HomeMy WebLinkAboutPermit Demolition 1994-11-17RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
PRINGFIELO
JoB NUMBEa a//?_GE
225 Fif th Street
Springfleld, Oregon gt 417
LOCATION OF PROPOSED WORK:1/Z-s 11. q /4
ASSESSORS MAP:2-a7- ?1-?=TAX LOT:/=oo
LOT BLOCK:SUBDIVISION:
PHONE:
ZIP:STATE:ffirtZ
"1ZCe"'18io
OL
L
iL-
CITY:
ADDRESS:
OWNER:
NEW
-.
REMODEL ADDtrtoN DEMOLTSH -X orHER
Er-a5CrArror-E bDESCRIBE WORK:
ADDRESS PHONE4-sI
\a q S z{-4t-o
CONTRACTOH'S NAME
GENERAL:
EXPIRES
PLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTFIACTOR ,
- oFFtcE USE -
WATER HEATER
ZONING CODE:
LAND USE:QUAD AREA:
E OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS:
--
RANGE:
OCCY GROUP:
'C OF STORIES:
\.
FLOOD PLAIN:
CONSTFI. TYi'E
HEAT SOURCE:
# OF UNITS: __--
To request an lnspecilon, you
made the same worklng day,
must call 726-3769' Thls is a 24 hour recording. All inspections requested be[ore 7:00 a.m. will belnspections reguested after ,'.oo a.m. will be macle the following work day.
REOUI REi.i INSPECTIONS
n Temporary Electrlc Rough Meclranical - prlor to Final Plumbing - When allplumblng work ls complete.cover.
Slte lnspectlon - To be madeafter excavatlon, but prior tosetting forms.
Rough Electrical - prior to Final Electrical - When ailelectrical work is complete.cover-
Underslab Plumblng/ Electrical /Mechanlcal - Prlor to cover.Eleclrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When allmechanical work ls complete.
Footlng - After trenches are
excavaled.f-l Flreptace - prlor to factng
-
materlals and framing lnsp.
Final Building - When allrequired lnspections have beenapproved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng,
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
8 Other
Wall/Celting lnsutation - prlor to
cover.
Underground Plumblng - prlor
to fllllng trench.[-l Drywalt - prtor ro raping
Underlloor Plumblng/ Mechanlcat
- Prior to lnsulatlon or decklng.
MOBILE HOME tNSPE TIONS
Wood Stove - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When altblocklng ls compleie. . '
i'
Plumbing Connections - When
home has been connected to
water and sewer.
Floor lnsulation - Prlor to
decklng.Curbcut & Approaclr - After
forms are erected but prior loplacemcnt ol concrete.Sanltary Sewer - Prior to fllling
lrench.
l-_l Storm Sewer - Prior ro fiiling
-
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Electrical Conneclion - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Water Llne - Prlor to filling
trench.
Fence - When completed
Rough Plumbing - Prior to
cover.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirtlng, decks, and'
ventlng have been installed.
t
f)
E
tf
fltl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typ-
-
lnterior
-
Corner
-
Panhandle
't
-
Cul-de-sac \r
---
P.L.HSE GAR ACC
N
s
W
E
IS THE PFIOPOSED WORK IN THE ,
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved bY the Historlcal
Coordinator prlor to permit issuance.
APPBOVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SO. FT. : VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City . of Springf leld, including the
Develgpment Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordinances.
Receipt Number:-
Plans Reviewed By Date
Plan Check Fee
Date Paid
Received By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT,
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certify that all
lnformation 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 Sprlngfield, 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 OFIS 701.055 will be used on this
proiect.
I further agree to ensure that all required in
requested at the proper time, that each
spections are
Slgnature
Date
it card Ifrom tho street, that the
of the property, and plans will remain
on the site at all ti ctlon.
ls readable
at the frontMISCELLANEOUS PERMITS
Mobile Home
State lssuance
Stato Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
4ra,q/3
TOTAL AMOUNT DUE (exctuding etectricat)
(A, B, C, Q and E Combined)
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
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