HomeMy WebLinkAboutPermit Building 1992-06-02RESIDEf\ii IAL
PERMIT APPLICATION
lnspections: 7:'0-3769
Oflice: 726'311")
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ION Ot' I)BOPOSI:D WORK:- A^f
ASSESSoRS MAP:- /723- ss--lz -
LOT:BLOCK:
JOT] NUMBER
225 Fllth Street
Spri nO lield, Oreg<:n 97 477
,fere t/< n rl D
TAX LOT:
-A-522O
_
SUBDIVISION:---.--__
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Irr,M()t)t t A= At)t)l'tloN DEMOT'l{ltl -- oTHER - -
PHONE:a)3P z-
Sra @L
-'
e b *rc<Zil4o-Ztttt z D..-,-OWNER
eoonEss; I OR
r7r q
S'[ATE:
-*CITY:
NF,W
DESCRTBF:, vvc)nK: fllct-aS t -
l,t toNt'EXPIREIIn t)DtlF-:;s
CONST.
CONTRACTOR C
CON TFIACIOII :J NAN,1I]
t--
dEruEttnL, (-
PLL'MBINC,
MECHANICAI
ELECTRICAL:
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS: -.-
--
SECONDARY I-IEAT
SOUARE FOOTAGE:
QUAI] A[I1:A:
# OF iILDC.S
OCCY GIIOUI'
s Ot :iTOlllt .
WAf t:ll tlt:AIr ll
- OFI'ICE USE _
LAND USE: -
CONSI R. TYPE:
l-IEAT:lOURCt'
BANGE: --
To request .rn irrspectioll' you must call 726'3
lnaclr-'the sillrrlr worklng <Jay' inspections re(l
769. Ttris is a 2'1 lrour
Lreste(l alter 7:00 a'nt'
REOUIRED INS
| | lcntuor;'Irv Elccrti(: I
-l |;J::t
Meclrirtric:rl - l'rior to
I' lsitc lrr:.licctioll - lt) llc trr'rtlt: I lRotrOh El<'etricirl - Ptttlr to
L I .1;i.,':;,'.;"1,ii,,,,, t,',t 1.,r"" t'' I r "o'"r
scttrltO l 'lllls
i--l Under sl.rlr Plunrbirrg/ Electrical /
Meclralrical - Priot to covt:r'
I - I Electrical Service - Must be
t -l ;pl)roved lo obtain perrilanent
recorcling' All inspections requested before 7:00 ;'r tn will lte
will be made the followir.rg work day'
PECTIONS
Final Plumbirrg - Wtrorr :tll
1-rltrttrlling wclt I is t:ott t1 rlt:tt-''
F- -l Final Electric:rl - Wlr.rl :rll
L-J,'1""1,1aa| wutI' is colrrl'l.t(''
l--'_l Final Mechanical - Wllr;n all
I | ,r,oclranical wttr[< is cr,trtplett:.
Final Building - Wht:rr all
ieouireO inspuctions llirv(: b('r:r I
approved and building ts
comPleted.
n
Footirrg - Af tcr trenches are
€X(l?V3tl' l'
MasonrY - Stcel localiorl' bond
beatns,,lrouting'
Foundation - After fornts ;rre
ui""toct l;ut Prior to concrete
Placenl (,11t.
Underground Plumbing - Prior
to fillirlg trenclr'
Underlloor Plumtringl Mechanical
:';',;;,- to instrlatiorr or tlecking'
Posl an(l Beam - Prior t<i floor
' nsUl -it i(ll1 or ctrlr:lit ttg'
l--l FirePlace - Prior to facing
I I m.rlrtals irncl framing lnsP'
FFraming
-' Prior to cover'
eler;trical Power'
WalttCeilirrg lnsulation - Prior to
cover.
Other
--
nt
L]
LJ
tl
tl
I orvwall - Prior lo taping'
IJ Wooa Stove - After installation'
lnsert - Af tcr f ireplacc approval
an(l lnstall,tliorr oI unit'
Curbcut & APProach - After
ioi,,l" "tu erectecl t)ut Prior to
placement o[ colloretc'
I --l Sidewalk & DrivewaY - ff te1
I --l ;;;;;;tiorr is conrplete' fornts
and sub-bl':;c ttlatcrial irr Place'
l--l Fence - Wlten comPleted'
MOBILE HOME INSPE TIONS
l---l Blocking anct Set'Up - Wlturr
t I hlocking is cornPlctc
t-' I Plunrbing Cotrrlectiorls ._ Wlrt:rr
| | ito,a" tras lre cn collll(:(:lt:(l lo
water and sewcr'Floor ltl:;ulatiorr - Prior to
det: I'i tl,1
SanilarY Sewer -- Prior to filling
trL:llcll
Stottrt Suwer -- ['r l()r to lilllrl0
tIctl(lll.
Waler l-irle - I'rior to fillittg
trenc lt.
Rough I)lumbirrg - Prior tcr
COVOI,
I]
Streel Trees - When all required
trec's are [)larrted'
Electrical Connectiorl - Wtictt
iri".xi,.lg, set-trl)' atrtl lrlurrtbitt<1
,rianaati,jnt lt'tve bc'"tr'rl'provt:(l
,riJ ,r," ltornc is colllrr':(;tu(' t(r
the service parlel.
Final - After all reqtriretl
insoections are aPPluv(i(l an(l
""iino", skirting, docl<s' and
iuniing havt., treen in:;tirllucl'
rl
tl
zv,QHJ -c/os 6
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typr \/
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
ACC
IS THE PROPOSED WORI( Ti THE
}]ISTORICAL DISTBICT, OR ON
THE H ISTORICAL REGISTER?,_---
lf yes, this application musl be signed
arrcl approved by thc llistorical
Coor<lirrator prior to peilnit issuance.
APPROVED:
P.L.HSE GAFI
N
S
E
VALUE
_/5r(A)
@
5.@
X $/SQ. FT.
BUILDING PERMIT
ITEM SO. FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condilion that the said
construction shall, in all respects, conform lo tlre Ordinance
adopted by the City of Springfield, inctuding the
Development Code, regulating the construclion and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordirrances.
Receipt Number:_ _ -
Plans Reviewed By Date
Date Paid
Received By:
PIan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developnrent Charge ls due on all un(,eveloped
properties within the City lirnits which are bcir.rg irnproved.
ITEM
Fix t u res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state ard agree, that r have caref uily exanrinedllre cornpleted application an<.1 do horeby r;r:rtity th;rl allinformation hereorr is lrue and correct, ancJ I f urilter certif y
that any and all work pcrformecJ shall be clone in accordance
with the Ordinances of ilre City of Springfielcl, an(, the Lawsof the State of Orcgon pertaining to the worl< rJescribc<lherein, and lhat NO OCCUPANCy will be rrr;.rdr: of anystructure without permission of the Building Safety Division.I further certify that only conlractors and ernployees whoare ln compliance with OFIS 701.055 will be trsecj on lhisproject.
I further agree lo ensure that all required inspections arerequested at the proper time, that each address is reada
trS n
gn
fpl lre
on lhe site
Date
from the street, that t ard is locateci a f rontof the property,app
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _-_.-- ft
Curbcut ==-=-- ft
Demolilion
Slate Surcharge
Total Miscellanoous permits (E)
TOTAL AMOUNT DUE (excluding el6ctrtcal)(A, B, C, D, and E Combtned)
29
VALIDATION:
RECEIPT NUMFsER
DATE PAID
AMOUNT RECEIVED
L 5
7t
RECEIVED BY --.
,
,75-
Permit No:a./12 I
Address:/<,4-/,64.
lssued b Date:
R OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTTON RESPONSIBILITTES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permitapplicants who are not registered with the Construction Contractors Board tosign the following statement before the building permit can be issued. This state-ment is required for residential htrilding, elec[rical, mechanical, and plumbingpermits. Licensed Architect and Engineer applicants, exempt from registratiot
under ORS 701.010(7), need not submit this statement. Thib statement wilt befiled with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
I own, reside in, or will reside in the completed structure.
aftz
1
2
3 A
I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
My general contractor is ,
Contractor reqistration number-.
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B..El I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. lf I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the office issuing this building permit of the name of
the contractor.
I hereby certily that the above informatio and that I have read and understand
the lnform Property about Construction Responsibilities on the
reverse side is
/2L
ignature Permit licant e
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE @PY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT