HomeMy WebLinkAboutPermit Building 1991-04-29SPRINGFIELr)
ESID ENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 72A'3759
LOCATION OF PBOPOSED K:
ASSESSORS MAP:
JOB NUMBER
225 Fifth Street
Spri ngf ield, Oregon 97477
LOT
h,
LOT:a BLOCK:SUBDIVISION
PHONE:
ZIP:STATE:
OWNER:
CITY:
ADD
DEMOLISH OTHERDDITION X
DESCRIBE WOBK;
NEW- REMODEL
EXPIRES PHONEADDRESSNAME
MECHANICAL:
CONTRACTO
CONST,
CONTRACTOR #
GENERAL:
PLU M BI NG
u)
\
RANGE:
* OF BDRMS:
WATER HEATER
_ OFFICE USE -
ZONING CODE:
FLOOD PLAINLAND USE:
* OF UNITS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
# OF STORIES
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24hour 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.
REQUIRED INSPECTIONS
l---l Temporary ElectricL_,1
Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover,
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.
Kttu-'ng - Prior to cover'
dfounaulion - After forms are
)Aerected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prior to
cover,
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decki ng.lnsert - After fireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.
\
r
E
E
r
r
E I--l Fence - When completed.
I
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type ,+
y' ,nr.rio,
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
-'S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
lf yes, this application must signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING 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
ewed By *{"
Plan Check Fee:
Date Paid
Receipt Number:
Recei
upon violation of any ions of said ordinances.
SO. FT.VALUEX
(A)45,6 z
BUILDING PERMIT
G.t6Total Value
Building Permit Fee
State Surcharge
Total Fee
ITEM
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
FT.
FT.
FT.
PLUMBING PERMIT
N0
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Laws
of the State 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 with ORS 701.055 will be used on this
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
Sign
Date
on the te at all times du
set of plans will remainof the property, and the aPP
ruction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
--
ft
Curbcut .-- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)DATE PAID
AMOUNT RECEI
RECEIVED BY
VALIDATION:
RECEIPT NUMBE
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
6s:1
Plumbing Permit
State Surcharge
Total Charge
)
Permit No:
qt
?
Address:
lssued Date:
OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS.701.055(4), requires residential building permit applicantsyLo a.re not.registered with the Construction GontractorsEbard to'dign thefollowing statement before the building permit can be issued. Licensed Architectand Enginggl.appllcants, exempt from registration under oRS 201.010(7), neednot 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 2El:
I own, reside in, or will reside in the com pleted structure
My general contractor is
Contractor registration number
I hereby cert ify that the above inform ation is correct and that t
l.will.instruct my general contractor that all subcontractors who work onthe structure must be registered with the Consirrction Contractorc goiio.
OR
B.I will be my own general contractor.
lf I hire subcontra.ctors, I ryill hire only subcontractors registered with theConst ruct i on Co ntiabt-o ri tiiiai,ii. li
e.onildctor,-i' il,iri conilaLt_ilIt6 ; t8l?,2P.,?#'"iHf!."isn?r",Jjffi"rfif*tconstructibn contiaCio?s'e'od;il;;i'i'tniri"iinlh6iii'tery notiry the officeissuing this buirding rieimit ol'In6'nrme 6f ih;';;niia"to..
the lnform ation Notice to p roperty Owners about Conreverse side of this
/)
have read and understa ndstruction Responsibilities on the
@PY TO ISSUING AGENCY PERMIT FILE
t
.op.ryglBqofl ON CONTRACTORS BOAR D0244J 1t90
COPY TO APPLICANT
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