HomeMy WebLinkAboutPermit Building 1995-09-09RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.3769
Offlce: 726.3759
SPRTNGFTELD
JoBNUMBEa@
225 Flf th Street
Sprlng f leld, Oregon g7 4ZZ
LOCATION OF PBOPOSED WOBK:L3o il"ttk
ASSESSORS MAP:/?)'TAX LOT:
LOT;BLOCK:SUBDIVISION:-
PHON E:
6\
J
),{L-6rzc
STATE:oe,ZIP:?1CITY:S {71
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHEB
-
I
it4{e'I €DESCRIBE WORK:Cc.a ^'4
ADDRESS EXPIRES PHONECONTRACTOB'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOB #
GENERAL:
PLUMBING
* OF BDRMS:
- OFFICE USE -
LAND USE:
WATER HEATER:
FLOOD PLAIN:
RANGE:
QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUABE FOOTAGE:
OCCY GBOUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOUBCE:
# OF UNITS:
---
To request an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. All Inspectlons requested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Electrlc
Slte lnspeclion - To be mado
after excavatlon, but prior to
setting forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavat6d.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement,
Underground Plumbing - Prlor
to fllllng trench.
Underltoor Plumblng/ Mechanlcal
- Prlor to, lnsulatlon or decklng.
Post bnd Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulation 4 Prior to
decklng.
Sanltary Sewer - Prlor to f llllng
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filllng
trench.
Rough Plumbing - Prior to
cover.
Rough Mechanlcal - Prlor to
cover.
Rough Electrlcal - Prlor to
cover.
Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power,
Final Electrical - When allelectrical work is complete,
Flnal Mechanical - When all
mechanical work ls complete.
Othor
MOBILE HOME INSPECTIONS
l-] Flreptace - Prlor to factngu materlals and framlng lnsp.
W fr^ tng - Prlor to cover.
Wall/Celllng lnsulallon - Prlor to
cover.
|*-l Drywall - Prlor to taping,
Wood Stovo - After lnstallatlon
lnserl - After flreplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prlor toplacement of concrete.
Sldewalk & Drlvewav - After
excavatlOn ls complete, forms
and sub-base materlal ln place.
Fence - When completed.
Street Trees - When all requlred
trees are planted.
[-_l Blocklng and Set.Up - When ail* blocklng ls complete.
P.lumbing Connectlons - When
home lras been connected to
Water and sewer.
Electrlcal Connection - When
blocking, set.up, and plumblng
lnspections have been approved
and the home is connected to
the servlce panel,
Final - After all required
inspections are approved andporches, skirting, decks, and
ventlng have been lnstalled.
i.,
ZONING CODE:_
l--l rlnal Plumbing - When ail'J plumblng worl< ls complete.
fl
fl
[-l Final Building - When ail
'J requlred lnspectlons have been
approved and buildlng is
completed.
tf
tl
PL.HSE GAR ACC
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot T1
- lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgnedand approved by the Histarlcal
Coordlnator prlor to permit lssuance.
APPROVED:
VALUE
,b-
(A)
X S/SO. FT
Garage
Carport
Total Value
Buildlng Permit Fee
Slate Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condiilon that the saldconstruction shall, ln all respects, conform to the Ordinanceadopted by the City of Sprlngfletd, inctuding theDevelopment Code, regulating the constructlon and use ofbuildlngs, and may be suspended or revoked dt any tlmeupon violation of any provisions of sald dydlnances.
Plan Check Fee: _
Recelpt Number:_
Plans Reviewed By Date
Date Pald
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge is due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MECHANICAL PERMTT
(D)
N0
Mechanlcal Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlnedthe comploted applicatlon and do hereby cerflfy that alllnformatlon hereon ls true and correct, and I f urther cerilfy
that any and alr work performed shail be done in accordance
wlth the Ordinances of the City of Springfield, and the Lawsof the State of Oregon pertalnlng to the work descrlbedhereln, and that NO OCCUPANCy wlll be made of anystructure without permlssion of the Bulldirrg Safety Divislon.I further certify that only contractors and employees who
are ln compliance with ORS 7O1.O5S wlll be usec, on thlsprolect.
I further agree to ensuro that all requlred lnspections are
requested at the proper ilme, that each address rs readabre
from tho street, that the permlt card ls located at the frontof the property, and the approved set of plans will remaln
non the site at all es du St rU
Slgnatu
Date S.-s-25
MISCELLANEOUS PERMITS
Mobile,Home
State lssuance
Slato Surcharge
Sidewalk --- ft
Curbcut
--
ft
Demolltlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctudtng etectricat)
(A, B, C, D, and E Combtned)
2AAMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
DATE PAID
l;'t
FT.