HomeMy WebLinkAboutPermit Building 1995-10-27SPRIh.GFIELE,
RESIDENTIAL
PERMIT APPLICATION
lnspections:726'3769
Office: 726-3759
JOB NUMBEB
225 Filth Street
Sprlngfleld, Oregon 97477
LOCATION OF PBOPOSED WORK
ASSESSORS MAP:TAX LOT:
LOT: BLOCK:SUBDIVISION:
To request an tnspectlon, you must call 726.3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
macte the sanre worklng day, lnspections requested af ter 7:00 a.m. wlll be made the followlng work day'
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumblng - When all
plumblng worl< ls complete.
Slte lnspection - To be made
af ter excavation, but Prior to
setting lorms.
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
Footlng - Af ter trenches are
excavated.
Masonry - Steel locatlon, bond
beams, grouting.
Foundatlon - After forms are
erected but Prlor to concrete
placement.
Underground Plumblng - Prior
to {llllng trench.
Underlloor Plumblng/ Mechanlcal
- Prior to insulatlon or decking.
Posl and Boam - Prlor to floor
lnsulation or decklng.
Floor lnsulatlon - Prior to
decl<ing.
Sanitary Sewer - Prior to f illing
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prlor to filling
trench.
Rough Electrical - Prior to
cover,
Electrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and lramlng lnsP.
f-flI Framlng - Prlor to cover.LP)
Wall/Celling lnsulatlon - Prlor to
cover.
l-_l orywall - Prlor to taplng.
Wood Stovo -- After lnstallatlon
lnsert - After flrePlace aPProval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but Prior to
placemont of concrete.
Sidewalk & Drlveway - After
excavation is complote, forms
and sub-base materlal ln Place.
I-_l Fence - When comoleted
Stroet Troes - When all requlred
trees are Planted'
Final Electrlcal - When all
electrical work is complete.
Final Mechanlcal - When all
mechanical work ls complete.
w Flnal Buildlng - When all
requlred lnspectlons have been
approved and building is
completed.
MOBILE HOME INSPE TIONS
Blocklng and Sel-Up - When all
blocklng ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and Plumbing
lnspections have been aPProved
and the home is connected to
the servlce panel.
Final - After all required
lnspectlons are approved and
porches, sklltlng, decks, and
ventlng have been lnstalled.
NEW -- BEMODEL ADDITION DEMOLISH OTHER
ZIP:STATE:
pHoNE: A3/* 2fr2
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
EXPIRES PHON EADDCONTRACTOR'S NAME
CONST.
CONTBACTOR #
GENERAL:
PLUMBING
RANGF.
r OF BDRMS:
- OFFICE USE _
ZONING CODE:
FLOOD PLAIN
WATEB HEATER
SECONDARY HEAT:
SOUARE FOOTAGE:
QUAD ABEA:
, OF BLDGS
CONSTR. TYPE:
HEAT SOURCE:
LAND USE:
, OF UNITS
OCCY GBOUP:
e OF STORIEST
Bough Plumblng - Prior to
cover.
7</7
E
E
E
E
tl
E
tl
E
E
E tl
tl
E
E
E
E
E
[_-l othor
E
E
tr
n
Lot faces
Lot sq. ftg.
Lol coverage
Topography
Total helght
Lot Type _
--
lnterior
--
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
IST HE PROPOSED WORK IN THEHrsToRtcAL D|STRtCL oR ONTHE HISTORICAL REGISTER? .---
ll yes, thls appllcailon must be slgnedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPFIOVED:
BUILDING PERMIT
VALUE
r
(A)
?@,:
z <://
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Plr.t_LD_tNG VALUE, PLAN CHECKAND BUILDING PENUIT
Thls permit is granted on the express condrtion that the sardconstruction slrall, in all respecls, conform to the Ordinanceadopted by the City . of Springfield, inctuOing theDevelopment code, regurating in" "-on"tir"tion and use ofbuildlngs, and may be suspended or revoked at any ilmeupon violation of any provisions of said ordinances.
Plan Check Fee: --_
Dale Paid:
DatePlans Rcviewcd t3y
Received By:
EMS DEVELOPMENT CHARGE (SDC)
(B)
SYST Systems Developmcnt Charge ls due on all undevelopedproperties wlthin the City limits which are being improved.
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
FT.
(c)
Plumblng permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical permit
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state ancj agrss, that I have carcf ully examlnedthe completed application and do hereby certify that alllnformatlon hereon is true ancl correct, and t f urther certlfythat any and all work performed shall be done in accordancewlth the Ordinanccs of thc City of Sprlngf ield, and the Lawsof the state of oregon pertalnrng to thc work describedherein, and that NO OCCUPANCy wiil be macje of anystructure without perrnission of the Building Safety Divislon.I further cerilfy that only contractors and employees whoare ln compliance with OFIS 7Oj.O55 will be used on thlsprolect.
I further agree to ensure that all requlred Irequested at the proper t{me, that each
and the approved set of plans will remaln
Date
con c@t
nspections are
address ls readablefrom the street, that the pe rqlt card ls located at the frontof the
on the slte I ti du
Slgnature
MISCELLANEOUS PERMlTS
Moblle Home
State lssuance
State Surcharge
Sldewalk -.._-- lt
Curbcut
--
ft
Demolitlon
State Surcharge
Total Miscellaneous permits (E)
TOTAL AMOUNT DUE (exctuding etec(rlcat)(A, B, C, D, and E Comblned) '
/?
DATE PAID ./2 ^.r
AMOUNT BECEIVED
RECEIVED BY
2
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vAtroatrotr:
RECEIPT NUMBER