HomeMy WebLinkAboutPermit Building 1995-03-23FIELDRESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Office: 726.3759 Zfr,
JOB NUMBEB
225 Fifth Street
Sprlng fleld, Oregon 97 477
LOCATION OF PROPOSED WOFIK:.rbb 5 Yo ia",an )enur
ASSESSOBS MAP:
LOT
-
BLOCK
TAX LOT:@>o t) ta
SUBDIVISION:
-PHONE
STATE:
l_I150sIl+l -9oz
ZIP:4t +-11CITY:
ADDRESS:
OWNER:
t
REMoDEL - a-ADDITION 'rt'
,4RDESCRIBE WORK
NEW
-ADDRESS EXPIRES PHONE
r)YfPlfkrv^\1r
Cx )v
CONTBACTOR'S NAME
ELEfiRICAL:
GENEBAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR ,
e-L \\\
- OFFICE USE -
LAND USE:
ZONING CODE:
FLOOD PLAIN
E OF UNITS:
SECONDARY HEAT:
SOUARE FOOTAGE:
, OF BDRMS: --
OCCY GROUP:
I OF STORIES:
QUAD AREA:
I OF BLDGS:
CONSTR. TYPE:
HEAT SOUFICE:
WATER HEATER:-RANGE:
To request an lnspecilon, you must call 726-376g. Thmade the same worklng day, lnspectlons requested
ls ls a 24 hour recordrng. Ail rnspectrons requested before 7:00 a.mafter 7:00 a.m. wlll be made the followlng work day.
wlll be
Slte lnspectlon - To be madeafter excavatlon, but prlor tosettlng forms.
I-_| Underslab plumblng/ Elecrrlcat/
-
Mechanlcal - prlor to cover.
ffi Footlng - After trenches are
-
excavated.
l-.l Masonry - Steel tocailon, bondu beams, groutlng.
Temporary Electrlc
Foundatlon - After forms areerected but prlor to concreteplacement.
Underlloor Plunrblng / Mechanlcal
- Prlor to lnsulallon or clecklng.
Post and Beam - prlor to floorlnsulatlon or decklng.
Floor lnsulatlon - prlor todecklng.
Sanltary Sewer - prior to Illllngtrench.
Slorm Sewer - prlor to filllngtrench.
Water Llne - prlor to filllngtronch.
Rough Plumblng - prlor to
cover.
REQUIRED TNSPECTIONS
ffi Rough Mochanlcal - prlor to
-
cover.
N Rough Electrlcal - prlor to
cover.
m
l-l Underground plumblnq - priorr-J to fllllig trencl-r. --"'o
[Y otv*utl - Prlor to taptng.
E Electrlcal Servlce - Must beapproved to obtaln permanent
electrlcal power.
[-l Flreplace - prlor to factng'J materlals and framlng lnsf,
[Y] Framlng - prtor to cover,
ffi Wa[tCelllng lnsulatlon - prlor ro
-
cover.
l-_l Wood Stovo - After tnstailailon,
[-l lnsert - After flreplace approval
-
and lnstallatlon of unlt.
E
tE
m
B
tr
[-l Blocking and Set.Up _ When ail
-
btocklng ls complete.
Curbcul & Approach - Aftertorms are erected but prior loplacoment of concrete,
Sidewalk & Drlveway - Afterexcavatlon ls completc, formsand sub.base material in place.
Electrical Connection - When
p_t9cxt1g, ser-up, and ptumbinglnspectlons have been approvedand the home is connected tothe service panel.
[l Fence - When compteted.
Streel Trees - When all requlredtrees are plantecl.
Flnal - After all requiredrnspectlons are approved andporches, sklrilng, decks, andventlng have been lnstalled.
MOBILE HOME INSPECTIONS
Plumbing Connectlons _ Whenhome has been connected towater and sewer.
t'l(.'tPlz-
5
ffi flnat plumbing - When ail'f plumblng worl( ls complete.
ffi Flnal Electrtcat - When all".+- electrlcal work is complete.
ffi Flnal Mechanlcal - When all'--{- mechanlcal work ls complete.
ffi Flnal Bultdlng - When all'1+' requlred lnspecUons have beenapproved and bullding iscompleted.
Lot faces
Lot sq, ftg.
Lot coverage
Topography
Total helght
Lot Type
-li tntu'i]6,.
-
Corner
-
Panhandle
-
Cul e-sac
,\7\7w_
IS THE PROPOSED WORK IN THE .
HrsToRtcAL DtSTRtcT, oR ON
THE HISTOFIICAL REGISTER?
--
lf yes, thls appllcatlon must be slgnedand approved by the Historlcal
Coordinator prlor to permlt issuance.
APPROVED:
PLUMBING PERMIT
ITEM
Flxtures
Hesldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
2-OD, .qC
?a ?P
y'o
32.r'o
FEE
No
FT.
Plumblng Permlt
State Surcharce 7,fo * ,1O
Total Charge
fOTAL AMOUNT DUE (excludlng electricat)
(A, B, C, D, and'E Comblned)
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
(c)
P.L.HSE GAB ACC
N
S
E
BUILDING PERMIT
?76
Ass.o3
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
= VALUE
ZZ-zSs',, ci Th(e
Total Value
Building Permit Fee
State Surcharge
Total Foe
3z/g/,10
ao6*=
r b.s3\o.33+ 3?
(A)
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
Thls permit is granted on the express condlilon that the saldconstructlon shall, in all respects, conform to the Ordlnanceadopted by the City of Sprln
ay be suspended or revoked at any tlme
ytr/rr
RevleP By
By:
23
gfleld, lncludlng theDevelopment Code, regulati ng the constructlon and use of
any provis of sald ordlnancss.
7--n,rre--
Recel pt Number:
Recel
Date Pald:
bulldlngs, and m
upon vlolatlon of
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (
(B)
SDC )Systems Development Charge ls due on all undeveloped
properties wlthin the City llmits whlch are belng lmproved.
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rn ace
Exhaust Hood
Vent Fan No Z,
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
Mechanlcal Permlt
lssuance
state Surcharse t7S f rlS
Total Permlt (D)-.r 2,O.31a.
7'
/ ,zo
/5 90
J/A-o_e
By slgnature, I state and agree, that I have caref ully examlned
the completed applicailon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I further certlfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to tho work descrlbed
hereln, and that NO OCCUpANCy wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvlslon.
I further certlfy that only contractors and employees who
are ln compllance wtth OFIS 7O1.OSS wlll be used on thls
prolect.
I further agree to ensure that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
<- z3- a-{
ure
Date
a.
on the slte I times durlng constructlon,
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Miscellaneous Permlts (E)
a3
RECEIVED BY
-7
c;3
FT-
FT.
57 z ,n*- , - -r-'
2/t)