HomeMy WebLinkAboutPermit Building 1994-12-30RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce:726-3759
LOCAT]ON OF PROPOSED WORK:
ASSESSOBS MAP:
LOT:
SPR!^lGFtELr)
JOB NUMBER o/ o-
Zfr,
225 Flfth Street
Sprlngfleld, Oregon 97477
4 TAX.LOT:
BLOCK:SUBDIVISION:
, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspectlons reguested before 7:00 a.m. wlll beday, lnspectlons requested after 7:00 a.m. wlll be made lhe followlng work day.
[_l Slte lnspectlon - To be madc r\4lJ after excavatlon, but prlor to nsettlng forms.
[-l Understab Ptumblng/ Electrlcal/
-
Mechanlcal - prlor to cover.
E(Footlng - After trenches are.I4 excavated.
l-l Masonry - Steot locailon, bond
-
beams, grouilng,
To request an lnspectlon,
made the same worklng ,
l-l femporary Etecrrtc
n Underlloor plumblnglMe
Prlor to lnsulatlon or r
Post and Beam - prlor tlnsulatlon or decklng,
Rough Plumblng - prior
cover.
REQUIRED !NSPECTIONS
ll Rough Mechanlcat - prtor to
-
cover.Flnal Plumblng - When altplumblng work ls complete.
Rough Electrlcal - prlor to
cover.
- Prlor toc
Flnal Electrlcat - When ailelectrlcalcomete.
Flnal Mechanlcal -mechanlcal work ls
K
Electrlcal Servtce - Must beapproved to obtaln permanent
electrlcal power.
[l Flreplace - prlor to factng'J materlals and framlng lnspl
f rru,nrne
all
l_l Foundatton - After forms are
-
erocted but prlor to concreteplacemont.l--l WallrCeillng tnsutarlon - prlor to
-
cover.
E iJf,i,i:!i,?l"ln'.'-olns - Prror [-] Drvwa[ - prrnr rn rar$^^
complete.
When all
ons have been
tdr
completed.
Othsr '4cce65 e76 dr
CJo. No. ?tl-t z-lJZ c4
[--l Floor tnsulatlon - prlor
-.
de-ckl1g. a il*W,,,lf-. trench.
ffiSrorrn Sewer - prlor to f!A{rench.
D(y#:lr-rne - Prror to rrrr
pazrrrr? TaTa
fu^*zprr V-
7/@afua77 fu<ryftffi$rya
MOBILE HOME TNSPE TIONS
l)a$Blocklng and Set.Up - When altllrbtocktng ts compteie./-
I{fI ptumbtng Connecrtons _ When-/<, home has been connected to
/ water and sewer.
[l) Electrlcat Connectton - When-^, blocklng, set.up, and plumblng
/ lnspecilons have been approv6dt and the home ls connected tothe servlce panel.
| ^l Finat - After all requtredLr(,fnspectlons are approved and
/nporches, sklrilng, decks, and/ ventlng have been lnstaileO.
CITY: STATE:
PHONE:
ZIP:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
-
a
DESCFIIBE WORK:
EXPIRES PHONE
PLUMBING:EZ G/-
CONTRACTOR'S NAME
GENERAL:
MECHANICAL:
ELECTRICAL:
CONST,
CONTRACTOR ,{'
SRnl U
HEAT SOURCE:
RANGE:
FLOOD PLAIN
OCCY GROUP:
- OFFICE USE -
CONSTR. TYPE:r OF BDRMS:
WATER HEATER:
r OF STORIES:
* OF UNITS:
LAND USE:
SECONDARY HEAT:
SOUARE FOOTAGE:
OUAD AREA:
r OF BLDGST
,
z/6/
2<z
Q,
ZONING CODE:
E
Lot taces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
r S THE PROPOSED WORK rN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historical
Coordinator prlor to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SQ. FT. X $/SO. FT. = VALUE
Total Value
Buirding Permit Fee c53DO)
State Surcharse + 3%
Total Fee (A)
r%:frr z f 2ft-
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, ln 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.
PZt/lr'7-0;6--Plan By
Receipt Numbe
3e->3
Date Paid:
Fleceived
Plan Check Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
Plumblng Permit
State Surcharge + 3?O
Total Charge (c)
CO
N0
FT.
FT.
PLUMBING PERMIT
FT.
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertaining to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Bullding Safety Division.
I further certify that only contractors and employees who
are in compliance with Ci,.S 7O1.O5S wlll be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Date
y'srsnutr,.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ftt#Ffuf,qve
Total Miscellaneous Perm (E)
d)
O
5p5
3253
Su
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
g
D
BECEIVED
AMOUNT REC
DATE PAID
VALIDATION:
RECEIPT NUMBER
a
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r876 SQ
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Pr0{'/d*tt7* %/afo
PERMIT #
Z-
REAUEST
FOR:€P71s .2&<m
SEPTE NSTAITD
NO OF BEDROCi/S
2e
I have ly read BOTH sides
PRINTNAI'E Signatute drtr-.--
this application and hereby certify lhat all lnformation is true and correct
READ CAREFULLYI Your Authorization ls Based On The Followi ng Conditlons
FEES DUE: $
DATE
PPROVED BY:
E(sE BA OFCK FOB'M FOR 68 7,LAL '-4065otherpermircexpireunlessinspections are currcnt,
CALL FOB INSPEC TION,sPSETtc'sermitp are odgo for one year,
LMD 040 Bev. 6/92
atter 180 days
fi \-3{
")ulLls,{ Li SU Fii.,,-l;
VIOLATIONS
SETBACKS AND OTHER, CONDMONS OF APPROVAL Ml'sT DB sTRICTLY OE38RV'BD. VTOI.ATION CAI RASULT IN REVOCATION OP T}IIS PERMIT.
CITATIONS MAY BE IIISU@ I'NDEN,TIIBPROVISIOTS ALANBCI'UNTY't EtrNACNONMDI}lAN(tsAND/ORCTTHERNEMEDIBS AIIOWBD BYLA$/.
A MINIMUM OF AT LEAST 24 HOTIRS ADVAT{CE NOTICE MUST BE GIVEN FOR INSPECTION REQTIESTS
Ilave the following information ready when you call: 6874M5
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special dtections to the site
powERroBNrERUpoNLAr.rD. "*-m,:fffl1fi#3l1ffiffi*t:'.H&l'iffi1ffi:3HlBli,fl'*?*-r "*oFnIBIRpuNcrIoNs,MAyBNTER I,JPON ANY LAND AND MAXE EXAMINATIONS AND SI,]RVEYS AI{D PLAG AND MAINTAIN 11IB NECBSSARY MONI,'MEI{TS AND MARKERS THEREON.
REQLIRED INSPECTIONS
FOUNDATION iNSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed, pnor to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPEQTION: To be made after all in.slab or under-floor building service equipmenq conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor.
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: To bemade after allplumbing rough-in is inplace, prior to being covered.
FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any
plastering is applied or before gypsum boardjoints and fasteners are taped and finished.
ADDITIONAL INSPECTIONS MAY BE REQLIIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in placg but before ary grout is poured. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and ap'proved.
FINAL MECHANICAL INSPECTION: To be made just prior to the struchxe or remodeled area being occupied and prior to operating any equipment.
FINAL PLUI/tsING INSPECTION: To be made just prior to the building, structrue or remodeled area being occupied.
FINAL BIIILDING INSPECTION: To be mader after fiaish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILEMANUFACTURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with state formdation requirements for mobile homes or as recommended by the manufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure'
APPROYAL REQTIIRED
No work shall be done on any part of rhe building or structure beyond the point indicated in each successive inspection without first obtaining the
approval of the building officiat. Such approval shall be given only after an inspection shall have been made of each successive step in the construction
as indicated by each of the inspections required.
APPR,OVED PI.A.NS MUST BE ON THE IOB SITE AT ALL TMES DURING WORKING HOURS.
TIIIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTN{IN I8O DAYS, OR tr WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS'
SUSPENSION OR REVOCATION MAY OCCIJR IF THIS PERMIT WAS ISSUED ON THE BASfS OF INCOMPLETE OR.ERRONEOUS INFORMATION'
ANYONE PROCEEDING PAST THE POINT OF REQIITRED TNSPECTIONS WILL DO SO AT THEIR OWN RrSK'
your signature on the front of this form verifies the following: I HAY-E CAREFULLY EXAMINED THIS CoMPLETED APPLICATIoN' and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in ttre property as owner of record or authorized agent' I
further certify ttrat any and all work performed shall be done in accordance withihe ordinances of L-" county and the laws of the state of oregon per-
taining to the work described ho"in] t further certify that if I am not the owner of the property, my registration with the Builders Board is in full force
and effect as required by on s zot.oss, and that if "i;p G basis for rhe exemption^ir "ot"a
nolon, and that only subcontractors and employees who
are in complianie with ORs T0l.005 will be used on the job' . ,
.. . , . ,. . ;" ':. "t.
SUBSURFACE & ALTERNATIYE sEwAGE DISPOSAL SYSTEMS: r
when subs,rface consrruction is complete, tlr" p"*ri;;"it;*ruu notiry the county Land M-anagement Division by-s.bltritting tip ;htallation record
form. An inspection will be made by a qualified sanitarian. If construchon "";;ii;r;d, "u
*r""r a.certificaie' of completion iuttiu" lstu"a to the permit
holder. If consrruction does not comply with rules, ;;;*rilh;ld* wil u nodnJ, and all corrections shall be madibefore a certificate of completion
will be issued. Failure to meet satisfactory completioi ii rri",rr" altoned time consii'tute's a,iotation of oRS 454'605 to'454145 and this rule'
, i'rr
SUBSURFACE SEWAGE DISPOSAL SETB-ACKS SEPTIC TANK- -f--, Interior ProPertY lines 10'
Edge of road right-of-waY 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10
10'
10'
100'
SEWAGE DISPOSAL SITE EVALUATION C-* _ TI'
TFIS.
Srtdiybirr:
lr,
. rPPUC*ilrsrruErlrt
{nu}GaE BtreAilD
sIHrsruBESNorotl
s.r.Job
fiVritten Directions
d-
HIEF {-Ggf
mq*'VLi_yrlL
PfiOPO,SED USE OF PROPEFTYI ttttol oitity fi i !,c.!at 3r?Em*!.rtlE ar{ arurale- lnlrfF.l t iel?:e IhetrtotriE ad irrcrest hth!trvelty: { atrrrd rEcoal: _CEnbrctP|r|tfiA$c
_ - mathorr!fit |lldh.. aditrtrl f-d r,ftEow!€rrtfi rul}=r4tr 5 dlo'theor.Frrc{rrnot a{ {.al st= orr r E -aE urlt 499rffi rloG.TEST HOLE
:r ..P
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OFFICE T'SE ONLY 8€LOV'SIIE MEETS S}rE SrAN DARDS YES
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::1'1 rfrch r frdlra, ras bcn assgr-r:d5t ullerraf ba rotraEdslHloQnE(Atrq,r ffi ftt a,rtfiits elhcr q(p.u9qt.{ Arl!.oo.ttefit wrt nol rnctreso Ercrl@tEa@dhfll.t lnr r,cr
REFOf,T
PIJiTS OB
SIIE
wHtcr{DoEs frtoT
E(PENOlTt.tEES
ISAPPROT/E0.SEE
ENSI.IH€THE
MADE IH RCLIAHCE
RFI,IEHSE SIOG.
ISSUAI{CEOFA Fl.nrnEUFONTHISffiT
O noCay,-k{,.,.'
RmHE}ITAL HEALIH, I25 EAST 8TH AYEIIUE, EUGENE , oREGoil 97401 (63I_40511
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