HomeMy WebLinkAboutPermit Building 1994-10-27RESIDENTIAL
PERMIT APPLICATION
3,i i.'.:'|'r[:i 720'3 76 e
SPR
TAX LOT
JoB NUMBE
^
oc/
225 Flfth street
Sprtngftetd, Oregon 91 471
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT BLOCK:
PHONE:
ZIP:STATE:ICITY;
ADDRESS:
OWNER:
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW- REMODEL
CONST.
CONTRACTOR #EXPIRES PHONE
ADDRCONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PLUMBING:
GENERAL:
- OFFICE USE -
LAND USE:
# OF UNITS: _
I OF BDRMS:
QUAD AREA:
I OF BLDGS:
OCCY GBOUP:
r OF STORIES:SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
FLOOD PLAIN:
ZONING CODE: _
WATER HEATER:FIANGE;
' you must call 726'3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll beday, lnspectlons requested after 7:00 a.m. wlll be made the folrowing work day.
REQUIRED INSPECTIONS
To request an lnspectlon
made the same worklng
[--l remporary Etecrrtc
[-l Underslab Plumbtng/Etectrlcal/
-
Mechanlcal - prior to cover,
ll Footlng - After trenches are|J excavated.
[-l Masonry - Steet locailon, bondu beams, groutlng.
n Foundatton - After forms are
-
erected but prlor to concrete
placement.
w
Storm Sewer - Prlor to fllllng
trench.
Rough Mechanlcal - prlor to
cover.
Electrlcal Servlce - Must beapproved to obtaln permanent
olectrlcal power.
l--l Flnat plumblng - When ail'4 plumbing work ls complete.
Slte lnspectlon - To be made [-l nough Electrlcal _ prlor toafter excavatlon, but prlor to U
"or"r.settlng forms.
WalllC'elllng tnstllatlon - prlor to
cover.
Flnal Electrical - ty\,$ren allelectrlcal work is complete.t
Flnal Mechanlcal - When allmechanlcal work ls complete.
Flnal Buildlng - When allrequlred lnspectlons have beenapproved and bullding iscompleted.
Other
MOBILE HOME INSPESTIONS
Plumblng Connectlons - When
home has been connected to
water and sewer.
Electrlcal Connection - Whenblocking, set.up, and plurpblng
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all requlred
lnspectlons are approved andporches, skirting, decks, and
ventlng have been installed.
ll Flreplace - prlor to factng
-
materlals and framlng lnsp.
[--l Framlng - prtor to cover.
l_l Water Llne - Prlor to filtlng|J trench.[-l Fence - When compteted.
Rough Plumbing - Prlor to
cover.
Underground Plumblng - Prlor
to ,llllng trench.n Drywall - prtor to taping
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor toplacement of concrete.Sanltary Sewer - Prlor to filllng
trench.
Sldewalk & Drlveway - After
excavatlon ls complete, forms
and sub.base materlal ln place.
Slreel Trees - When all requlred
trees are planted.
l-l tnsert - After flreplace approval
-
and lnstallatlon of unlt.
[-_l elocking and Set.Up - Whel ail
-
blocklng ls complete.
,uf -
tl
fl
tl
E
fl
1. r
, ,. i .;. rjl
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total [elght
Lot Typ _
-
lnterlor
-_
Corner
-
Panhandle
-
Cul-de'sac
P.L.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE -
HtsroRlcAL DISTRICT, OR ON
,.THE HISTOBICAL REGISTER?
lf yes, thls appllcatlon must be slgned
and apProved bY the Hlstorlcal
Coordinator prlor to permit issuance'
APPBOVED:
VALUE
(A)
x $/so. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT,
Main
Gaqage
Carport
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
upon violation of any provisions of sald ordinances'
Plans Fteviewed By Date
Recelpt Numbe
Plan Gheck Fee:
Date Pald
Received By;
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.
Besidentlai Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
{72f" easee
No
?.5e
/a
FT.
----7:-Z?-.2<
a6(c)
?an
PLUMBING PERMIT
Plumblng Permit
State. Surcharge
Total Charge
']='woa
Flxtures /
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuahce
State:surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon 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 Springfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compliance with ORS 701.055 wlll be used on thls
project.
I further agree to ensure that all requlred lnspectlons are
requested at the proper tlme, 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
Slgnature
7Date
I remaln
on the slto at imes du
MISCELLANEOUS PERMITS
Mobllo Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolltion
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, Q and E Comblned)
ae
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
FT. *
--_--FT,
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