HomeMy WebLinkAboutPermit Building 1992-01-16SPRINGFIELE,q,tU.UAe
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBEFI
225 Fifth Street
Springfield, Oregon 97 477
LOCATION OF PROPOSED WORK:
ASSESSOFIS MAP:t7.o>-<-B TAX LOT:.8,?46
LOT:BLOCK:SUBDIVISION
OWNER
ADDRESS
CITY:STATE:ZIP:
DESCRIBE WORK:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
TRACTOR'S NAME ADDRESS
CONST.
CONTRACTOR #EXPIRES PHONE
ENERAL:
PLUMBING:
MECHANICAL:
-
ELECTRICAL:
-
_ OFFICE USE _
QUAD AREA:
# OF BLDGS
LAND USE:FLOOD PLAIN
* OF UNITS:ZONING CODE:
OCCY GFIOUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
* OF BDRMS:
WATER HEATER:RANGE:
SECONDAFIY HEAT
SQUARE FOOTAGE;
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
l-l Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When allplumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
Foundalion - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling Insulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.f_l Drywall - Prior to taping
MOBILE HOME !NSPECTIONSUnderlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decking.Curbcut & Approach - After
forms are erected but prior toplacement of concrete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Water Line - Prior to filling
trench.[-l Fence - When compteted.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.
5 ir *- ( ?4 ;f - PHoNE: za4-a-<2?
4^i -?
r
E
ilr
E
E
E
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typt V
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L HSE GAR ACC
N
S
E
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
BUILDING VALUE, PLAN CHECK
AND 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 ordinances.
Plans Reviewed By
F
Date
Receipt Numbe
PIan Check Fee
Date Paid
Received By:
VALUE
42Hw
(A)/<--
X $/SO. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
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
herein, 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
project.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the f ront
of the property, and the approved set of plans will remain
on the site all ngimes duri construction.
Signatu
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
qv;3 6
DATE PAID /-,/Z-2 2
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
COIJRTESY INSPBCTION APPLICATION
(RENTER REQUEST)
CITY OF SPRINGPIBLD BUII,DING DIUTSION
================================================================================
DATE:?-JOB NUMBER:
ADDRESS IN
OI.INER:PHONE NUMBER:
OUNER'S ADDRESS:<J:{}-t ."r
RENTER:
STGNATURE 0F occuPANT (RENTER ):
FOR ACCESS TO PROPERTY _
a
TYPE OP DIIELLING:STNGLE FAMILY
BRIEF DESCRIPTION OF MAJOR PROBLEMS:
PHONE NUMBER:
1a &
I *l
B[. DUPLEX n MULTIPLE I
'7 a
6-
FOR OFTICE USE ONIY
COURTESY LETTER SENT:
DATB OF INSPECTION:
DATE FOR COMPLIANCE:
COI,IPLIANCE OBTAINED
NOTICE AND ORDER I SSUED TO
- DATE:
OVNER:
ffi wtbrk
NUMBER:
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