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HomeMy WebLinkAboutPermit Building 1991-10-09eg9eo BLOCK:LOT: TAX LOT: SUBDIVISION JOB NUMBER LOCATION OF PROPOSED WOBK: ASSESSORS MAP: RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Otfice:726-3759 225 Fifth Street Spri ngfield, Oregon 97 477 - '-?3/nPHONE: ZIP:OKSTATE: ,{ I CITY: ADDRESS OWNER: NEW - REMODEL ADDITION DEMOLISH OTHE DESCRIBE WORK: EXPIRES PHONEADDRESSp2,CONTRACTOR'S NAME MECHANICAL: ELECTRICAL CONST. CONTRACTOR # GENERAL: PLUMBING RANGE: # OF BDRMS _ OFFICE USE _ LAND USE: ZONING CODE: FLOOD PLAIN WATER HEATER r OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: QUAD AREA: * OF BLDGS: OCCY GROUPT # OF STORIES To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS l--l Temporary Electric Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.E Fireplace - Prior to facing materials and framing lnsp. E Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting. OtherFoundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping MOBILE HOME INSPE TIONS Underlloor Plumbing / Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set-Up - When all blocki ng is complete. Floor lnsulation - Prior to decki ng.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 filling tren c h.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. Water Line - Prior to filling trench. Fence - When completed. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Rough Plumbing - Prior to cover. /.1</, ,O/eas*or 1-i: 7 CONSTR. TYPE: HEAT SOURCE: [-l Rough Mechanical - Prior toU cover.r E r E r E E E E E E E I Framing - Prior to cover. t]E Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac PL.HSE GAR ACC N S E VALUE /5.7s(A) AD X S/SQ. FT. ,7s Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport ( ?qt?o 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 said ordinances. Receipt Number:- Plans Reviewed By Date 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 Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance with 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 Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Signature Date o- MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition I Miscellaneous PermitsTO (E) Su rc harge TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 7s 10 7-?/ 77 t- 2t5.7 & DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER , THE PROPOSED WORK I N THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved bY the Historical Coordinator prior to permit issuance. APPROVED: N0 /3 Permit No: Address: lssued bY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS. -ABOUf CONSTNUCTION RESPONSIBILITIES Fill in the applicable blanks, and initial box 1 and either box 2A or 28: 1. t---l I own, reside in, or will reside in the completed structure' 2. AEI-MY general contractor is Note: oregon Law, oRS 701.055(4), requires residertial building-permit applicants *no "i"-iot regi6Gred with tne'Coirstruction Contractors Board to sign. the following statemenioeiore the building permit can be issued. Licensed Architect "no engin"., "ppiit""ii, "*9.pt frori iregistration under oRS 701'010(7), need not submit this statemeht. Thii statement will be filed with the permit. 2 * <u ,/I Date: /C -.1*7' / / Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure musf be registered with the Construction Contractors Board. OR B I will be my own general contractor. lf I hire subcontractors. I will hire only subcontractors reoistered with the Construction Contractors Board. lf I chanoe my mind and llo hire a oeneral contractor. lwill contract with a contrattor-who is reoistered w-ith the Constructibn Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contradtor. .l I hereby certify that the above information is correct and that I have read and understandthe lnformation Notice to Property Owners about Construction Responsibitities on thereverse side of this form. Si gnature of Perm pplicant Date WHITE COpy TO tssutNc AGENCY pERMtT F|LEPINK COPY TO APPLICANT GONSTRUCTION @NTRACTORS BOARD 0244J 10t24t89 @s X {) L-l--z