HomeMy WebLinkAboutPermit Demolition 1994-05-24SPFrI}tGFIELt)
t,.ESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759 ?fr,
JoBNUMBE" 2/a>-3
225 Fifth Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WORK:p
ASSESSOBS MAP:12 ^a ) -aG 1Z q TAX LoT; -Z Elcz*,
LOT BLOCK:SUBDIVISION:
e-1 ZIP:STATE:
PHONE:
CITY:
ADDRESS:
OWNER:
DEMOLTSH =w OTHER
DESCRIBE WORK:
NEW
-
BEMODEL ADDITION
PLUMBING:
MECHANICAL: '
ELEfiRICALT
ADDFIESS EXPIRES PHONECONTRACTOR'S NAME
GENEBAL:
CONST.
CONTRACTOB #
RANGE:
r OF BDRMS:
- oFFrcE usE -
LAND USE:
WATER HEATER:
FLOOD PLAIN:OUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
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 working day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
l--l femporary Etectrlc Rough Mechanlcal - Prlor to
cover.
Final Plumbing - When all
plumblng work ls complete.
Slte Snspectlon - To be made
after excavatlon, but prlor to
setting forms.
Rough Electrical - Prior to Final Electrlcal - When all
electrlcal work is complete.cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When all
mechanical work ls complete.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Flnal Buildlng - When all
requlred lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
[Zl other
Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plumbing - Prlor
to fllllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcat
- Prlor to lnsulatlon or decklng.Wood Stove - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulalion - Prlor to
deckl ng.Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanitary Sewer - Prlor to fllling
trench.Electrlcal Connection - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home is connected to
the servlce panel,
Storm Sewer - Prlor to fllling
trench.
Sidewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base material ln place.
Water Line - Prlor to filling
trench.[--l Fence - When completed.
Street Trees - When all requlred
trees are planted.
Flnal - After all required
Inspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled,
Rough Plumbing - Prlor to
cover.
6***6-Q.f
E*4e>,<A*7
ZONING CODE:# OF UNITS:
-
E
E
tl
[-l Underslab Plumbing/ Electrlcal/lJ Mechanlcal - Prior to cover. I I
l-l Footlng - After trenches areU excavated.tl
E
E
E
E
tl
E
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type <
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
W
E
THE PROPOSED WORK IN THE -
-xrsrontclL Drsrnrcr, oR oN
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
(A)
X $/SQ. FT. = VALUE
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Maln
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
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
bulldings, and may be suspended or revoked at any time
upon vlolation 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 being improved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
No
r76,
,20
FEE
Fr./47
FT.
ua
(c)
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fl replace Unlt
Dryer Vent
(D)
N0Vent Fan
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordlnances of the City of Springfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlil be made of any
structure wlthout permission of the Building Safety Division.
I further certify that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thls
prolect.
I further agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls readable
lrom the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
Slgnature
Date
on the slte mes durlng ructlo
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
VALIDATION:
RECETPT NUMBER / ?a-
DAMOUNT RECEIVED
RECEIVED BY
DATE PAID
I
/f
FT,
+?r.?e/