HomeMy WebLinkAboutPermit Building 1994-12-09RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
Pl:lInlGFIET.D
JOB NUMBER
225 Fif th Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WOFIK:=?3a OBE6 o ,l sY.
ASSESSORS MAP:2
TAX LOI
LOI BLOCK:SUBDIVISION:
To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recording. All inspections requested before 7:00 a.rn. lvlll bemade lhe same worklng day, lnspections requested afler 7:00 a.n,. wlll be macle the followlng work day.
REQUIRED INI;PECTIONS
I--l Temporary Electrlc Rough Mechani, ol - Prior to
cover.
SIte lnspectlon - To be made
after excavatlon, but prior to
settlng forms.
Underslab Plumblng/ Electrical,
Mechanlcal - Prlor to cover.
Foollng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Undertloor Plumblng I Mechanlcal
- Prior to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor Insulatlon - Prior to
decklng.
Sanltary Sewer - Prlor to fllling
trench.
Slorm Sewer - Prlor to filling
trench.
Waler Llne - Prlor to filling
trench,
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtairr permanent
electrlcal power.
Flreplace - Prlol to faclng
materlals and frarnlng lnsp.
Wall/Ceiling lr-r.r';alion - Prlor to
cover.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work ls complete.
K Final Building - When all
required lnspectlons have been
approved and building is
completed.
tr o,n",sada.
MOBILE HOME INSPECTIONS
l--l Drywall - Pr it; ,i> taptng
Wood Stove -- ,',(ter lnstallatlon
lnsert - Af ter iiir:place approval
and lnslallatlon ,.rf unlt.
Curbcut & Appruaclr - After
forms are ereclc(l but prior lo
placemcnt of corrcrete.
Sidewalk & Drivrway - After
excavation ls c('rnplete, forms
and sub-base rI],rlerial in place.
l--l Fence - When r.cmpleted.
Street Trees - V'.'lren all required
trees are plante,j.
Blocking and Set.Up - Wh.en all
blocklng ls compteie.
i
Plumbing Connections - When
home has been connec'ted,lo
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspections are approved and.porches, skirting, decks, and'
ventlng have been lnstalled.
s>>.x
€ te oi
OWNER:Bse.es PHONE:
-.t.ls
J o+\
STATE:ot:ztP \"1+)E
Rh hsseE <o".1
A So- (ADDRESS:
CITYI
NEW
-
REMODEL ADDITION DEMOLISII \
Fxl sr,g6n
OTHER
DESCRIBE WORK:bq Nr oLr stt S iG.a aT uR Hu to E'q\ TO Buru S \{E \I
EXPIRES PHONE
\DR. H
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
ADDRESS
PLUMBING:
GENERAL:
CONST.
CONTFIACTOR 'f
_ OFFICE USE -
LAND USE:
I OF BDRMS:
BANGE:WATER HEATER:
ZONING CODE:
HEAT SOUFICE:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
I OF STORIEST
\.
FLOOD PLAIN:
# OF UNITS: _.
CONSTR. TYPE: __
Rough Plumbing - Prior to
cover.
tl
E
fl
tl
tl
f_l rinal Plumbing - When ailtJ plumblng worl< is complete.
tl
l-l Framlng - Prior to cover.
tl
Ail
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typr_
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
etbacks
P.L.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE,
HISTOFIICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved bY the Historlcal
Coordinator prlor to permit issuance.
APPBOVED:
VALUE
a
(A)
X $/SO. FT.
Carport
Main
Garage
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express conditlon that the sald
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City .of Springfield, including the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordlnances.
Plans Reviewed By Date
Beceipt Numbe
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
FT.
PLUMBING PERMIT
No
Plumblng Permit
State Surcharge
Total Charge
FT.
FT.
ADDITIONAL COMMENTS
O/ldVO@ ',,/,U,-z ,
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhausl Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth 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
structure without permission of the Buildirrg Safety Division.
I further certify that only contractors and employees who
are ln compliance with OBS 701.055 will be used on this
project.
I further agree to ensure that all reguired lnspections are
requested at the proper time, that each address is readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remain
Date
on the si at all times durln g construct
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
2< Demolition
State Surcharge .?O *, fy'
/?/4Total Miscellaneous Permits (E)
/.44
60
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Comblned)
a#-7*67
.Z
AMOUNT RECEIVED
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
$r<zs nql -- ^-T
/ s 42,'Z-
)