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i:PRI:;0FIELD, ?REcOl 97477
adldi"g Dittisipi
726-37 53
SPRINGFIELD
.. RESIDENTIAL -.
COI,IBINATION/ APPLICATION PERMIT
iltr t )?, tl (. J.hr,.Ldob Location:
$bdioision:
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Pags 1 of 2
Deacribc ilouk
Adli.tionnP,anodaL
Ccinttttcrors ;ldp Phune #
GeneraZ,
llectr[aL
ll*irctceZ
CowtqEti,oi tatdet
REQUIRED INSPECTIOUS
It is the responsibillty of th€ pelnit hoLden to sE! th3t al]. iespcctions arc nadc at the ProPcr tilte' that cach address is
ncad"abLc f:cn thc strcetr ard tha: tha pernit card is located at th. fiioot of the propety
4 .{11 raanholes aud cleanouts ar. tc b. adjusted at no cost to thc Clty
SITE IIISPECfICN: To be rmdc afterffi;]liif p:rlon to sct up of
forns.
TNDEP.SLAB PLIMBTNG, EL9CT9.IC.qL 6
HEg{ANICAL: To be made beforc anyGffi*'.r.d.
!9ST 6 BEAU: To be nade prior toEffi'n of flaor insui.ation
or Ceckiog.
P.CUCH PLUHBING, ELECTP.IC.4L 6 HECI{-
AllCIltL: llo 'rork is to be covered
uaEthese inspections havc been
uaCe and approved.
EIREPLACEI;Effi
tion.
FRA}II}IG:EiffiIar
DRYI{ALL INSPECIION:ffij@.s
Must be requested afE€r
of rough plurnbing, clccfiri
CIRB E APPROAC:{ APP.o$: After forts
arc erected but prlor to Pcurrng
concrete.
SIDEHALK 6 DRtvfvrAY: For al,l con-
crct6 pavia5 lrIEtifi stree! riSht-
of-way, te be Eade aften al.I exca-
nating ccoplete 6 foro vork 6 sub-
basG 6ateri3J- iD p.l,ac6.
Pllor to pJ.acing faciag IJoQDEIQVE!: Aftcr instaalatior ,ffii-:eteaand befone fraring
n
FOOTIIIG 6 FOUllDr.TIOll: To bc rnade
after trcnches are e:icavated and
fstrrs ars .?cctrd, but pricr to
pouning conc.etc.
UNDERFLOOR, PL'JI{BING E MECHANICAL:@orfloor insulaticn or deckiog.
ca.l. 6 aechanical. A11 rooflng,
bnaclng E ehitrreys' etc. :mrst bo
conpleted. No rork ls to bc con-
cca.Led uDtil this inspectioa has
bcen made end apporoved.
INSUUITT0N/VAPOR BARRIER INSPECTION !
To be rnade aften alJ, insulation and
requi:red vapor barriers are in place
but bafore any or
na1l coveriag
any insulation is concealed.OTHER IIISPEC?IONS: may bc required
in accordance with Building Code'
UIIDERGROT'ND PLI.,uBIHG, SEI{ER, WATER,
!!{!jj!Q!, To be made prior to fil-
ling trenehcs.
to be indicateC in ;lans or by no-
tice frou Building Inspecto:r.
To be rncdc
ia place,
but pnior to any tapiog.
EIIIAL BUILDIIIG: The Final
Electrical, end HechanicaL
llASollRY: Steol, Location, bood
trns-, grouting cr verticals in
accordancc rith U.8.C. S€ctlon
2$15.
AIl project conditions, such as the installation of st?aet trees, coapletion of the
required lanCscaping, etc.' nust be satisfied bcfonc the BUILDING FINAL can be rcqu€sted.EI}IAL PLUHBING
EIIIAL ELECTS,ICAL
BuiJ.ding Inspection rnr.rst be requested after thc Final Plunrbing
tnspeetions have been rlade and apprcved.
lto occupancy of the premises een be made untiJ. the Flnal Auifaing Inspection has been
nade and aPprovedr and a CERTIFICATE OF 0CCUPAilCY HAS BEL{ ISSUED By lHE BUILDIIIG DIVI-
SICN A}ID POSTED O}I THE PREI{ISES.
will be pade the sane daY, requests made after 7:00 a.D. wiLl, be rnade the next
PRoCEDURE FoR. INSPECTI0II_3EQ[E!!: Call 726-3769 (ree:rder)state your Clty designated ,robectionrequestedandwhenyourri]'1bereidyforinspcc-
ticn, Contractols or Orners nane and phone numbers. Requests received before 7:00 a.t!.
rtIIAL HECHA}IICI.L
day.YOUR CITY DESIGNA?ED JOB NUUBER IS
working
C, rtrl t t1 -At,tltotlaed C ;q Ageni;
JOB :'IT'}!EER.L-COC 'iR.ETE.RENCE NTI},IBERS
OCCLIPANCY GROUP TY?T/ COI'STRUCTIOI,IZONE BEDROOMS
Lot Souate !ta.
i cJ'Lot Couetedi of Stortee'-ovaL dgldn:
-c?ogrqryl
Lot Faces:
or ilot.se-
North
Ed.at
Sortth
t/eet
Setbacks
0thet
Lot ry?e
Intertor
Cor,ner"
FEES
Sq. Ftg. Cor47e
Sq. Ftg. Caryorr
t/alye
Susten DeuELop"tent Chatqe
No ps"eon ehalZ constmtoE, inatell, ellet ct ehozge
@g neu ot eststtn4 plunbtng ot ddnage sgarai in
uhcle or in pot, tmkse auch petaot ia :he legal
poaeesaot of a ualid plunber's Licerae, ascelb that
c, pe"son nag b pbnbing wo:,k to p?o?ar?! u'r.ach ie
wned, leasad or opetated bg the qryLicant.
PLTNBINC PERI4T!
sw?dt.4L
?ITAL CHARGS,
Stat.
l{here 1tale ta.t requirea that the eiect-ical uork be
dotte by ot ELzctrical C.nt?ccto?, the eiect-)caZ pot-
tion cf tlris petnrit shall not be oai;td tmti't ihe tg-
bel laa been signed, by tle ilec*tc:L Ccnaeto".
lhe EkctyicaL Safetg Lao doee rot
"equ':te c ?elaonto obtain a Licetsc as @t electriian al/op elee-dco,! corttv:qrc? fp rake an electt:.caL ins::Llcticn
on p?o?etfl ahich is or,med bg lrinseil or a za:tbe: of
kis imedicte lantly ukLch is not izten=ed ;':r eale,
Lease ct r**.
ELEQRICN PePME
TAML CHARGES
ls-tensicn/Cineui
AECEAilTC.AL PSAEI
Hood
Vett Fot
tl@d, Stottefilate?
EltcRcAcHuelt
Sesur|ty PLot Eatn-te Date
f EAW CAREYULLY EXAMINED the co@Leted, qplication fon penrit, @td, dD
henaby certifg tlat aLL infoztation h*eot is tmte atd, correct, otd. I
fr,a.tha" cettifg tllat d! ovl aLL wtk petforned slull be done in aceor-
dance otth tle rNitrotc$ of thB Citg of Springfield, end, the ta,,s of the
State of 1frgai pe"td[nidg t-c the LD"k deec?i.bad h*ein, @d, t tat ilO 0C-
CWAllCy trill be mda of di! et?rcture tritlout penrtaricn of the tsuild,ittgDi,tieion. I fithet cettify that otly eonttacto"a od aqloyece wlp arein conpliance tilh oRS ?01.05s dill be wed. on lhis ptoiect.
i'laincnazee
Percdt
Avoulrf D!!E
Sidr:utalk
Zlectrieal h,bel
AI,PUIIT DUE tinea.
Dtvision appro.ted plot slull rawin on th.e Building te at aL L
-a
2
BVTLDTNA VALW/PERIIZI
thi.s petrnit is gzwttod, oi the er?"€ss crndi!'nn thct
the eaid cotsimtction shall, in ali ree=ects, confcnto the M-to..ces &pted by the C1:1 o;' Spingjied,
incl;ziing the Zoiag Ninoee, regzlatlng ;i"e ccn-
ettucriorl otd, uee of htildin4s, ani tq be asizrl.ed
or te,toked a! oq tine uVoa ttolaticn olt dt'i crcti-
eiona of ead. Crtinouee.
PZot Opck ?ee
Date Ptid
Rceeipt l{
P2*v:t Cnozea
-
.9tatc Su:.a-hrrr,.ae
IOAAL C&4PGES
1. S u t/dlle
tto.
?iiuree
llater Sem;iee