HomeMy WebLinkAboutPermit Building 1994-06-08SPNI]\lGFIELC'
NESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
()ffice: 72tl-3759
LocArroN oF pnoposED WoRK: - 3>.O-- -
225 Fifth Street
Springfield, OrerJon 97 477
TAX LOT:
SUBDIVISION
JOB NUMBER -%g**Z
?fr,
ASSESSORS MAF'
r-oT:BLOCK:
OWNEFI: -- -),till)fi '-efa)PHONE:
/5t o rfla )z/TDDRESS:
CITY:STATE:ZIP:?zrzz
DESCRIBE WORK
NEW_=- REMODEL ADDITION DEMOLISI.I OTHER-Eera<z
MECHANTcA t-, /Wt&y'/* {bgl,&.1a- *r-?6 ?}
EXPIRES PHONEADDRESS
I:LECTRICAL. !C_ S-_-
CONTRACTOR'S NAME
CONST.
CONTRACTOR #
CI--NERAL.: .-
t,t.tiMl-llN(l:
QUAD AREA: ---
I OF BLDGS: -.
OCCY GROUP:
r OF STORIES: -
WATER FIEATER:RANGE:
* OF BDRMS:
_ OFFICE USE -
LAND USE: ---
ZONING CODE: ----
FLOOD PLAIN
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF UNITS: _._._
CONSTFI. TYPE:
HEAT SOURCE:
To requesr an inspection, you must call 726-3769. This ls a24hour recording. All lnspectlons requested bcfore 7:00 a.rn. wlll be
madc lhe same working <iay, inspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
[- I remnorary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing worl( is complete.
Site lnspection - To be made
after excavation, but priot lo
settin0 fornrs.
Rough Electrical - Prior to F(rinat Electrlcal - When all,flelectrical work is complete.oover,
n Underslab Plumbing/ Electrical /
Mechanic;rl - F'rior to cc,ver.
Electrical Service - Must be
;rp1;roved to obtain perrnanent
r:lr-,r: trir;;rl pc,wer.
w Final Mechanical - When all
mechanical worl( is complete.
[ ' I Fireplace - Prior t() fa()lnql- J rrrirluri:rls anrl f ramlrrg lrrsp.
Final Building - When all
required lnspections have been
a1.lJrroved and btrilclirrr1 is
c()rnplete(J.L_l Masonry - Stcul lot:ittiott, l.lrlttr!
bc,arns, groutir-tg.
f] Framing - Prlor to cover
OtlrerFoundatiorr - Aftet' fornts itre
erecled but prior to concrete
placement.t]Wall/Ceiling lnsulation - Prior to
cover.
Underg;round Plumbing - F'riar
to filling trench.[--l Orywall - Prior to taping
MOBILE HOME INSPECTIONS
Underlloor Plumbing / Mechanical
- Prior to insulation or clecking.Wood Stove - After installation.
Posl and Beam - Prior to floor
insulation or deckin6l.lnserl - After f ireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decking.Curbcut & Approach -- Af ter
forms are erecled but prior to
placernent of concrete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to f illing
trench.Electrical Connection - When
blocking, set-Lrp, ancl plumbing
inspections have been approved
and the home is connected to
tlre service panel.
Storm Sewer - Ptior to fillirtgl
trench.
Siclewalk & Driveway - A{ter
t;xcavation il; coml:lete, forms
and sub-bzrse nraterial in pla<;c.
Water Line - Prlor to {llling
trench.f_] fence - Wllen conrpleted
Streel Trees - When all required
trees are planted.
Final - After all reqtrired
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plunrbing; - Prior to
cover.
A-7
--PU;4e6---Zraruzz
Footing - Afler trenches ;rre
cxc arva tecl.
tl
n
t_l
r
tl
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type--
-
lnterior
-- Corner
---- Panhandle
---. Cul-de-sac
Setb IS THE PROPOSED WORK IN THE
HISTORICAL DISTFIICT, OFI ON
TI.IE HISTORICAL REGISTER?
-
lf yes, this application must be signed
ancl ;rpprovcd bY tlle Historical
Coordirrertor prior to permit issuance.J
E APPROVED:
P,L.HSE GAR ACC
N
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrnit is lIanterJ orr the express corrditiorl tllat the said
construction shall, in;rll respects, conform to the Ordinance
adopted by the City of Springfield, including the
Developrtnent Cocle, regulatirrg the oonstruction ancl use of
buildings, and ntay br: suspetrcJed or revoked at arly tinle
upon violation of any provisions of said ordinarrces'
Plan Check Fee: -----
Receipt Number:---
DatePlans Flcviewecl BY
Date Paid
Receiverl BY:
BUILDING PERMIT
VALUE
(A)
SO. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Developnrent Charge is due on all undeveloped
properties within thc City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
No
FT.
FT.
(c)
Plumbing Permlt
State Surcharge
Total Charge
Wood Stove/lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT (/J? /tLt .
3r,
(D)
N0
,75,+5
Mechanical Permit
lssuance
State Surcharge
Total Permit
_tE:
7/{t aA_
Furnace
Exhaust Hood
Vent Fan
By signature, I state ancl agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performecl shall be done in accordance
with the Ordinances of tlre City of Springficld, and the Laws
of lhe Statc of Ore-c;orr pertaining to thc work doscribcd
lrerein, ancl tl.ral NO OCCUPANCY will .be made of any
structure witl)out pcrnti:;siot.t o( the Building Sa{cty Division'
I f urther cortify that ()tlly contractors and crnployees wlro
are in compliance with ORS 701'055 will be used on tl.tis
proiect.
lfurther agree to ensure that all reqtrired inspections are
requested at the proper time, that each address is readable
frorn the street, th;rt thc permit card is located at the front
tho approvecl sct of 1-rlans will retnain
Signaturc
Date
of the proPertY,
on the s cluring;"
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk .-.---_ ft
Curbcut _-.- {t
Demolition
State Surcharge
Total Miscellaneous Permits (E)
g
a
i 32 -76
/.
AMOUNT NECEIVEI]
RECEIVED BY
DATE PAID ')-o
VALI DATION:
RECEIPT NUMBEN.-
?TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)
FT.