HomeMy WebLinkAboutPermit Demolition 1994-04-22SPIlI]{GFIELI)
RESIDENTIAL
PERMIT APPLICATION
lnspections:726'3769
Office: 726-3759
LOCATION OF PROPOS
ASSESSORS MAP:
LOT:
Zfr,
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
L\
BLOCK:SUBDIVISION
PHONE:
IP:STATE:
OWNE
CITY:
ADD
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WOR
i,EAU NIIAA I
,S NAME EXPIRES
\l.\r
CONST.
A ESS o
ELECTHICAL:
PLUMBING:
G EN ERAL:
CONT
3RS[-
WATER HEATER:
-o
* OF BDRMS:
RANGE:
* OF UNITS:
LAND USE:
ZONING CODE:
FLOOD PLAIN:
FFICE USE -
\\\ \
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
S OF STORIES:
OUAD AFIEA:
* OF BLDGS:
CONSTR. WPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. Thls ls a 24 hour recording. All inspections 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.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
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 Eleclrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framlng lnsp.
Final Building - When all
required lnspections have been
approved and building is
Masonry - Steel location, bond
beams, grouting.
complet
Foundation - 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 flreplace approval
and lnstallation of unit.
Blocking and Sel.Up - When all
blocking ls complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumblng Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
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.
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.
t
)L
E
E
E
D
E
E
E
E
E
E
E
l--l Framing - Prior to cover.
E
E
E
(Dn
D,!{}L
E
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type *'
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
( -rS THE PROPOSED WORK lN THE
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the sald
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.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee:
Date Paid:
Received By:
VALUE
(A)
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
SO. FT. X $/SO. FT.ITEM
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Flxtu res
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
FEE
/50
I 51:;(c)
No
FT.
FT.
FT.
PLUMBING PERMIT
le Ho
Plumblng Permlt
State Surcharge
Total Charge
15
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
N0Vent Fan
Mechanlcal Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordinances of the City of Springf ield, 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 ln compliance with ORS 701.055 will be used on thls
project.
I further agree to ensure that all required inspections are
Date'
L
Si
c
ton
agree, tBy signature, I carefully examined
rESSrequested at the time, that each
from the street,
of plansof the pro
durion the s
is readable
at the front
will remainMISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk .-.._..-.--.-.- lt
Curbcut
-
ft
Demolltion
State Surcharge
Total Miscellaneous Permits (E)
2
2
<. t4DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
I
.'\\.\r,5
TO:
FROl.t:
SUBJECT:
Building DePartment
Springfield Fire DePartment
Structural Damage to Buiiding
SPRI}iGFIEL} FlRE DEPAi.T}lENT
FIRE DA}{PGE REPOP.T
OR
ELECTRICAL HAZARD
nozs\3fl c3\CL
DATE:5-7/?
*{' teoAddress or 'loca.bu
Name of ouner5
Type of buiiding
Estinated val ue of bui i di ng
Estimated loss to build'ing
ion I cii no 3
(Dwel I
S 00
0 bB\6TCLS DTiUq-,
09,Store, Iiarehc use, etc. )
O-O 4A)IS
6rowW
q4z1
v-s-? 4Date of fire
Location of dan'age i n bui'ld'ing
(Rcof, I,Jal l , Exterior, inter ior, etc. )
Structura'l weakness as a result of the fire
(Burned rafters, Beams,Joi s ts, etc. )
1L u
Add'i ti onal perti nent, i nf orma ti on
Electrical Hazard
9o
(lli ri nq , 0utl ets , etc.)
cc
Siqned //,
Z
30,ooo
10
I
SPRINGEIELD FIRE DEPAR.T}IENT
FIRE DAI4PGE REPORT
OR
ELECTRICAL HAZARD
DATE:
TO:
FR0t.1:
SUBJECT:
Buildjng Department
Springf ield Fire Department
Structural Damage to Bujlding
Address or loc ion fbu lding
Name of ounerS
Type of buiiding
-o eAj
(Dwe1 1 n9 , Store, l,larehouse, etc. )
3
IS ev{. teo
Est'imated val ue of bui 1di ng
Est'imated loss to buildin-q
Date of fire
s 30,000
$3o 000
v- g-? //
Location of damage jn bui'lding
(Roof, Wa11, Exterior, Interior, etc.
Structural weakness as a result of the fire
)
(Burned ra f ters , Beams , .1s i s ts , etc .
r!Los t/
Addjt'ional pertinent informatjon o
Electrical Hazard
(l'li ri nct, 0utl ets , etc. )
cc:
75-?/
siqned /d., U trl*t^--oM