HomeMy WebLinkAboutPermit Building 1997-07-08. RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
LOCATION OF PBOPOSED WOFIK:
ASSESSOBS MAP:t1
H-
:iPFlINGFtELD
BLOCK:
TAX LOT:Z6(>
SUBDIVISION:
- z?14PHON9 VAu-g.1 .11tA\I StZ
t
z
STATE:ZlPi I
OWNER
ADDRESS
CITY:
NEW
--
REMODEL ADDITION DEMOLISH X OTHEFI
FrQE P-er S\€\IttApDESCRIBE WORK:
EXPIRES PHONE
CONTRACTOR'S NAME
G EN ERAL:STXTt>,*L
ADDRESS
rOrl
PLUMBING:
MECHANICAL:
CONST.
CONTRACTOR ,
- OFFICE USE -
LAND USE:
'/ OF UNTTS: __-
CONSTR. TYPE:
--HEAT SOURCE:
-
ZONING CODE: _
# OF BDRMS: .-.-
SECONDAFIY HEAT _.
SOUARE FOOTAGE: _
WATER HEATER:
FLOOD I)LAIN
QUAD AREA:
e OF BLDGST
OCCY GFIOUP:
E OF STOBIES:
To request an lnspecilon, you must call 726-3769.
made the sante worklng day, lnspections rcques
[*-l Tomporary Etecrrtc
SIto lnspoctlon - To be mado
af ter oxcavatlon, but prlor tosotting forms.
Undsrslab Plumbing/ Eloctrical /
Mechanlcal - prior to cover.
Footlng - Af ter trenches are
excavated.
' Ttrrs rs a 24 hour rccordrng. Alr Inspections requested before 7:00 a.m. wi, beted after 7;00 a.m. wlll bo made the followlng work day.
REQUIHED INSPECTIONS
Rouglr Mechanlcal - prlor to
cover.Final Plumbing - When allplumblng worl< is complete.
Rough Electrlcal - prlor to FInal Electrlcal - When allelectrlcal work is complete.
cover,
[--l Flroptace - prtor to factng
-
materlals and framlng lnsp.
tr'
Electrlcal Servics - Must beapproved to obtalr.r permanent
electrical power,
Frarnlng - Prlor to cover.
Wall/Celling lnsulation - prlor to
cover.
Wood Stovo - Af ter lnstallailon.
l-_l Finat Mechanical - When all
-
mcchanlcal worl< ls complete.
poino' J,a ^7 7. Cry,
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When altblocklng ls cornplete.
Flnal Buildlng - When allrequlred lnspectlons have beenapproved and bulldlng is
complotod,
Plumbing Conneclions - Whenhome lras been connected to
water and sewer.
Electrical Connection - Whenblocking, set.up, and plumblng
lnspections have been approved
and the home ls connecled tothe servlce panel.
Final - Af ter all required
inspectlons are approved andporchos, sklrting, decks, andventlng have been lnstalled.
Masonry - Steel locatlon, boncl
beams, groutlng.
E l'Jflil:;"i,::jJ:-trns - Prror [-l orywail - prror to raprns
Foundatlon - After forms are
orecled but prlor to concrete
placemont.
Floor lnsulallon - Prlor to
decklng.
Sanltary Sewer - Prior to f llllng
trench.
Storm Sewer - Prlor to fllling
trench.
Waler Llne - Prior to filling
trench.
lnserl - Attor f lreplace approvsl
and lnstallatlon ol unlt.
Sidewalk & Driveway - Alter
excavatlon ls completc, forms
and sub.base materlal ln placc.
Fence - When completed
{ilrosl Troos - When all requlred
lrees are planted.
Rough Plumblng - Prlor to
cover.
JoB NUM.E "2ru/5r,225 Fif th Street
Springflelcl, Oregon g7477
,(
ELECTRICAL:
T
tf
tf tl
E
[_-l Underlloor Plumblng/MechanicalI I - prtor to tnsutarto-n ;r-J;;lii;;. t]
[-_l Post and Bsam - prlor to ftoortJ lnsulatlon or docktng. t]
Curbctrt & Alrprroaclr - Alter
forms are erocted but prlor toplacemont of concrctc.
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
. Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
J
E
IS THE PROPOSEO WOBK IN THE .
HISTORICAL OISTRICT, OR ON
TIJE HISTORICAL REGISTEFI?
-
lf yes, thls applicatlon must be slgned
and approved by the Historlcal
Coordlnator prlor to permit lssuance..
APPROVED:
I
VALUE
(A)
X $/SO. FT,
Main
Carport
Garagc
Total Value
Bullding Permit Fee
Statc Surcharge
Total Fcc
BUILDING PERMIT
ITEM SO. FT.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrmlt is grantecj on the cxpress condltion that the salcjconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfleld, includlng theDevelopment Code, regulating the conslructlon and use ofbulldings, and may be suspended or revokcd at any ilmeupon violation of arry provisions of sald ordlnances.
Date
Heceipt Numbc
Plans Rcvlewc<.1 t3y
Plan Check Fee
Datc Pald
Beceived By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Devclopmcnt Charge ls due on all undeveloped
properties withln tlra City linrits whlch are belng improved.
ITEM
Flx tu res
Residential Bath(s)
Sanllary Sewer
Water
Slorm Sewer
Moblle Home
PLUMBING PERMIT
FEE
N0
,7f+,4 f
FT,
FT.
FT.
/ ru"
/a:( (,,
,/,2 o
Plumblng Permlt
Stato Surcharge
Tolal Charge
ADDITIONAL COMMENTS
4
Wood Stove/lnsert/Flreplace Unlt
Dryer Vent
MISCELLANEOUS PERMTTS
Moblle Home
Stale lssuance
Stato Surcharge
Sldewalk
-
It
Curbcut
-
ft
Oemolltlon
State Surcharge .? O f .54
Total Mlscellaneous Pennlts (E)/2tr
OrO
/4
(D)
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
Vent Fan No
Mechanlcal Permlt
lssuance
State Su rcharge
Total Permll
By sl0nature, I statc and agree, that I have carof ully examlnedth€ complctcd appllcatlon and do hereby corilfy that alllnformatlon hcreon ls true ancl correct, ancl I f urther cerUfy
that any and arr work performed shail be done rn accordance
wlth the Ordlnanccs of tho Ctry of Sprlngflctd, and the Lawsof tlrc Stalo of Orcgon pertalnlng to tho worl< descrlbed
hercln, and that NO OCCUPANCy wlll be made of any
Structure wlthout pcrrnission of the Bulldlrrg Safety Dlvlslon,
I lurther certity that only contractors and employees who
are ln cornpllance wiil.r ORS 701.OSS wlll be used on thls
p ro jec t.
l(urther agree to ensurc that all requlred lnspectlons are
roquested at tho propor tlmo, that oach address ls readable
from tlrc street, that the pcrmlt card ls located at the front
of the property, and thc approved set oI plans wlll remaln
on th s lte all tlmes ln lon.
slo
Date - c>a-?'?
VALIDATION
RECEIPT NI
DATE PAID
AMOUNT R
RECEIVED
UMBER
ECEIVED
TOTAL AMOUNT DUE (excludlng clectrical)
(A, B, C, D, and E Comblned)BY
con
a4
Sata< ry
I-DL
r - u'47
ilob+3tor s5'lao 3sa-/ -0
fhal{- 1a{ tor bZoo
SFq,l o ae!
FD-l6
NJM
SPRI}iGFIE]-D EIRE DEPAR.TMENT
FIRE DAMA.GE REPORT
OR
ELECTRICAL HAZARD
DATE:ZD
TO:
FROI4:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Address or location of buiiding
Name of orrner
Type of building
Estimated value of building
Estimated loss to building
Date of fire
Location of damage in buiiding
(Dwe 'l i ng , Store, [,larehouse, etc. )
Doo
D
Z
L
(Roof, WalI, Exterior, Interior, etc.)
Structural weakness as a result of the fire
Burned rafters, Beams, Joists, etc.
Additional pertinent information
r 4-
(tlirinq, 0utlets, etc. )
z-Itt=, l- 23_!11_a arcc:
S i qned
D*tt lli71r,
Electrical Hazard