HomeMy WebLinkAboutPermit Building 1992-04-09LOCATTON OF PROPOSED WORK: --Ql=---LJa-c-rr*- 5 I tt
SP'r FIELD
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SUBDIVISION
ASSE.SSORS MAP
RESIDENTIAL
PERMIT APPLICATION
In:i ;rect ions: 7?6'3769
0flice: 720.3/59
JoB NUMBE R3z-o59:b---
225 Flfth Street
Sprlnglleld, Oregon 97477
LOT ___ _
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A DD R ESS: -_%.T E --.N}-A-TTS-L
PHONE: .,
ZIP:STATE: 6(-
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NEW _--_ REMODEL ADDITION DEMOLISH OTHER
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PLUMBING:
ELECTRICAL: -
PHONEEXPIRESADDRESS
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MECHANICAL:
CONTRACTOR'S NAME
CONST.
CONTRACTOR #
OUAO AREA:
r OF BLDCS:
OCCY GROUP:
I OF STO]IIES:
WATER HEATER RANGE:SOUARE FOOTAGE
FLOOD PLAIN:
I OF UNITS:
_ OFFICE USE -
ZONING CODE:
r OF BDRMS: -..
SECONDARY HEAT:
CONSTR. TYPE: --- --.
HEAT SOURCE: --
LAND USE:
To request an inspection, you must call 726-3769. This ls a24hour recording. All inspections requested be
rnacte the same working day, inspections requested after 7:oo a.m. will be made the following work day'
REOU!RED INSPECTIONS
TemporarY Electric
Site lnspection - To be made
after excavation, but firior to
setting fornls.
Underslab Plumbing/ Electrical /
Meclranical - Prior to cover'
Footing - Af ter trenches are
excavated.
Masonry - Steel location, bond
beafits, grouting.
Founclalion - After (orms are
erected but Prior to concrele
placetnent.
Urrderground Plumbing - Prior
to (illing trenclt.
Underlloor Plumbirrg/ Mechanicat
- Prior to insulation or decking'
Post and Beam - Prior to floor
insulation or decking
Floor lnsulalion - Prior to
decki ng.
Sanitary Sewer - Prior to filling
t renc h.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbitrg - Prior to
cover.
Rough Mechanical - Prior to
cover.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain Permanent
electrical Power.
Fireplace - Prior to facing
materials and framing lns1t.
Framing - Prior to cover-
Wall/Ceiling lnsulation - Prlor to
cover.
fore 7:00 a.m. will be
Final Plumbing - When all
plumbing work is comPlete.
Final Electrical - When all
electrical work is comPlete.
Final Mechanical - When all
mechanical worl< is comPlete'
Final Building - When all
required insPections have been
approved and building is
completed.
Other -_--_.--.
l--l Drywall - Prior to taoing
l-l Wood Stove - After installation
lnsert - After fireplace approval
and installation of unit.
Curbcut & APProach - Af ter
forms are erected but Prior to
placement of concrete.
Sidewalk & DrivewaY - Af ter
excavation is comPlete, forms
and sub-base material in Place.
l--l Fence - When comoleted.
Street Trees - When all required
trees are Planted.
MOBILE HOME INSPE TIONS
Blocking and Set'UP - Wlten all
blocking is comPlete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set'uP, and Plumbing
inspectaons have been aPProved
and the home is connected to
the service Panel.
tl Final - After all required
inspections are aPProved and
porches, skirting, decks, and
venting have been installed.
fl r
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tl
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L_lr
E
r
r
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total height
Lot Type S tbacl<s
PL.HSE GAB
N
J
ACC
lnterior
Corner
Panhandle
Cul-de-sac
E,
,S THE PROPOSED WORK IN THE
-HISTORICAL DISTBICT, OR ON
THE HISTORICAL REGISTEB?
-
lf yes, this application must be signed
and aPProved bY the H istorical
Coordirlator prior to permit issuance'
APPFIOVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grantcd on the express condition lhat the said
consiruclion shall, in all respects, conform to the C)rdinance
adopted by the City of Springfield, irrclr'rding tlte
Developrrent Cocie, regtrlating tlre construction antl ttse of
buildings, an<J may bo suspenclecl or revoketl at any time
upon violation of any provisions of said ordinarrces'
DatePlarrs Rcvicwed [3Y
Plan Chcck Fce
Date Paid
Receipt Nutrbcr:
Receivecl BY
VALUE
6,o
(A)_Lb'3?-
fr
____,b?>_.
loQe--!':
BUILDING PERMIT
Total Value
Builrling Pcrnrit [:cc
St;rte Surchargc
Total Fec
SQ. FT. X $/SO, FT.ITEM
Main
Garage
Carport
Systems Developrrtcrrt Charge is clue on all undeveloped
properties within the City lirlits which are being improvecl'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Hotne
'SOlf-!rgtg-iA!*f-
Plumbing Permit
State Sr.trcharlle
Total Ch;rrge
PLUMBING PERMIT
FEE
(c)
N0
FT.
FT.
FT. :-D
j5.oP
-4r:o-r
---'l ta-t
42. ao
Woorl Stove/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certi{y that all
information hereon is true and correct, and I f urther certif y
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Laws
of the State of Oregon pertaining to the work described
trerein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division'
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all requircd inspections are
requested at tl-re proper time, that each address is readable
from the street, that the permit card is located at the front
Date
o fnaSi
of tlre propertY,arrcl t
+ ->
d sct of 1'll:rn:; will retrtaitr
ction.d u ringon the site at all ti
MISCELLANEOUS PERMITS
Mobile Home
Stale lssuance
State Surcharge
Sidewalk .- -- ft
Curbcut
----
ft
Demolition
Stale Surchargc
Total Miscellaneous Perrnits (E)
VALIDATION:
RECEIPT NUMBER - q}=EEL
DATE PAID
AMOUNT RE,CEIVED
RECEIVED BYTOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q ancl E Combined)
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