HomeMy WebLinkAboutPermit Building 1998-04-24ELE,RESIDENTIAL
PERMIT APPLICATION
inspections: 726-3769
Office: 726-3759
JOB NUMBER
225 Fifth Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WORK:eb %n.?z S?nt ezd,Op
ASS
LOT:
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5BLOCK:/r SUBDIVISION
a
PHONE:
ZIP:
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STATE:?7 €r/CITY:
ADDRESS
OWNER
ADDITION DEMOLISH OTHER
,T oDESCRIBE WORK:
coco N
N
ST.
TRACTOR EXPIRES ,: PHONECONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
ADDRESS
PLUMBING:
GENERAL:
?sB"
E:
_ OFFICE USE -
FLOOD PLAIN
ZONING
RANGE:
LAND USE:
# OF UNITS
QUAD AREA:
I OF BLDGS:
OCCY GROUP:
* OF STORIES:
CONSTFI. TYPE:
HEAT SOURCE:
To request an lnspection, you must call 726-3769. Thls ls a 24 hour
made the same working day, lnspections requested after 7:00 a.m. wil
REOUTRED tNSPECf,S$
Temporary Electric l--l Rough Mechanlcat - prior tolJ cover.
Site lnspection - To be made
after excavatlon, but prior tosetting forms.
Unders!ab Plurnblng.r E!ec!rica! /
Mechanlcal - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concreteplacement.
n
Rough Electrical - prior to
cover.
Eieciricai Service - fuiust be
approved to obtain permanent
electrlcal power.
d be fore 7 :00 a.m wl be
ing work day.
Final Plumbing - When allplumbing worl( is complete.
Final Electrical - When all
electrical work is complete.
Fi;a! L.'iechanlcal - lvtilen alimechanical work ls complete.
Other
r---ltt
l-l Footlng - After trenches areIJ excavated.
l--l Masonry - Steel locatlon, bond
-
beams, grouting.
[l Flreplace - prtor to facinglJ materlals and framing lnspl
ffirinat Buildlng - When alF(required lnspecilons have been
approved and building is
completed.
- Prior to cover.
Wall/Celling lnsutatlon - prlor tocover.
E l'Jflii:l"i,ll"ln'.'.oing - Prior [l orywan - prior to tapins.
tl Underlloor Plumbing/ Mechanicat
- Prior to lnsulation or decking.
Post and Beam - prior to floorlnsulatlon or decklng.
MOBILE HOME INSPE TIONS
Wood Stove - After lnstallation.
Floor lnsulation - prior todecking.
I Sanitary Sewer - prior to fillingtrench.
Storrn Sewer - prior to fillingtrench.
,Y#:rn.a,"" _ Prtor to fiilins
E 3#r,.: Ptumbing - Prror to
i Curbcut & AJtproach - Afterforms are erected but prior toplacement of concrete.
Sidewalk & Driveway _ Afterexcavation is complete, formsand sub.base materia, in place.
Fence - When cciirpleted.
X $:';".,,Ij"ffi;fren arr required
Eleclrical Conneclion _ Whenp^,1-"Ii?9, set.up, ano prumoin!'rnspections have been approved
t"# Jffi,::Te is,connected to
r6ifr:r;;;*i:rj#:kr
fl tnsert - After fireptace approval
-
and installation ot unit.
[-l elocking and Set.Up _ When ail.J blocklng ls compleie.
Plumbing Connections _ Whennome has been connected towater and sewer.
34ss-Esar'.
/9i>
u
WATER HEATEFI:
lt
tl
fl
t]
. i:-; rlr''
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterlor
-
Corner
.- Panhandle i
-
Gul-de-sac
IS THE PFIOPOSED WORK iN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPFIOVED:
P,L.HSE GAR ACC
N
S
E
State Surcha rse 2-,?> + l,t4
VALUE
3of,o-
w_
3,s7
,07Total Fee
,(Y "fu'
ADof gvu,cq,
(A)
+
Total Value
Building Permit Fee
BUTLD!NG PER[,IIT
ITEM
Main
Garage
Carport
SQ. FT. X $/SQ. FT.AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in 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 violation of any provisions of said ordinances.
TUe, iSTRN cHEcK
Plans Reviewed By Date
Receipt Nu
Plan Check Fee:
Date Paid
Fleceived By:
BUILDING
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
FEE
(c)
Nc
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exha,;s'. i-lood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
information 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 the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Buildirrg Safety Division.
I further certlfy that only contractors and enrployees who
are in compliance with ORS 701.O55 wlll be used on thls
proiect.
I further 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
the approved set of plans will remain
t(o"t"
a imes during construction.
of the property,
on the site
Slgnatu
Y
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
sldewal'k
-
ft
Curbcut
-
ft
b&k^'@r*'l
Total Miscellaneous Perrnits (E)
&
44f"
TOTAL AMOUNT DUE (excluding electrical)
(A, B, q D, and E Gomblned)
/a%g
VALIDATION:
RECEIPT NUMBER &1 5zb
DATE PAID 4
AMOUNT RECEIVE.D
RECEIVED BY
2/- 7/
5