HomeMy WebLinkAboutPermit Building 1994-07-27RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.3769
Office: 726-3759
ELr)
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97477
/7 cr,LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/70 J TAX LO]i //m
LOT:BLOCK:SUBDIVISION:
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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 followlng work day.
REQUIRED INSPECTIONS
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Temporary Electrlc
Slte lnspectlon - To be made
after excavatlon, but prlor to
settlng forms.
Underslab Plumblng/ Electrlcal I
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated,
Masonry - Steel locatlon, bond
beams, groutlng,
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prlor
to fllllng trench.
Underlloor Plumblng/Mechanlca!
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng,
Floor lnsulallon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllllng
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filllng
trench.
}]l'nough Mechanlcal - Prlor to
f\over.
Flnal Plumbing - When allplumblng work is complete.
Flnal Electrical - When all
electrical work is complete.
Rough Electrlcal - Prlor to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Drywall - Prlor to taplng
Wood Stove - After lnstallatlon
lnsert - After flreplace approval
and lnsta,latlon of unlt.
Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Sldewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base materlal ln place.
Fence - When completed
Slreel Trees - When all requlred
trees are Planted.
Flnal Mechanical - When all
mechanlcal work ls complete.
Flnal Bulldlng - When all
lred lnspectlons have been
approved and bullding is
completed.
Other
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MOBILE HOME INSPECTIONS
Blocklng and Set-Up - When all
blocklng ls complete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Electrlcal Connection - When
blocking, set-up, and plumblng
lnspectlons have been approved
and the home is connected to
the servlce panel.
X
E
N**tng - Prlor to cover.
[--l WaltlCelllng lnsulatlon - Prlor toU cover.
Flnal - After all required
lnspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
7q7-PHONE:
STATE:
t DC
3-e <l 9-
ZIP:q7q-7'2
OWNER:
ADDRESS:
CITY:
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW- REMODEL
ADDRESS
Sfat{
CONTRACTOR ,? NAME
MECHANICAL:
ELECTBICAL:
t|-?/ 74a..2
PLUMBING:
GENERAL:
EXPIRES PHONE
CONST.
CONTRACTOR #
BANGE:
r OF BDRMS:
- OFFICE USE -
LAND USE:
WATER HEATEB:
ZONING CODE:* OF UNITS:
QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
[--1 Rougtr Plumbing - Prlor to
l-l 66yg1.
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FLOOD PLAIN:
E
.1;. .e ., i |,,i if1
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot TYpsv
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC'
N
S I
tr
q- lS THE PROPOSED WORK tN THE ,. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcallon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
VALUE
7r lDZbr* 5 >zz.<-r-
-
J'b6
X $/SQ. FT,
lat?
J)e
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILD!NG PERMIT
ITEM SO. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls 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
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Plan Check Fee:
Date Paid:
Beceipt Num
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
No
FT.
FT,
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
/Do-a
3)o nLrr',O
t ,{D-2
(D)
N0
f r4eL)
Vent Fan
,7f
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
(1 ./ >O
>,'l-- |
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther cerflfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Building Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 7O1.OS5 wlll be used on lhls
project.
I further agree to ensure that all required lnspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
a'.Slgnature
Date
on the slte at all times durlng ructlon.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk I]
Curbcut _-_- ft
Demolition
State Surcharge
(E)
Total Miscellaneous Permits
TOTAL AMOUNT
(A, B, C, e and E
DUE (excludlng electrical)uombtned),/7 /7
DATE PAID
AMOUNT BECEIVED
BECEIVED BY
VALIDATION:
RECEIPT NUMBER
i.: I