HomeMy WebLinkAboutPermit Building 1994-09-011
SPRINGFIELD
ESIDENTIAL
ERMIT APPLICATION
R
P 3So
lnspections: 726-3769
Office: 726-3759
LOCATION OF PBOPOSED WORK:
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon
v72-,(/, /< ! \ Sy'r.-- 4-
ASSESSORS MAP:TAX LOI
SUBDIVISION:LOT BLOCK:
777 6, o'ze>PHONE:9r
ZIP:Qz,<CITY:
ADDRESS:
OWNER:
ADDITION DEMOLISH OTHER/_
2- /(
DESCRIBE WORK:
NEW- REMODEL
PLUMBING:
ELECTBICAL:
ADDRESS EXPIRES PHON E
)
CONTRACTOR'S NAME
GENERAL:
MECHANICA
CONST.
CONTBACTOB #
RANGE:
FLOOD PLAIN
- OFFICE USE -
WATER HEATER;
,+ OF UNITS:ZONING CODE:
QUAD AREA:
I OF BLDGS:
LAND USE:
OCCY GROUP:
* OF STORIES:SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR, TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:OO a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumbing - When attplumblng work ls comptete.
Slte lnspecllon - To be made
after excavatlon, but prlor to
settlng forms.
Rough Electrlcal - Prlor to Final Electrlcal - When all
electrical work is complete.ccover,
Underslab Plumblng/ Electrlcal /
Mechanlcal - Prlor to cover.Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
,k Flnal Buildlng - When all
requlred lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.ffirramlng - Prtor to cover.,?Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng
MOBILE HOME INSPE TIONS
Post and Beam - Prlor to floor
lnsulation or decklng.lnsert - After flreplace approval
and lnstallatlon of unlt.
l--l Btocking and Set.Up - Whep ail
-
blocklng ls complete.
Floor lnsulallon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Ptumbing Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prlor to filling
trench.Electrical Connection - When
blocking, set-up, and plurqblng
inspectlons have been approved
and the home is connected to
the servlce panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base materlal ln place.
Water Llne - Prlor to filling
trench.
Fence - When completed.
Slreel Trees - When all requlred
trees are planted.
Final - After all required
inspectlons are approved andporches, sklrting, decks, andventlng have been lnstalled.
Rough Plumblng - Prlor to
cover.
7 ?1-rq
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# OF BDRMS: ..
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f---l Underlloor PlumbinolMechanicall-J :'P;i;'-i; ;;;;r.tr.";;;;;;,'i;;: l--l wood stove - Arter rnstarratron'
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'it
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total [eight
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
tbac ks .S THE PROPOSED WORK TN THE .
HISTORICAL DISTRIGT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
lEoa-e-
(A)
61D
,Zf----*1t-/,/ zo
X $/SQ, FT. : VALUE
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMTT
ITEM SO. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordlnance
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 Revi By Date
Plan Check Fee:
Date Paid:
Receipt Num
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties wlthin the City limits which are being lmproved.
ITEM
Flxlures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N'
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State_ Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuahce
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do hereby certlfy that all
lnformatlon hereon is true and correct, and I further cerilly
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the pormlt oard ls located at the front
of the property, and the approved set of plans wlll remaln
on the site at all times during construction.
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, Q and E Combined)
// 2-o-+b--'-
2o
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT BECEIVED
RECEIVED BY
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