A.E.
AtL pnoiebt eonditione, ouch as bhe i.netall.atlon of atreet tnee1, crylotion.of t;E
".q"Znlla-io"aroipirS,|tu., mtet be satisficd befire the BUILDIN? PINAL.can be requeated'.
FINAL BUILDINC: The Final Duilding fnspection mtet ba nequeoted aften tha final Plwnbing
Elecbrical, and Meclanical Inapect:iono Tlrcloa been tada atd approved
Job locaticn:
Aeceacora Map ll t Tc,z Iot fl
S\bdivision:
Asncn:
Phone:
ci
Address:
Describe llork:
t"C)
T-l NeD
rnt
VaLue 3Date of
additicn
ntracEo
Gener
Plumbl
l.lechanica
t, ):
Srrtre Iilec u r c lill-l
OR
Sani!a41 oet:et capped at ptoperty Line
Septic tank p.nped ad fttled ttith gta:tel
Final - l{hen aboue itans are conpleted
and ulen dmolition ie oaaplate oP atrus'
ture toved atd, premisea cleaneC up.
llcmee
Blooking atd Set-up
Plunbing connections -- la,ter atd ualet
Electrtcal Cctrneotion - Blooking, eet'uV
and pluttbing conneotiona i*st be approt;ad
beforc requeating eleclrtcal inapeolion
Aaceasoog BuilCing
Final - Aftcr pcrchea, ekirting, decks,
eto. are canpleted.
M
^At.t, t.lANilCrJ::; iND Ct,EtttlOUt'S tttt{:'r nt AC::E!;SIB\.E, ADJUS'l'ttl:tlt TO nl: MAI\I': /1'T NO CLTST T0 ef'lv
tr
Ptlto ! of :l
L-CO *SOLAR ACCESS REQ.-
BedvoomaGro.
JOB NO.
:3- t
f.at Faees -
Aceesa
LOT ?YPE
fnterton
Corne?
Panhandle
Cul-de-eac
-- Feee --
Building Volue & Permit
Thie permit io granted on the etpreas oottdition that the said.-conatntction
sllzll', in all nZapects, conforn'to the Ordinanee edopted by the ci'ty o.f
Spning|ield, including- the -bning C'rdinance, regulating the ccnstntcticn
aid ui" of buildinga,- and may \e auopended or reookeC at cng tine upon uic-
lation of any ptooiaiona of eaid ordinancee.
?OTAL VALUE
,ITEM FTG x Va
A
i
a7
t/0 r
S.D.C. 1.5 r,
Plan Cheek Pee
Signed
Date Paid:
Receipt tl:
Duilding Perntt
Total Clntgea
State
Plumbing Permit
No peroon shall conatruct, inatall, alter or clange -cnlJ neD _cr existing
plitbing on drainage ayetez in uhole or in part, unless such petaon ie the
iegal pbsdessor oia rt-alid plu benta ltcenee, ercept that a pe"son ^oy 4o-ptmtihg uork to propertg ihich ia oumed, Leased or opetated by the appli-
cant.
NO.FEE
t
t63
{o
3
Reetdenti.al (1 bath)
Sewen
Plwbtng Pernit
9tate
Electricol Permit
l'lhere State La,t nequites tlat the electrical uork be done by an Slectrical
contractor, the electrical pontion of this permit elall not be oalic until
the Label lae been aigned by the Electri.cal Contractor.
Total ,
Nas/Extetd Cincuits
Sentice
ooI
oo
@
^
Mechqnicol Permit
,Qo
tulunat llood,
llcodatoue
Vent F@t
Pendt lesuorca
Meclanical Penit
.. ENCROACTIMENT -.
Sectritv Dawsit
Storage
I'b.intet'nnce
Permit
Cvrba*
Sida'nLk
Fence
Electnical Label
lilobile llone
7/rz/qo
Total
I ttAVE CAREFULL| EXA\IINED the conpleted application for permit, and do
hereby certtfy that aLL infonrution heteon ia true and. cornec.t, .atd I
furtier certi"fy that any o?a ott tntk perforned alall be dond in acoor'
dance tith the'ordinances of the city of Spningfield, atd the ta";e of thc* State of onegon pertaining to the wrk Ceacnibed herei.n, and' *ltat N0 0CCU-
PANcy btlll ble ruie of dny structure ui,thout permiesion of the Building Di-
oieion. I further certifil that o:tly contractona axd etplcyeee uho are i.n
;THU';#Wf.'''j',ii\r'b*F!,r"fr f ilV"'''6'brLL,tlc
C,V/y
Ddrc/ I
f - l3-?o
,MtqAf Aunttil,lr nilD. a 217,?/.t
Dabe
Iot Sq. Ftg.
7 of Lob Corterage_
! of Stoies
Total Height
Topogruphy
ITEM
Fi.stwee 4
lJalon
lotal Chanaes
F\tnnaoa FVll'S
I
?otal Clnroc-a
Stata Swclume
Permit No:ry
Address
lssued Date
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 28
1 I own, reside in, or will reside in the completed structure.
2. A.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 I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors reoistered with the
Construction Contractors Board. lf I chanoe mv mind and Eo hire a oeneralcontractor, Iwill contract with a contrattor'who is reoistered wlth theConstruction Contractors Board and I will immediately-notify the officeissuing this building permit of the name of the contraitor.
I hereby certify that the above information is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
?^ t3.40
Date
CONSTRUCTION @NTRACTORS BOARD
02e) fit24tw
COPY TO ]SSUING AGENCY PERMIT FILE
p
COPY TO APPLICANT
@s
'-\
w
SPRINGFIELD
CITY OF SPRINGFIELD-
Department of Planning and De opment
Building Safety Divisron
225 North 5th Street
Spri ngfi e1 d, 0regon 97 477
726-37s3 (sus.) 726-3769 (InsP.)
HOUSING INSPECTT
APPLICATION
102ccG-lg -gcDATE:
JoB ADDRESS: \ 135
OWNER.:S yw@a-,
OWNERS ADDRESS \sf.
APPLICAT{T : LOT<E-I-IE-c[*.$r- Rt r*.tne-
APPLICANTS ADDRESS l.\ t It e
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:
Woe-x* -7 ZTOL
A $35.00 TNSPECTTON FEE rS REQUTRED AT TIIE TrI'tE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TIiE OI^IT{ER OF THE PROPERTY TO BE
INSPECTED.
SIGNATURE
FOR OFFICE USE ONLY
TY OhINER
DATE OF INSPECTION (t'm ,c7o RECEIPT NUI'{BER
DATE PAID:L)DATE OF REPORT
DATE OF CERTIFICATE
COIO{ENTS:
OMPLIANCE:
t
..RESIDENTIAL..
/PERMIT
SPFII^lGFIEI-.D
APPLICAT]
225 North ith Street
Springfield, 1regon 97477
Butldtng Dtuision
7 26-37 53
Ce-'
Date
#
,t /3{/t/r'/fsfiifJob [ocation:
tas lot IAosessors Map #
**uro,, /-r* ; 6het /a @ 1r*
a+( Pla,r":Lt74?S
Phone:7,///--)
L
I
//.q i i/?.!)
,.1-tQ /c
Address
-.;efr'te-c- -boK'/OO
Descrtbe htot'k:
Val.ue
NeD
nDate of App Licattcn
r //cf-'additicn
RenoCel
y'eru
5e
'1. snfractors
General
P lurnb
l.Iechanica
cc Crica
Srrpe Electrician11Sl-n
DEtl)Lrrfill 0R
Sanitary seuet, capped at property Lire
Septic tank purped ard filled trith gratsel
Final - I{hen abcue itens are eotpleteC
and uhen Cer.al'ttion is conplete oP at!'1^3-
ture moved od, prenises cleaneC up.
Hcmes
Blocktng od, Set-up
Plwnbi.ng connectiona -- sarer ail uatet'
Electtical Connection - Blocking, aet-u,
and plwnbing conneetions rntst be appz'a;ei
before requeeting eleclr,tcal inspeclion
Aecelsor,'i BuilCi.ng
pcrchea, ekirting, decks,
Leted.
Final - After
etc. ate comp
Pcge 1 of i':
SIIE INSPEC'IIQ!,1: ?o be nade aftez'
escao;ii-;;;-frt pz.tot, tc set up of
forme.
UNDERSLAB PLUMBING, ELECTRICAL &
WCHAIIfCAL: ?o be nade before ang
tlotk is eotleted.
PO1?INC & FOUNDATICII: lo be rnade
after trenches are eccaoated and
forns are erected, but ptior to
pouring ccncT,ete.
UND\RCR1U\ID PLUMBING. SIWER, W.ATER,
On$lle.ffi: To be naCe pnior to fil-Tfi'66rchee.
UNDERFLOOR PLUMBING & MECflANICAL:of
floor ineulation or decking.
POS! AND BEAM: To be nnde Pri.ot to
iiitaTTatlffo1 floor insulation ot'
decking.
ROUCH PLU!4BITIG. ELECTNTCAL & MECH-
nmcnL: N-Lroik is to be couered
ffilTthese inspections hatte been
nade and approtsed..
ilPEPLACE: Prior to plccirg facingmaterials ard befote frotring inepec-
tion.
EEfiIllCt tlust be requested after
apptoval of rough plwr'bing, electri-
cal E nechanical. All roofing
Ioun City Desigr,ated Job Nwnber fs:
rNsuLA't' r)N / vAP{tR BALRr!! !!s!!!!!0N :
roE ,"d" "ft.";L, lnsutiitci ail
requit ed uapor baruiers are in place
but before any lath, gypsun boarC ot'
tnLL coueting is applied, and before
ay inaulation is concealed.
DRYWALL INSPEtrION: Ic be made
pto?er time, that each addvess is readabl-e
, nurnber, iob adit'eas, type of inspee=ictr
nwtbet". P,equests receixed befcte 7:00 ct
tt ie the responsibility of the pernrit holder to aee that aLL inapections are nade at the
front the atreeL, and tlnt the petvrtt oavd ie Located at the ftont of the propenty,*Buildiyq biuicion approxed plan shcll remain on the Bu.:-Lding JiLc at aLL tines.
PR7C1DUPE FoR INSPECfIgyngQWS!-rCaUl 726-3769 (t,ecorder,) state your City Cesi.gnated. job
eadyfor,inspection,co,,ltt,actorsot,a,mersrtcneandphone'*ill be made the sane dag, ?equests nad.e after ?:00 an wiLL be nade the nect lmrking day.
fite"nn &y-uaafis in place,
but prior to any taping.
ILASONRI: Steel location, bond
\iffilgrouting or oerticals in
accotdance uith U.B.C. Section
241 5.
W))DST)'|E: Aftet installation ie
atrpleted.
CURB & APPRCACH 4?N!: After fornsu.. .r.e"tA-fuiV;G to pouring
concrete.
SIDEHALK & DRI'".EWAI: For all con-
ct,ete paDTng-fiTfi; stneet night-
of-?,aA, to be nade after aLL exca-
oating complete & forn wrk & sub-
base nw.terial in Place.
?ENCE:
gatee
P. U. E.
Nhen conplete -- ProttiCe
or mouable sectians thtough
bracin4 E chinmega, etc. rruat be
completed. Ilo ucr.k ie to be con-
cecled until this inspection lae'been nade anC approted.
\
I g2)
FTTIAL PLUMBING
PII,IAL MECHANICAL
FINAL ELECTRICAL
ALL project conditions, such aa the i.nstallation of alreet trees, conpletion_of the
rnqrin"-d. Lantl.sccpitg, etc., mtst be aatisfied before the BUILDINC FIN*L ca.n be requested.
\INAL BIJfLD\NC: The Final Building Inepection mtat be requested alten the Pirnl Ptwnbing
Electrical, anC Mecharical fnspections hgue been made ard approrteC,
*AT,L I4ATIIICLES AND CLTANOUT'{: III]ST BE ACL-ESSIBLE, ADJUSTIIENI TO BE I.IAI,1E AT IlO CCSI'?O CI?Y
a)
(-)
7ru
SOLAR AC(:ESS REQ.-JOB NO.d
Zone
L-CO
Bedtoona
Ener(u Soureee ?gpe-[ot Faces -
lteatSetbacks
P.L House Can,aqe Accegs.Water lleater
NoPth
FireplaceEos t
Woodstot;eSouth
Weat
Iot Sq. Ftg.
% of Lot Cooeraga
I of Sbrtee
Total Height
Topography
LCT TYPE
_ Interior
Co?ner
Panlnrulle
CuL-de-sac
Building Volue & Permit
This pertn.t is granted on the ear)?esa cond_ition that the said.-constnlction
slall", i-n all rLspects,- ioi'1ii "to the ordinance cdop.ted 6iy the lity o.f
Spi.t"gyi.nta, incl'udtng- the Zoning Crdinanc-e, regulathtg the ccnstmtcticn
i"a
""oZ
of Luildings," and may be euspended oy, reuokeC at cny time upon oic-
lation of any prcui.sions of aaid 1rdinances.
-- Fees --
Value
TOTAL VALUE
s. D. c.
FTG XITEM
A
*7.5 x
Iotal Clnrgea
Building Perwit
State Date Paid:
Signed:
Receipt #:
Plumbing Permit
No person slnll consttact, inetall'- alter or ehange -any tuu-cr existing
it*rtt"g or drainage syatan in ulale or in patt, unles_s s.ueh petson is the
iegal p"oases"on o1" o uiotid pl*rbnr"s Lic-ensb, escept that a -pe?son '*! 4o-
ptfitl.Lg uork to property ihi.h i" ooned, Leased or operated by the appli-
cant,
CHARGE
Fi.ittd,es
Resi.dential (1 bath)
Sani Seuer
Plumbing Pemit
Stdte
Electricol Permit
I,lhet,e State Lan requirea that the electyical uork be ilone by an Eleotrical
contractor, the el)cb,ical portion of this pernit stall not be oali.c. until
the Label
-has
been sigzed iy the Elecbrical Contractor'
Permi
Neu/Eotend Circuits
Set'tsice
State
lotal
Erluttet Hood
NC FEE CIIARCE
?
Mechqnicol Permit
Vent Fot
llcodstote
Permlt Issuanee
Mecltanical Permit
Secarity Depostt
Storage
Maintetance
Permit
Curbcu!
Sidettalk
Fence
Electrical Ia.bel .AO
Mobile Home
PLan Eronlne!DaLe
I HAW CAREFULLy EXAMTNED the contpleted application for permit, attd do
herebg certify that aLL infotnation heteoi is true and eorrect, ami I
furtkZr certiiy that any ard. aLL uork perforned slnll be dote in accor--dance fith the- Ordinancbs of the City of Springfield, and the Laas of the
state of oregon pentaining to the uork cescribed he?ein, and tlut N0 occu-
pANCy titl b"e nntle of any stnuetuye uithout permiasion of the Building N-
uiaion. I fut,ther eet'tiii1 that only contractors and anployees uho are in
conplianee dith oRS 701.055 uiLL be uaed on thie proieet
TOTAL AMOUN? DUE: */s.?5 Signed Date
Water
Total Clnraes
d
" Rt5lurhN I lAL..
225 NOrth Sth STTEEAPPLICATIONIPERI.UT
SprLngfield, )regon 97477
Building Diutsion
7 26-37 53
Job Iocaticn:/35
Aesessore Mao #
S'ubdiuision:
Otmer:
Address
city:
Desctibe llotk:
SPFIINGFIEI.D
tr(?7
lr\\N
Additicn
RenodeL
e flome
Date of App Licatian
GeneraL
Plwnbing
tltr*Ud
i
-/8 -Date
Yalue
3)-z- 3' ?a lat *
Phone:-haas
ELectyLcaL
tlech.o:ieaL
Co4gtnetion Lelder
It ia the tesponaibi-Lily of the permit ttotdet to aee tlat aLL inspeetiotts oe nad.e at the p?ope! time, th61t sssfi :tt,itsss ,is vsasnhigiy.-tl" at?ee.t'. and. titat the-permtt_ead. ie Located at the fzvni of the propez,tg*Buiuing Diuiciol cp-prw-ed plant slnzl remain on tle s"i,/ai"b- iile'at aLL' fihes.' i
PNOC9DUPE FOR INSPECTIOT,I R!)u|ST;CALL 7
requesced a-ci ahen you uiLL be ieady for'-iLZ be nade the sde dcg, n.qun"t"-r*i.
26-3769 (tecorden) state youz, Citg designated job nzor:bet, iob aCiress type of ir:soee=icninspection,Contractors or Oumers ncme cnd plane nwnber Requests receited befcre 7:00 cl7:00 on uLLL be nnde the ne.ct wtking day
Yo?D City Desigra.ted Job Nunbet, Is:E{o0tcISITE INSPECTION: Io be nade aftet,e-ccaation, but prtor tc set up of
forns.
-- WDFRSLAB pLUMBrNc. ELECTRTCAL &)wns,tbfk Le Core?ed.
I poprnic g rQunoarrcn: ?o be naceI aitet Drenches are ercaoated and.
forms are ereeted, but prioz, topour.ing ecncreta.I
TNSALA?TON/VAPOR BARRTER ITISPEC?ION :
?o be naae after aLL insulaticn ed.
required oapor borie?s @e in pI.aee
but before ory Lath, Wpslm baatC ot,
tnLL cooering is applied, od beforeoty irculation is concealed.
DRWALL TilSPEtrION: ?cafter aLL dryuall is in
Sanitary saser capped et ptoper4i Lir:e
Septic tank p:.nped dnd fnlled vtth gta;tel
Final - I'lhen abcrse itens are camleted
and uhen Cer.tcli,tion is eonpleterbr sttuc-ture moued otd. prerrises cleanai up.
{''. ./
DEMOLTTIO!] OR
I rllolnrrca! pru.nntc a rmcsnnrcar,,
-
'12 be maae p"ior to installation offloor insulati.on or decking.
I P.1Sr 4tip BEAM: To be made pri.ot, toI installaxian of floor insuTa.tion oy
deckLng.
-1 ROt-tGH pLUtDIItc, ELEC?pteAL & MECH-
1
- ,until these inspeetiors lwtse been
nal.e and approued,.
I FIPEPLACE: prLot to placira fceinaI mcteriaZs and. befone froninlg irrpnl_tion.
I FRlr:IttG: ttust be requested afterI app-tooal of rough plttrbing, eiectr.t_cal & nechanical. ALL toofirq
.' btacing A chinmega, ete. ayss- 5.ieorapleted. Ito tp"k is to be eon_
.. ....cecled until this inspection ltae
..?bee.n na<ie anC apprcoed.
ttenche€
FTilAL PLUMBITIG
PIIIAL MECHANICAL
FIIIAL ELECTRTCAL
:'a ,t \,.
SEhE.?
To prdor to
be made
plaee"
but prior to ang taping
IIASONRI: Steel Location, bond
beans, gtouting ot oerticaLs in
accot<iotee LtLth U.B.C. Section
241 5.
W)2DST)VE: Aftez, instaltation ieanpLeted.
CURB & IPPRCACH Ap.o.ON: Aftet fortnsee etecteC but prior to pour"rng
Qo., a I
STDEWALK & DRfIEWAI: For aLL eott-
cr-ete patting uithin stteet right-gf-txA, to be maCe after aLL ecca-
rsating conplete & forn tptk & sub-
base natet tal in place.
nD^tnD.
sA;;
hhen conplate -- ProuiCe
oy, mouable sections tlwough
P.U.E,
lll
l
ALL pnoiect conditions, sueh as the installation of street t7ees, colwlet?:on of tip \-
required landsccpir.g' etc. ' tust be eatisfied. bcfore the gutlpinc FINaL can be requested.-
ilNAL BUTLDTN|: The Final B-uild.ing. rnepeetion nwet be requested aften the Firal plrnbirqElectrical, otd Meclur.ical Inspectlon" 'tlrclun been nad.e- ind- ipp"oind.
Hcnes
Blocking otd Set-:,tp
Plunbing eonnections -- aaie? o-d, ualer
I
Eleefu,icaZ Ccmnection - Bloeking, set-up
and plwnbing connections mtst be apprcied
before requesting eleelrLcal inspebtiol
Accessory BuilCing
Pi,nat - After pctekes, slirting, decks,etc. a?e conpleled.
Page 2 of 2
,ALL MANH1LES ANb cLEAttbws MUST BE AccgssrBLl, ADJasat{EIlr ro BE 1L4DE tr No ccsr ?o cpy
eL
(-,
T
,'
l
tr
tr
JOB NO.
Lot Sq. Ftg.
Z cf Lct Cooerage_
! of Sbrtes
Total Eeight
TopogrcPhy
-. EI|CROACHMENT .-
?otal
Cvrba*
S(JLAK ALL;ts5s KtsV.-
Gr.-a
IM ?YE-
Inter.ion
Coraen
Panhand.Le
CUL-de-sac
L-CO G'
Beitoqts
Lat Faces -
Reeeipt #:
EIWEcaniner ToFe
f HAW CAREFALLY ZXA.I,IINED the eompleted application for perwit, ar1d. do
hereby eettify that aLL information hereon is tmte and' eottect, otC I
furth-et, eevtifA that any ard aLL wtk perfozned slall be done it acoot-
dance rtLth the 1rdinances of the City of Springfield' and' the Lass of the* State of ?regcn pe?taining to the Lto"k Celcrtbcd herein, otd, that N0 OCCA-
- PANCL'rttt tb rmd.e of dtA st"ucttt"e vtthott permissiot of the Building DL-
lluision. f further c"rtt|y that otly contractors ad' enplcyees t)ho dre in- canpllance utth ORS ?01.055 aiLL be used on this proiect
Sida,talk
9edze
Mobtle Hatre
TCITAL AMOUNT DUE:.
lieat
P. L.House Aeeess
tor;e
F?G Value
TOTAL VALUE
S.D.C. I.5 c
Date Paid:
Building Volue & Permit
This pennLt is graated on the enpress eordition tha,t the sciid conetnaction
sltaLl', in all iespeets, conform to the Zrditrorce adopted tig the City of
Springfield, irchtding the Zoning Ctdi.nance, regulating the ccnstmtcticn
otd. use of buildings, otd. may be suspet'td.ed or reookeC at ary tine upon oic-
La.tion of aly prcoisione of aaid 1rdinances.
*
,t
Building Penit
?otal Charyes
Stdte
Sigred
NO Ptrtr CHARGE
Ftbhnea
Residential (1 bath)
Seuer
Plumbing Permit
No person sltall consttuct, inslall, alter ot ehange dnA neD cr eristing
plutbing or drainage syst*lt in u?ole or in part, unless such person is the
Legal possessor of a oalid phlnber's License, e$cept tltat a pe?son nay do
phnbing uork to property uhich is ormed, Leased or operated by the appli.-
eant.
*
Plunbing Pernit
NO.FEE CiIARGE
Nas/Eztend Citcttits
Iatpcroy Sensiee
I{he?e State tan requivee thai the electrtcal rwk be done by'im Eleetrical,
Contraetor, the electrLcal portion of this permit elall rat be ualiC w*il
the Lobel lne been signed bg the Electrtcal Contracto?.
Total *
Electricol Permit
IYSM NC FEE CI]ARCE
blunet HooC
Vent ?a
llcodsto;te
t
Mecharnicol Permit
Permtt fssuorce
Meeluaiczl Permit
l,zo
DC
0
rTEM
'llttot
?ato7-
h-amea- YTII'S
State Suvchcrqe
Total- Chndes