HomeMy WebLinkAboutPermit Building 1992-08-06t:SPRINGFIELO
RESID ENTIAL
PERMIT APPLICATION
I rrs pec tions: 7 26'37 69
Office: 726'3759
I-OCATION OF PnoPOSED WORK: --/L3 +/z
ASSESSORS MAP:/ ZoS _S b _42-_
LOT:BLOCK
OWNER
33'17 <,>wt
JOB NUMBER
225 Fifth Street
Springfield, Orcgon 97 477
5*
TAX LOT
SUBDIVISION
PHONE:1{/ -t{L
ZIP:
s
h,
<.
ADDRESS:
()lTY: ,+IiTATE: -
REN4ODEL
-_B,ut{;
DEMOLISH OTHER
__D
ADDITION
I)F-SCNIBE WONK
I.IEW
R'S NAMEth -:r?t
-i*ttf,e1-t {h/!'
PHONE-__g&{L//1E
ADDRESS()ONTRACTO 5l / qz 7r{-g1(AhQE 6CE-NENAL
I)LUMBING: ,
EXPIRES
MECHANICAL:
-
_---
CONST.
CONTRACTOR #
ELECTRICAL: .-.
--
RANGE:WATER HEATER:
A OF STORIES:
_ OFFICE USE -
ZONING CODE:
FLOOD PLAIN
OCCY GROUP:
SECONDARY HEAT:
SOUAFIE FOOTAGE:
CONSTB. TYPE:
HEAT SOURCE:
LAND USE:
# OF UNITS
OUAD AFIEA:
-r OF BLDGS:
-
To request an inspection, you must callz26-3769. This is a24hout recording. All lnspections requested before 7:o0 a.m' wlll be
rnade the same working day, inspectlons requested after 7:00 a.m. will be made the following work day'
REOUIRED INSPECTIONS
[__,] rcmnorarY Eleclric f --l RouOh Mechanical - Prlor toL-l r:ovcr.
Final Plumblng - Wlten all
plumbing worl( ls comPlete.
Site lnspection - To be tnade
af ter excavtttion, but Prior to
setting fornls.
Rouglr Electrlcal - Prior to Final Electrlcal - When all
electrical work is conrPlete.covcr.
Underslab Plumbing / Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain Permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavaled.
Final Building - When all
fl Fireplace - Prior to facin0lJ rnatcrlals and framlng lnsP.
uired lnspections have been
approved and building IS
Masonry - Steel location, bonrl
beams, grouting.
completecl.
Other
Foundation - After forms are
erected but Prior lo concrete
placentent.
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing -. Prior
to filling trerlch.[_] DrVwall - F'rior to taning.
MOBILE HOME INSPE TIONS
Underlloor Plumbing/ Mechanical
- Prior to irlsulatioll or cleckinr;'Wood Stove - After lnstallation.
Post ancl Beam - Priol to floor
insulartion or decl<lng,Irrserl - After flreplace approval
an(l installation of unlt.
Blocking and Set-UP - When all
blocklng ls comPletc.
Floor lnsulation - Prior to
decki ng.Curbcut & APProach - After
forms are erecle(l but Prior to
placement of concrete.
Plumbing Conneclions - When
horne has been connected to
water and sewer.
Sanitary Sewer - Prior t() f illing
trench.Electrical Connection - When
blocking, set-up, and Plumbing
inspections have been aPProved
anci the home is connected to
the service Panel.
Storm Sewer - Prior to lilling
trench.
Siclewalk & DrivewaY - After
excavation is comPlete, fornts
and sub-base material ln Place.
Water Line - Prior lo filling
trench.
Fence - When conlPleted.
Street Trees - When all requlred
trees are planted.
Final - After all required
lnspections are aPproved and
porches, sklrting, clecks, and
ventlng have been installed.Rough Plumbing - Prior to
cover.
L]
7
# OF BDRMS:
----
fl
rr
I]
L]rr
tl
Fr"-ing - Prior to cover'
fl
r
tl
E
GARP.L.HSE
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type
--
lnterior
-- Corner
_- Panhandle
-
Cul-de-sac
Setb 3THE PROPOSED WOBK IN T}]E
-"i]ISTORICAL DISTRICT, OB ON
THE HISTORICAL REGISTER? _--
lf yr:s, tlris erpplication lnusl bo slgncd
and ;rpproved bY tlre t1 istorical
CoorcJinator prior to pcrmit issuance.
APPROVED
ACC
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform lo the Ordinance
adopted by the City of Spri ngfield, including the
Development Cocle, regulating the construction and use of
builclings, and may be suspended or revoked at any tirne
upon violatic,rn of any provisions of said ordinances.
D:rtcPlans Rcviewed BY
Plan Check Fee
Date Paid
Receipt Nutnber:-.
ReceivecJ By:
VALUE
(A)
oO
BUILDTNG PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SO. FT.ITEM
Main
Garage
Carport
--&Ee
Systerns Developrrrent Char gc is due on all undcvclopecJ
propertics witlrin tlre City limils which are bcinl; itnprovt:tl.SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
NO
FT.
FT.
FT.
PLU MBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/Fireplace Unlt
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk ---- ft
Curbcut
--_
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
By signalure, I state and agree, that I have caref ully examined
the completccl application and do lrereby certify that all
inforrnatiotr lterc'otr is trtrc attcl t;orrccl, anrl I f r"rl llrt:t ccrlily
lltat arry and itll worl< per Iorrnecl slrall bc dotrr: itr acooldarl(;t]
witlr thc Ordin;rrrces of ttrL'City of Springlicl<1, ;tnd lltc L;tw:;
of tlro S;tate of Orcgon llcrtairring to tl)c worlt clc:;crillt-'tl
herein, ;rrrrl that NO OCCUPANCY will bt: tnadr: of atry
structure witlrout pcrtnission of tlre Building Safety Divisiotr.
I f urther certify that only contractors and etrrployees wlro
are in compliance with ORS 701.055 will be used on this
projcct.
I f urther agree to onsure tlrat all required inspections are
requested at the proper time, that eaclr address is readable
from the street, that the permit card is located at the f ront
of the property, and the approved set of plans will remain
on the site at all tirne s during construction
/
-> {.
.,1 *
,/-I
IL
Date
-
Signature
TOTAL AMOUNT DUE (exclucling electrical)
(A, B, C, D, and E Combined)
4eE
VALIDAI'ION:
NECEIPT NUMAER _
DATE PAID
AMOUNT NECEIVID
5-o tL
z
/5
/23- --- {.r- , -
/e,y'3