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Home My WebLink AboutPermit Building 1999-10-20CITY OF ONEGON !tPFh\IGFIELD tv :1, RESIDENTIAL PERMIT APPLICATION.,1.\.CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUILDING SAFETY Page 1 ilob Nurnber: 99L259 725 -3759 726 -3769 225 North Fifth Street Office: springfield, oR e7477 NOTICE: rnspection Line: r,ocation or Propoaed work : 33 JHLEPEBIVIITSHALLEXPIRE IFTHEWoRK i: : : " ; ;' " Map #' " i ; :' I; ; 1,, ". -Uffif,U :iJltr#ffi itilo*; : :,,, " O\^rner: DUKES & DUKES CONST. Address : P. O. BOX 41578 Describe Work: S.F.RESIDENCE Phone #: 33€-45J4 5'//-7-I?O city/state / zrp: EUGENE oR, 97404 NEW Contractor Const. ConEractor #Expires 03/L6/OL 06/LO/ee 02 /26 / ee 1-O/0L/Ot Phone 7?7 3/3a -€€€-e61-4. 588-1931 746-7677 7 4]--a499 General: Plumbing: Mechanica]: Electrical: DUKES&DUKESC OL2O552 31OB SE 115TH PORTLAND OR 97255OOOO DON LEWIS PI,UMB OO33O75 5OO GREENFIELD ST EUGENE OR 97404L6 HARVEY & SON 0055582 4580 MAIN ST SPRINGFIELD OR 9747850 EASTSIDE EI,ECTR OLT777O 38253 BOSCAGE LN SPRINGFIELD OR 974 QUAD AREA: 3RNC CONSTR. TYPE: VN INSUL PATH: P1 -- OFFICE USE LAND USE: # OF BDRMS SQ FOOTAGE 1l_l-1 :3 z 22OO OCCY GROUP: R3 HEAT SOURCE: FG To requeats an insPection,call the 24 hour recording at 726-3769. A11 inspections requested before 7:00 a.m. will be made the same workj-ng day, inspections requested after 7:00 a.m. will be made the following work day' --- REQUIRED INSPECTIONS --- FOOTING - After trenches are excavated' FOITNDATION - After forms are erected but prior to concrete placement. ITNDERFLOOR PIJITIIBING - Prior to insulation or decking' ITNDERFLOOR DR.AIN - Prior to cover or placement of concrete. ITNDERFLOOR MECHAI'IICAL - Prior to insulation or decking. posT Al{D BEA}I - Prior to floor insulation or decking. INSULATION - Floor; prior to decking Wa11/Ceiling; Prior to cover WATER LINE - Prior to fill-ing trench' SAI'IITARY SEWER LINE - Prior to fi-f]i-ng trench' STORII SEWER LINE - Prior to filling trench' ROUGH PLI,MBING - PTiOT tO COVCT. ROUGH GAS - after line is insLa]led and capped if not attached to an appliance ROUGH UECIIAIiIICAL - Prior to cover ' ROUGH ELECTRICAI, - PTiOT TO COVET. SHEAR WALL NAILING - Before covering sheathing with finish materials ' FRAITIING - Pri-or to cover. INSULATION - Ftoor; prior to decking wa11/Cei1j-ng; Prior to cover DRYWALL - Prior to taPing. cAs SERVICE - Aft.er line is install-ed and fine has been connected to a minimum of one appliance. Pressure test done at t.his point. ELECTRICAL SERVICE - Must be approved to obtain permanent power' cuRBcuT - After forms are erected but prior to placement of concrete ' SIDEWALK - After excavation is complete, forms and sub-base materi-a1 in place /0,1 //r(2 r{f 4{ cail'i 7 SPFII{GFIELD Job Number: 99L269 CITY OF SPruNGFIEI-O, ONEGON Page 2 FINAL PLIIMBING - When aII plumbing work is complete. FINAL MECHAI{ICAL - When all mechanj-ca] work is compleLe. FINAL ELECTRICAL - When alL electrical work is complete. FINAL BUILDING - when all required inspections have been approved and the building is comPfete. Lot Faces: S Topography: 2 House Garage Setbacks SW 5 20 Lot Sq. Ft.: 5398 Total Height: 25 Lot Coverage: 26 % Lot Type: INTERIOR N 15 E 1,2 Item Main Garage Total Value Building Permi-t Fee Surcharge/admin TOTAL FEE --- BUILDING PERMIT Square Feet x L7 82 41,8 $/Square Feet 69 .64 18.34 (A) Value L24,O98.O0 7 ,555 .OO L3A ,7 64 . 00 505.00 50.50 55s.50 --- PLI'MBING PERMIT --- Item Residential Bath(s) PJ-umbing Permit Surcharge/edmin TOTAL CHARGE 3 (c) Fee L92 .50 L92 .50 L9.26 zLL.7 6 --- MECHANICAL PERMIT --- Furnace Exhaust Hood Vent Fan Wood Stove/Insert/Fireplace Unlt Dryer Vent GAS PIPE W/H Mechanical Permit Issuance surcharge /admi-n TOTAL PERMIT 4 6 4 12 4 3 5 00 50 00 50 00 00 35.00 10.00 3.50 (D)48.50 --- MISCELI,A}iIEOUS PERMITS --- Surcharge/admin Sidewalk Curb Cut CITY SDC WILLAIq'\LAI{E TOTAL MISCELI,A}IEOUS PERMITS (E) 0.00 60.00 60.00 2 ,650 .95 1, 000 . 00 3 ,7 80 .96 (Excluding Electrical) unless otherwise noEed --- TOTAI, AII{OUNT DUE --- (A, B, C, D, and E combined)4,596.72 SPRINGFIELD .fob Number: 99L259 CITY OF SPruNGFIELT', ONEGON Page 3 --- 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 DevelopmenL Code, regulating the constructi-on and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of sai-d ordinances. Pl-an Check Fee : 328.25 Date Paid: Received BY: Plans Reviewed BY: AL WARD Date: Building Site Reviewed By: BOB BARNHART oe/1.5/ee 1-o /LL / ee Receipt Number: 035580 --- ADDITIONAI, COMMENTS CITYS DEFAULT FOR A&T,RIS SYSTEM DOWN A SEPERATE ELECTRICAL PERMIT IS REQUIRED DRIVEWAY REQUIRED TO BE PAVED 1 STREET TREES REQUIRED By signaEure, I Etate and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify Lhat any and alf work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the SEate of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. f further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I furLher agree to ensure that all required inspections are requested at the proper Lime, that each address is readable from the street, that the permit card is located at the front of the property, and the approved seL of plans will remain on the site at all- times during construction. a ture Da --- VAI,IDATION --- 0%fqrReceipt Number Date Paid Amount Received Received By /o tu fq 'f r?6 .'lL CITY OF SPRINGFIELD, OREGOA'c LEGAL DESCRIPTI JOB DESCRIPTION Expiration Date -ol -oo SPRINGFIELO EI,ECTRICAL PERHIT APPLICATION Ci ty Job Number COHPIJTB FEE SCEEDTII;E BELOS Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost 3 A Sum Permits are non-transferable and expire if vork is not started vithin 180 days of issuanee or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI.,ATION ONIY Electrical Contrac rc, @ - Address 36)s3 oScA 6 e L-L,, Ci ty SPEUD Phone 2Y l- /{.tq Supervisor License Number 3 Expiration Date lo-ol -ol Constr Contr Number I )7 77 C L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or Modular Dvelling Service or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps - 401 amps to 600 amps - 60L amps to L000 amPs- Over 1000 amps/vo1ts - Reconnect 0n1Y 200 amps"or less 201 amps to 400 amPs Over 401 to 600 amPs 0ver 600 amps or 1000 SUBTOTAL OF ABOVE /NZ state Surcharge 32 Admi n i.s t ra t ive Fee TOTAL t-/- $ Bs.oo EE . $ 40.00 $ B Sso s50 $100 $130 $300 00 00 00 00 00 0040 C. 40.00 55.00 80.00EfEs see "B"aEove D Branch Circuits Nev, Alteration or Extension Per Panel one circuit $ 35'oo Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) Temporary Services or Feeders Installation, Alteration or Relocation i $ $ $ ciry E/q. 97y'4 Pho"" 1?b-nbl+ Signa Supervis BlectricianofI 0vners Name Address OIINER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DATE: -Each installation Pump or irrigation $ sign/outline Lighting- $ Lirni ted Energy/Res $ Limited Energy/Comm $ 40.00 40.00 20.00 36.00 OO 5 BRECEIVED o -1+f 225 TIFTE STREET sPRtNGFrEl,D, oREGoN 97 477 INSPECTION REQ{IEST z 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALI,ATION 3!370 t^Rpa LN, Srz C JOUR|{AL O^ JOB NO. qq tza 1 ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME OR COMPANY: D t r<5 + -Do r4sr c - - s--,---rr,, ,r-, LOCATION 3>z c Pnrr-rayr- uAnJ 6 )1o Z lq'{3 o 37o o DEVELOPMENT TYPE Z SrrDra SF TA BUILDING SVE: Z.Loc; @ Aa.a A 1. STORM DRAINAGE IS? + + LOT SIZE S Q.Ft S laq 3.Ln, s 4 7l.ao S s zqz,l G S ZZ,o€ ZLvLo DArvlw*r1 MO IMPERVIOUS SQ. FT.Zo t+ X S0.232 PER SQ. FT 2. SAMTARY SEWER.CITY NO. OF PFU'S X548.27 PER PFU (See Reverse Side) 3. TRANSPORTATION NO OF LINITS X TRIP RATE X COST PER PM PEAK HOUR TRIP l.or X DU X 5486.73 PER TRIP X 5486.73 PER TRIP 4. SAMTARY SEWER-MWMC A. REIMBURSEMENT COST: NO. OFFEU'S I X ZL+2,1b PERFEU B. IMPROVEMENT COST: NO. OF FEU'S i X ZZ.O{ PER FEU MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMIMSTRATryE FEE 5. ADMINISTRATIVE FEES: CHARGE (suBroTAL ABOVE) X .05 Coordinator $ 10.00 TOTAL-M\\T|\,{C SDC $ 21 z.tl SUBToTAL (ADD ITEMS t,2,3 &.4)$ z5 3q.zs $ I 20.-11 X ATTACH'A.WPD TOTALSDC S ZGQ0,16 \ s )G1 .25 Z1 FIXTURE UNIT CALCULATION TABLE! NumberofNewFivturesXUnitEquivalent=FixrureUnits (NOTE: For remodels, calculate only tt f, additional fixtures) NUMBEROF LINIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT I.JNITS Bathtub......... Drinking Fountain...... Floor Drain.. Interceptors For Grease/OiVSolids/Etc. Interceptors For Sand/Auto WasVEtc. Laundry Tub/Clotheswasher/1v{op Sink. Clotheswasher - 3 Or More............. Mobile Home Park Trap (1 Per Trailer).. Receptor For RefrigeratorAVater Station/Etc........... Receptor For Commercial Sink/DishwashetEtc...... Shorver, Single Stall.. Shower, Gang............ S ink: Bar, Commercial, Residential Kitchen..,......... Urinal, StaInvall.. Wash Basir/Lavatory, Single Toilet, Public In stn lletinn Toilet, Private. Miscellaneous: 2 TOTAL FIXTURE LINITS 2 I 2 3 6 2 6 6 oL II I 3 2 I 2 2 I 6 4 /FIead CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after anaexarion date in table, calculate credits Credit for Parcel or Land Only If Applicable Improvement (if after an:lexation date) o.tt x $ lS.oo = Z.-o (Rate X Assessed Value)x$ (Rate X Assessed Value) Year Annexed Rate per $ 1,000 Assessed Value Year Annexed Rate per $ 1,000 Assessed Value 1979 or before 1980 l98l t982 1983 1984 1985 1986 1987 1988 $4.47 4.38 4.32 4.20 4.03 3.88 3.68 3.38 3.03 2.62 I 989 1990 199 I 1992 l 993 1994 1 995 t996 1997 2.18 1.75 1.35 t.t7 1.03 0.86 0.71 '0.57 0.39 RUNOFF COEFFTCIENTS FOR STORM DR{INAGE (For Estimating Purposes Only) Residential.. Commerical. Indusu-ia1...... Govemmental.. 0.4 0.9 0.5 0.5 FIXUNTT.WPD IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT =---T -Z Z 3 =21 CREDITTOTAL =$ 2:1O Willamalane Park & Recreation District SYSTEM DEVELOPMENT CHARGE WORKSHEET d N. '\*." .lon. No. 11 NAME:o Qrr*rst PHONE:[.1 ADDRESS: ING SITE: sst\lcl, {xrx" Plat Name:o r,3 Tax Lot Number:bSZUD =$ =$ -lu t Date \ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t ype detinitions are on the back) :A Single-Family Detached 7!- Single Family home Manufactured home not in a park -orC -'NO. OF UNTTS X $1,000 Per unit = $( B. Single-Family Attached NO. OF UNITS X $924 per unit = $ C. Multi-Family Apartment O. Manutacturea Home Pa* WILLAMALA,NE SDC $ 2. SDC CREDTT ([ applicable) SDOpayer must (umish proof of Witlamalane ireoit-"pproval. See doC creAt Wodahoet' $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ City of Services Department 2.,?1 srATE:Q\- zlP: 1t4oq CITY OF SPR'I\IGFIF'OREGCA' zoning approval Zoning Date zz5 rrrrE STREET Autnorrzec siEnature SPRTNGFTELD, oREGoN 97 477 INSPECTION REQITESTz 726-3769 OPBICE: 726-3759 1. LOCATION INSTALLATION /, /.11-r r ko{ l^ rt City Job Nunber COHPI,ETE PEE SCMDULE BELOTI Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 $ 8s.00 t-p,u SPT".JGFIELD rtion or Dfl PBRHIT APPLICATION TE:DEI ?9 19?? REID:I $ 44.00 IHf,NEE: [f,SHiER:04I AHT q?t L07 i 3 A 1 lCO Sum JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of i""u.nce or if vork is suspended for 180 days. 2. COI{TRACTOR INSTALI.,ATTON ONLY sq. ft thereof $ 40.00 Each Modu Serv B. Servi Installa t Electrical Contractor Address Ci ty Phone 5qr- q84 -8Ovd Supervisor License Number 464t Jt-F Expiration o^r" t t' fec c Constr Contr. Numbe 4x t q 4 Expi ration Dat 'll S trician 0vners Name Address 0rs ()rr, 1t f) q5 ci Phone 5"tt-r41- 4th0 {)t1LL,( or Relocat io 200 amps or less 201 amps to 400 amPs - 401 amps to 600 amPs - 601 amps to L000 amPs- Over 1000 amPs/volts - Reconnect 0n1Y E. SUBTOTAL OF ABOVE 7% state Surcharge 3Z Admlnistrative Fee TOTAL Temporary Services or Feeders rnsiallaiion, Alteration or Relocation $ $ 00 00 00 00 $300 40.00 5s.00 80.00 130 $40 OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent' Ovners Signature: ee trBil a566 D. Branch Circuits Nev, Alteration or Extension Per Panel one Circuit $ 35.00 g;"h AaditionalCircuit or vith Service or Feeder Permit - $ 2'00 Miscellaneous (Service/feeder not included) 200 amps"or less S zOi .r'p" to 400 amPs - t0ver 401 to 600 amPs $ over 600 amps or t()OOTofis s -Each installation Pump or irrigation Sign/OutIine Lighting- l,imited EnergY/Res I Limited EnergY/Comm $ 40.00 $ 40.00 $ 20.00 s 36.00 T.-,o,rt DATE: RBCETVED 5 $ 1s.00 This permit is required for any site activity in the.flood plaln and everywhera elte alteratlon contlstE ol fifty (60) cubic yards of material of moro and/or lf a.dralnageway ls affectod, wlthln Clty limlts and Thls Slde To Be.'Fllled Cnfi by Appllcant 1 Site Address .333 L c /o r 7 Date of Application Pormit'Expiration Date: Phonti: 'r{/- 779- O6/fProperty Owner Address : d, Oregon 37crTal LotNo: n.oH q-+3 Journal number applicable Land Use tr uGB Tax Map I6o, t' rial tr { Msup GBADING, Ouantity Destiriation:EXCAVATION, Ouantity >o ?4' Sou.rce Locatio Projoct Supervisor Phone { ,,tt,ouantity Supplier Address tr P,TF,?".-#, g?,2'{:!,!,1u::i,13f;1!'1"X1fr?','?l',tl: ElsB:'JIJ1!Sir3l? fffS:ExSl;'eld%,fi:T.""0 y;n,'xt""""*t#ll3*"',*,iJ'i;PJ:illxr:'ilj33"'td'i'3JsP^?;ti'?il"':"^';:'YflJ3'ui6 runo . slidos, Proposed sitn irnprovements. n tr tr tr tr SOILS&GEOLOGYPLAN, . . - DRAINAGE, POLLUTION AND EROSION CONTRPL PLAN REPLANTING PLAN CITYADDRESS: COMPANY NAME: , PHONE PHONE STATE STATECITY COMPANY NAM PROJECT SUPERVISOR ADDRESS: EMERGENCY PHONE: ZO, Expiratioh Date OFF|CE PHONE 5.//:3r9-d-fq Registration Number: ?/Z7R FAX CITY:ADDRESS: 'oi- PHONE MOBILE PHONE PBOJECT SUPERVISOR: STATE: flr4 , ZtP, CONTRACTOR NAME: ily".,,g?il#.iJ,:l:,,",?;10".".j!";"1i3lJ,x?,,0:,",.#l*'.:1il1fi:,,I".r::m::iii^i":,?rJ:?i:i".1{.:s#i !!:;ix"ii{:'ir*!:-,it.. wirh tho ordinances or tni'Citi-or-Siiriiiiiiirir, ippriii'ulilcjii.siiiairo ipecitications ond Drawings, and the laws of the s.ri of orroon pfft.ininc'io'ihi *Jil liidrrbjtliiiiinlt tuh[ii ocntif itiit onty, contrrctors and- emplov.os who trr in compliance ;ith'ORS 70i.055 will bs udod on thi. Ptoj.st. The Ciry may inspoct tho work sire described in this permlt at any time.durjlg a one yoar poriod lollowing tho receipt bY. the ciry ol notice ot co-pioiion-,,iri,o describuo *ilfitnJrdeclly, r1ttt" ciiy's eolc'desocration, anv additional roetoretion work required ro return tne-iiie to a srandard.acg"pigLle!-ihi.CItv. ttre perrhittee will be notified in writins of any work raouired and wi1 trave trriiiiiilbi o.vCiiom irri-oiidttini idilpi.do-.co-mitere tne urork. Work not completed !t thr ond ot iil-il'ily-e;y;'i"irr-6J piitir,ri",i ov ini iiiv ind the cost wlll be bllled to tho p€rmltte€. rcqu.ltcd ct the propor dme, that proioct addr€ss is readable lrom th'c rllc,at all times during construction. 0rc arn Oato Aozz that all rcquirod sot ol A[o /qq?-ndzs( Signature F -l M-- I.J.Jo- Zo -F rv -EaLIJFJ I.JJ U Z -rv -o oZ cZs ttJF6 zo EG UJ E oz 5 oFz lrJ =o EoltlEl=lo I ltlIE oFz E =azoo EoFo OEFzoo az5o- ul TE3F =lr ulcc kz,c,6 Etuz =o Burlbrg Prutt r.t #-- qq ttu7 1qr'.v1 have future ihe that which may.beI understand this time. I this LDAP,MEY succ6ssors luture I r i\' :" ! .,' i -.\ 1/6,41.998 tr x.tr tr DRAINAGE, O Storm, O Ditch, O Culvert, C Natural FLOOD PLAIN, Zone: X , FEMA CornnrLrnity Panel No , DateFLOODWAY, FEMA Community Panel No WETLANDS, Description A,lone- ' .i.. .\ '. :. ' s20 oo s 30.00 s40.00 S40.00,For the tirst 1O,00O cubic yards, plus 92O.00 tbr eich'additiohal'10,000 cubic yards or fractro,r thereol S220.00 For the lirsr 10O,001 cubic yards. plus S20.00 f or eaclr addrtional 10,000 cubic yards or tractron lhereol S340 For the f rrsl 200,001 cubrc yards. plus $6,00 for each addrlronal 10,000 cubic yards or tractron thereol s 30. o0 S3O.00 For the f irst 100 cubic yards, plus S 14.0O tor each adclrtional 100 cubic yards or f raclron llrereol $ I 56.00 For the f rrsl 'l ,OOO cubtc yards, plus S12.00 for each additronal 'l ,000 cubrc yards or lraclron lhereol S264.00 For the f rrst 10,000 cubic yards, plus S54.00 lor each additional 10,000 cubic yards or tractron thereof S750.O0 For the frrst 100,OO1 cubrc yards, plus S30.00 for each additional 10,000 cubic yards or traclron Ihereof Drr" tpL?_D-l11 G6 ZO .c'z)il N,"1/ fip.oo c 't &t trtrC 1,001 TO lO.OOO CUBIC YARDS 10,000 To 100,000 cuBrc YAHDS Grading Permit fee Received By PLAN CHECK FEES: UP TO 1OO CUBIC YARDS 1O] TO 1,OOO CUBIC YARDS 1,001.To 10,000 cuBrc YARos ,._..1_9;,O00 To 100.000 cuBlc YARDS Receipt No: 03 S flD ouru Date: arui Receipt ,o' -#7'15 Date: 100.001 ro 200.000 2OO,OO1 CUBIC YARDS OR MORE GRADING PERMIT FEES: UP TO 1OO CUBIC YARDS 101 TO l,OOO CUBIC YARDS 100,001 To 200,000 Estimated Volume Plan Check Fee: NMBLESIDE, MEADOWS SURD. This propcrly is locatcd in an arca ofhcavy clay soils (cxpansivc clnys). A liccrrscd cnginccr shall verify thc stability ofthc soils in thc proposcd building arca and makc any rccomrncndatiorrs nccessary lo assurc thc continucd stability ofthc soil. A copy ofthc cnginccr's rcport shall bc submitted to thc Building OIlicial prior to bcginning construction of thc structurc. "41Gru*ztrt/e:2.a24€/82 d ET D tr Date Date Date Date ?/zel?a Malntenarrce Pla n nin g Eng ineering Burldrng: t] Land and Drainage. activity.as outlined in this permit has been completed rn accordance wirr-the provisions of this permit. tr Land and Drainaoe activitv as outlirwrrh rh6 provi]PJJrer%?tlY]ilf,nrgyJ,lin"o in this permrr has not been complered rn accordEnce tr Land and Drainage actrvrly wa6 perform0d prror to apptrcarron tor rnrs permrt, Accepted by Date utoz, Enarloo< Permit Number lssued by Reqtrired Final lnspections' Planning: E nginee r in c; Burldrng . Maintenarrcc: Dat e Date Date Date Date s4st Received by: ide To Be Filled city staif lrjo z Eo IU uJlr ozo F6zoo aut =ut =utE U'zo t UJo-q, =