HomeMy WebLinkAboutPermit Demolition 1992-03-17SPR ELO
HES ID E NTIA L
PERMIT APPLICATION
lnspections: 726'3769
Of lice: l?6-3759
LOCAI ION OF PROPOSED WORK:
ASS ESSo RS v ap, /2O2-25:32--=
JoB NUMBE R -22-o-/Ce--
225 Fif th Street
Springf ielr1, Oregon 97477h,s zFz
TAX LOI: -EBg#-
BLOCK:SUBDIVISIONLOT: ----_-.-
OWNER:
ADDRESS:
!-Pr-roNE: Z6-97.€/
SrArE: -eF-zre,-/Q/2=
tb
CITY: ---- -
OTHERDEMOLTSH r
DESCRIBE WORK
NEW -- REMODEL ADDITION
PHONEEXPIRESADDRESSCONTRACTOR'S NAME
MECHANICAL
CONST.
CONTRACTOR #
ELECTRICAL:
G EN ERAL:
PI,UMBING
OUND AREA:
g OF RLDGS:
OCCY GF1OU[):
r OF STOTtIES:
WATEN HEATER:
FLOOD PLaIN:
l
IZONING CODE: - 1
c OF BDRMS:
i
SECONDNRY HEAT:
l
souARE FOOTAGf:
P OF UNITS: -
_ OFFICE USE _
LAND USE: _
CONSTR. TYPE: .--
1-IEAT SOURCE: ---=_
recording. All inspections requested befdre 7:00 a'm' will be
will be tnade the following work day'
1
PECTIOI{S
Final Plumbing - When all
plumbing worl< is comPlete'
To request an inspection, you must call 726'3769' This is a 24 hour
macle the sarne working day, inspections requested after 7:00 a'm'
REQUIRED INS
[-l TemfiorarY Electric
ll
Site lnsPection - To be made
a{ter excavation, btlt Prior to
setting lorms.
Underslab Plumbing / Electrical/
Mechanical - Prior to cover'
Footing - Af ter trenches are
excavated.
Masonry - Steel localion' bond
beatns, llrouting'
Foundation - After forms are
erectecl but Prior to concrete
placelnen t.
Undergrouncl Ptumbing - Prior
to f illing trenctr'
Underlloor Plumbing/ Mechanical
]- pii"t to insrrlation or clecl<ing'
Post and Beam - Prior to {loor
insulation or decking'
Floor lrrsulalion - Prior to
decking.
SanitarY Sewer - Prior to (illing
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
Rough Mechanical - Prior to
cover.
Rough Electrical - Prior to
cover,
cover,
Electrical Service - Must t)e
approved to obtain Permanent
electrical Power.
Fireplace - Prior to facin0
materials and framing lnsP
Framing - Prior to cover'
Wall/Ceiling lnsulalion - [)rior to
t--1 Finat Mechanica'l - Whcn all
U mechanical wor|,i is complete.
Final Building - Wtren all
reouired insPections have becn
approved and builcling is
cornpleted.
Final Eleclrical - Wlren all
electrical work is oornPlete'
o the alv
[--l OrYwall - Prior to taoing
MOBILE HOME lli.lsPEgrloNs
[--l Wood Stove - A{ter installation
Blocking and Set'UP - When all
blocking is comPlete'
lnsert - Alter firePlace aPProval
and installation of unit'
Curbcut & APProach - Af ter
forms are erected but PrioI to
placement of concrete'
Sidewalk & DrivewaY - After
excavation is comPlete, {orrns
inO suO-nase material in Place'
[--] Fence - When comoleted
!-_-l Srreet Trees - Wh'en all reqr'1ired
I I ir""" are Planted'
kvl?a
Electrical Connecliotr - When
btocXing, set-uP, and Plumbing .
inipu.ti-"n" havd b*n aPProved
un,i th" home is connected to
the service Panel.
required
.pproved and
, decks, and
n installed.
Final - After all
inspections are Pporches, skirtin$,
venting tlave beol
:
E
E
n
E
E
tl
E
[]
r
Plumbing Conlrections - Wllen
nome has been bonnccted to
water and sewerf
Er
Lot faces
Lot sq. ltg.
Lot coverage
TopograPhY
Total height
Lot TYPe -
-
lrrterior
--
Corner
-- Panhandle
.--- Cul-de'sac
Lracks
P.L.HSE GAR ACC
N
J
E.
S THE PROPOSED WORK
-IIISI.ORICAL DISTFIICT, OH ON
TI-IE HISTORICAL REGISTER?
-
lf yes, this application rnust be signed
and aPProved bY t he H istorical
Coordinator prior to permit issuance'
APPRQVE.D:
IN THE
Plan'Check Fee:
--
DatePlans Bevi ewed BY
Recei Pt Numtle
VA EH KcNCPLAEULNGUDLB
MR TEGPDLNBUNAD
he dnatI'rdoconSSlrexedteonpretsIannlslriTSper eancnrdothcnformcoto;1tn rCS l)ecallslrrucronStcon ['r cnCtJLItngedaI1goprCchvbyoedadptofSCoant-)LIrlL'C tiocIIS,rt n(lllc,Cotl rc(l t Iocvel)l]lcD tneaanyl<t:ICVO tJedrloCtrsllpclrnd;1 m;rydbu|lgs,CCSannorddnoofSsiroviofiolonanypUnpo
Date Paicl
Received BY:
BUILDING PERMIT
VALUE
(A)
X $/SO. FTSO. FT.ITEM
Main
Garage
Carp<-rrt
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is clue on all undeveloped
properties within the City limits whicl.r are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
FEE
N
FT.*.@
[:1.
Fi
aet
(c)
-.?5
Plr-rmbing Permit
State Surchargc
Total Charge
ITEM
Fix tu res
Flesidcntial Bath(s)
Stortn Scwcr
Mobile Horne
SanilarY Se
W:rtcr
Woocl Stove/ lnsert / Fi replace Unit
Dryer Vertt
MECHANICAL PERMIT
(D)
NO
Mechanical Pertnit
lssuance
State Surcharge
Total Pcrmit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state atrd agree, that I have caref ully examined
the completecJ application and do hereby certify that all
information hereon is true and correct, and I f urtlrer certif y
that any and atl worl< per{ormed shall be done in accordance
with the OrcJinances of tlre Ci ty of Springfield, and the Laws
of the State of Orcgon pertaining to thc worl< dcscribctJ
herein, ancl that NO OCCUPANCY will be made of any
structure without 1:ertnission of the Building Safety Division'
I further certify that only contractors and ernployees wl'to
are in compliance with OHS 7O1.055 will be lrsed on ll.tis
proiect.
I further agree to ens(lrci that all required inspections are
requestecl at tlre proper tirne, that each address is readable
from the street, that tlrc pcrmit card is locatcrl at the front
of the proporty, illld tlrc::pprovcd set of 1rl;rrr:; will rcIIl'lirl
on the site at al inrcs durinl; co truction
Sign;rturc
Date
MISCELLANEOUS PERMITS
Mobile Hotne
State lssuance
stalo surcharg6
Sidewalk
----
ft
Curbcut =-- ft
Total Miscellaneous Permits (E)
State Surcharge
,w?fr
,AMOUNT RECEIVT--D
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
/6€
I
thc
ti
ADDITIONAL COMMENTS
/5--
FD-1 58
CITY OF OFEGO'U
SPRIhGFIELO
r'tARClLJ, __, l9_L
T0: city of Springfield, a Munic'ipa1 corporation, acting by and thro
Department of Fire and Life Safety
You are.hereby authorized and permitted to burn under supervision and foand instruction purposes that certain house or building iocated on
DEPARTMENT OF FIRE AND LIFE SAFETY
539 SOUTH 2ND STREET
SPRTNGI'IELD, oREGoN 97477
1. The property owner(s) shal
burn within sixty (60) day
of Fire and Life Safety.
2. The property owner(s) is t
permits from the Building
3. 0uts'ide City Limits, Count
4. The property owner(s) shal
includes:
TRAINiNG BURN AUTHORIZATION
emove al I debris on the 1ot(s) involve
fter complet'ion date of the burn by th
470 SOUTH 2ND STREET
225 FIFTH SI8EEI
SPRINGFIELD, OR 97477
(50s) 726-3737
h its
educat i on
are theall liens,
ther person
1y given,
to any
s letter.
y the
s.
d in this
re Department
Tax Lot # crn , in Addition to Sp
Oregon which is designated as Street, Springfiel ,Oregon.
I/I.le, expressly warrant and represent to you that I/we, the undersigned,
owner(s) of said property, and that the same is free and clear of any and
encumbrances, judgments, and any interest, right, title or claim in any o
other than the undersigned, and that this consent is freely and voluntari
and that we will save the C'ity of Springfield harmless from any liability
person whomsoever by reason of any statement or warranty contained in th'i
I/l^le, the undersigned, a'lso agree to the following requirements'imposed b
Department of Fire and Life Safety to assure comp'letion of al1 regulation
IIr
d
ngfield,
lr
SA
o secure the required demol'ition and plumbi
Department when'inside the City Lim'its.
y regulatjons apply.I nave the structure inspected for asbest
a. An internal and external'inspect'ion of the structure by an as
or env'ironmental consulting f irm.
b. Removal of asbestos containing matepials, as indicated by the
firm.
-Non-friable (bound) asbestos may be removed by non-certified
-Friable (unbdund) isbestos must be removed_by. peop'le.certifi
c. The propeity owneilsl shall submit a copy-.of the original asb
inspbction ls written by the 'inspecting f irm.
capng
s. Th is
es tos
inspecti ng
p eopl e.
rd to do so.
rs tos
(so3) 746-846r
PRO