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Home My WebLink AboutPermit Fire 1994-03-28RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 JoB NUMBEa ? /O7a5: 225 Fifth Street Spri ngfield, Oregon 97 477 H LOCATION OF PROPOSED WOHK; ASSESSORS MAP:/ 2-a7- " 9- 2 11 TAX LOT o72aa LOT: BLOCK; PHONE: ZIP:STAT ADDRESS: CITY: OWNER: NEW - REMODEL ADDITION DEMOLISH OTHEFI IDESCRIBE WORK: \4trCHANICAL. ADDRESS EXPI RES PHONE co CO ELECTRICAL: CONTRACTOR'S NAME NST. NTRACTOR # G EN ERAL: PLUMBING RANGE: # OF BDRMS _ OFFICE USE - LAND USE: ZONING CODE: FLOOD PLAIN WATER HEATER: * OF UNITS: SECONDARY HEAT SOUARE FOOTAGE: QUAD AREA: # OF BLDGS OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. Thls ls a24hour recording. All lnspections requested before 7:00 a.m. will be made the same working day, lnspections requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - Prior to cover. f--B Final Plumbinq - When all*'ryFw'z*,y:"ea* Site lnspection - To be made after excavation, but prior to settlng forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumblng I Electrlcal / Mechanical - Prior to cover. Electrical Servlce - Must be approved to obtaln permanent electrical power. Footing - After trenches are excavated.Flreplace - Prlor to faclng materlals and framlng lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, grouting.Framing - Prlor to cover. Foundation - After forms are erected but prior to concrete placement. p other Wall/Ceiling lnsulatlon - Prior to cover. Underground Plumbing - Prior to filling trench.l-l Drywall - Prior to taping. MOBILE HOME INSPECTIONS Underlloor Plumblng / Mechanical - Prior to insulation or decking.Wood Slove - After installation. Post and Beam - Prior to floor insulation or decking.lnsert - After flreplace approval and lnstallatlon of unit. Floor lnsulation - Prior to decki ng.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer. aSanitary Sewer - Prior to filllng trench.Electrlcal Connectlon - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material ln place. Water Line - Prior 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 and porches, skirting, decks, and venting have been installed. SUBDIVISION: E r E fl E E tl E tl tl E E E Final Mechanical - When all mechanical work ls complete. Blocking and Set.Up - When all blocking is complete. Lot faces Lot sq. ftg: Lot coverage Topography Total height Lot Type v - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E THE PROPOSED WOBK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTEFI? - 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, ln 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 vlolation of any provisions of said ordinances. Plans Reviewed By Date Recelpt Numbe Plan Check Fee: Date Paid: Received By: VALUE (A) BUILDING PERMIT.' Total Value Bullding Permit Fee State Surcharge Total Fee SQ. FT. X $/SO. FT.ITEM Main Garage Carport SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Besidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home *UA- c-$o Plumblng Permlt State Surcharge Total Charge /5Po / e7c FEE (c) FT. FT. 8d ,75 PLUMBING PERMIT ITEM -\ror3 -/! l_Flxtures I ADDITIONAL COMMENTS Wood Stove/ Insert/ Fireplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have carefully examined 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 Springfield, 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 Buildlng Safety Division. I further certify that only contractors and employees who are ln 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 ls located at the front of the property, and the approved set of plans will remain Signatu Date on the site at all ti unn ton. MISCELLANEOUS PERMITS Mobite Home s€ie state rssuance i\1+c^-claeJ State Surcharse I e-ile.f.QrC,ttASldewalk ,, Cr, +q O€_ Curbcut -ft -'J f\l/ Demorron 5P rLlnfieq,J, Total Miscellaneous Permits (E) Zaz-State Surcharge lg@ ,@ TOTAL AMOUNT DUE (excluding electrical ffi-/r.29 ? 3^29--)/ t/ AMOUNT RECEIVED DATE PAID RECEIVED BY '*-< VALIDATION: RECEIPT NUMBER Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. FD-158 Z15 III. IHSTREET SPRINGFIELD, OR 97477 (5O3) 726-3737 city of springlield, a Mun'icipal corporation, acting by and through itsDepartment of Fire and Life Safety You are hereby authorized and permitted to burn under supervis'ion and for education and instruction purposes that certain house or bui'lding located on Tax Lot #LL$-AS e4^Nre in f%naJd_&f,k_Addition to springrield, 0regon which is desig nated as rh Street, Springf ie'ld, 0regon. TO: I/We, owner encum other DEPARTMENT OF FIRE AND LIFE SAFETY TRAINING BURN AUTHO RIZATI ON expr es s 1 an t and represent to you t(s) of property, and that the same i bra s, judgments, and any 'interest, r'ig an the undersigned, and that this cons /!,le, the undersigned epartrnent of Fire an Fire and Life Safety. e property owner(s) js t rmits from the Building 3. 0uts'ide City Limits, Count 4, The property owner(s) shal firm. -Non-friable (bound) -Friable (unbound) a c. The property owner(s inspection as writte ,lryt hat I/We, the undersigned, are the s free and clear of any and al l 'liens, ht, title or claim in any other person ent is freely and voluntarily given, I and ny pe on whomsoever by reason of any statement or warranty contained'in th at we will save the C'ity of Springfield harmless from any liabilit ytoa ris let ter. , also agree to the following requirements imposed by the d Llfe Safety to assure completion of al1 regu'lations. I T b o T p he property owner(s) shall remove all debris on the lot(s) involved'in thjs urn'within-sixty (OO1 Oays after completion date of the burn by the Department o secure the required demolition and plumbing cap Department when insjde the City Limits. y regu'lations apply.i naie the struttuie inspected for asbestos. This includes: a. An jnternal and external'inspection of the structure by an asbestos or environmental consulting firm. b. Removal of asbestos contaiiing materials, as indicated by the'inspecting 2 f h e asbestos may be removed by non-certif sbestos must be removed bY PeoP le cert shall dubmit a copy of the ori n by the inspecting fi s\Ct.,rNx!-,D"5 t;}r \t0 SLN j ied people. ified to do so. asbes tos dth.G 0 q tB33e\-1\\('J & \o \ \AS-LO & shciour