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Home My WebLink AboutPermit Demolition 1997-02-12RESIDENTIAL PERMIT APPLICATION lnspections: 726.3769 Off ice: 726.3759 SPFlINGFIELD JOB NUMBER 2 ?z 225 Fif tlr Street Sprlngf lelcI, Oregon 97477 LOCATION OF PFIOPOSED WORK:/3 2, /22 4z ASSESSOFIS MAP:/zQV -z f^z/TAX LOT 26a22 LOT:BLOCK:SUBDIVISION PHON E STATE:ztP DE HE * K: R I ADDI 2>4 LISH CITY: ADDRESS OWNER AME ADDRESS EXPI RES PHON E CONTRACTOR' MECHANICAL: ELECTRICAL: GENERAL: CONST. CONTRACTOR # BANGF-: E OF BDRMS: _ OFFICE USE _ LAND USE: ZONING CODE: r:LOOD I)LAIN HEAT SOURCE: OUAD AREA: * OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE:WATER HEATEB: OCCY GROUP: N OF STORIES: # OF UNITS: _ CONSTR. TYPE: __ To request an lnspectlon, you must call 726-3769. Thls ls a24 hour rccordlng. All lnspections requesrecl before 7:00 a.m. wlll bemadethe same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following worl< day. REQUIRED INSPECT]ONS l-l Temporary Electric Rough Mechanical - Prlor to cover. Final Plumbing - When allplumbing worl( is complete. Slte lnspectlon - To be madc af ter excavatlon, but prior to settlng forms. Rough Electrical - Prior to Final Electrical - When all electrical worl< is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover.Electrical Service - Must be approved to obtalrr perrnanent electrlcal power. Final Mecharrical - When all mechanical worl( ls cornplete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng materlals and f raming lnsp. Flnal Building - When all required lnspectlons have been approved and building is completcd.Masonry - Steel locatlon, bonci beams, groutlng.Framlng - Prlor to cover. Foundatlon - After forms are erected but prior to concrete placement. ffi ornar Wall/Celling lnsulation - Prlor to cover, Underground Plumblng - Prior to fllllng trench.Drywall - Prlor to taplng MOBILE I.IOME INSPESTIONSUnderlloor Plumblng/ Mechanical - Prlor to lnsulatlon or decklng.Wood Slovo - After lnstail;rtion Post and Beam - Prlor to floor lnsulatlon or decklng.lnsert - After flreplace approval and lnstallatlon of unlt. Blockirrg and Sel.Up - When all blocl(lnq is cornplete. Floor lnsulation - Prior to decklng.Curbcul & A[:trrroach - Af ter forms are erected but prior to placemcnt of concrete. Plumbing Connections - When home has been connected to water anCl sewer. Sanilary Sewer - Prior to filling trench. t Storm Sewer - Prior to filling trench. Sidewalk & Driveway - A{ter excavation ls completc, forms and sub-base material in place. Eleclrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Waler Line - Prlor to filling trench. Fence - When completed. Street Trees - When all required trees are planted. Final - Af ter all rcquired inspeclions are approved andporchcs, sl(irting, decks, and ventlng have been lnstalled. Rough Plumbing - Prlor to cover. PLUMBING: tf il E E tl tl E E E E fl fl fl E tl E E tl Lot faces Lot sg. ftg. Lot coverage Topography Total helght Lot Type - lnterior -- Corncr - Panhandlc - Cul-de-sac Se .- THE PROPOSED WORK iN THE , , HISTORICAL DISTFIICT, OR ON THE HISTORICAL REGISTEFI? - ll yes, this applicatlon must be slgned and approved by the Historlcal Coordinator prior to permit issuance. APPROVED HSE GAR ACCP.L. N S E VALUE (A) X $/SO. FT, Main Carporl Garage Total Value Building Permit Fee State Surcharge Total Fco BUILDING PERMIT ITEM SO. FT. BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the cxpress condilion thal the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, includlng 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 Reviewcd By Date Receipt Numbe Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City lifilits which are being improved. FEE (c) NN FT. FT, FT, Rcsidential Bath(s) PLUMBING PERMIT Plumblng Permit State Surcharge Total Charge Sanitary Sewer Water Storrn Sewer Mobile Home ITEM Fixtures ADDITIONAL COMMENTS Wood Stove/ lnsert/Fircplacc. Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnacc Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned tlre completed application and do hereby certify that all lnformation hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance with the Ordinanccs of thc City of Springfield, and the Laws of the State of Oregon pertainlng to the work descrlbed herein, and that NO OCCUPANCY will be made of any structure without perrnission of the Building Safety Division. I further certify that only contractors and employees who are ln compliance with ORS 701.055 will be used on thls proiect. I (urther agree to ensure that all requlred inspections are requested at the proper time, that each address ls readable from the street, that the permit card ls located at the front of the property, and the approved set of plans will remain onon the site at d u ring Slgnatu. Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk - ft Curbcut -- ft Demolltion State Surchargc /2%-Total Miscellaneous Perrnits (E) TOTAL AMOUNT DUE (excludinq clectrical) (A, B, C, D, and E Combincd) ?',/-2.27 ? DATE PAID VALIDATION RECEIPT NUMBER AMOUNT RECEIVED RECEIVED BY ,/8,nE_:B RESIDENTIAL PERMIT APPLICATION lnspectlons: 726-3769 Office: 726-3759 LOCATION OF PRO ED ASSESSORS MAP: LOT: SP FI efr, JOB NUMBER 225 Fif th Street Springfleld, Oregon 97 477 TAX LOT SUBDIVISION: - 7 BLOCK: OWNER: ADDRESS: CITY: PHONE STATE:ZIP: NEW - BEMODEL ADDITION DEMOLISH DESCRIBE WORK: OTHER ADDRESS EXPIRES PHONECONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTHICAL: CONTRACTOR ,{ NST. RANGE: r OF BDRMS: - OFFICE USE - LAND USE: WATER HEATER ZONING CODE:C OF UNITS: SECONDARY HEAT: SQUARF. FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspection, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same working day, lnspections requested after 7:OO a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS [-l femporary Electric Rough Mechanlcal - Prior to Final Plumbing - When allplumbing worl< ls complete.cover. Slte lnspectlon - To be made after excavatlon, but prior to settlng forms. l-l Rough Electrical - Prior tot-J cover.Final Electrical - When all electrical worl( is complete. tl Underslab Plumblng/ Electrlcal / Mechanlcal - Prior to cover.Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Final Mechanical - When all mechanical work ls complete. E Footlng - After trenches are excavated.Final Building - When alt required lnspections have been approved and building is completed. l-l Flreplace - Prlor to faclng.J materlals and framlng lnsp.tl Masonry - Steel locatlon, bond beams, groutlng, firpr4-tl Foundatlon - After forms are erected but prlor to concrete placement. Other ( Underground Plumblng - Prior to fllllng trench._ gtn %n/t{cap ILE HOME INSPECTIONS Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. Posl and Beam - Prlor to floor lnsulatlon or decking.lnsert - After flreplace approval and lnstallatlon of unlt. Blocking and Sel.Up - When all blocklng ls cornplete. Floor lnsulalion - Prlor to decklng.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer. Sanltary Sewer - Prior to filling trench.Electrical Conneclion - When blocklng, set-up, and plumbing inspections have been approved and the home is connected lo the service panel. Storm Sewer - Prior to filllng trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material ln place. Water LIne - Prlor to filling trench.[-l Fence - When completed. $treet Trees - When all requlred trees are planted. Flnal - After all required inspectlons are approved and porches, skirtlng, decks, and venting have been installed. Rough Plumbing - Prior to cover. I QUAD AREA: * OF BLDGS: FLOOD PLAIN: E D E E E E tl I-l Framlng - Prlor to cover. n WallrCelllng tnsulatlon - Prlor to|J cover. l-l Drywall - Prlor to taplng. [--l wood Slovo - After lnstallatlon.tt tl tl E Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type - lnterior -_ Corner - Panhandle - Cul'de-sac i IS THE PROPOSED WORK TN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - ll yes, this applicatlon must be slgned and apProved bY the Historical Coordinator prior to permit issuance' APPFIOVED: P.L.HSE GAR ACC N S E BUILDING PERMIT ITEM SO. FT. Main Garage Carport VALUE (A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fec BUILDING VALU E, PLAN CHECK AND BUILDING PERMIT This permit is granted on the cxpress 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 tlme upon violation of any provisions of said ordinances. Recei pt Number:- Plans Reviewed By Date Plan Check Fee Date Paid Fleceived By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within tlre City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home lb,lo FEE tr q- flilt{ CaP 5'7, (c) No FT. 5?o '7 PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge FT. ADDITIONAL COMMENTS By slgnature, I state and agree, that I have carefully examlned the completed application and do hereby certify that all lnformation hereon is true ancl correct, and I f urther cerilfy 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 Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on thls project. I further agree to ensure that all required inspections are requested at the proper tlme, that each address ls readable from the street, that the permit card ls located at the front of the property, and the approved set of plans wlll remaln Slgnatu Date flon the site at all tlon. Wood Stove/ lnsert/ Fi replace Unit Dryer Vent MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Perrnits (E) Y\.. No nrW Vent Fan (D) MECHANICAL PERMIT Fu rnace Exhaust Hood Mechanical Permit lssuance State Surcharge Total Permit TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) / BECEIPT NI DATE PAID AMOUNT R RECEIVED LlEO BY VALIDATION: UMBER ECEIVED : i,,'lli' FT. V*K-q7 FD- 1 58SPR'A}jFIELO DEPARTMENT OF FIRE & LIFE SAFETY OPERATIONS 225 FIFTH STREET SPRINGFIELD, OR 97477 (sos) 726-s737 FAX (503) 726-2297 Area Code changes to (541) November 1995 TRAINING BURN AUTHORIZATIO N o*e: /.:7-77 TO City of Springfiel( a Municipa.l Corporatioq acting by and through its Department of Fire and Life Safety You are hereby authorized and permitted to burn under supervision and for education and irstruction purposes that certain house or located on: NK/o fA Addition to Springfield" 3, Tax Lot #o C) Oregon wirich is de.signated as Springfiel4 Oregon I/We, expressly warrant and represent to you Orat I/We, the undersigred, are the owner(s) of said property, and that the same is free and clear of any and all liens, encumbrances, judgments, and any interest, right, title or claim in ary other person other than the undersigrred, and that this consent is freely and voluntarily giveq and tlat we will save the City of Springfield harmless from any liability to any person whomsoever by reason of any statement or warranty contained in this letter. UWe, the undersigned, also agree to the following requiremenls imposed by the Department of Fire and Life Safety to assure completion of all regulations. l. The property owner(s) shall remove all debris on the lot(s) involved in this burn within sixry (60) days after completion date of the burn by the Department of Fire and Life Safety. 2. The property owner(s) is to secure the required demolition and plumbing cap permits from the Building Department when inside the City Limits 3. Outside City Limits, County regulations apply. 4. The property owner(s) shall have the strucnre inspected for asbestos. This includes: a. An internal and external inspection of the structure by an asbestos or environmental consulting fi rm. b. Removal of asbestos containing nr,aterials, as indicated by the inspecting firm. L An Orvnersupant may perform ashstos removal' a. The Waste Shipureni Reocrd (ASN-1) must be fiiiql out b. Senrp an appointrnent v,ith Short Mountain Landfi-ll - 6874120 - for disPosal. 2. [f not an ownercupant' a removal company must perform asbestos removal and disPosal. c. The property owner(s) shatl suUmit a copy of the original asbtos inspection as written bV tfrl iffing firm and a signed note stating tlut the asbestos has been removed' OWNER(s)/.k*,+Kf tt< ADDRESS 7fl PHONE -e -2 furE /r4/*r/at' t/e uatart,rtq