HomeMy WebLinkAboutPermit Building 1990-04-18Rc I.. RESID'\TIAL..
APPLICAMN/PERI4TT
225 North ith Street
SprLngfield, )r,egon 97477
BuiLding Diuision
7 26-37 53
E1 ctr c lan
Reati,narl Ta *noafi.nn<
SPFTINGFTELI)-
Date:
LL726-3769 (tecoydet) state your Ci tg designated job ntmber,,
fot, itopection,Conttaetcrs or A.met,s ncttte and pTane nunbet
mcde aftx ?:00 an tiLL be nnde the nect 'nrking day
your CitA Designated Job Nutnbet, fs
^
ut
Su
fes
job aCitess, type
P.equests receixed
of inspeelicn
befcre 7:00 ctr
It ie the reepoaaibility of tle penit ltolda to aee tlut alL iwpectiotls ee nade at tle ptope" tine, tl,at ecch address is ?e,LCabie
frun tlu atreet, ard that the perntt cad. ia l,@ated at the frcttt of the wopertu,tBuiUing Dioicion appro"'ed pLan shcll remain on the Buniding Site'at aLL' tilmes.-
PROCEDUPE FOR INSPECruON RISUEST:CA
requested ard uhen ilou uiLL be neadyliLL be made the sane dcg,
"equests ,
Page 1 of 2
Job Locaticn:
Aesessote Map #?c,z lat #
svbdioision:
axmer:
Addtess:Ph,.one
City:
Desct4be Honk:
VaLueDate of
d
LTI
OC
a_Addi.tion
RenoCeL
Gener r\4
Plurnbing
l,lechanic
ectrtr a
X
SITE INSPECTI)N: Io be nade aftet,
ercansation, but prtoz, tc set up of
forme.
UNDERSLAB PLUMBING, ELECTRICAL &
WCHA.IIICAL: lo be nade before anywrk ia couet ed.
POOTTNG & FOUNDA?ICN: ?o be rmCe
TNSULATION /VAPOR BARRIER II\SPECTION :
?o be nade aftet, aLL insuLaticn atd.
required uapor bavie?s @e in place
bat before any Lath, gApsun bcarC or
ta.LL colseting is applied, and before
otg insulation is concealed.
Sanitarg ser.ter eapped at ?r,operw- Line
Septic tank p,trped and filled rrtth gra;sel
Final - l{het obwe itene a?e conpleted
and uhen dqnolition ie corplete o? strae-
ture notsed and. prenrLaee cleaneC up.
Le Hcnes
Blocking od. Set-up
Plmbing connectiorut -- aaue? od. uatet
Eleetrical Ccmnection - Bloeki,ng, eet-ua
and plunbing connections nast be apptct:ed
before requeeting eleclrtcal insp eetion
AcceasoPr' BuilCing
afie"-trencne, .a"e ezcaoated attd
forms are etected, but ptior to
pou?ing ccncrete.
AIIDERFLOOR PLUMBTNG & MECIIA,NTCAL :
of
floor ineulation or decking.
POS? AND BEAM: To be made p?iot, to
installatian of floo! insul,ation ov
decking.
ROUCH PLAEITIC, ELECTRICAL & T,IECH=
ANICAL: No uotk is to be co.*et,ed
wztil these inspections lntte been
nad,e and appnorted..
DRIWALL INSPECAT)N: ?c
after aLL dtguall is in
be nade
place,
but pz,ior to any taping.
MAS1NRI: Steel Location, bond
beans, grottting or oerticals in
accordotce tLth U.B.C. Section
241 5.
I,IO2DST1VE: After irwtallation is
anpleted.
crete patirq uithin stteet right-
of-txy, to be maCe aftet, aL! edea-
tating sqnplete & font wrk & sub-
base na.terial in place.
IENCE: hhen conplete -- PtotiCe
gates o? nottable seetions through
P. U. E.
CURB & APPROACH APPON: After fornsee erecteC but prior to potrtng
concrete.
SfDfitALK & DRI',E?IAY: For aLL eon-
FTPEPLACE:
,nat;"i-;G
tion.
FII|AL PLUMBII]C
FINAL MECHANICAL
FINAL ELECTRICAL
PrLor to placirq
and befot,e franing
Pinal - After
etc. a?e c,rmp
pcrekes, skirting, decks,
Leled.facing
inspec-
ft] prutttt'tC: l,tust be tequested af..er'C)
"pproual of rough plttr,bing, eiectri-cal & neclnnical, Al,t toofing
bracing E ehirrneys, etc. rust be
completed. llo ucrk is to be con-
.. cecled until this inspection lus'been rrud.e anC approued.
rr,l
ALL pnoiect eon&ttions, such as the installation of street tnees, eo:plation of the
required LanCscaping, etc., rmtst be satisfied before the B|)fLDINC FIIiAL ean be requested.
?INAL BUILDING: The Final Building Inspection rmtet be requested altet the Final PlunbinXElectrical, and Mechanical fnspeetions h4ue been nade and'approtted.
,4ALL I4ANHCLES AND CLEANOUTS MUS? BE ACCESSIBLE, ADJUSTIIE|II ?O BE |I.4DE AT IIO CCST TO CITY
M
(
T
T
tr
JOB NO SOLAR ACCESS RE a-L-CO G*
Grt Bedtoons
% cf Lct Cczsetage
# of Sturtes
Total Height
Iopography
?otaL
LOT TWE
_ fnierior
_ Coz,ner
Lot Feces -
Heat
Panlwnd.Le
CUL-de-sae
-- Fees --
I HAW CAREFULLY EXAAINED the eontpleted appltcation for permit, and. dohereby cettif.A that aLL informatibn hereoi ie ttae and. eorrect, anC. Ifutthet'.ce,tify that any ard. aLL aork perfotned slnll be done 7n accor-
dance tLth the Oz.dinances of the City of SprLngfield, anC the La;s of theState of )regcn pertaining to the uork Cescribcd herein, cnd ltat NO OCCU-
Pl-llcy ttll b-e n ,ude of any sttueture urithout permission of the Buitding Di-ulaion. f further certify that otly cont?actors cnd enplcyees uho are inconpliance aith CRS ?0i-.055 uiLL be used on thie projeet
D
DT Aeeess.House
North a'
Eaat ./a 'Finepi
South
t/est
I
ITE14 SQ. F?G x Value
Main
Geaoe
Carpot,t
Aceessontt t?z rb {{a,'o
?OTAL VALUE
Date Paid<-a7
S.D.C. 7.5 o
Building Volue & Permit
?his permit is granted on the ecpress condition tbnt the said. constructions^lul.L, in_a-ll -r,es_pe,cts, eonfcrmlo the Crdirnnce cdopted 6iy the City ofspringfield' including the zoning crdinance, regulatZng th"e ecnsttu"cticn
and .use o_f buildings, and may be suspen-d.ed or rbuokeC -at
"*y time upon oic-lntion of anA prcuisione of iaid Ordinances.
Duilding Permit
?otal Clnrgee
State
Signed:77
No_ person shall constntct, inetall, alter ot, elnnge anA neD cr exti,stingql*\lrrS or d,ainage syst*Tt in uhole or in patt, inles-s sueh person is'theLegal.possessor of a oalid plwnbet,s LicensZ, eceept tlnt a pbt,sonnag doplwnbing uork to p"opertA uhich is otmed, Leased or operated ty tte oppti-cant.
NO.FEE CHARGE
22-
2
?i.chpes
ResiLentia,L (1 bath)
Sani Seuer
-,<a
*yLumblng ."eftiilt
State
Plumbing Permit
Electricol Permit
llhez'e state Las requirea tlnt the electv,ical uotk be done bg an Eleetticalcont?aeto", the eleetrLcal portion of this permit stnll not- be ualic untilthe Label lae been signed bg the Electyieal' Contractor".
FEE
Na,t/Eztend Circuits
Set"uice
State
?otal
-- ENCROACHMENT --
NC.FEE U;iMAL
d
Mechqnicol Permit
ilcodstope
Vent Fot
khalst Hood.
BTU I
Permtt Issuotee
Meehanical Permit
9ectrit! Deposit
!!9nog.
I,laintenanzce
Penrt t
Cvrbcut
SLdA)aLk
Pence
Electrical Iabel
Mobile llone
TOTAL AilOUilT DI]E: **73
*
;
4-/--Za
uate
CoraLte
PLan Check Fee:rl :1iq-rt
Reeeipt #' / lo\ft(
t
.. RESIE- NTIAL..
APPLTCATI)N/PERl,lrT
225 North Sth Street
SprLngfield" )r,egon 97477
ButLding Dioision
7 26-37 53
Plumbing
1
t,
Srr El-ectr lan
SPFiINGFIEL.D
Date
ptoper tine, tldt eaeh a,l,lress is neqdahle
'ntoizber, job alirees, type of inepeelicn
nunbc*. P.equests receited befcre 7:00 al
It ie the responsibility of tle pendt hold* to aee tlut aL'|, inspections ee nade at *he
fran the st?eet, and tltdt the penrit anl. is laated. at the frttt o7 the wop*ty.teuilding Dioiciol approt;ed plbt shdll remain on tle Bunding Site'at aLL' tihes.-
PROCnDUPE FOR INSPECTION RgqUESTiCaU 726-3769 (tecordet) state Aow, City Cesignated job
tequested a.-,-d, uhen you uiLL be ready for inspection, Conttaetars or A,nets nane cnd. p,\nne
',viLL be ttade the sane dag, ?eEosts nade aftet 7:00 an uLLL be nnde the nest,,nrking da,y.3you! City Desigra.ted Job Nunber fs:
Reouinad Tnsneatians
Job Locaticn:
- 0v-Aesessore Mao #?da Iat #
S\tbdioision:
&-
Addtess:Phone:
elL zLp:
ftfi,ttW
5- t4-Qo
Descz"ibe llork:
Additian
RenoCeL
l--t Na)L&t-l
VaLueDate of
(,ubu*
General
Pege 1 of 2
SITE INSPEC?f)N: ?o be rmde aftet,
e.acantation, but prion tc set up of
fonns.
ANDERSLAB PLAMBING. ELECTRICAL &
MECH{IITCAL: ?o be made befoz,e anywrk is caered.
PAOIfNG & FOUNDATICN: Io be nnCe
INSULATION/VAPOR BARRIER IJISPICTIOII :
To be nade aftez, aLL insulaticn ed.
tequired oqor burie?s @e in place
but before ory lath, Wpsl^on baazC ortnll cooering is appli.ed, otd. before
ary iwulation is concealed.
DRY\IALL fNSPE*r)N: Ic be nad.eafte;m@tris in ptace,
but priot, to any taping.
MASONRL Steel Locati.on, bond
beons, gzouting ot oertieals in
aecordotee uith U.B.C. Seetion
2415.
\|O2DST)I|E: Aftez, inetalTntion ia
arnpleted.
Sanitoty se.ser ecpped at pz,operfui Lire
Septic totk pwrped ann filled tith gratel
?ina.L - l{hen abase itens axe canpleted
and uhen dq,olition is cornplete o? strae-
ture mouel otd prenrises cleaneC up.
OR
Pinal - After
etc. are comp
pcr.ckes, skirting, deeks,
Le!ed.
aftet, tnettcnG at e e*cattated and
fonns ate erected, but prior to
poul"Lng ccncreta.
ANDSRCROUIID PLUMBING, SEWER. W,4TER,
pR4!!14!E: To be naCe pr4or to fil-
@-6inchee.
V uaowrtooR pLUr,ErNG & trEcgANrcAL:ttof
floor insuktion or decking.
P1SL AND BEAl,l: ?o be made priot, toTist7ffiVof floon insulation or
deckittg.
ROUGH PLA-DING, ELECIRICAL E MECH:
ANICAL: No uov,k is to be co'*ered
,GllT-these inspeetions haoe beqn
made and approtted.
FEEPLACE: PrLor to placirq faeing
matez:iaLs and befot,e franing inspec-
tion.
FRAETIIG: lhtst be requested after
appGit of rough plttrbing, e1ectui-
a.L & neclwnical. ALL roofing
btacing & ehinmeys, ete. nast be
. contpleted. llo ucyk is to be eon-
- cealed until this inspeetion las
'been rrude anC approoed.
After fonnsto pouring
concrete.
SIDWALK & DRfIWAI: Nor aLL eon-
;r,ete palrfuniffi street right-
of-uny, to be maCe after aLL etca-
oating canplete & forn Lprk & sttb-
base naterLal in plaee.
Hcmes
Bloeking otd Set-up
Plwnbing connectiate -- aa)ev otd uatet
Eleetrica| Cor.nection - Bloek'tng, eet-up
and plwnbing eonnections rrust be apprcted
before requesting eleetrLcal inspeclio;t
Aecessory Bui-LCing
W
FIIIAL PLUUAING
FINAL I4ECHAIIICAL
FINAL ELECTRICAL
ALL pt,oject conditione, such as the installat:-on of street trees, conpletion of the
required Landsccpir4, ctc., rmtst be eatisfied before the BUILDING F|NAL ean be requested.
PINAL BUILDINC: The Final Building Inspection rrust be requested cfter the Fi.nal Plunbing
Electrieal, otC Meeharieal fnspectiona hatse been nade and approtleC.o
*ALL I4ANI\CLES AND CLEANOU?S MUST BE ACCESSIBLE, ADJUSTltEltl TO BE l.tADE t\.T ll0 CCST T0 CI?y
//
tr
T
IENCE: Wen complete -- ProtsiCejatd or nooable sectians through nP.u.E. I I
Otmer:
I
r
L-co dJOB NO.
Iotal
soLAR AC,^Ess REQ.-
lteat
I HAW CARE0ULLy EXAILINED the eontpleted application for petwtt, and. do
hereby eertify that aLL infornation het'eon is true and conect, and f
fut'ther certify that any ard aLL uonk perfor-ned slnll be done in accor-
dance tvLth the Oy'dtnances of the city of Springfield, and the La;a of the
State of Oregon pertaining to the uoz.k Ceeeribed herein, end tlat NO OCCU-
PANCy tfill be rm.de of any sttaetu"e uithout perwission of the Building N-oision. I futthen eertify thct only conttactors od enplcyees uho are in
conpliance uith CRS 701.055 uiLL be used on thie projeet
BeCtoons
Lot Sq. Etg.
% cf Lct Cotserage
LOT TWE
_ Interior
Come?
Lot Faces -
P.L House
# of Stories
Total Height
Topography
Panltandle
CuL-de-sac
rTEM SQ, FTG x VaLue Building Volue & Permit
This permit is granted on the erpt'ess condition that the said constrwction
slnlL', in alL r,"espects, conforrn to the Crdinance adopted by the City of
Springfield, includlng the Zoning Czdinance, regalatitlg the ccnstracticn
and use of buildings, otd nay be suspend.ed ot' reookeC at cny time upon oic-
Lation of crry prctsisions of said ordinances.
?OTAL VALUE
s.D,c. 1.5 c
Building Parrit
State Date Paid:
Reeeipt #:Total Clwrges Signed:
rTEM CHARGE Plumbing Permit
No peteon slnll constntct, inatall., alter or charqe any neu cr eristing
pkttnbing or drainage s4stan in uhole ot in part, unless such pet,son is the
Legal possessor of a oali-d plumber's License, escept tlnt a pe?son nag do
plutnbing uork to p?opez,tlJ uhi,ch is ouned, Leased or opetated by the appli-
cdrlt.
Pi^rtutes
Resid.ential (1 bath)
Sati Seuer
Plurnbing Perrri,t
Nal/Eotend Citcuits
Electricol Permit
Where State Lan requires t?nt the electy,ieal uork be done by an Electrical
Contraetor, the electrLcal portion of this pernit sltall not be oalil until
the Label has been signed by the Electrtcal Contz,actot'.Setoiee
Total *
ITlM FEE CHARCE
Mechq nicol Permit
khanst Hood
I'lcodstooe
Vent E@t
PermLt fssuorce
Mechanical Penr[t
-- ENCROACHMENT --
Secaz.ttT1 Deposit
Storage
Maintenantce
Petmit
C\tbcut
Sida,salk
Fence
Electrieal Ia.bel
Mobile Horne
/ 4.00
Tyoe
PLan Esaniner
TOTAL AI4OUilf DUE: *l3,Oo
Signed Date
NO.FEE
llctar
Totol- (hnraes
APPLICATION FOR A SECOND DRIVEWAY
1tL 6:U floDATE:
APPLICANT (PROPERTY OI.IN
ADSRESS OF APPLICANT:8 q5 N, .%stfu+
ER):Cfu^ukt't
ADDRESS OF PROPERTY FOR 2ND DRIVEWAY:
APPLICANT'S TELEPHONE NO. :
trq; N 74'gSUetl-
r:
\..
The following conditions must be answered affirmatively in order for this
application to be considered for approval:
'l). Property is either a single family residence or duplex. YES X N0_.
2). The proposed driveway will take direct access from a minor street
(not a collector or arte.ial street). YESJ! N0_.
3). The driveway will have a minimum setback of 30 feet from the
curb return of an intersection (for corner lots). YES X I!0
4). The proposed driveway (parking area) must have a minimum depth of
20 feet between the front property line and the garage, carport,
fence or wall, if any (identica'l to setback for garage).
YES X N0_.
5). The second driveway must have direct access to a garage, carport,
rear yard or the side yard where the vehic'le, trailer or boat
wi I I be stored. YES-.X- N0_.
6). If the vehjcle, trai'ler or boat is to be parked/stored in the sideyard, there must be a minimum setback of 5 feet between the stored
vehic'le and the side property 1ine. This setback is for fire
fighting access and to cornply with the intent of the zoning code.
Setback satisfied YES y N0
7). The proposed parking/storage area must not create a vision
obstruction to adjacent property driveways or to any vehicular
movement on a pub'lic street. Sati sf ied YESX N0_.
Applicant hereby agrees to insta'll the requested driver^ray to City of Springfield
standards. The applicant further agrees to have 6" of concrete in the sidervalk
area adjacent to the proposed driveway and further agrees to pave the area
behind the back edge of the sidewalk adjacent to the driveway wjth a minimum
depth of 3" of asphaltic concrete or with a minimum depth of 6" of portland
cement concrete. The area behind the sidervalk shall be paved to the property
line or for a distance of 4 feet which ever is greater.
The applicant agrees that if he/she does not pave the area behind the sidewa'lk
within 30 days of cutting the curb opening, the City of Springfield has the'authority to close the driveway access by the removal of the curb cut. All
incurred costs shall be assumed by the applicant and'if unpaid, said costshall become a lien of the property.
-2-
t
i
-S.0.P.P. #T-4..la
l,lhen this application js approved by the City, the applicant (Rloperty owner)
must obtain a driveway permit from the Public lrlorks Department Bu'ilding
Division.
PER}1I T FEE
a. 0n an improved street (existing curb):
S.l2.00 plus 12d per lineal foot of curb cut.
b. 0n an unimproved street (not curbed): $.l2.00.
c. 0n currently unimproved streets that are under-
construction: $12.00.
a-a-
PROPERTY OI,INER'S SIGNATURE:
DATE:
APPROVED BY:
i DiV]Si
DATE: 5 /L/o
Qoo3 e Z
*?
TRA
ATT
BUILDiNG PERMIT NO.:
DATE:
C i ty of Spri ngf i e'l d Standard Drawi ng No
Dated 10/8/Bz
* p,ff- k4rutf*,N /i, oA a.€ss k)DTr/
oP^ D,QtuEr pqxrntn cupts cu: FEo^-ro? c)F cu$ / f"f oF c,re! 24!
e'f ---2.
I
/\AL IL
fv
.+
K0-- i?.fr,^z
o
J
I
,-3r\
)
Io
j: " [81[i#]]hl"
225 North |th Street
SprLrqfieLd, 2regon 97477
BuiL&ing Diuision
7 26-37 53
SPFIINGFIELD
Job Location:
Aeceasonc tlap fl \O4>odTc.r Int ll
Subdioision:
1cl
Otmer:
City:
Phone:
zip:
Addt,ess:
Descr'.be h'ot'kt-l Ile0
ValueDate of App Licaticn
20 O A,"P
O\eetdditicn
RcmoCeL
G,. ?o\e
6trt,
Rcceipt ll
pbSimed
p
11 t 4/
e0-*
Date: S/e,r
ril tors
Gcneral
Plurnbing
tri-ca
c].aElec E rSuDe
It io the rceponsibility of the penrtt ho_Lder to see that aL!, inspec-tions are nade at the propet tine, that ecch cddreas is realabi'e
fran the stnelet, atd that the permtt catd ie. Located "t.th-q fro_l! of ,the.ProPe-tt!.1s";ldt"S Oiuicion appro"^ed plan.shcll remain on tle Building Sitc at aLL tines.
ppocEDUpE FoR INS\ELION,g_!.gt1EST:cALL726-3769(yecorder) state yout City cesigruzted iob nmber, iob acitess, type of inspeclicn
requested ard uhen yoi-r,rilTbe teady fo-t tnspection, contractars o"r oomers-rarne Znd phoie nunbe. Requests teceixed befcte 7:00 c:t
.*iLL be made the sane dcg, reqteats-iade aftet ?:00- an viLL be nade the nczt:,ntking day.
ci@ZIour Ctty Deeigr.ated Job Nunber rs:
Remti-narl
SITE INSPEC?ION: To be nade after
"-""oatton,Tt Pri.ot' tc set uP of
forns.
UNDERSLAB PLUMBTNG. ELECTRICAL &
MECH{IIICAL: ?o be nwde before anY
ffiF7ii6oeved,
FooTItlC & F)ANDATICN: ?o be tmCe
TNSULATION/YAPOR BARRTER IttsP.lcTr0N-:
T;-6;-,MA aner aLL insulaticn ad
required oapon batriers @e in pl.aee
bui before any l.a.th, Wpewn b-oat'd ot'
rnll eooeri,ng is applied' and- before
ay insulation is concealed.
after *enches are
forms are etected,
pourtng ecneret€.
but prior
PrLor to plccirq
atd befote franing
DRYWALL INSPECAI0N: TcZfGiffi'&@lTls in
but pnior to any taPing
MASONRI: Steel, Location, bond
ffijg?o"ting or oerticals in
accotdorce tLth U.B.C. Section
24L5.
be nade
place,
After installation is
and
to
il
UNDIRGPOUI]D PLUM9ING" SEY|R, t't.4L!-.1.
DRAIIIAGE: To be made Pt'Lo? to lLL-
T@66nchee.
UTIDERFLOOR PLUI.EING A I,IEC\IANTCN-:
T;b-;Ae wiot' to installation of
floor insulat'ion or decking.
POS? AND BEAM: To be nade Pniot' tofrfrTTffi{of floor insulation ot
decking.
ROUCH PLU\EI\\G. EIqCIRI7AL & MECH;
1N1zAL-- No t on|Zs to bc cou*et'ed
ffilTthese inspecttons hatse been
made ard. approtted.
CURB & APPRCACH AP?.1N: After forms
"r,.-""";T;{frt pi\". to pouning
concrete.
SIDEIIALK ,9 DRIVEI|A!: Fon aLL con-
1 i,i icrete pat rg uithin street right-
of-r.xy' to be na'de aftet all ezca-
oating canplete & forn ttork & sub'
base naterLal in Place.
WOODSTOVE:
enpTeteA.
FTPEPLACE:
mcterials
FIIIAL PLUI4BIIIC
FIIIAL T,IECHANICAL
facing
inspee-
tion.
FRA!1ING: ltust be requested after
@aL of rough plurbi,ng, electt"t-
cal E meclnnical. ALL t'oofing
btacing E ehinmeys, etc. tnast be
. conoleted. lto ucrk is to be eon-
, ceiled until this inspection lus
'been nnde anC apptoued.
?ENCE: hlher conplete -- PtouiCe
@G or nooable sections through,P.U.E.
ALL proi:ect conditions, such as the i.nstall.ation of stteet tlee_1-a con?Letion of the
required. Landscepirg,'Lto., ,*"t be eatisfiid befi"e the BUILDING FII.AL can be requested'
FINAL BUILDINC: The Einal Bui,Lding Inspection nrust be tertected aften the Fi'nal Plwnbin3
\J tt"oinl."l,- otC Ueeharical Inspeetions heuc been nade and approoee.
0R !.!owD
Sanilarg sanet capped et pnoperty Lix,e
Septic to'tk p;.c'ped ard filled ttth gra;sel
Final - l{hen abctte itens ate ccnpleted
and uhen Canolition is complete ot 8tru3'
tuye notsed attd. prenises cleaneC up.
e llcmes
BLocking otd Set-uP
Ptumbing connections -- aare! otd uatev
El,ectrical Ccmnection - Blocking' set-u?
and pLwnbinq connections mtst be apprct;ed
befirc requ-esting eleclrtcal inspecliot
Accelso"'i BuilCing
Final - After pcrches' skitting, decks,
etc. a"e cornPleted.
FINAL ELECTRICAL
lAr,L UAIIIICT,ES AND CLEANOUT{| TTI(;T I'E ACCESSIBT.E, AD'IIISTITEilT TO !78 INDE AT IIO CCST TO C|TY Pape 1 of 2
T
u
r
soLAR ACr'^ss REQ.-JOB NO.
Zofie:
dL-CO
Bedrooms:
LOI TWE
rntetiot
Lot Fdces -Lat So. Fts.
7 of Lot Cooeraga-
I of Stories
Total Height
P. L.House
Co"ner
Panhandle
Cul-de-sacIopograPhY
I?EM Frc Va Building Volue & Permit
?hispenttticgrantedontheecpr^sscond.itiontlwtthesaicl'oonat'ntctionslnll, in all respects,- ;";ii;'io th-e. ordinance adop.te't ty the city of
lfitiiff"ta, inotiiing'tiZ,-[-o"i"g Cvdinanc-e, regulcti.ng the ccnsttacticn
and use of build.ings, oi'i'a"y tn" suapended br r-et:okeC at cny time upon oic-
Lation oi ony prcrtlsione of said 1rdinances'
A
TOTAL VALUE
s. D. c.
Buildi.ng Permtt Fee
Date Paid
State il:
lotal Clnrges ,t Signed:
ITEM FT:E CHARGE Plumbing Permit
No Dereon sl'talL constract, instal!, alter or clange-any netr)-cr eristing -
;irrirb'r;"";U"ti"i"- tiil*, ;." it'oie or in patt, Tnless such person is the
Legal possessor of " ;LL;a irr^bni'i tt"nns", eacept that,ali77.s7r nay do
pthlt;,g r"nx to ptopelt;'"ii;;'" otmed, Le-ased ot operated by the appli-
cant.
Firfises
Residential (1 bath)
Scni Seuer
Plumbing Penit
State
*
ITEM Electricol Permit
Whet'e State Lau requi?es tlat the eleetrical uot'k be done by -an Electtieal
Contractor, the elec*llc"t po"lio" ,f this -pernit stall not be ualiC until
lie Label'lns been signed Ay fie Electrical contractor'Neu/Erterd Circuits
Set"uice
State
Iotal
NC CIIARCE Mechqnicol Permit
bhanet HooC
Vent For
Wcodstope
Perrtt fssurtee
Mechanical PeYrtt
*
.- ENCROACHMENT --
Secaritg Deposit
Storaqe
l,laintenance
Pernit
Cvtbeut
Sida,talk
Fence
Electrical Ia.bel
Mobile Hone
uauePLan Ercnlnet'
I HAW CAREEULL| EXANINED tle completed appli,cation for permit.' atd- do
herebu certifu tt-i-"lt- f"lornati'on heteoi ie ttae and' coweet, anC I'i""r\'"r- irrliiy iiit ""y ira "1t uo.rk penfot'ned stwlL be done in aceor-
ii)"ii-uitn th'e" ondiiaii."n"-oy ihn cifu bf bprlnsfield, .and tha .Laas of thc
* state of
^regon
pr":;;;;1;g-',to'ti" ,oitraeezribed herein, end llut N0 ,ccu-
pt1cy titl be nace ;i- ;;;i" ,tr";itpe wlthout perniaaion of the Building Di.-
ui,sion. I further er;;;?!- th"i- irly- con-tnactore md, 3nplcyees uho are tn
Lip1i""i"'rt.tt ons 7u.bss uiLL be-used on thia proiect
Total
t,IOTAL AI'IOIJIIT DI)E: I
Daba
Permit No Qmzuz
qc9-
Address:
lssued by e&Date:
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B..
1. ry I own, reside in, or will reside in the completed structure.
2.4 My general contractor is
Contractor registration number
I will instruct my generaf contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
I will be my own general contractor.
OR
B
lf I hire subcoltractors, I will hire only subcontractors reoistered with theConstruction Contractors Board. lf I chanoe my mind and Eo hire a oeneralcontractor, I will contract with a contrattor -who is reoistered with theConstruction Contractors Board and I will immediately-notify the officeissuing this building permit of the name of the contraitor.
I hereby certify that the above information is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side ol this form.
q 3l: r \qr)
ure of Permit Applicant
CONSTRUCTION CONTRACTORS BOARD
02A) 10t24t89
Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
@s
*Qq A)
5/, ,1,,,