HomeMy WebLinkAboutPermit Building 1995-10-31SPFtII\lGFI
RESIDENTIAL
PERMIT APPLICATION
lnspections:726'3769
Office: 726-3759
JOB NUMBER Qs t 6bZ
225 Fif th Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WOBK:
ASSESSORS MAP:r? oz _28 \TAX LOT:
LOT:BLOCK:SUBDIVISION
To request an inspecilon, you
made the sante worklng day,
must call 726'376s' Thls ls a 24 hour recordlng. All lnspections reguested before 7;00 a.mlnspections requested after 7:00 a.m. wilr be made the folrowrng work day.
REQUIRED TNSPECTIONS
wlll be
Temporary Electrlc
Site lnspeclion - To be madeafter excavatlon, but prior tosetting forms.
Underslab Plumblng/ Electrical/Mechanlcal - prior to cover.
Foollng - After trenches areexcavaled.
Masonry - Steel locailon, bonclbeams, grouting,
Foundatlon - After forms areerected but prlor to concreteplacement.
Post and Beam - prlor to floorinsulation or decklng.
Floor lnsulation - prior todecking.
Water Line - Prlor to filling
trench.
Rough Plumbing - prior to
cover.
Rough Mechanlcal - prlor to
cover.
Rough Electrlcal - prlor to
cover.
Flnal Plumbing - When ailplumblng worl< ls complete.
Finat Electrical - When allelectrical work is complete.
Final Mechanlcal - When allmnical work ls complete.
FInal Buildlng - When allrequlred lnspecilons have beenapproved and building iscompleted.
Electrical Servlce - Must beapproved to obtaln permanent
electrlcal power,
[-l Flreplaco - prtor to faclng.J materlals and framlng lnspi
lng - Prlor to cover.
Wall/Celling lnsulatlon - prior tocover.
[--'l Unaerground plumbinq _ priorL-J to filling trench f Drywall - prlor to taplng
Underlloor plumblng / Mechanical
- Prior to lnsulatlon or decking.
MOBILE HOME TNSPECTIONS
Wood Slovo : After lnstallatlon.
lnsert - After flreplace approvaland lnstallatlon of unlt.
[-l glocking and Set.Up - When ail
-
btocklng ls complete.
Plumbing Connectlons - Whenhome has been connected towater and sewer,[--l Sanltary Sewer - prior ro fiilingu trench.
Curbcut & Approach - Afterforms are erected but prior toplacemcnt o, concrete.
Storm Sewer - prlor to filling
trench.
Sidewalk & Oriveway - Afterexcavation ls complete, formsand sub-base material ln place.
Fence - When completed.
Electrical Connection _ Whenblocklng, set-up, and plumbinglnspections have been approvedand the home is connected tothe servlce panel.
NEW
-
REMODEL ADDITION DEMOLISH OTH
PHONE:
APor rJoF1g.qr6;
CONST.
CONTRACTOR ,'ADDRESS EXPIRES PHONE
&STATE:ZIP:9-*t7
Jo."s*' Vat-"ra**
t4Gs Pqre-e,t
tL->1b-Ll"iAA KK bPL-
CITY:
CONIRACTOR'S NAME
ADORESS
OWNER
MECHANICAL
ELECTFIICAL
DESCRIBE WOFK:
GENERAL:
PLUMBING
, OF BDRMS
- OFFICE USE _
LAND USE:
ZONING CODE:
SECONDABY HEAT:
I OF UNITS:
SOUARE FOOTAGE:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
r OF STORIES:
FLOOD PLAIN:
CONSTR. TYPE:
HEAT SOURCE;
RANGE:
Street Troos - When all requlredtrees are planted,
Final - Af ter all requiredtnspectlons are approved andporchos, sklrilng, decks, andventlng have been lnstalled.
Erru.uO Er.Gs * Da.< Qar ?.ePQvrz
WATER HEATER:
tl
tl
Lot laces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type-
-
lnterlor
--
Corner
-
Panhandle
-
Cul-de.sac
PL.HSE GAR ACC
N
s
E
I\
ISTHE PROPOSED WORK IN THE
HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER? ".._-ll yes, this appllcailon must be slgnedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
VALU
(A)
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
2sao
%.so
.3.o8
4i FrZ
SQ. FT, X $/SO. FT.ITEM
Maln
Garage
Carport
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
Thls permit is granted on the express condiilon that the saidconstruction shall, in all respects, conform to the Ordlnanceadopted by the City of Springfield, includtng theDevelopment Code, regulating the construction and use ofbulldings, and may be suspended or revoked at any ilme
upon violation of any provisions of said ordinances.
Recei pt Number:--..-.......=---.-..._-
Plans RcGwcd-13y Date
Date Paid
Received By:
Plan Check Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties within the City limlts which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
FT.
FT.
FT.
(c)
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Tolal Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
NoVent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carcf ully examlned
the completed application and do hereby certlfy that all
lnformation hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of thc City of Springf ield, and the Laws
of the State of Oregon pertalnlng to thc work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure wlthout perrnission of the Building Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address ls readable
from the street, that the perrjlt card ls located at the front
of the property, and the approved set of plans will remaln
X
on the site at Itimes durlng const ructlon
Slgnatu re
Date
.-2
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elec\rical)
(A, B, C, D, and E Comblned)
At,ca
VALIDATION:
BECEIPT NUMBER o144bl
DATE PAID
AMOUNT BECEIVED 4\.4
RECEIVED BY
-ber+-
N0
JOB NUMBE " ?V68
,16 Fitth street
i-pringf i.rO, Oregon 97477EEi"ff,1.I$t'"o''o*
lnsoections:726'3769
Ot(ice: 726'3759
LQOATION Otr PF{OPOSED WORK:
ASSESSORS MAP:
TAX LOX
SUBDIVISION:LoT: BLocK:
PHONE:
ZIP:STATE:
OWNER:
ADDRESS:
CITY:
ADDITION DEMOLISH OTHER
DESCFIIBE WORK:
NEW .---- REMODEL
MECHANICAL: -
ELECTFIICALi
PHONEEXPIRESADDRESSCONTRACTOB'S NAME
CONST,
CONTRACTOR #
GENERAL:
PLUMBING
RANGE
I OF BDRMS:
- OFFICE USE -
LAND USE:
ZONING CODE:
WATER HEATEFI:
SECONDARY HEAT:
SQUARE FOOTAGE:
QUAD AREA:
# OF BLDGS
OCCY GFTOUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS: _-
To request an inspectlon, you must call 726-3769. Thls is a24hour recording. All lnspections requested before 7:00 a.m. wlll be
made the same working day, lnspections requested after 7:00 a.m. will be made the following work day.
REQU IRED TNSPECTIONS
[--l Temporary Electricll
Rough Mechanical - Prlor to
cover.
Final Plumbing - When all
plumblng worl< ls complete.
Site lnspection - To be made
af ter excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Eleclrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Servlce - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Fireplace - Prlor to facing
materlals and framing lnsp.
Final Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
Other
Foundatlon - After forms are
erected but prlor to concrete
placement.Wall/Celling ln.sulatlon - Prlor to
cover,
Underground Plumbing - Prior
to fllling trench.Drywall - Prlor to taping
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanical
- Prior to insulatlon or decking.Wood Stovo - After lnstallatlon
Post and Beam - Prior to floor
insulation or decking.lnserl - After flreplace approval
and lnstallatlon o{ unlt.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decking.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 f llling
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.
Waler Line - Prior to filling
trench.
l--l Fence - When completed
Street Trees - When all requlred
trees are planted.
Final - After all required
inspections are approved and
porches, sklrting, decks, and
ventlng have been installed.Rough Plumbing - Prior to
cover.
h,
)
FLOOD PLAIN:
E
E
tl
E
w
fl
E
E
E
fl
E
E
E
tl
E
tf
E
tl
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ,
v
--
Interior
_*_ Corner
-
Panhandle
.- Cul-de-sac
PL.HSE GAR ACC
N
S
E
s IS THE PROPOSED WORK iN THEHISTOFIICAL DISTR rc]1 OR oNTHE HISTOFIICAL R EGISTER?
lf yes, this application must be slgned
1nd approved by the UistoitcalCoordinator prior to permit issuance.
APPFIOVED:
BUILDING PERMIT
VALUE
(A)
SQ. FT. X $/SQ. FT.
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Dl.ry.g_v.ALu E, PLAN CH ECKBUILDING Pi=RMIT
This permit is granted on the express condition lhat the said .construction shalt, in all respecis, "onio, io-tne Ordinanceadopted bv the citv, gf spiingrieiJ, incrudins theDeveropmenr code. regurating in" Jon"Ju"iion ,nd use otbuildings, and may be suspended or revoked at any timeupon violation of any provisions of saiJ orJin"n""".
DatePIans Reviewed By
BUIL
AND
Plan Check Fee;
Date Paid:
Receipt Number:
Received By:
EMS DEVELOPMENT CHARGE (SDC)
(B)
SYST Systems Development Charge is due on all undevelopedproperties within ilre City limits which are being improved.
ITEM
Fixtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
No
Fr.<fur
7).a
FEE
FT.
FT.
(c)
4>.<
-4dfrrePlumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
By slgnature, I state and agree, that I have carefully examlnedthe completed application and do hereby certify that allinformation hereon is true ancl correct, and I f urther certify
that any and ail work performed shail be done in accordance
with the Ordinances of the City of Springf ield, and the Lawsof the State of Oregon pertaining to the work described
hereln, and that NO OCCUPANCy will be made of anystructure without perrnission of the Building Safety Divislon.I further certily that only contractors and employees who
are in compliance with ORS 701.055 will be used on thisprolect.
I f urther agree to ensure that all required inspections arerequested at the proper time, that each address is readable
from the street, that the permit card is located at the fronlof the property, and the approved set of plans will remain
Slgnatu re
/0* z) -?,Date
r
on the site at ll times during construction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -- ft
Curbcut _ ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding etec$icat)
(A, B, C, D, and E Combined)
vhuoRrroN:
RECEIPT NUMBER
DATE PAID -27 .=,
AMOUNT RECEIVED
RECEIVED BY
<68,