HomeMy WebLinkAboutPermit Building 1995-09-18SPRII\.GFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspections:726'3769
Office: 726-3759
LOCATION OF PFIOPOSED WORK:
ASSESSOBS MAP:
LOT:
Zfr,
JoB NUMBE " ?f 'Prt
225 Fifth Street
Sprlngfleld, Oregon 97 477
TAX LOT:
BLOCK:SUBDIVISION
z2Z>2ZIP:STATE:
PHoNE: ?/Z:=*.
CITY:
ADDRESS
OWNER:
REMODEL ADDITION DEMOLISH OTHER+-
DESCRIBE WORK
NEW
MECHANICAL:
-
ELECTRICAL:
-
ADDRESSE EXPIBES PHONECONTRACTOR'S NA
CONST.
CONTRACTOR ,f
GENERAL:
PLUMBING
z8-p
r OF BDRMS:
_ OFFICE USE _
LAND USE:////
ZONING CODE:
FLOOD PLAIN:
WATER HEATER
-*-eL-
SECONDARY HEAT:
SQUARE FOOTAGE:
----7---r-T-
RANGE:
CONSTFI. TYPE:
HEAT SOURCE:
OCCY GROUP:
r OF STORIES:
QUAD ABEA:
I OF BLDGS:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the sanre worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanlcal - Prlor to
cover.
Final Plumbing - When all
plumbing work ls complete.
Slte lnspection - To tre made
after excavation, but Prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prlor to cover.
Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
p Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.,p Final Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.p "^ '"9 - Prior to cover'
Other
Foundatlon - After forms are
erected but prior to concrete
placement.
Wall/Celling lnsulatlon - Prlor to
cover,
Underground Plumblng - Prior
to filling trench.
MOBILE HOME INSPECTIONS
Underltoor Plumbing/ Mechanlcal
- Prior to insulatlon or decking.Wood Stovo - After lnstallatlon
Post and Beam - Prior to floor
insulation or decking.lnserl - After fireplace approval
and lnstallatlon of unlt.
Blocking and Set-Up - When all
blocklng is complete.
Floor lnsulalion - Prior to
decking.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to f illing
trench.Electrlcal Connection - When
blocking, set-up, and plumbing
inspectlons have been approved
and the home is connected to
the service panel.
Storm Sewer - Prlor to filling
trench.
Sidewalk & Driveway - After
excavation is comPlete, forms
and sub-base materlal in Place.
Water Line - Prlor to filling
trench.[--l Fence - When comPleted.
Street Trees - When all requlred
trees are planted.
Final - After all required
inspectlons are approved and
porches, sklrting, decks, and
ventlng have been installed.Flough Plumbing - Prior to
cover.
17rt
E
Er
tl
tl tl
tl
E
r
E
tl
l-_l Drywall - Prlor to taoing.
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ,
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK IN THE
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? .--
lf yes, this applicailon must be slgnedand approved by the Historical
Coordinator prior to permit issuance.
APPROVED
BUILDING PERMIT
VALUE
lfr +2
(A)
SQ. FT. X $/SQ. FT.
:@77=5
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
f21%("R
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granted on the express condition
Date Paid: /A2>-
DatePI
that the saidconstruction shall, in all respect s, conform to the Ordinanceadopted by the City of S pringfield, including theDevelopment CocJe, regulatin g the construction and use ofbuildings, and may be sus pended or revoked at any timeupon violation of any provi sions of said ordinances.
Plan Check Fee
Receipt Number:__.
Received By:
Reviewed By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) /a2^7 /
Systems Development Charge is due on all undevelopedproperties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Tolal Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANTCAL PERMIT
(D)
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlnedthe completed apptication and do hereby certify that alllnformation hereon is true ancl correct, and I f urther cerilfy
that any and arr work performed shail be done in accordance
wlth the Ordinances of the City of Springfield, and the Lawsof the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Division.I further cerilfy that only contractors and employees who
are ln compliance with ORS 70j.OS5 will be used on thlsproiect.
I further agree to ensure that all required Inspections arerequested at the proper time, that each address is readable
from the street, that the permlt card ls located at the frontof the property, and the approved set of plans will remain
on the slte at all times during con ruction.
Slg natu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _-- ft
Curbcut
--
ft
Demolitlon
State Surcharge
Total Miscellaneous permits (E)
TOTAL AMOUNT DUE (excluding elec\ricat)
(A, B, C, Q and E Combined)7?,:*AMOUNT RECEIVED
RECEIVED BY
DATE PAID
vhlroerroru:
RECEIPT NUMBER
No
FT.