HomeMy WebLinkAboutPermit Building 1993-05-25Ay
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S}'FlINGFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspectiorts 726'3769
Office: 726'it759
LOCATION ()F PROPOSED WORK:
h,
JOB NUMBER 4 Snzz 7
225 Fifth Street
Springfield, Oregon 97 477
TAX LOT:t4oz-
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o 3 4z-ASSESSORIi MAP: - -
SUBDIVISION
LOT:BLOCK
PHONE
7tPSTATE:
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7 7u77o
oWNER: - TE?J>L 'a/
CITY:
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ADDRESS: J5?7- M
ruEw I - REMoDT:L --- nDDlrloN DEMoLISH orHER
DES()RItsE NORK:
EXPI RES
ul^<eL. Roj ca-u*rlo Gs4 '{t.6 -/f€13t q)oCONTRACT()R'S NAME
G EN F.RAL:
MECHANICAL:
--
PHONE
/ {6 si€yADDRESS
37i)3
CONST.
CONTRACTOB #
_ OFFICE USE -
oCC'/ GRoTJP --
, OF STORIES
RANGE:
FLOOD PLAIN:
ZONING CODE
SECONDARY HEAT:
SOUARE FOOTAGE:
# OF BDRMS:
-="-==.-CONSTR. TYPE:
HEAT SOURCE:
LAND USE:
# OF UNITS
WATER HEATER:
To requcst irn inspection, you must call 726-3769 This is a24hour
made the same working day, inspections requested after 7:00 a m
recording. All inspections requested before 7:00 a'm' will be
will be made the following work day'
REQUIRED INSPECTIONS
TemporarY Electric Rough Mechanical - Prior to
cover.
Rough Electrical - Frior to
cover.
Final Plumbing - When all
plumbing worl( is comPlete.
Site lnspection - To be made
af ter excavatron, but Prior to
setting {orms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover'
Final Etectrical - When all
electrical work is comPlete'
Electrical Service - Must be
approved to obtain Permanent
electrical Power.
Final Mechanical - When all
mechanical work is comPlete.
Footing - Af ter trenches are
excavated.l'--l Fireolace - Prior to facing
U materials and framing lnsp.
Final Building - When all
required insPections have been
approved and building is
completed.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erectr:d but Prior to concrete
placement.
Underground Plumbing - Prior
to lillrng trench.
Underlloor Plumbing / Mechanical
- Pr'or to insulation or decking'
Framing - Prior to cover'
Other
[]Wall/Ceiling lnsulation - Prior to
cover.
E f-l DrYwall - Prior to taoing
MOBILE HOME INSPECTIONS
|_-l Wood Stove - After installation
Post and Beam - Prior to floor
insulirtion or decking'lnserf - After f irePlace aPProval
and installation of unit'
Blocking and Set'UP - When all
blocking is comPlete.
Floor lnsulation - Prior to
decki ng.Curbcut & APProach - After
forms are erected but Prior to
placement of concrete.
Sidewalk & DrivewaY - After
excavation is comPlete, forms
and sub'base material in Place'
Plumbing Connections - When
home has been connected to
water and sewer.
SanitarY Sewer - Prior to filling
trencll.Electrical Connection - When
blocking, set'uP, and Plumbing .
inspections have been aPProved
and the home is connected to
the service Panel.
)ty'=,orn, Sewer - Prior to filling
zlA.itt"n"n.
Water Line - Prior to filling Fence - When comPleted
trenc n Final - After all required
insDeclions are aPProved and
oorches, skirting, decks, and
venting have been installed'Rough Plumbing - Prior to Slreet Trees - When all required
trees are Planted.n covel
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A
OUAD AREA:
* OF BLDGS:
E
fl
E
E E
if
E
tl
r
fl
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
--
Corner
-
Panhandle
-
Cul-de-sac
IS\+IE PROPOSED WOFIK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEN?
lf yes, this apltlication must bo signed
and approved by the Historical
Coordinator prior to permit jssuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
VALUE
(A)
X $/SQ. FT.
Main
Carport
Garage
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
BUILDING VALUE, PLAN CHECK
AN D BUILDING PERMIT
This 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
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinarrces.
Plan Check Fee: __
Fleceipt Number:__
-- oJte--Ptans nlFeweo el
Date Paid
Received By:
/v/*
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is clue on all undevelopecl
properties within the City limits which are being im1:roved.
FEE
{f.oo
7S
(c)€{6
FT.
FT.
Residential Bath(s)
Plumbing Permit
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtu res
N0
Sanitary Sewer
Water
Storm Sewer
Mobile Home
ADDITIONAL COMMENTS
MECHANICAL PERMTT
Fu rnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert / Fireplace Unit
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
By signature, I state and agree, that I have caref ully examined
the completed applicalion and cJo hereby certify that all
information hereon is true and correct, and I f urther certily
that any and all work performecJ shall be done in accordance
with the Ordinances of the City of Springfield, ancl the Laws
of the State of Oregon pertaining to the work clescri bed
herein, and that NO OCCUPANCy will be m;rde of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with OFIS 701.055 will be used on this
project.
I further agree to ensute that all requircd inspectionp are
requested at the proper time, that each acldress is readable
from the street, that the permit card is located at the f ront
of the property, and the approved set of plans r,vill renrain
gnatu
5-JSDate
on the site at ull tl mes ion.g const
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -_- ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VzTOTAL AMOUNT DUE (excluding etectricat)
(A, B, C, D, and E Combined)
<4,79-_-
VALIDATION:
FIECEIPT NUMBER
-DATE PAID
AMOUNT RECEIVED -
5:Z r-"3zr-
ZZ
RECEIVED BY =-=- ,-,
FT. 2ao /