HomeMy WebLinkAboutPermit Building 1999-04-12INGFRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WOBK:i Al PL.-
JOB NUMBER
225 Fifth Street
Sprirrgfleld, Oregon 97
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ASSESSORS MAP:l7 olt s>(0 oDTAX LOT
LOT
-
BLOCK:SUBOIVISION
0 PHONE:s
S I STATE:
7rt 7- €{/ 7
ZIP:
3ad
4*//
01/L
OWNER:
ADDRESS:
CITY:
NEW- REMODEL DEMOLISH OTHER
DESCRIBE WORK:
/.1,r C
3,}ADDRESSCONTRACTOR'S NA
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
coNST. t A 44
CONTRACTOR #
At t ENT I o N : ur86ErAEi,YE6.,-r res yo u to
followunles affitgq !$1e9l99on t{lly
Notification Center. Those rules are sGtlorth
in OAR $ffffi t[Sffi5ffigh€rAR€52401 -
00e0. yoo r646ebt$E: cg!99 qllglugx bv
callino the center. (Note: the telephone
numoBFbI fiBt{SrQfton-ut+ittl'tetitieatien
is 1-800-332-2341').
r OF BDRMS:
WATER HEATER:
FLOOD PLAIN:QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
r OF STOBIES:
ZONING CODE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be ma<Je the followlng work day.
REQUIRED INSPECT!ONS
n femporary Electrlc Rough Mechanlcal - Prlor to
cover.
Final Plumblng - When all
plumbing worl< ls complete.
Slte lnspectlon - To lre made
after excavatlon, but prior to
settlng forms.
Underslab Plumblngl Electrlcal /
Mechanlcal - Prlor lo cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to lloor
lnsulatlon or decklng.
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prior to fllling
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filling
trench.
Rough Plumblng - Prlor to
cover.
I--l SiAewall< & Driveway - After
'J excavation ls complete, folms
and sub-base materlal ln place.
Rough Electrlcal - Prior to
cover.
Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and lrami ng lnsp.
lng - Prlor to cover.
Wall/Celling lnsulatlon - Prlor to
cover.
Wood Stovo - After lnstallatlon.
lnserl - After flreplace approvql
and lnstallatlon of unlt.
Curbcut & AJrproach - After
forms are erected but prior to
placement of concrete.
Fence - lVhen coirrpleted.
Streel Treos - When all requlred
trees are planted.
Final Electrlcal - When all
electrical work ls complete.
Final Mechanlcal - When all
anlcal work ls complete.
nal Bulldlng - When all
required lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumtring Connectlons - When
home has been connected to
water and sewer.
Electrical Connectlon - When
blocklng, set-up, and plumblng
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
fl
E
E
I
E
tl
Drywall - Prlor to taplng.
rl
tl
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total height
Lot Type \-.
-
lnterior
-_
Corner
,.- Panhandle i
-
Cul-de-sac
backs ;
-J
THE PROPOSED WORK TN THE .
HISTORICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
-
l, yes, this applicatlon must be slgned
arrd approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
BUILDING PERMIT
VALUE
tq;7
(A)
SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
*
X $/SO. FT.
" r).
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pernrit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld, includlng the
Development Code, regulating the constructlon 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:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are belng lmproved.
ITEM
Fixtures
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N'
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
- FT.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I further 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 pertainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Buildlng Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.05S wlll be used on this
proiect.
I further agree to ensure that all required lnspections 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
cng n.times durl
Slgnatu
Date
on the site at
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
lt
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
NoVent Fan
(D)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Comblned)
RECEIPT N]
DATE PAID
AMOUNT R
RECEIVED
3) L/6 7
4
6.
BY
VAl-IDATION:
UMBER
ECEIVEO